The Hidden America: Ruby Mendenhall MPP'94 Confronts Bias in Policy

Public policy is only as good as the questions we ask. The problem is that many policymakers fail to ask the right questions due to their own biases, lack of cultural understanding, or not taking the time to talk to the people their proposed policies will affect.

Ruby Mendenhall MPP'94 believes that effective public policy does not start in the ivory towers of academia or governmental agencies, but in the community and on the street. Throughout her career, she has strived to seek out the mostly unheard voices of “Hidden Americans” in an attempt to shape policy that reflects and impacts their lived experiences. 

As an associate professor of African American Studies and Sociology at the University of Illinois and an assistant dean at the Carle Illinois College of Medicine, Mendenhall examines social inequality and public policy's role in facilitating socio-economic mobility. Her research includes the effect of periodic earned income tax credit payments on the budgets of low-income families, students of color experiences with racial microaggressions at a predominantly white university, how black women cope with racial microaggressions, and the use of big data to recover Black women’s lost history.

Mendenhall’s recent focus is on the long-term and often devastating effects of violence and the threat of violence on the mental and physical health of black mothers on Chicago’s South Side. Her research findings on the south side led Mendenhall to her most ambitious undertaking to date: addressing the racial trauma and toll on mental health that 400 years of racial injustice have inflicted on people of color.

To fund the extensive project, Mendenhall and her team submitted their proposal to the MacArthur Foundation's 100&Change competition, which will award a $100 million grant to a single proposal that promises real and measurable progress in solving a critical problem of our time. Recently, Mendenhall found out that they had advanced to the next round of review.

As Mendenhall states in the 100&Change proposal, “Racial injustice has caused cultural trauma that continues to affect Black mental wellness across the life course.” The proposal cites Daniel Dawes and Keisha Holden who argue that Black people with mental health issues are commonly “undiagnosed, underdiagnosed or misdiagnosed because of a combination of various, cultural, linguistic, sociopolitical, environmental, economic, or historical reasons.”

The goal of the project, christened H.O.P.E. National Mental Wellness Tour and Black House Rock Toolkits, is to raise awareness, decrease stigma, increase help-seeking behaviors, expand the pipeline of mental health workers, and provide unprecedented access to local resources, proper diagnoses, and interventions for Black Americans.

In addition to a 16-city tour of conferences, training, and community engagement, the project aims to increase public awareness through a campaign inspired by the popular Saturday-morning Schoolhouse Rock series that educated kids about grammar, math, science, and history. Black House Rock would incorporate black music, black culture, and black language to address issues like trauma, grief and bipolar depression. 

“We’re trying to get information out in ways that can be accessible to everybody. Mental health is the focus, but that trickles down into so many other areas. It influences physical health and vice versa and then it’s tied to education, employment, and so many other things." said Mendenhall.

The need for such programs and services is particularly acute in communities with high levels of violence, such as Chicago's Englewood neighborhood, where Mendenhall conducted her recent research. As noted in the 100&Change proposal, individuals in these environments have PTSD rates that are similar to or higher than soldiers in war zones.

Mendenhall's research found that the violence and the near-constant threat of violence affected mothers at a physiological level. A range of measures from blood (genomic) analysis to Fitbit tracking to diary entries revealed that individuals experienced elevated levels of stress on a consistent basis. The stress manifested itself physically through migraine headaches, back pain, and hair loss. The preliminary genomic analysis reveal possible increased cortisol (stress hormone) output from the hypothalamic pituitary axis (HPA) by mothers who perceive their neighborhood as unsafe. 

Most people cannot even fathom living in such an environment. Some of the mothers living this experience were unaware of the impact their environment was having on their mental and physical health. 

“One of the youngest mothers in the group was saying, ‘You know, I just think about it as normal and then when I'm wearing the sensor, and I'm writing in the diary, I'm realizing how much it affects me,'" Mendenhall recalled.

Mendenhall would never have gained the high level of insight she achieved through surveys, statistical analysis, and observation. Her research relied on being in the neighborhood, talking to mothers in focus groups, and building trust. She does not consider these women subjects. Instead, they are "citizen/community scientists" who Mendenhall insists should have a voice in research and shaping the policies that impact them.

Giving a voice to the voiceless has been a cornerstone of Mendenhall's career. She learned early on, by listening to those with the greatest need, it is possible to understand better how to serve them.

After receiving her bachelor's degree in occupational therapy from the University of Illinois at Chicago (UIC), Mendenhall worked at Cook County Hospital, where, as a member of the hospital's protective services team, she would "see kids coming in failing to thrive.” By engaging with the mothers, she quickly learned they were stretching their baby formula by adding extra water to the mixture, which resulted in their children lacking essential calories and nutrients.

Mendenhall didn’t see it as an issue with the mothers, but with public policy that wasn’t providing low-income mothers with enough financial support to feed their children. It was that experience and the desire to improve policy that pushed Mendenhall to pursue her master’s degree at Harris. 

After graduating from Harris with the distinction of being one of the first recipients of the Irving B. Harris Fellowship at the Ounce of Prevention Fund (OPF), Mendenhall lobbied legislators on childcare and welfare policies. She helped OPF with a grant for Early Head Start programs in Chicago's Robert Taylor Homes, a public housing project on the city’s south side. 

“I was sitting around tables at policy meetings with mostly white men who were well intended, and I remember thinking, ‘When was the last time they talked to a mother, especially mothers of color, to see what they needed?’ Although I was Black and female, I also had to ask myself questions about social distance because I didn’t live in a neighborhood with high levels of violence, and I didn't have kids at the time," Mendenhall recalled. "So, I went to work in Robert Taylor Homes (RTH), trying to get more information from mothers like, ‘What do you need? What is your life like? What is it like to struggle to feed your children?’”

Mendenhall said the RTH experience was very eye-opening, especially in terms of the violence. She also saw first-hand the disconnect between those living in Black segregated neighborhoods and those living outside of it. Employers who had no exposure or any knowledge of these people's lives could not comprehend a call from Mendenhall on behalf of an employee who was unable to work because an ongoing gang war made it impossible to leave her building.

Experiences like this led Mendenhall to earn her Ph.D. in human development and social policy from Northwestern University, thus bridging the gap between her policy education at Harris and her occupational therapy degree and human-centered training from UIC.

According to Mendenhall, Harris provided her with the tools to look at issues more broadly and from a multidisciplinary perspective that still drives much of her approach to research and policy solutions. She acknowledges the value of data in developing measurable solutions but firmly believes that qualitative research is just as important in capturing the lived experiences of those benefiting from public policy.

"Numbers may not lie, but numbers can tell a biased story. I don't think people understand that. Numbers are not objective. Who you are can influence the questions that you ask and the data that you get. It can influence how you interpret that data,” she explained. 

"Even with big data, there are voices that remain silent. So, we always need to be thinking about how we can develop holistic evaluations that can influence policy and talk about individuals' lived experiences in nuanced ways,” Mendenhall added.

As a long-term goal of the H.O.P.E. project, Mendenhall wants to create spaces of hope, where black women, men, and children can not only gain access to the mental and physical wellness programs they need but also have a voice in creating the policies that affect them. She has a TEDxUIUC talk on the subject, “DREAMing and Designing Spaces of Hope."

“I want to expand how we think about data, what it could look like, and who it comes from. We want to create a space where marginalized groups can engage with policymakers. It’s all about breaking down barriers and providing unprecedented access to people who, historically, have not had access," she concluded.