Daphne Smith knows systems–from the inside out. As a health equity advocate and co–executive director with Northwest Health Law Advocates (NoHLA), Smith’s work sits at the intersection of healthcare access, policy, labor rights, and racial justice. In this conversation, she reflects on her roots, her path into advocacy, and why universal healthcare is not about charity–but about survival, dignity, and collective power.
Q: Can you start by saying and spelling your name, and telling us a little about yourself and your connection to Spokane?
I’m originally from Ogden, Utah. My mom got a job here in the eighties and relocated all of us up here. I struggled being up here because there’s a lot of white people and I was not used to being around a lot of white people. So I moved back down to Ogden and stayed there until my senior year in high school.
I went back and forth my senior year, then came back up here, got out of the trap, graduated high school, started college up here, then went back to Utah to finish college and manage family relationships I had been running from. After I graduated, I got married and stayed up here.
Q: People don’t often associate Utah with Black communities. Can you talk about Ogden and its Black history?
Ogden was a redlined district. It had to have been redlined when the Union Pacific and the Continental railroads met. Ogden became one of those western frontier cities, and it ended up being the second largest city in Utah outside of Salt Lake.
There was an actual Black population there, including my grandparents, because of the railroads. People like Duke Ellington would come through. He would take his train to Salt Lake for gigs, but then come down to Ogden to hang out with Black people and eat food, because that’s where we were welcome.
By the seventies and eighties, Reaganomics came, they closed our schools down. I had Black schools, Black crossing guards–everything was Black and Latino. Then they shut our schools down and bused us out to rural areas. That’s where I was exposed to white people–in second grade.
Q: How did you get into health equity and advocacy work?
Our organization is called Northwest Health Law Advocates. My background is in human resources. I graduated with an English degree, minored in communications and journalism.
Originally, I wanted to be a lawyer–but really I wanted a boyfriend in California, a house in New York, and to travel to London and Paris. God had a different idea. I changed my major my senior year.
I didn’t know anything about human resources, but I ended up in HR and realized I got to deal with the law and how people treat people in organizations. That was everything for me.
I wanted to understand strategy–why people were hired, how money moved, what development looked like. I did that for about 18 to 20 years. I didn’t want to be an executive director, but this role works because I’m a co–executive director. I focus on strategy, systems, and advocacy.
Q: Why isn’t representation alone enough in these spaces?
I’ve had to be my own advocate because I couldn’t trust human resources to have my back. A lot of people don’t know how to protect themselves at work, and by the time they figure it out, it’s too late.
Representation matters, but representation with awareness matters more. If the process excludes people for unfair and biased reasons, then I have to talk about the system–not just show up as the representation.
Q: Why is health equity and universal health care so important right now?
Universal healthcare allows people to actually go to a doctor–not just have coverage. It means seeing a doctor who can take care of your basic needs and having a plan to address them.
If you have a country without healthy people, you’re not going to be a well-off country. If you don’t support the people with the least–the homeless, Black communities, immigrant communities, children, the elderly, the disabled–everything else falls apart.
Healthcare should be built on supporting those who need support, not giving access to people who already have options.
Q: What systemic barriers are you seeing in Washington state?
Washington is one of the race cars of healthcare, but we’re dealing with a massive state deficit. If there’s no money, nobody gets care.
Now add federal policies that penalize states for covering immigrants–even lawfully present ones–and costs explode. People are facing $2,000 copays and still can’t get in to see a doctor.
I had to wait six months for a mammogram. That’s recent. It’s bad out here.
Q: How do race and gender compound health care inequities, especially for Black women?
Doctors still aren’t aware of the medical abuse that happened to Black people–Tuskegee, Henrietta Lacks, millions of Black women experimented on. That history lives in our communities.
Serena Williams almost died after childbirth. She had to advocate for herself to get doctors to run tests. If the greatest tennis player in the world had to fight to be heard, we’re way further down the totem pole.
Q: What is NoHLA doing to center community voices?
We are going out to the community. We’re not asking people to come to us. We want to hear from Washingtonians about what kind of healthcare system they want.
Our role is to help people build advocacy skills. This isn’t our strategy–it has to come from the community.
Q: Why is collective organizing so important right now?
When people experience generational disenfranchisement, they lose the desire to fight. There’s fear. But there is power in numbers and strategy.
Look at what Dr. King was doing before he was assassinated–bringing poor whites, Black and Latino families together. If we come together now, when the system is breaking, there’s an opportunity to build something new that includes all the people pushed to the margins.
Q: What gives you hope moving forward?
Empowerment. Teaching people how to advocate. Giving people tools.
The systems–healthcare, education, banking–are all built the same way, and they were never built with us in mind. But we can learn them, navigate them, and change them together.