Trace It Back One More Layer
Born in Trinidad and Tobago, Tamieka Atkins is an immigrant, naturalized as a U.S. citizen in 2021 and is now raising the first American-born generation in her family. These aren’t details she keeps separate from her professional life. Instead, they are a grounding force in the work of ProGeorgia, the civic engagement coalition she leads across Georgia’s 159 counties. These counties represent the homes of millions of people, families and children impacted by substantial differences in what we call the social determinants of health. But Tamieka’s work isn’t rooted in what we lack but in the assets we already have, a philosophy she learned from Trabian Shorters.
“Define communities by what they make possible, not by what they lack, because that choice determines whether you build with people or for them.”
At a recent convening hosted by Grantmakers for Southern Progress, Tamieka challenged funders and movement partners to adopt an asset framework around the social determinants of health impacting Southern children and families. And challenged us to view those outcomes as a true measure of democracy. It was the first time that she’d described democracy as a child health issue, but she knew it to be an undeniable truth that would reshape how she talked about her work henceforth.
“Every policy that touches children was written, funded or gutted by elected officials,” Tamieka said. It’s the kind of fact that makes your ear perk up and the hairs on the back of your neck stand up, because everyone doing this work already feels it, but rarely hears it said with that much certainty.
Tamieka’s call was clear and backed by an asset we already have — data. This work does not begin in a clinic or a classroom. This work begins with understanding and expanding who gets counted, who gets to vote, and who gets to stay in a community long enough to raise a child there. Democracy isn’t just another social determinant sitting beside housing, food, and education. Democracy is the system that everything runs on.
“Everything that we are calling child health work is being shaped upstream by whether democracy is working.”
Who’s being counted, and who isn’t? Children under five are undercounted more than any other age group in the country. If a child is missed in one census counting cycle, they will have to wait an entire decade to be counted again. That means there’s a decade of schools, clinics, and food programs that are funded based on census numbers that were wrong from the very beginning. The data that decides who gets funded, least represents the communities that would gain the most from being counted.
Who gets to vote? Voting access is directly connected to health outcomes. There is a consistent pattern showing the ten least healthy states in the country vote at meaningfully lower rates than the ten healthiest. In the Georgia counties carrying the most disenfranchised communities, closed precincts, reduced drop box access, and hours-long wait times force parents to weigh the importance of voting or taking care of their children.
Who gets protected? Mass incarceration and immigration enforcement are two sides of the same coin, both separating children from parents, and both now formally recognized by researchers as producing the same lasting harm as abuse or household instability. Tamieka notes a 2024 workplace raid in Georgia followed by a documented drop in school attendance, and pointed to what that actually means: a child not in school isn’t seen by a nurse, isn’t fed, and isn’t referred for care.
The cycle continues.
So we’re asking funders the same thing: If the harm is upstream of the clinic or the classroom, is the investment upstream too?
A child health strategy that starts and stops at the doctor’s office is only treating a symptom. Tamieka asks funders to trace their work back one more layer, to where democracy actually lives.