Racism in Philanthropy

04:51

Hello, my name is Adonai. And I'm Jeremiah. And we are the host for today's Deep Dive show. Today we're gonna be talking about medical racism. So we're gonna be talking about the racial disparities in the medical field, whether that's getting into the medical field or concerning patients in communities of color, as well as the reason behind the lack of access to healthcare for people of color. And so Jeremiah is gonna tell us a little bit about the history to introduce us into our show today.

05:20

There's a long history with medical racism from the horrific testing upon humans during the Tuskegee syphilis experiments involving human trials on the effects of syphilis in black people to the advent of craniometry or the measurement of human skulls, which supposedly proved that white people were biologically superior to black people. So it shows us there's a long history with many, many more examples, but just to quickly summarize medicine has long been used to support the racist and problematic beliefs of its practitioners. And

05:49

in our modern day medical practitioner system with our practitioners still not reflecting the racial and ethnic diversity of the communities that they serve, these same issues stemming from racism still plague our health systems.

06:02

That is very true. And because of this history, it has caused biases and traumas that we see and that we call medical racism today. For example, these biases can come on both sides. For example, in the medical field, the perception because of these experiments and things like that, and the long history of how POC were treated in the medical field, and also the dehumanization of African Americans has caused the medical system and parts of the medical system to see people of color as like...

06:32

less experiencing pain because over the past 400 years African Americans have seen as has been seen as stuff has has been seen as non-human right so that perception of like oh they experience less pain than a non-POC is something that's prevalent this has also called also has caused stereotypes on the other side people of color as well after going through all this history there has been a distrust in the medical system

06:59

This has also caused them to lose access to medical resources and to actually reaching out for those resources and losing trust in the medical system. And so today we're gonna be having a special guest come on our show. And she's one of the 2.8 black women who are actually in the medical field today. So that's 2.8% of black women who are in the medical field today. So that's an amazing thing. So we're gonna welcome Renee Rates to come on our show and talk about how she's been helping community

07:27

communities of color get access to these medical resources. And so let's welcome Rene Brake.

07:34

Renee, thank you so much for joining us. I'm gonna quickly introduce you with all of your really impressive background and experiences and then pass it on to you. So for our audience who doesn't know Renee and hasn't had the privilege of meeting Renee yet, Renee is the president and caucus collaborative representative of the Black Caucus of Health Workers. Renee, you're also an epidemiologist with the CDC Foundation. You're a community health worker. You're the founder and president of the Black Community Health and Wellness Association of Nevada. And-

08:04

among so many other things. You just have such a wonderful track record of really advocating for the health and wellness of underrepresented communities, particularly black people in the communities that you occupy and serve. And we can spend this entire show going into who you are and the work you've done, but briefly, can you just tell us an overview of how you got here, why you chose to work in this space, and why you've committed yourself to promoting health equity in particular among black communities?

08:34

Yes, I started out with public health and kind of crossed them between public health and health care because they kind of work hand in hand. And I started to work in the space because of my own experiences as an African-American woman, getting health care services, dealing with certain things that weren't so great and some were quite good, and seeing a need, an area for improvements, and trying to reduce disparities and trying to advocate for populations.

09:03

So that's how I got into the field.

09:08

Awesome. And I remember when we talked last week, you talked about your personal experiences with the health system and how even despite being an extremely high caliber medical professional yourself, you still are receiving the bias and racism as a patient being treated by white doctors. Are you able to share a little bit about those experiences and how that has shaped your work to fight for health equity?

09:37

in your professional life? Yes, yes. About, I would think about two years ago or so, I had an incident where I was basically kind of dropped, but dropped into free falls and actually hit the floor, but it caused enough of an issue where it caused a severe cervical sprain and then it caused lip lash and then a concussion by, yes, by a fire department in Vegas and...

10:05

Because of those problems, it led to other issues too. I had a nerve injury and because the nerve was injured so bad that it wasn't sending the proper signals to my brain. So having issues with seizures and trying to speak. And then I had to go into inpatient rehab facility where I had to learn how to walk again and learn how to use your fork and your spoon and use the bathroom and all the stuff that you kind of take for granted when you're able bodied. So.

10:30

It was an experience, but even to just get to the rehab facility before I got to the point where I was so bad, where I couldn't walk because of the pain, the way my back was contorted when I was kind of put down, I came across a lot of people in the health field and especially when I had to go into like emergency services or if I was just like non-responsive and they were trying to figure out like what was going on. And yeah, lots of times. Unfortunately,

10:59

The stereotypes that you hear from other people and not just being stereotypes, but actually things that you hear and you hope that you don't experience yourself as an advocate is like, if you're white and if they're male, you're probably gonna have an issue lots of times and they're probably not gonna be listening to you at all. I know I had one time where I had back-to-back seizures and that was the time that put me in the hospital and then got me on the...

11:25

pathway eventually to getting into rehab and I was just totally out of it because after the seizures it does take kind of a few days for everything to kind of calm down a little bit. I kind of like vision troubles, you have memory issues, it's hard to multitask and focus on one thing at a time. So it's almost like your body trying to like reboot itself or like your brain trying to reboot itself. That's like the best way I can kind of describe it.

11:52

Yeah, and the ambulance that took me there, again, they were white male, these EMTs, and they basically thought I was doing drugs or I was just grossly exaggerating. And, you know, I couldn't even talk correctly. If anyone's ever heard anyone that has had a stroke, that's exactly what I sounded like. So I couldn't make sense of everything because

12:16

I had just had back to back seizures. So everything's just is very hypersensitive, you know, the lighting, people talking very loudly, things like that. And then you're trying to catch what they're saying, but you're so, I don't want to say slow, but you're so slow to catch what they're saying. Like you're not really, you know, given a chance to, you know, try to re rebuttal anything that they're saying. So they're saying, oh, well, do you do drugs? You do this, you do that. And you're trying to explain to them. Well,

12:40

Yeah, I'm on this nerve medication and yeah, I'm on this. And then, you know, then they're onto the next question and then they're patronizing you. So yeah, it was just a, it was a horrible experience. And basically in that one, they didn't believe me at all. And it just, but again, I was doing drugs and of course I went to the hospital and they ran tests. They saw they had no drugs in my system. That's beside the point. They just thought how they treat you. I had another...

13:04

white male hospital's doctor too, that just thought it was just all in my head and I was just making it up. Even after they had about two physical therapists come into my room and be like, no, this is like, her legs are not like working properly and something's wrong with her back and her spine because she can't put pressure on her legs without her just like shutting down. So when I put the pressure on my feet to walk, it was like rubber. There was like.

13:32

there was no resistance at all. So it was just not happening at all. And he still just thought it was just psychologically related and that something just happened to my brain and they don't listen to you at all. And I'm like, I'm a person that was teaching people how to advocate for themselves. And here's the advocate in this situation and they're still not listening to you. So that just shows you how bad the system can be.

14:02

at times, yeah. Yeah, wow. Thank you for sharing. That's such an impactful story and such a grotesque example of the system working so poorly. Would you be willing to share a little bit of history about this desensitization of pain and this false bias that people with darker skin have higher pain tolerance and how this assumption has, you know,

14:30

showed up over time and how it's continually perpetuated through outdated ideas being being taught still in in medical textbooks.

14:41

Yeah, yeah. And that's a thing that's gone on, like you said, a lot through history, American history, that there's this whole stereotype and assumption that black people just don't feel as much pain. And if they do, so they feel any type of pain, it has to be for some reason that they're trying to get over. Like they're trying to see pain medication, they just want more attention, they're lazy, they just want to get over on the system, they just want to collect a check and go

15:11

work, you know, there has to be some rhyme or reason to it, besides you're just flat out in pain to it as well. And I was even reading about the history one time that modern gynecology, and they were saying that the doctor that facilitated all these different procedures on these black women who were enslaved at the time, didn't believe that these women needed any pain medication at all. So I was like, I'm just

15:40

went through things that people should not be going through at all when it comes to possibly reproductive care and were left sometimes worse off than when they came in. And that just kind of proves what do they think about you and what are you doing for this test and everything. As in the one too, I think I saw that the, I'm not misquoting it, but I think it was the US Army, if I'm not mistaken. They tested tear gas, I believe.

16:10

on US soldiers some years ago. And it was to the point where, you know, I think that they did different types of tear gas exposure. So one was like a pseudo battlefield test. So they would kind of recreate the battlefield for them. And they've got out in the fields and they've exposed them, I guess, to the tear gas. The other one was a direct skin contact, I believe. And I think the last one was if they put you like in a kind of a gas chamber.

16:37

just to kind of see if it was like in a concentrated area. So I believe those were the three. But for a lot of the men of color, they did this too. So it was people who were Hispanic and basically black that they did this to a lot of. When they went to go seek treatment and because it wasn't written on their records when they left the military, nobody believed them and nobody believed their pain. So a lot of them had skin conditions afterwards, respiratory issues.

17:06

Um, a lot of them suffered all types of degenerative problems. And again, they're paying traces. And now they're going to leave with you crazy. And then that you got the stereotypes again, now you're crazy and you're put out and you're a vet and you're black or maybe you're, you know, um, Latino or Latino, and you know, no one believes you at all. Nobody particularly cares that you're just another person that the system cannot use it up, um, at that time.

17:36

And of course it didn't come out till much later that the army did these kind of gruesome tests and experiments and everything and eventually apologize for it. But that was way after the fact. You know how that stuff kind of works, you know.

17:59

Yes, for sure. And I feel like going back to the story that you told us in the beginning of how you have to go through that whole experience with those white male doctors who didn't believe that you were experiencing what you were experiencing. First of all, I think that's absolutely lame. Obviously, this is the world that we live in, right? This is systematic racism. But as being an epidemiologist, a Black woman epidemiologist, I definitely just draw history and how

18:27

you know, systematic racism works and racism works. People don't automatically assume that by yourself that you are this doctor with a really, really high degree as well. So kind of shifting the topic of the conversation into getting into the medical field as a black woman being the 2.8% of black women in the medical field. How has this lack of representation like stopped you or prevented you from getting these profession, like advancing professionally or

18:56

Do you feel like you're on the same page as your white counterparts? Yeah, and I just wanted to preface saying that I am working towards my PhD. I do not have an N.D. But I have epidemiologist, I don't want anybody to hit me up online, but can you help me with, no, I sure cannot. So yes. But yeah, it shows up a lot professionally. It just, where can I even like start with the stuff? Like you can be.

19:23

black and excellent and you can do well in your private life. Like me doing stuff for the community, might have your own organization, working with the Black Caucus of Health Workers that's also underneath the American Public Health Association. You can get awards, you can be recognized, you can have stellar performance reviews, but your best is not as good as your, I hate to say it, average person who might not be black.

19:53

Um, because that's the way these, you know, kind of people are, especially if you have people in administrative positions who are higher up and are not people of color or people who are not black, but they might be black, but they're not gatekeepers. Um, they can, if they kind of keep you out, um, a lot. And I have seen it a lot. Um, I saw this, um, uh, trend one time on tick tock, which was interesting tech, medical trauma.

20:21

And it was also talking about folks that work in the medical professions and health professions. And they were talking about, you're only as good as your mediocre white counterpart. I mean, it doesn't matter how hard you work, the most mediocre outside of you being the opposite of if you're black and they're white, they're probably still gonna get ahead. And it's very well true and I've seen it myself. It's like...

20:45

You work your work, you put up with a whole lot of crap all the time, you bite your tongue, you try to be a professional, you go over and beyond, you're very helpful with everything, you research the most, you try to go to school the most, you gotta get your certifications and graduate top of your class. And then when it comes time for promotions, it's all hush, hush for other people behind these doors that you didn't even know existed. And then all of a sudden they're promoted and all of a sudden they're moving up. The, you know.

21:13

the hill really, really fast. And I've had talks about that too, as some of my other friends and colleagues where they are just basically being shut out, especially if they don't kind of play the game of being silent, staying in your place, staying in your lane, doing a little bit too much where it's getting you a lot of a positive attention.

21:40

They don't like it. They don't. I think some of them, a lot of these, I would say kind of health-based jobs, trying to put a little bit more bluntly, whether they're public health or health or some type of intersect or both, I think they have their token few people who probably don't upset the system as much. And then after that, everyone else is just kind of out there by themselves. So...

22:05

moment funding gets cut or someone wants to hire their best friend or things like that, then you're kind of on your own. Which is why I do see a lot more people in the healthcare field trying to, especially if they're Black, trying to just go into business for themselves, whether it's healthcare consulting or having their own private practice or things like that, because they just get tired of the games they do.

22:35

kind of political but in an office sense and you see it, you know, and your efforts aren't really that well rewarded for what you're doing. You can be a shark, their favorites and pick people that don't make them question themselves and question the system and that's what they like to have, but it's a real issue. Even like in public health too, there's a huge lack of diversity in a lot of places, which makes no sense.

23:05

These people say that they serve diverse populations or special populations. But then when you look at the tier-leveled on down, everyone, it just looks like they're white or they're closely akin to white. Like they could be maybe passing for white if you didn't ask them what their background is. I think one of my colleagues said that before too. He said, the higher up you go, it's a blizzard. I mean, you don't hardly see.

23:34

Any color at all. Yeah.

23:41

I really, really like that reference. But just like, I'm kind of interested personally in like, in your attitude towards it. Because personally, I've been learning and experienced and in a club at my school, and was kind of talking about like black women's attitudes, even in just the ways in the world, like their ways of living, so like their epistemology, is like, we never can be doing too much. Like for example, like if something had happened, let's say in your workplace or et cetera.

24:09

We can't be too loud. We can't be too quiet if we're too quiet if we're not smiling something's wrong with us Like we always have to be put into this like very thin narrow box to fit Some type of stereotype that even people are not like satisfied with so what what is like your attitude? I'm kind of interested on your attitude in that way when you do encounter something like a recent a racist incident or a microaggression Etc. What is your attitude towards that?

24:37

Sometimes on the past, depending on where I've worked and who I've worked with, you'll try to fix it. You'll try to open up the very tight gates that they put up there and everything. So maybe you could try some DEI programs, which that's under attack now too. Yeah. You could try that. Maybe sometimes talking to some people on administration, sometimes maybe leading your own programs are a good...

25:07

kind of alternative as well. And sometimes if all that doesn't work, I just had to look for other alternatives, doing stuff in my own private life, trying to work with people who are more like-minded and trying to get stuff done. Because it's clear when you talk to people several times and you mentioned something and they're like, oh, okay, that's a great idea. And they go back to doing the same thing the next, you know, couple months, maybe a year or two, it's been a long, you stay there and what you're doing and what your tolerance level is.

25:36

that they're just not gonna do it. They're just flat out not gonna do it. So in that event, when that happens, sometimes it's just trying to leverage your stuff in another capacity, whereas maybe looking for another job or contract in the meantime, maybe starting your own organization, again, working with like-minded people in those organizations. And then sometimes if it's really bad enough and it's well documented, then maybe it's time to...

26:04

maybe talk to some people outside of that organization to kind of hold people more accountable. If you have to even take it up to like maybe your local state legislature level or bring media attention to it, yeah, then you might have to go that far depending on what it is. But it's definitely an ongoing issue and I don't foresee it going away, particularly since a lot of stuff, like I said, is under attack. Like the DEI programs that were supposed to be little.

26:33

little channels for us to be getting through as black and brown people to get through and like make a way, make a platform for ourselves. Not those are getting closed and closed a lot more or very heavily monitored and controlled, but it is possible, but it's not the easiest at all. You just see it in so many places. It is very...

26:57

very rife. That's why it's important to kind of get into your own niche of things so that way your voice can be heard. Yeah. Yeah. Well, I love the reclaiming of power that is involved in starting your own private practice and having that wealth building come from that. But at the same time, I feel like we need to put the burden of responsibility for change on white people and

27:27

while I don't think that'll actually work, for the white audience who is listening and does want to do something, both patients and people engaged in the health system as practitioners, do you have, and maybe I'm putting you on the spot here, but do you have ideas for what white people can do to deconstruct this medical racism system and how we can make this a more equitable system? Yeah, besides, you know, trying to, you know, maybe...

27:53

maybe form partnerships or help organizations that are working to those kinds of capacities. Also too, in your everyday life, say something, cause that's the main issue. It doesn't help if you just do it in a controlled and professional environment. And then when you're out, you know, and you see something, maybe you're in a healthcare facility, maybe you're out in the community, maybe you work with some community health workers, just depend on what you're doing and how you're doing it. And you don't say anything.

28:21

Even with the doctors and the EMTs, I mean, these people were not working alone. I'm pretty sure the people that they worked with knew these people had these tendencies and they had to see it multiple times. And they didn't say anything about it. They just kept going. Cause I'm like, some of these folks were just too comfortable just being disrespectful. And especially being disrespectful to someone who was in a very vulnerable and compromising position. So I'm like, if you're doing this to me,

28:51

and I have a patient and I'm not screaming, I'm not yelling and I'm barely cognizant most of the time. And you're already giving me medication that kind of makes me a little sedated in any way. So I'm lightweight when it comes to giving me care. I can't imagine what you would do to anybody that would try to say anything back. So I think a lot of that falls on the shoulders of everybody. These people are being enabled every single day.

29:21

by folks who just want to just get along. They just want to get a paycheck. They just want to get ahead. They just want to move on to the next thing. They just want to have this good record. But in the meantime, these folks are, you know, folks and me myself too have been basically victimized, you know, every day. And another thing too is, is don't think it can't happen to you. If they're doing it to patients of color, if they don't like you or you say something or you go complain, they can be retaliatory. And the system,

29:51

being the system, the healthcare system, down to the base level is really not set up for patients who have been, I guess we say victimized, it's not set up for the victim, it's set up for the people that kind of work in it, especially people who have a lot of power in it, people that are tied to people high up in the administrative level, people are tied to the executives.

30:16

folks who might be physicians and might kind of roll the roof over their iron fist or whatever, and might bully other coworkers. Yeah. So you gotta definitely say something and then speak up as well too, and hold people's feet to the flame. If it's enough people doing it, I think it will help, but lots of times stuff doesn't happen because people just kind of walk away from it and they just don't say anything.

30:46

at all, which makes them just as guilty, to be honest. So I think that's the main things there. Yeah.

30:59

I'm kind of taking a little bit of a tangent, but kind of go on the same level is, I heard you kind of talking about like, obviously this is something that you do with your organizations and that is help provide resources. So kind of going in that direction. Personally, I don't know if this relates with you, but in a lot of communities of color that I see is like a lack of trust in the medical field, medical system, because of these past histories and just their experience, right? So.

31:27

The first thing that communities of color, people of color that at least I know, is the first thing they will do is not go to the doctor. That's not going to be their number one thing to do. They want to fix it themselves. And if that's their last resort, they will go. I realized that that was a thing and I was kind of wondering why is that? I think obviously now that I've done more research, I kind of see the history and the system behind it. And I also feel like it's a lack of resources, too. And as I know, you're providing a lot of these resources for people of color. And so I kind of want to ask, like.

31:56

What is your response to this kind of mindset? Do you think that people should fix this kind of mindset? And how would they do that? And what resources do you provide? What are your thoughts on this? So the first question was fix the mindset of, I'm sorry, it cut out a bit, fix the mindset of? What is your response to this type of mindset?

32:20

for people being basically racist in medicine? Yeah, like saying like, here, let me rephrase it for a second. So like how POC don't have trust in the system. So what's your advice to them, I guess? Should they be seeking out more resources? Yeah. Sorry. For justice system, yeah.

32:42

No, and I totally agree. I was not scared to go to the doctor until I had all this with having the seizures in the fall and then not being believed and calling names. And I mean, I was like, oh my goodness, I did not know it was this bad. Like I thought it was kind of bad, but I had no clue. So I could see why they would have distrust and not going to the system. Even if you didn't have it and a distrust within yourself because of your own personal experience, but you had it by proxy.

33:11

If you saw your parents, your wife, husband, whoever, girlfriend go through that kind of stuff, I can see why you don't wanna go because you might think, well, if I go to the hospital, I might not make it out and my story's not gonna make it out or I might end up worse. So I could definitely see that too. I would say try to, as much as you can, in an emergency situation, sometimes you have to take what you can get and I totally get that as well. But

33:40

Try to do as much research as you can about a provider, about a hospital or any health center that you are getting some type of treatment from or being seen or whatever, just to make sure that they're able to serve diverse populations. See who's on their board and everything. What does it actually look like? Who's actually in charge of things? Do they have an advocacy committee?

34:07

Some of these places have like, you know, community advisory boards, where people can bring up their issues and, you know, just everyday rather people can sit on them. You don't have to have a fancy title, you don't even have to go to college, but you just can be a concerned, you know, citizen and how people are being treated in your community. Look at that as well. And then also make sure that everything is documented.

34:31

So, you know, if a doctor tries to give you something that you don't wanna take or you've had like an adverse effect too, make sure that's documented. Make sure they're just not skipping the part that gave you an adverse effect in saying that you're just combative or you're just hard to deal with, you know. Make sure you're putting that down there too. Make sure that you're following up right away. And that's a mistake that I did because I was just in such a amount of pain all the time. And...

34:59

because I was always kind of like slightly confused all the time. And I was just so, I guess at the time also traumatized, it was just a lot going on. You go from being able-bodied to not able-bodied like overnight. And then on top of that, you're having people being very cruel to you and just being very patronizing. All of that was just a lot to deal with. So I didn't think at the time to basically, I swear to say, basically report people when I should have.

35:28

Timing is definitely the essence. So report the people right away. You can wait till you leave, so that way they're not trying to do some weird stuff while you're in there if you would like to. But yeah, make sure you report them right away because if you wait a little bit too long or you just don't report it all, they're gonna document that. And they'll say, well, why didn't you report it right away? Or why didn't you say anything? And that's a huge problem.

35:55

I think it's true that a lot of places have patient advocates. And there's also health organizations like ours with Black Community Health and Welfare Association that do advocate for patients as much as we can. So you can reach out to those organizations. They can write a letter on your behalf, help you reach for maybe your local political office, whether that be your congressperson in your area.

36:23

or sometimes even going with you to the doctor so that way they can sit with you and that someone else can listen to what's going on and that way you're not just being kind of pushed around and just fobbed off and pushed out the door. Even though sometimes like a lot of the insurance companies doing this too, but it's another subject. So yeah, I would do that as well. I'll cover your bases there. Maybe have an advocate, seek for patient advocacy.

36:48

document everything and then also do your research about where you're being seen and who you're using it to. And that's what you can do besides report it to the institution. You can also report it to your health care insurance. So if you get enough people complaining about a certain, let's say provider, doing something that's not right or unethical,

37:15

Yeah, the insurance company is probably not going to want to work with them over some time and they're probably going to want to pay out less because they don't want to keep dealing with that kind of thing. Now you're becoming a liability to patients and you're becoming a liability to the insurance company. So you can report them too. And then I think there's also another network too for hospitals. I forgot the name of it. I think for the data.

37:41

It's like a healthcare type of like association. I did forget the name, but I can send it to you all. So you can report them as well as a hospital. If you just feel like they're just giving you a run around or if it's another healthcare facility, especially if it's a state licensed healthcare facility, you can report them. Yeah. And did you have another question? Sorry, was there a part two to the question?

38:07

Now, there was some parts here I just wanted like a general overview, but now that you do say that, I realize that you did tell us a little bit about like your organizations and what you do with them. But if you could share out to the viewers watching this, like what kind of you do in your organization and how you created your organization a little bit more in depth about how you provide those medical resources. Yeah. So we had to help cover gaps in health insurance costs.

38:36

So, you know, sometimes we have families that will reach out to us and say like, hey, my insurance only provides, we'll say a new walker once a year, but it's not enough. I need a new one now. So we can provide that for them. Or if they say I need help, you know, transportation, some of the people we work with ride public transportation. And they say, hey, we need passes to get back and forth on the bus. Or we need, you know,

39:03

someone to pay for our par as well too because it's then we can do that. Um I that needs to be covered the funding, then we'll p there's some other stuff we do for that. Oh yeah, So I know one time this l had a traumatic brain inj a lot of issues with her which makes sense becaus

39:32

and then we set her up with a massage and exercise therapist. So we pay for that as well. So that's kind of stuff we do for trying to connect them with the healthcare and if they have the kind of gaps in their insurance and cost. Another thing too is we do the patient advocacy sign. So if you come to us and you feel like, you know, you're kind of just being pushed around a lot, then we can, you know, try to like go to bat for you as much as we can.

40:00

And if it gets a little bit too technical and legal and it might be out of, you know, kind of our scope of work then we'll try to get you with the right person but still try to at least support you to some capacity at that time. And then another thing too that we try to help with on the holistic side is like we do a lot of free services when it comes to mindfulness, meditation and holistic care. So whether it's acupuncture or Ricky or sound vibrational therapy.

40:30

I find that people just don't need the health care side as well. That's a good thing too to get your medicine to get to you'll see a doctor in a timely fashion, get your testing. That's very important. But also to to trying to heal the mind and the body and if you wouldn't plan what you believe in your kind of spirit to because you need that support from your community as well. And the other thing too is we do try to help people with housing. So sometimes people have come to us and have

40:58

getting ready to get addicted, not necessarily because they couldn't just pay the rent. Sometimes their rent just gone up astronomically very quickly. So we try to cover that as well because you can't be healthy if you don't really have a place to stay or you're worried about food or you don't have gas in your car. You can't go pick your kid up from school. So all that kind of encompasses together. So that's just some things that we try to help with. And then of course, patient education.

41:23

So if anyone came to us and wanted to learn about, you know, different things, whether it's chronic diseases, patient rights, things like that, then we try to help them as well there too. Yeah.

41:39

That's such wonderful work that you're doing, Renee. And it just brings up a great point that you mentioned that you can't be healthy if you don't have a place to live, if you don't have your basic needs met. And it's something that I don't think about very often when I think about health. I think often about reactive medicine, but proactive medicine to prevent issues from happening in the first place and to maintain health is such an important aspect of our health system that is

42:09

overlooked. And yeah, I don't really know where I was going with that. But it's just, I want to reflect that, that sentiment that you're sharing and the intersection of, of your needs being met and how all of our structural systems can really beat down the health of people who have less privileges and less access to resources than others. Yeah.

42:38

We can shift the focus of conversation a little bit to talk about maternal mortality. And this is something that we touched on when we spoke last week and is really just a striking statistics or you can really go deep into statistics on this and be shocked by how poor maternal mortality rates are for black women in the US as compared to white women. And I

43:06

don't have the number up in front of me, which is shameful. I wish I did. I can't find it right now. But maternal mortality rates for black women in particular are astronomically higher compared to white women in the US. And a lot of that is due to discriminatory birthing care and poor access to healthcare and a lot of the things that we've been talking about. And I wonder Renee, if you can just talk to or speak to

43:35

specifically maternal mortality in the US and how that plays out, how that affects people and if there's anything that we can do to overcome that aside from what we've already talked about in having conversations and speaking up and advocating when you see problems.

43:54

Yeah, I yeah, my kind of retaliation and you know access and then treatment of people in healthcare Especially if you're black and then if you have If you had to have a tier system within a race like I should say race slash ethnicity You would have black men and then black women so you feel like you're already kind of you know Making it black and you're a black woman. So you're being treated probably

44:20

even maybe two or three times worse sometimes, you know, I would say sometimes, I would say probably lots of times and everything, because you got the gender thing going on as well. So yeah, maternity brutality rate in the US for women of color and black women is absolutely horrendous and it really doesn't matter what background the woman has. It doesn't matter if she's able to advocate for herself, doesn't matter if she's educated, doesn't matter if she works in the health field herself.

44:50

It doesn't matter she's fully insured and has two health care insurance plans. Doesn't matter she has great access to what's a top notch hospital somewhere. It doesn't matter. It's like it does not matter across the board and it's really sad because it should not be that way at all. I like said there's a lot of stuff that people have done already trying to do advocacy.

45:17

bringing that to the forefront, bringing it up to all the way up to DC and state capitals and trying to bring awareness to that all the time. I think one of the things again is trying to make sure that, trying to alleviate that and making sure that you're doing your research when it comes to who is gonna be your provider. There's also a lot of programs that have been developed trying to combat that.

45:44

a lot of doula based programs. I know even the state of Nevada has started support doulas by giving them a stipend to work with women and particularly black women to kind of bring those numbers down. So they work with them. They basically I think about, I want to say, is it is it week six or week seven something on I want to say we six or seven on from their their pregnancy, unless you just have your own doula.

46:13

and they work with them from like basically the beginning to end to make sure they're getting the right nutrition. Sometimes they can go with you to do your appointments. They make sure that everything's going okay with you and the baby. They can even advocate for you while they're in the hospital. Some hospitals have policies where you can't have newels inside the birthing room and then some do. So again, that's going back to make sure.

46:37

Do you research and then if they try to change it upon you, when you get there, make sure it's in writing that says, no, he said my doula could be here while I'm having this child there too this fall. But yeah, the rates are just quite out of control. And I kind of wish that it would definitely change because again, that's one of your most vulnerable times, especially as a woman is having to lay on your back and have a baby. And sometimes there's complications with that as well too.

47:06

And the last thing you need to worry about is someone, you know, not believing you when your pain might be out of control or you might be bleeding excessively and then not taking it seriously at all. You know, or you leave in the hospital and then discovering that you have some issues and they're just trying to tell you just to, you know, sleep it off or go take some maybe proofing. Yeah. It's honestly, um, it's, it's not the, it's not the best. I have watched.

47:32

So many videos about it at this point. And I've had, you know, some of my friends as well that's had some bad experiences with trying to birth basically while black. And then so much research reading it. And I feel like, you know, maybe over time, morals change because more people from our black community are getting involved, whether it's having the dual services and then learning from kind of the bad experiences that their friends have gone through.

48:01

over time, but I wish it didn't have to get to the point where a lot of women have had to suffer or just all out together just lose their lives for them to actually be believed, you know, so yeah, so birthing while black is not a good experience sometimes at all sometimes can be a very beautiful experience, but I think it definitely needs to change, especially for an industrialized nation like the US or it shouldn't be happening as much.

48:31

Yeah. Yeah, absolutely. I like that phrase birthing while black because it really captures how systematic this problem is, but it's also horrific that we have to have a phrase that embodies that pain. Thank you for sharing all that though. Yeah. I want to kind of switch towards a more hopeful

48:58

topic, if I may. And we've been talking about a lot of the problems with racism within medicine, but there has been a trend that has emerged in the past few years that has reshaped how some practitioners are thinking about medicine and they're treating racism as a disease rather than, well, racism is still ever present in all of us and we're all exhibiting various biases.

49:28

you know, ignoring racism and letting it just go on unattended to some practitioners throughout the US have started to treat racism as a discrete disease and focus on all the intersectional issues that go along with that and trying to make sure that everyone's basic needs are met that their mental health is sound and build people's health up from.

49:55

from the ground. That analogy didn't really work. Can you speak to that a little bit, Renee? I don't know how your background lends itself with that particular field of emerging medicine, treating racism as an intersectional disease, but how can this approach reshape how we think of racism within medicine? And how has it already affected people?

50:22

Yeah, and you know, and we've kind of, you know, discussed this, you know, a little bit, you know, before, you know, we've kind of had this discussion, and then also now, obviously, but yeah, racism is definitely a factor and trying to see people's diseases and

50:48

was their likelihood of coming out of a situation that might be critical or not in comparison to their counterparts. So I think at least for me and my experience of living in Nevada, I think more people are trying to see it as that, but I think it's still catching on. Probably other parts of the country are going to take that into consideration as well too, because that does have

51:18

But it does and I also think being racist is being part of the disease as well, too Because it doesn't make any logical sense to Want to have these stereotypes play out even when you see what you're doing is totally illogical And it just doesn't make any sense at all. So I think that's part of a two-part there

51:42

I guess you'd say health and poor health and these poor health outcomes and all these disparities that come with is a symptom of a larger issue from being racism. And I'm glad people are just calling it out and saying what it is. Lots of times before people tried to polish it and say, well, no, it's this and it's just that and they're just low income and they just can't read that well, their English is their second language or they just don't connect well with the doctor because the doctor is not from their urban community.

52:12

No, it's just racism. And we just need to call it what it is. And try to move forward from there because kissing up and trying to cover up people's bad behaviors that can cost people their lives is not doing our communities any well service at all. So yeah.

52:36

for sure. Thank you so much for sharing. Honestly, like you've read it so much feedback for us today, we learned so much from you, resources that we needed to know, your experiences that you have experienced that a lot of the viewers may or may not have experienced. So we're so glad to have you on the show today. Jeremiah, do you want to add anything else before we end the show and provide resources? I just want to, Renee, give you one last opportunity. Do you have a final message you want to leave with our viewers? If there's one thing to

53:06

how our conversation has gone today about racism within the medical system, about how to advocate for yourself as a patient of color within the medical system. What should our final message be for viewers? Yeah, I would say definitely speak up, speak up for yourself, speak up for other people. Don't be scared to do it because if it's happened to you or it's happened to someone else, it's happening to a lot of people more than you think.

53:34

And the more you talk to people, the more you see that there's a lot of stuff going on. That's just, you know, going unchecked because people are scared to talk and they're scared of retaliation. And a lot of these folks that are doing this kind of stuff, where they're perpetuating racism or trying to help prop these systems up, they're not as big in that as you think that they are. They're only allowed to do as much as they're allowed to do because they have people enabling and being quiet around them. And then...

54:00

You know, again, you can't get where you need to go as far as to dismantling racism in healthcare, getting people to get more access to stuff, making sure that people come out alive, if they're even just birthing and should be having a baby, stay in the hospital maybe for a few days and coming home, but now they're not. We can't do any of that if people just remain silent and remaining complicit. We all have to go there together. And impacts everyone. Don't think that just because someone is black.

54:29

or they're Latino or Latina or they're Asian, that that won't happen to me. It can happen to you. And you have to say something for all of it to work. We live all in this society together. And it's all like kind of being on a ship. We're either going to float together or we're just gonna all go down group by group and one by one. So definitely speak up and say something.

54:57

Awesome, thank you. Thank you, Renee. For our viewers, we are going to summarize some of the resources that Renee has put together for us. And we're gonna post that on the resources page of AHRQ's website. So stay tuned for that. There are gonna be lots of resources for... If you need resources for yourself or for someone you know, they're gonna be available. And there's gonna be educational health resources. It's gonna have patient advocacy sort of stuff. Know your rights as a patient.

55:27

Lots of great resources, so make sure to check those out. And is there a way that viewers can stay connected with you in the future, Renee, as you continue to make impactful changes and work in this meaningful space of Black Health Equity?

55:50

Yes, they can reach me at bchwandy@gmail.com. That's one way you can reach out to me. I would give you my personal email, but it's very long. So yeah, I think bchwandy@gmail.com is probably the fastest way to reach out as well to you can reach out to the caucus directly as well, which I think let me see here really quickly.

56:17

If you send us that email, we can just post it on the website. We don't have to you don't have to find it right now. OK, that would be that would be great. Because I always kind of forget what it is in order that it's in for the email address. But yeah, you can reach out to the caucus directly. You can go on scroll to the APHA website, tap in Black Caucus and all the information will come up to you. So, yeah. Awesome. Wonderful. Well, thank you again so much for joining us. We have really had a wonderful conversation. I've learned a lot of.

56:47

I hope our viewers have gained as much from this conversation as Adonai and I have. Adonai, do you want to close us out? Sure. Thank you guys so much for watching. Again, thank you, Renee, for joining us and sharing this amazing information. Keep tuned on our LinkedIn, Facebook, and Instagram at anti-racism coalition, and we'll be posting when we make our next Deep Dive show. So thank you, Renee, for joining us, and hope you guys learned well. Thank you.