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"Human dignity is the basis of justice, while the recognition of every person's inestimable worth is the force that impels us to work, with enthusiasm and self-sacrifice, to overcome all disparities."

This meditation is inspired by those working to ease the transition of individuals who have recently arrived in this country, usually from places where they are escaping violence, unrest or unjust conditions. The Catholic health care ministry includes community health workers — like those described in this issue's Mission column at Avera Health in Sioux Falls, South Dakota (see pages 61-63) — who are already serving as leaders in their communities. They work tirelessly to draw from their expertise and experiences — some as immigrants and refugees themselves — to build trust between their communities and health care systems. Through the power of their relationships and community building, they help to create an environment where human flourishing is possible.

In 2020, the Catholic health ministry was moved to respond to the deaths of George Floyd, Breonna Taylor and Ahmaud Arbery and the disproportionate impact of COVID-19 on racial and ethnic communities through the renewal of our commitment to equity, justice and the dignity of all persons.

I accompanied my daughter and her husband to a toddler's birthday party so I could keep an eye on their son while they mingled with other parents. When we opened the gate to the backyard, the host greeted my grandson and his parents. I was right behind them and held out my hand, but he had turned his back and was leading them to the party. I am invisible, I realized. I am a professional with interesting ideas, but the dynamics at play seemed tied to the number of my own celebrated birthdays. Ageism.

A global health care worker shortage — worsened by factors such as the COVID-19 pandemic, burnout, violence and an aging workforce — is the focus of a recent report. Its intent is to initiate meaningful dialogues among ministry leaders as they grapple with persistent workforce challenges within the context of the ministry's deep-rooted tradition of global solidarity and the common good.

Death accompanies our living.1, 2 We know this, yet death is often pushed back from the daily routine of our lives. And then, when death happens, it may take us by surprise or feel unanticipated. Despite the mental hurdles, taking time to think about choices related to our death and dying may allow us to better prepare for it.

Catholic hospitals and health systems have been leading the way in community health for many years — ever since the women religious who pioneered the Catholic health ministry in the U.S. first adapted their care to address the needs of the communities they worked in.

This past October, more than 350 delegates from the Catholic faithful worldwide gathered in the Paul VI audience hall at the Vatican over the course of three weeks. The diversity of individuals included bishops, lay faithful, and women and men from all walks of life and every region across the globe. Together, they listened. They told and received stories from around the world, and each carried the joys and hopes and the griefs and anguish of the people of God. This Synod on Synodality reflected Pope Francis' vision for being Church.

Do you get out of your comfort zone? Do you visit neighborhoods you're not usually in, or occasionally strike up a conversation with someone new to get a fresh point of view, some thoughts different from your own?

Competition in the hospitality industry forced astute practitioners to discover and embrace new ways to reach, engage and listen to feedback from guests.

Humans have a complicated relationship with alcohol. We drink when we're happy, and we drink when we're sad. We drink with others, and we drink in isolation. In fact, we have a complicated relationship with most psychoactive substances. We eat, drink, swallow, snort, inhale and inject them. We advertise them, compare our favorite brands, and use them in family traditions and religious ceremonies. Some of our substances are legal, some are legal and regulated, and others are illegal, yet still commonly used.

Cheryl Johnson, the sixth of seven children, grew up on the far south side of Chicago, tagging along with her mother as she went to community meetings. "I grew up in a period where whatever your mother said to do, you do it," Johnson said. And so she did. Johnson was there as her mom investigated the industrial waste facilities surrounding their public housing complex and demanded attention for community health concerns. Hazel Johnson came to be known as the "mother of the environmental justice movement" for her work helping to launch grassroots efforts to address environmental issues in the United States.

Health care providers have a responsibility to ensure that every patient receives equitable care with cultural humility, which includes a commitment to self-reflection and learning, reducing power imbalances and improving institutional accountability. At CHRISTUS Health, we recognize the importance of integrating a health equity lens into our daily routine. To achieve health equity, it is essential to consider the patient's environment, lived experiences, support and resources at every step of the process. And in our work for healthy and equitable communities, we've expanded and refined our data analysis and strategic responses.

Nonprofit hospitals, representing nearly 60% of all U.S. hospitals, are enduring increasing pressure to demonstrate the value they offer to the communities they serve and whether (or not) they deserve their tax-exempt status. In fact, the Ways and Means Subcommittee on Oversight held a hearing on tax-exempt hospitals and the community benefit standard in April 2023. During the hearing, Congressman Brad R. Wenstrup, R-Ohio, said: "Nonprofit hospitals should be providing a level of community benefit that aligns with the value they are receiving from their tax-exempt status. Taxpayers who are on the hook for providing this benefit deserve to know what they are getting in return.

Every day, I wake up with a deep sense of purpose: to play a role in nurturing communities, particularly those marginalized and underserved, so that they may thrive, find healing, and grow in love, hope and fulfillment. Over 35 years ago, the Sisters of St. Joseph of Orange had a similar vision when they founded the St. Joseph Fund. Their mission was clear: Every individual must be healthy for society to flourish.

On my first day as a public health civil servant in the Bronx, New York, the assistant commissioner gave me a tour and brief history of our district office, which had just opened two years earlier. The building was certainly older than that, so I asked what had previously occupied the space. She said it had always had a health focus and, although nonprofit organizations were the immediate past tenants (and some remained), there had been another public health office located in it some 20 years ago. "We're still trying to get past that," she noted. I asked what she meant. "We left. We set up, built relationships, provided services, and then an administration changed, budgets tightened, and we left. They don't trust us."

"The hurrier I go, the behinder I get," said the white rabbit in Alice's Adventures in Wonderland. So many people in public health could be forgiven if they expressed this sentiment as well. While the public health sector has made substantial progress in fostering healthy communities by identifying and, more importantly, addressing the social determinants of health, the nation has moved backwards.