A bridge builder across the healthcare divide

'We've broken a conspiracy of silence. People are more willing to talk about what's wrong with them. Talking out loud helps.'

Byllye Avery has fought for 30 years to bring an awareness of social issues into healthcare. (Dominic Chavez/Globe Staff)

Diana Chapman Walsh, the former president of Wellesley College, remembers the first time she heard Byllye Avery's voice. It was more than 20 years ago, and Walsh had taken her daughter to a women's health rally on the Mall in Washington, D.C. It was a boisterous, carnival-like atmosphere, Walsh remembers, and the speakers, whom she couldn't see but could hear through a loudspeaker, were being drowned out by the boisterous crowd. Then Avery came on, and the crowd fell silent.

"She was absolutely riveting," Walsh remembers of the passionate voice that boomed through the speakers. "She brought herself into the story with this wonderful, modern perspective. She wasn't harsh or judgmental, but she brought this moral authority because she was a charismatic persona who was telling the truth, the reality from her perspective."

After more than 30 years as a healthcare activist, Avery, who has close-cropped salt-and pepper hair and purple glasses, is still bringing her perspective to women's health issues, particularly in the black community. As the founder of the National Black Women's Health Project (now known as the Black Women's Health Imperative) and the Boston-based Avery Institute for Social Change, she has spent her career fighting to get people to look at problems through ethnic eyes, to consider cultural and social circumstances, such as race and class, as relevant factors in medical treatment.

Sitting in her Jamaica Plain home last week, gently stroking her cat, Fudge, Avery explained that she came to this realization the hard way. In 1970, her husband - who was just months away from earning his PhD at the University of Florida - had a massive heart attack and died at the age of 33.

"Just before he died, he'd read 'The Feminine Mystique' by Betty Friedan," she said, referring to the book that is credited with starting the "second wave" of feminism. "He really wanted me to read it, but I never had the time. About a year later, I finally picked it up and it excited me."

She was working in child psychiatry at the time, but began thinking about bringing a feminist view to healthcare, a new tack to counter the days when, she said, a woman who asked a doctor a question about her pregnancy was told to leave the worry to the doctors.

"The important thing that feminism taught me about women's health is you have to look at it from your own perspective," she said. So, in 1974, still in Florida, she created the Gainesville Women's Health Center, and helped pioneer the use of self-help groups for women facing poverty, crime, and violence - bringing social issues into the medical equation to help explain and combat the poor health that was statistically higher in the black community. Four years later, she helped create "Birthplace," an alternative-birthing environment that created an intimate, at-home feeling for the childbirth process.

In 1983, she founded the National Black Women's Health Project to do something about the statistical discrepancies on a national level, and organized the first conference on black women's health. Organizers expected 200 people to attend; they got 2,000. It was, for Avery, a "magic" moment that set the black women's health movement off and running.

The organization celebrates its 25th anniversary next month, and while Avery says there's still much work to be done - "There are a lot of issues, like reducing infant mortality, that could take generations to accomplish," she said - she's proud of the fact that the movement has been able to significantly raise awareness.

"We've broken a conspiracy of silence," she said. "People are more willing to talk about what's wrong with them. Talking out loud helps. And I think that has improved self-esteem dramatically. People accepted that there were a lot of other forces involved in what was happening to our health. That's our biggest accomplishment, but the second big one is getting [the medical community] to look at health problems through ethnic eyes."

Though she's 70 now, Avery says she still has plenty of fight left in her (her mother, after all, is pushing 100). In recent years, much of her work has centered on healthcare reform through the Avery Institute, which she founded in 2002.

"The topic [of healthcare] can numb you. People roll their eyes," she said. "They always ask, how are we going to pay for it?"

But Avery sees the issue as just a continuation of the question she's been asking her whole life: What do we need that we're not getting?

"We're bringing a human rights perspective, with people at the center. By dint of birth, we have a right to healthcare that's readily available, affordable, and culturally relevant.

"What I want," she said, with a hint of a knowing smile creeping across her face, "is a healthcare center for every bank and liquor store."

Hometown: Deland, Fla.; lives in Jamaica Plain.

Education: Bachelor's degree in psychology from Talladega College in 1959; earned her master's degree in special education from the University of Florida in 1969.

Family: She is married to her partner, Ngina Lythcott, the associate dean for students at the Boston University School of Public Health; Avery has two children from her first marriage: Wesley, 46, a UPS driver in Florida; and Sonja, 42, who works at the University of North Florida.

Genius: In 1989, Avery was recognized with a fellowship from the MacArthur Foundation, which is commonly referred to as a "genius grant."

Hobbies: Avery said she enjoys The New York Times crossword puzzle, homemaking, and gardening, but said her real hobby is making magic. "I don't make things disappear, but I like to bring 'ta da' to ordinary situations."