Community is Medicine: Public Health, Engagement, and Trust-Building with Domenica Perrone

This episode aired on 12/04/24 on WICN 90.5FM

Introduction: In this episode of Public Hearing, we continue our conversation with community engagement practitioner Domenica Perrone to explore the intersections of health equity, community engagement, and institutional accountability. Domenica brings her wealth of experience as the Director of Community Engagement and Outreach at UMass Chan Medical School’s Collaborative in Health Equity to discuss the challenges and opportunities in fostering meaningful relationships between institutions and historically marginalized communities.

Join us as we unpack how trust, transparency, and restorative practices can reshape our cities, heal past and present harms, and build a future rooted in equity.

Key Topics Discussed:

• What Community Engagement Really Means
  Domenica explains the depth and complexity of community engagement beyond traditional perceptions, emphasizing equity, reciprocity, and trust-building over transactional relationships.
• Historical and Present Harms in Community Relationships
  We discuss the importance of addressing both historical injustices and ongoing harm caused by institutions to rebuild trust with marginalized communities.
• The Role of Institutions in Advancing Equity
  Insights into UMass Chan’s Collaborative in Health Equity, which is building pathways for community-driven health solutions, workforce development, and inclusive research.
• The Balance Between Advocacy and Institutional Change
  How practitioners like Domenica navigate tensions between community accountability and institutional pushback while staying values-driven.
• Youth Engagement and Pipeline Development
  The critical role of creating spaces and opportunities for young people to step into leadership and health equity careers.
• A Call to Action for Listeners
  Domenica challenges us to find our role in community work and to embrace collective responsibility, whether as advocates, organizers, or bridge-builders.

Chapter Markers:

• [00:00:00] Introduction: Joshua introduces the episode and welcomes Domenica back.
• [00:02:03] What is Community Engagement?: Domenica reframes community engagement as a practice of trust-building and reciprocity.
• [00:04:45] Acknowledging Harm in Community Work: Addressing historical and present challenges between institutions and communities.
• [00:08:49] The Role of Institutional Commitment: Domenica shares UMass Chan’s approach to health equity.
• [00:13:25] Navigating Advocacy and Accountability: Balancing community trust with institutional change work.
• [00:21:56] Collaborative Goals: Building pipelines for youth and advancing health equity with community coalitions.
• [00:26:32] Dinner Table Conversation: Domenica’s call for intentional engagement and community-focused action.

Conclusion:
This episode emphasizes the need for intentionality and accountability in how we engage with and support our communities. As Domenica says, “Community is medicine.” By fostering relationships and addressing harm, we can collectively advance equity and create spaces for all voices to thrive.

Tune in, reflect, and take action! You can listen to Public Hearing every Wednesday at 6 PM on WICN 90.5 FM or wherever you get your podcasts. What do you want to hear on the show? Reach out at QueerForCities.com! 

Learn more and follow at QueerForCities.com/PublicHearing

Created & Hosted by Joshua Croke<

Transcript

[00:00:00] Joshua Croke: We are back with Public Hearing, a show about the second largest city in New England Worcester, Massachusetts, where we have interesting and timely conversations about issues that impact our community. I'm your host, Joshua Croke, and I am thrilled to be back here with Domenica Perrone to continue our conversations from last episode and dive even deeper into topics and issues affecting our city.

[00:00:22] This is Public Hearing. Let's dive in. 

[00:00:24] So, Domenica, for folks who may not have tuned in last week, would you reintroduce yourself for our fabulous listeners?

[00:00:31] Domenica Perrone: Absolutely. So my name is Dominica Perrone. I'm a community engagement practitioner here in Worcester, where I have lived for the past eight years or so.

[00:00:40] I have the privilege of working at UMass Chan Medical School and their collaborative and health equity where I'm the director of community engagement and outreach, but I've worked in public health. I've worked in higher ed. I'm a lifelong youth worker and truly just an advocate and passionate person about health equity and public health.

[00:01:01] So that's what I'm here to talk to you about today. Thanks for having me.

[00:01:04] Joshua Croke: And I'm excited to dive in Being both so passionate about Worcester, but also, you know, a lot of the work I think that we do intersects with issues that so many communities are facing and looking at your background specifically in public health and at the intersections of youth and community engagement.

[00:01:26] Can you talk a little bit about Maybe how you approach this work. I think sometimes saying to someone that we work in community engagement can mean and feel different to a lot of people and there's a depth to it that goes beyond engaging community in a way that I think a lot of folks kind of build that in their minds of like, Oh, you go in a community, you meet people, you're making kind of connections, but there's a depth to.

[00:01:53] this work, especially when it's built on a foundation of equity and representation. So, can you talk a little bit about that as a practitioner?

[00:02:03] Domenica Perrone: Absolutely. Yeah. And I, I love to talk about this because I do think when we talk about community engagement, historically, the field of community engagement, as you see it in relation to different institutions, I think higher ed could be a good example. We've seen great growth in the field.

[00:02:22] That being said you know, we know that there's best practices, there's ways of doing things, you know, how do you center reciprocity, how do you center co creation with community partners in the work but what we've seen historically is that a lot of the work originating in community engagement kind of came from this white savior perspective that was like, I'm going to go into community, I'm not a part of community, but I'm going to go into community and, I'm going to save you or I'm going to help you.

[00:02:54] I'm going to help your business. I'm going to help your marketing plan. And that. Mindset is so harmful. Right? And I think that I'm very grateful to be in this work right now, because for me, it happened very organically, right? Working in public health and managing public health initiatives, especially during a pandemic, centering relationships with community partners; trusted leaders, trusted advocates, trusted ambassadors who have strong relationships to folks in our community that are well beyond my own touchpoints is truly where the beauty in community engagement lies and where we can make an impact. 

[00:03:38] Worcester is a city with a rich history. It's very culturally diverse and there is some pain in this history. There's ongoing pain and harm that takes place now. Some of those pain points are between these institutions, whether they be government, private, non profit. There is a complicated history in this city and all cities kind of probably have that, that piece to them, right?

[00:04:07] So if you're going to get into this work, I think building relationships well beyond well before the point of Oh, I need something from this community partner, or I'm looking for this community partner to work on with a grant or X, Y, and Z. Absolutely not. We need to build relationships. We need to be a part of our communities.

[00:04:27] And that means that it takes place outside of the nine to five. It means showing up to support events. It means getting coffee every now and then and building friendships with people in our communities. And that is how the work organically comes to the surface. Because community partners, you know, we need to build trust.

[00:04:47] And if you are not a trusted individual or representative from your organization, then the projects are not advancing the needle when it comes to equity. They're not advancing the needle when it comes to truly making an impact for our communities that need it the most. And that's kind of how I see it.

[00:05:06] Joshua Croke: I so appreciate that you named pain in community as something that needs to be not only acknowledged but part of the work I was in Redesigners for Justice cohort through the creative reaction lab, which is based in St. Louis and they developed this equity centered community design framework that guides a lot of my practice as a facilitator as a as a designer and it foundationally is built on addressing a harm and healing before doing it Moving forward in a design process and that is so critical to hold because I feel like a lot of especially institutions or municipalities will jump into community engagement from a very action oriented, present perspective and not want to do anything outside of acknowledge the harm history of the relationship between that institution and the public or the residents, right? So it's saying, Oh, no, we recognize that in the past, we used urban renewal to redline neighborhoods and push black and brown families out of their homes.

[00:06:21] And you know, create these really unjust banking practices that separated people from the ability to finance loans and actually build equity in the community, et cetera, right? But just forget all of that, we want to, we want to start doing the change work or the fixing work now. And so like, let's not acknowledge that there is a lack of trust between our institution and this community.

[00:06:45] Let's just move forward with good faith.

[00:06:49] Domenica Perrone: Absolutely. And not only acknowledging the past, but acknowledging the present, right?

[00:06:55] Like, we might be good actors in this work with good intentions and, you know, open to feedback, our own relationships. But also, sometimes the institutions we represent, we're not everybody in those institutions, right? So, how challenging Is community engagement and rebuilding trust when, yes, we might have a good relationship with our community, but, you know, this other person or other department in my institution might be causing active harm, whether intentionally or unintentionally, right?

[00:07:29] And so I find that holding space All the harm. And all the pain. It's like, yes, let's acknowledge it. And us as community engagement practitioners, it's like we're holding one leg in community and one leg in the institution. Right? And I need to be informed by community so that I can do the accountability work inside as well.

[00:07:52] Joshua Croke: And that requires a level of investment from the institutional side and belief that this work truly matters.

[00:08:03] Because the other thing I see people slap the title of community engagement on is like the placating to community role, right? It's saying, oh, this is actually our PR person who's out there to just mitigate the concerns of community and put on the face that the institution is doing X, Y, and Z.

[00:08:23] Domenica Perrone: And we can always smell that from a mile away, right? Community has an amazing way of discerning when that is happening from that institution, right? And unfortunately, that person is becoming tokenized, right? Their own relationships are being challenged. And the institution is not actually doing that investment work to advance the common goal of the community and the institution.

[00:08:49] Joshua Croke: Absolutely, and recognizing that that practitioner, despite being an employee of the institution, is also there to hold the institution accountable.

[00:08:59] And that work can be really difficult because you're out in community and then are coming back and saying, hey this is what we're hearing, this is what we know. We need to reflect our institutional practices to change the culture that is here that has been causing and continues to cause the harm. And that requires change work that is often a little friction centered, right? And, and tense. And people burn out in these roles.

[00:09:28] Domenica Perrone: Absolutely. And that's what I was going to say.

[00:09:31] It shouldn't be one person's job, right? We're looking at offices, departments, and I'm very grateful to say that the institution that I'm a part of now, UMass Chan Medical School, has made this commitment to advancing health equity. And in some ways, I see it as like, Putting your money where your mouth is, right?

[00:09:52] Like, not only do you want to advance health equity, but you are putting the human power and human resource support on the team that you are, you know, supporting and believing in to do that work. And so I'm a part of the Collaborative in Health Equity. It's fairly new, about a year old. But we have an amazing, brilliant team. Our fearless leader is Dr. Krista Johnson Akbakwu. She's an OBGYN. She's always pulling from her lived experience. very passionate about maternal health and equity, very passionate about health equity in general and holding our institutions accountable. And so when I have, you know, entered this role and I see that UMass Chan Medical School has not only trusted but supported an individual like her to build out a team, create an office, start exploring different initiatives, engaging with community, I see that that is an institutional commitment to advancing this goal of health equity because everyone believes that that is where we need to, the direction we need to be going in.

[00:11:02] And not all institutions are there yet. I have faith that, you know, there are plenty of people like us in these spaces that will continue to work together to push from the inside, but it's refreshing to see a large institution and player in our city that is willing to commit to that.

[00:11:20] Joshua Croke: How do you balance, because I think we are both very values driven people, and I'll speak for myself in saying I feel like I am in a privileged part in my life where, not without some challenge, but I make decisions to step into roles that are values aligned, which is not something a lot of people in community can do.

[00:11:47] And so I feel very grateful to be able to say yes and no to things based on how they align with my value system.

[00:11:55] Having been involved in liberation work and community justice work feels and looks really different. And especially, you know, I'm thinking a lot following this election and like the outcome at like national scale and what movement building and community work looks like.

[00:12:12] And I feel, I've been called in and maybe called out by some friends around association with or affiliation with institution, in this broad sense of, you know, oh, you're moving more towards this. I don't want to call it the center from like a political frame, but it's like, there are things that we like should not accept and we should, you know, bang the table.

[00:12:40] And I am in some conflict personally, like internally thinking about how do we show up in this work in a way that is actually going to lead to change as the outcome. And as someone who gets so fueled and angry and fired up around issues, and I have my community to scream at the sky with, which is really important.

[00:13:05] And personally, the screaming at the sky is healing work, but I don't know if it is completely change work when we're on the ground in community, especially working at institutional scale. So I don't know if I've made a coherent statement there, but I'm wondering if any of that resonates.

[00:13:25] Domenica Perrone: So much of it. First I want to, there's several things I want to say, and thank you for sharing you know, your, your place right now and that internal struggle, because that resonates with me.

[00:13:35] And there's a couple things. One, I want to make sure that we're giving ourselves grace, right? Because this is a learning journey and and I do think that So, you know, community engagement, anti racist work community organizing, none of those things are perfect. They're slow moving. People, like ourselves, are value driven.

[00:13:58] That means we are emotional, right? When the topic is something that's close to home, when it's literally life or death, that is how we see the work that we do. And so not just ourselves, but the community that we're interacting with, the other organizers, we are all moving from a place of passion and along with that passion, like our own internal pains, right? Our own internal traumas that we've experienced within these systems, right? So I think it's really important to give ourselves grace, to give our community grace when we're not always perfect or when conflict may arise. But at the end of the day, if we have a common goal and common mission, I am hopeful in the way that I approach it is like, I have no problem apologizing.

[00:14:43] I have no problem being like, maybe I wasn't right in this situation. How can I do better? And also being transparent. I think like you said, like we're in a privileged place in the sense that we are affiliated with different institutions. We have visibility. We have quote unquote the ear of certain people and the privilege of having access to certain spaces, right?

[00:15:09] And so for me, I find that being transparent about the what I have access to and how I can use my own privilege within those spaces to advance our collective mission for the people who are not in those rooms. You know, they, I might not do it in the way people would like to see me do it, but I know that internally, like my goal and my mission is to advance health equity, right? Health equity for everybody. And that encompasses so much. I'm saying health equity now because it includes housing, it includes youth work, it includes education, it includes health care, right? So that is always going to be my goal. And In my relationships with community, with community partners, with my friends, my family, I am always, you know, talking about it.

[00:15:59] How can I use my power and privilege to advance this mission in spaces that other people don't have access to? And I might not always do it perfectly well, but sometimes it requires us to be brave. It might not mean that every single time we're in those spaces we are batting the hatches or whatever the saying is, you know, yelling to the sky and, and, doing it in a way that, you know, might not be quote unquote well received, but I'm going to use my superpower, which is the way that I talk, the way I communicate, the way I build relationships, and I'm going to hold these people accountable in my own way.

[00:16:37] And they might not even realize it. By the end of it, they might be like, wow, Dominica has a great point. I think I agree with her. Mission accomplished, right? I didn't necessarily need to raise my voice or do things in a certain way. And really early on in my upbringing you know, my early 20s when I was going to different community organizing spaces where I was learning about the framework of community organizing.

[00:17:02] Someone wise once told me that we need a Malcolm X and we need the MLK. And it's not that one is right or one is wrong, and in that saying is like, we need the MLK that is going to be the person at the front of the rally, the person who is engaging in these diplomatic quote unquote spaces and conversations, still never compromising his own values.

[00:17:28] And we need the Malcolm X that is going to be there agitating, right? We need community to move this needle in health equity through community organizing. We need the folks that are going to shut down the streets, and we need the folks that are going to run for office.

[00:17:45] We need them both, right?

[00:17:46] Joshua Croke: for office. We need them both, right? Absolutely. And I am interested in your observations of this cause I feel, and being in spaces where I see that work really well and being in spaces where I see that not be connected, think, and, and I'm trying to think of the best way to frame this.

[00:18:04] Cause I think it's really about like, those folks folks, the Malcolm X and the MLK need to be in relationship as well. And even if there is tension, navigating through tension, and I'm seeing this a lot, I think with youth and young people stepping into community, stepping into work, there is a divide, a, or a lack of desire to be at tables where conflict is very present. And I think that is different in different spaces. Right? I think it is very averse in our institutional environments. And I'm wondering if you have thoughts on what, what is that interconnective tissue?

[00:18:49] Domenica Perrone: I have just the thing that I think is the interconnective tissue, and that's actually restorative practice or restorative justice, right? And so the way that I handle conflict is that if my common goal is, in this situation, health equity, that means that I want the person who has the least in common with me.

[00:19:11] Maybe someone who doesn't share my values, someone who doesn't believe in health equity. I want to get that person. to believe in this, right? And how do we do that? If not, having a restorative practice or restorative justice framework. And if we're thinking about, you know, the people who are organizing in the sense of, you know, maybe it's protests, maybe it's rallies different types of community organizing, that's really visible in terms of like, occupying space or shutting down meetings, for instance, right?

[00:19:45] It's up to those of us that are straddling the institutional space to make sure that we are fostering and watering our trust with the folks on the ground. Because if we are not doing right by the folks on the ground, then I feel that we've lost our way a little bit or that we have not necessarily lost or compromised our values, but there is space for us to do more.

[00:20:13] And it just means that we need to be a little bit more brave. And it might mean that certain people certain relationships are, strained because of that. But I would rather my relationship with the institutional space be a little bit strained because that means that we're doing work. If there is no push and pull with the institutional space, then we're not really moving the needle versus my relationship with community. It's like, I need to water that. And there may be strain and pain points because of personalities, how we do work, there's always someone who's hurt somebody's feelings, there's always a little bit of harm that takes place within those spaces intrapersonally. But at the end of the day, I don't want to live in a city or a world where we don't have protests, right?

[00:21:05] Like we need that so much in order to make the push and pull that we need internally. And so for me, I will always try to do my best to meet folks where they're at, give each other grace, ask for grace when I need it. And then I'm going to use that and use my own tools, my own superpower to navigate the internal space the best that I could.

[00:21:29] And hopefully there is some strength, there is some push and pull, but there's also celebration when we move the needle little by little. 

[00:21:37] Joshua Croke: Pivoting slightly, but this is all interconnected. The Collaborative in Health Equity at UMass, you are leading community engagement work. Can you talk a little bit about the, the hopes, the dreams, the motivations behind the collaborative and what that work is looking like?

[00:21:56] Domenica Perrone: Absolutely. So our Collaborative in Health Equity, our mission is very simple, but very, difficult to attain. And it really is to rebuild and foster trust with communities who have been historically marginalized and impacted by our health care systems. That is huge. That is very difficult work to do and achieve.

[00:22:19] So our fearless executive director, as I previously previously mentioned Dr. Krista Johnson Akpaku has built out a team and we have different core areas. We have global community engagement and impact. We have education and research. We have workforce development and capacity building for folks who are underrepresented in medicine.

[00:22:40] And then my core area, which is community engagement and outreach, which really intersects with all those areas. And what are You know, pie in the sky goal and mission is to really be the team that can get a pulse on what's going on internally at the medical school, weave this needle and thread with the healthcare system, and at the end of the day, be informed and directed by our community, specifically those who represent historically marginalized communities.

[00:23:12] And so, again, like kind of what we just described, I am sort of the person that has my foot on the ground in the pulse and community. I am constantly informing my team, and we're looking forward to hopefully, you know, getting some funding to support community engaged research that is driven by community community needs.

[00:23:35] We want to ensure that we're providing educational opportunities to our community partners that want to do health equity work. Many of them have been doing health equity work for 20 years or so. Internally, we always know that institutions are doing various forms of community engagement or health equity work, but it's not always done super well.

[00:23:56] Or some people do it better than others. Some community partners may experience fatigue because they have too many touch points coming from the institution. And so there's always a piece of the work that is getting your arms around what's actually happening and improving the quality of what's taking place.

[00:24:13] And there is, You know, there's a ton of amazing work being done internally and externally. And so as a new work newer organization Right now we are finding our space and figuring out how we can support existing work That's been taking place in the community and letting that work inform the institutional level work that's taking place while also partnering and supporting our health care system to you know Execute and make that impact in health care when we're actually seeing community as patients.

[00:24:46] Joshua Croke: I'm energized by that work and eager to support that, that mission for so many reasons. Folks, often in smaller community organizations or groups that recognize the importance of health equity and have like these different touchpoints to it can often be such critical resources for gathering like data and information and often don't have the, the well to fill and look at how to organize that and share that data or have the capacity to process. And, and so the institutional relationship where research and those activities are so central I think is going to be a really beautiful kind of pairing with bringing folks together across, across the city.

[00:25:35] Domenica Perrone: Right, like a pie in the sky idea is to hopefully be able to go for large federal grant money together, right? Work with community. We have so many incredible coalitions, Coalition of Healthy Greater Worcester, Together for Kids coalition, just to name a few. How can we let these coalitions drive our needs and be an institutional player with a massive name? Big clout, big resources to get that money and work with community on implementing these programs that are going to make an impact for the members that are on the ground. While at the same time, you know, we're going to have some youth programming opportunities We want to make sure that we're also visible and present from a programmatic perspective, not just as A funder an institutional partner. So we want to do a little bit of both and that's kind of what we're working towards right now.

[00:26:24] Joshua Croke: Absolutely. Developing the pipeline for the young people who should be leading and at these tables and stepping into these careers and these fields.

[00:26:32] In our last minute here, I like to give listeners a, like, kind of a prompt to bring to the dinner table. So. In your work, is there anything that you feel folks should be being thoughtful to or talking about or bringing back to? So if, you know, if a child is listening to this episode and they're going home to the dinner table, what should they be talking about with their folks?

[00:26:56] Domenica Perrone: Well, selfishly, if it's a child, I would be like, consider coming into healthcare or public health spaces, right?

[00:27:03] There is space for you and your voice matters in this field. But also considering what's going on with our national climate around politics and things like that, I would just say, Everyone has a role and responsibility to do community engagement and to do it intentionally and well and to be motivated by fostering these relationships.

[00:27:28] At the end of the day, I always say community is medicine and we cannot be so individualistic and isolated because that is never going to achieve our common goals, especially around health equity. So find your own space in it. It's not. that we all have the same role to play. Are you a Malcolm X, or are you an MLK, or are you somewhere in the middle?

[00:27:49] Find your space and own it.

[00:27:52] Joshua Croke: Thank you so much, Domenica. We've been talking to Domenica Perrone, and you're listening to Public Hearing, I am Joshua Croke, your host, where we're talking about Worcester, Mass., the second largest city in New England, having interesting and timely conversations about issues that impact our community.

[00:28:07] Our audio producer is Giuliano D'Orazio, and you can learn more and follow Public Hearing and other projects of Queer For Cities at QueerForCities.com