Chapters Transcript Video How Do We Make Black Lives Matter in a Different World Plenary SessionOriginally Broadcast: Monday, October 19, 2020 | 5:00PM EDT Hello. My name is Bevy Smith, and I'm honored to welcome you to the plenary session for the U. S. Conference on HIV AIDS. Tragic events of racial violence such as those suffered by Ahmad Auberry, George Floyd, Trayvon Martin, Eric Garner, Sandra Bland, Mercy Mac, Rianna, Taylor and more have been highlighted by the Black Lives Matter movie. This movement has put into focus that the health and lives of black people isn't just a matter of a doctor's visit, unnecessary surgery or secret experimentation, but the chronic disease of discrimination and ever present systemic racism which permeates all of our society, including our health care delivery system. The murder of a black man has become the catalyst to change our justice system. The death of black men Thio HIV AIDS is still at an alarming rate. While blacks make up only 12% of the population, they account for 44% of deaths attributed to HIV AIDS. Death is a tragedy which drives us to move the world, and the Mo mentum is here and now it is our moment together to create meaningful change. Now is not the time to be silent and observed. It's time to put words into action and acknowledge how we all live in a different world. What does it take before we realize this must end this year? The deaths of Amman Arboria, George Floyd, Briana Taylor, Andrea McCarty, where Clarion call for the world toe? Finally see what black and brown communities in America have known and suffered with for decades thes air, the names you know for every name you know their arm or you will never recognize, like Tony Munday and Brie Black. Despite these horrific killings and subsequent protests, more killings have occurred in a. In addition to the social justice inequities, black community continues to be disproportionately impacted by the HIV AIDS epidemic, with 7053 deaths from HIV AIDS complications in 2017 and with one out of seven black African Americans with HIV unaware they have. What will it take for us all to admit that racism is embedded in every facet of our lives? That the disease of racism and discrimination has taken hold of us and is more potent and unrelenting than any virus ever could be? No area of our lives is exempt, not housing, not education, employment or health care. These are essential areas of the lives of each and every American citizen. We stand because we know in our spirit that this is unacceptable. We stand because in our battle against systemic racism, we must be the heroes and Xiros in our own stories. Way stand because we want our Children to be free way stand to create a different world free from stigma, prejudices and injustices that lead to disparities and health care. What will it take before we speak? For those whose voices air crying out and falling on deaf, ear, marginalized communities often intersect. For those of us who have the least power in society, whether you're homeless and at risk, youth or suffering from a chronic disease such as HIV or AIDS, any one of these situations is devastating. Imagine dealing with one or more of these challenges and being powerless, voiceless and lacking adequate health care. We fight to give marginalized people a stage to be seen and heard. We fight to ensure everyone has access to the same standard of care, free of judgment and discrimination way fight, because as a society we will be judged on how we treat the underserved. Despite all that confronts us the challenges and the obstacles, we know what we must do. We must learn from our failures and refused anything less than freedom and health equity for us all. For us to breathe for us to live in a world free of fear and stigma for being who we are born to be. So we can simply be We know this life is something that will have to be fought for and protected fiercely. And the time is now. We will not let this moment pass us. We will not let the lives of our brothers and our sisters we lost in vain. We will kneel. We will stand, We will fight. Thank you. We will live. We will live, we will live. We will live in spite of it all because freedom and access to health care is a birthright. And we have no other choice. Because the time is now to remove the stigma and the prejudices within our systems that lead to inequities and health disparities. Our time is now is now is now is now you have seen, heard and learned that the standard of care for patients who are black, indigenous people of color and members of the l G B T Q plus community will need to change in the midst off to pandemics, a racial pandemic as well as the HIV epidemic. We hope through this experience you've found ways in which you can enrich black lives by addressing these disparities head on. This is what we live, that we're gonna make it free. Hello. Good afternoon. And welcome to the 2020 US Conference on HIV and AIDS. My name's Chris Freeman, and I lead the US HIV business unit at Gilead Sciences. I'm very excited to be joining you today. I don't know about you, but when I first saw the for us see a 2020 I was excited about two things. First, I gotta be honest. Supposed to be in Puerto Rico. I'm not gonna lie. Never been. And I was excited. But second and more importantly, the conference name was changed from U. S. C. A U S, C. H J. To recognize Paul and a knack for this important update. We all know that words matter. And while seemingly small, this change signals just the progress that's been made against the fight but the fight against HIV. But there is still much work to be done access to the program today, and to that end, I'd like to welcome you to the Gilead Sciences plenary session on How do we create in a different world below your screen? There's a button with an option to listen to this program in Spanish. Please click that button. Now. If you'd like to view the program with translated audio, U. S. C. H. A conference is unlike anything else in health care. The energy that we've come to know Nance and expect from the gathering of so many passionate leaders from across the HIV landscape is amazing. In fact, it's palpable, and I hope that you feel that same passion and energy throughout the week, in the conference and in the session this afternoon. Today you'll hear from community leaders, medical professionals and advocates who recognize this moment to create real change in addressing racial disparities in our health care systems at Gilead are intimate, are in tow, and commitment to HIV focuses on areas of innovation, prevention, education, access and partnership to end this epidemic. We all know it takes more than a pill to see the end of HIV. It's going to take all of us to break through the barriers that can lead, take suitable health care for all the patients that we serve to discuss the ways that that we can effectively create in a world. I am excited to introduce today's moderator for our panel discussion. Bevy Smith is the host of Bevel ations on Sirius X M radio and the former co host of Page six TV. She will guide our Panelists through a conversation on the ways in which we can creatively create a different world that will help end the HIV epidemic. Thank you. Good afternoon and welcome. Bevy. Thank you so much, Chris. It's my pleasure to be here, and I, too wish we were in Puerto Rico. Welcome to the 2020 U. S. C. H. Plenary session, sponsored by Gilead Sciences as the great Reverend doctor Martin Luther King Jr quoted of all the forms of inequality and justice and health care is the most shocking and inhumane. Today is a critical moment. We have the opportunity to develop strategies and actions to establish inclusive public policies that protect the rights of healthcare professionals, patients and those living within the communities we serve now. This session will address how the medical community needs to give attention to black communities to reduce and prevent further disparities. Develop strategies to establish inclusive public policies that protect the rights of healthcare professionals, patients and those living within all the communities that we serve. We are excited to have a roster of distinguished medical professionals and leaders who worked tirelessly to strengthen our community and end this pan pandemic. I would like to welcome Dr Lisa Fitzpatrick, who we know as Dr Lisa. Welcome my Love. Dr. Lisa is a board certified infectious diseases physician, C. D. C. Trained medical epidemiologist. And there's the former medical director of the Infectious Diseases Care Center AH United Medical Center in Washington, D. C. Next up, we have to divine Rhonda Copeland. Rhonda is the president and chief executive officer of the Black AIDS Institute. In 2000 and 19 she was named one of the routes 100 most influential African Americans. Rhonda is an opinion leader and a seasoned advocate leading the charge and HIV and black communities last but certainly not least, Kendrick T Clack, Kendrick is a board certified family nurse practitioner with her nursing career that spans over 10 years. Kendrick is passionate about working in underserved populations and advocating for health equity, and currently serves as a director of clinical services. AIDS FOUNDATION Houston Now, let's hear from Dr Lisa. Yeah, thank you, baby. And it's so nice to be here with all of you to acknowledge the present. We really need to remember the past. The US has seen decades of an unequal distribution of wealth, which is rooted in slavery, as many of you know, if not all of you. And this has led to an historically traumatic relationship between medical institutions and the African American community. In addition, there impacts from stigma emanating from religious beliefs in their structural barriers, including poorly funded educational systems and a lack of comprehensive sexual health and relationship education. It's also important to acknowledge the historically traumatic relationship between medical institutions and the African American community, which has led to a lack of trust in research, public health and oftentimes, health professionals like myself. Appointing an example highlighting historical reasons for distrust of the medical establishment is a Tuskegee syphilis study, which I hope all of you know about this research study project began in 1932 and was conducted for 40 years. Participants were misled about the study, and we're not given penicillin to cure their syphilis, even when it was accepted as the standard treatment. The study was eventually terminated in 1972 after media exposure and public condemnation. But that wasn't the beginning or the end of medical mistreatment of black Americans moving ahead. Additionally, this has all been accompanied by mass incarceration, criminalization of black men and undocumented immigrants. And there have been significant barriers to health care access, including rights of uninsured people. Health provider shortage is reduced access to health care services and, in many cases, lack of services for a substance abuse prevention and treatment moving on. Of the 677 disproportionately black counties, of which 13% of the population there black Americans, 91% of them are concentrated in the southern U. S. And the South has relatively higher numbers of of the poor, uninsured adults than other regions. It has higher uninsured rates and more restricted Medicaid access and eligibility than other regions. But most notably of the 14 states opting not toe expand Medicaid. Nine of those were in the South, and as a result, over 90% of people in the coverage gap live in the South. And while of the 6 677 counties have high rates of unemployment, they also have high rates of chronic diseases like diabetes, heart disease and HIV, and these pre existing conditions player an important role and poor clinical outcomes from Kobe 19 across these counties. In addition, transport, social and health services air inadequate in rural areas, many of which you're in the south, and cultural factors that fuel stigma and discrimination are prevalent in places like these, where services are most needed. There is a slow adoption of the latest testing, treatment and prevention services. Moving ahead trauma. These events is embodied or help personally and maybe passed down for generations. Generational trauma often results in higher stress vulnerability, potentially impairing the ability to cope effectively with stressors. Stressful environments, conditions and conditions can leave an important mark or imprint at the cellular level, or what we call the F B genome. In addition, psychological and nutritional stress during pregnancy can lead to biological changes that predispose Children to negative health outcomes. And these biological and psychological expressions of historical trauma are likely contributors to the current health disparities we see. And this means trauma ultimately impacts the individual, the family and the community moving ahead. In recent months, the cove in 19 epidemic or pandemic has swept across the globe, bringing immense challenges, including for tens of millions of people living with or affected by HIV. Covert 19 is the most lethal pandemic since AIDS emerged nearly 40 years ago. Kobe, 19 has drawn attention toe longstanding issues influencing exclusion from health services. For example, the overlap of coronavirus hotspots with areas of higher incidence and prevalence of HIV point to a variety of social determinants of health, including access to care, education, employment, housing, discrimination, cultural competency and even quality of care, all of which have historically affected disadvantaged population. But I know you know this, but it's worth noting how Wachovia 19 is impacting the HIV response and it impacts the HIV response in three ways. First, the shift of the health system resource is to focus on Cove in 19 and national lockdowns has severely affected HIV treatment and prevention services, including interrupting care and increasing obstacles to accessing treatment and clinical services. Second, covet 19 has exacerbated challenges for people living with HIV and cue populations who are experiencing renewed stigma with evidence of increasing vulnerability to HIV in the l G B T i Community and third, the Kobe 19 pandemic is highlighting existing system level weaknesses in health care and supply chains which adversely affect people living with HIV. For example, disruptions of HIV services and supply chain are affecting large numbers of HIV programs in many countries. According to a survey, Disruptions to service delivery due to Cover 19 has affected 85% of the global funds HIV programs in 106 countries. And a model that shows a total interruption of six months of RT across Africa could result in an estimated 500,000 additional lives lost to HIV related causes. These data and experiences highlight how the overlap of the coveted 19 pandemic creates challenges for disadvantaged populations moving on, and this slide shows the disparities in the impact of Cove in 19 by race ethnicity, with a focus on impacts of covert 19 among African Americans. As you can see African Americans account for 12.4% of the total population, but 22.1% of deaths from Cove in 19. Very sobering information. And now I will turn this over to Kendrick Clack, who will discuss barriers that Dr Health disparities. Thank you, Dr Lisa. While the U. S population is becoming increasingly, ethnically, ethnically and racially diverse, and the minority segment of the United States will become the majority by 2044 people of color steel face structural and systemic barriers to access in health care in the United States in 1998 Melanie Travel on and Jan Murray Garcia recognize the changing demographics of the United States and asserted that there is a need to ensure that health health care providers have the tools needed to skillfully and respectfully negotiate the changing racial and ethnic diversity of the United States. You know, in 2020 many people ask for it to bring them clarity. It has brought mawr of a revelation. The cove it 19 pandemic and its disproportionate impact on minority communities has revealed the longstanding impacts of systemic health and social inequities on health outcomes among black and brown people in the United States. Next lot next slide. The impact of health disparities is multifactorial. People are not monolithic. We have complex lives and live in many intersections. Health disparities, adversity affect groups of people who have systemically encountered greater obstacles to health based on the following factors. Race or ethnicity, sex, sexual identity, eight disability, socioeconomic status and geographic location. We know that black folks and gay and bisexual man are disproportionately affected by HIV. We know that folks living in the South were more likely to be love of low socioeconomic status and uninsured, thereby limiting their access to care. And while folks who are disabled and our older age may be insured, there may have ridiculous deductibles that MP their access to care. Or they may not understand how to navigate our complex healthcare structure. All of these factors affect the person's ability to achieve good health. Over the years, efforts to eliminate disparities and achieve health equity have focused primarily on diseases or illnesses and on health care services. However, the absence of disease does not automatically equate with good health moving forward, um, or arch and influencer of health disparities. It's stigma, and unfortunately it is present and persistent among us as health care providers, some contributors or lack of awareness among health care providers of what stigma looks like And why doesn't that and why it is damaging. You have fear of casual contact standing from incomplete knowledge about HIV transmission. You have healthcare providers who associate HIV with improper or immoral behavior, and they possessed assumptions about clients based on their HIV status. Individuals must focus on the individual environment and policy levels at the individual level, increasing awareness among health care workers of what stigma is and the benefits of reducing it is crude is critical, raising awareness about stigma and allowing for critical reflection on the negative consequences of stigma for patients such as reduced quality of care and patients. Unwillingness to discuss their HIV status ended here to treatment regimens are important first steps in any stigma reduction program at the environmental level when the programs to ensure that health workers have the information, supplies and equipment necessary to practice universal precautions and prevent occupational transmission of HIV. And lastly at the policy level, we need policies, they're the base in recent science and not that of the past. The lack of specific policies are clear. Guidance related to the care of patients living with HIV reinforces discriminatory behaviors among health care workers. So what did we do to address stigma? Mhm. There are some practical steps that can be taken to help address stigma in the health care setting. We must first make sure that that we must first make sure that the forms that we have in our offices that ask about identity have options for right in. So the individuals can either write in their gender or race or sexual orientation. We must create spaces that are comfortable and accessible for everyone. We should have images that look like the populations we serve, and reading materials that a costly congruent. We must sit and reflect on the power structures that perpetuate through space design. Think about how you sit in front of your clients versus sitting next to them, which may make them feel more comfortable. Think about asking your client about their thoughts and their treatment plan, and if it fits into the daily routine when it comes to staff training, include everyone, including support staff. Make sure the janitorial staff know that we have bathrooms that are gender neutral for everyone and lastly, cultivate an environment of learning so that everyone feels comfortable about asking about training an additional information so that everyone can help patients. Other points to consider. If a client identifies their need for prevention medication as a provider, do due diligence together enough information, including sexual history, toe adequate. Assess the patients overall health and treatment needs if it's not something that you have to provide a wish to do. Find the referral. Not every woman who has sex with men identified his heterosexual and not every man who has sex with a man identified this homosexual. These assumptions may adversely impact individuals, access to care and desire to be engaged in care and lastly, stay up to date with new biomedical interventions and their reception in different communities. It does no good to have a tool and be infected ineffective, beginning to the people. I want to close with one of my favorite quotes from Dr Maya Angelou. People will forget what you said. People will forget what you did, but people will never forget how you made them feel. In my practice, I've learned to allow people a little grace and I encourage them to be my partner in creating their treatment plan. Now we will hear from a dynamic lady for a discussion on culture humidity. Miss Ronaiah Copeland. Thank you. I'm excited to speak here today. Andi, I think what we've heard thus far really highlights the flat. The fact that we as individuals, live in complex and interwoven systems. And there's work for us to do in dismantling systems of oppression that have been here since 16 19 when the first slave ships landed here. And what now we know is the U. S. And there's work that we can do as individuals on the individual level that we can do and how we interact with each other, How we look at the services that we provide and how we show within our humanity. Cultural humility is a really important part of that. Um, we as individuals have several different cultures that we go through on a day to day basis. Me as a black CIS gender woman living in Los Angeles is something that impacts the way that I view things and how I interact with the world. We have a role to play and how we interact with with each other, and cultural humility really supports and shapes our ability to respond to the individuals that we interact with and how we how we show up as individuals ourselves. The health care delivery system often involves a one size fits all approach, and we know that that one side that our health care system fits, like many systems that we have in the U. S. Is one that marginalizes the experience of black and other people of color. Practicing cultural humility allows us to be more aware of our own beliefs and values, and you can't be aware and understood understand somebody else's life without first being aware and reflective of your own background and situation. Looking forward, there are two concepts that go hand in hand when we talk about cultural humility. Cultural competence is supposed to be a tool for leveling imbalance. Patient provider dynamics and cultural competence is really focused on learning about culture and differences within culture. But one of the challenges with cultural competency is that what we've seen in data and in studies is that cultural competence uses competency measures that uses whiteness as what's understood and representing the norm and then cultural incompetence eases in, framed as a lack of knowledge about the other. So ultimately, you know, the goal of cultural competence is toe learn about others. Cultural background. We've evolved from cultural competency, and now we really talked a lot more about cultural humility. Cultural humility is really about a lifelong practice about regular inquisition. It's about including a deep awareness and understanding of historic, uh, realities like legacies of violence and oppression against certain groups. And there's no end point to cultural humility, right? You are gonna learn everything that you can learn about the trans community by going through, you know, a 90 minute training or a webinar. There's a constant learning that we have to have when we think about others, others, identities and even our own identities. Cultural humility is a very important step in a path towards becoming anti racist. We know that racism is ingrained into every system that touches our lives here in the US and really across the world. And so it is upon us as individuals and as community to become anti racist and cultural. Humility is a pathway is a part of that pathway towards becoming anti racist looking forward. Alright, So cultural competence, Um may have us thinking that, you know, you're the expert. You've been through the training, you understand the content and that's it, right? Um, it says I'm the expert. I know everything there is to know about black women living in the South. I've been through the webinar. I read that book I read. I listened to the PBS special in the podcast. Cultural humility, on the other hand, is always being open. It's always learning. It's always being inquisitive towards the services that we're providing. How do my own biases reflect in the work that I'm doing? How to my own biases as a black woman? Show them my engagement with other people? It's about how we constantly are evolving constantly having questions conversations is that constant reading that we're doing to make sure that there is, uh, that were constantly learning about anti racism work. They were thinking about how gender, sexuality, a socioeconomic status play a role in the individual clients life. I'd also add that cultural humility is really about helping us, uh, not just think about health care settings or patient provider interactions, but it's a concept of to infuse our daily life and apply at each step as we become more anti racist. Thank you for that. I will send it back to the organizer from there. But thank you guys so much for your presentations, and I'm incredibly thrilled to have a conversation with you all. So first question. How does a lack of cultural competency need to patient dissatisfaction? Dissatisfaction? Well, I can I can start. I'm sure other people have thoughts about this. It's a really provocative question because I think there are a lot of providers who actually don't believe it really matters. I think the biggest issue is it's linked to trust, and as much as sometimes people don't like to admit it, many paint and not I won't say all. But I will say many of my patients have opened up to me about things they felt more comfortable opening up about simply because I was a black physician and they were a black person, and there's something to be said for that understanding. Um, oftentimes they don't have to explain things because I understand the history and the background, and so that's a form of cultural confidence. I think that comes naturally. But you can also work to build your cultural confidence. And I think, um, is it Ronnie was talking about how you can You can work on cultural humility. Sometimes that means walking, you know, a day or even a few hours in the shoes of the people you're serving. And that gives you a lot of insight that you can take into the healthcare studying so that you are providing culturally appropriate care for people. Yeah, I would say, you know, cultural competency is a lot about, you know, learning on your own or understanding if you're working with a trans client that you have a foundational understanding around hormone therapy. Um, and the experiences they may have in the educational system and in the housing system and in the homeless, You know that all these different experiences they have that you haven't understanding of it. Um, and that's important, right? Because understanding that will help you think about how you talk about having medications and taking medications with your clients. Um, it helps you when having conversations. You know, if you understand childcare systems and the challenges around childcare when you're talking to, um, a woman with Children, you're gonna have conversation and understand how that impacts their, uh, their health care delivery plan. And then cultural humility, though, is also understanding that you are never going to be the expert in these communities, right? Um, that constantly be asking questions. You have to constantly be understanding and believing that the person who is in front of you is the best expert on their life. Andi, when you don't do that, particularly with black communities, um, you you deal with your I think you know, it's not speaking to the humanity of black folks, and it's also not really acknowledging the systems that we live in. And it's very kind of varied experiences, oppressive system that really impacts our daily life. So cultural competency, cultural humility are really important ways that we, as individuals, can impact, um, care for folks across the country. Yes. So moving on covert 19 has magnified and inequities in health care in black communities. Now, how has the pandemic heightened the sense of urgency to create a fair system for all? Because we've seen so much in the news about this. Um but I want to know about the action because we heard a lot of talk. I know, for example, what I have observed. What I have observed is the uptake of telemedicine. When previously there was all these barriers, it was a challenge and then covert came, and telemedicine and relaxing of all these restrictions that were in place were gone. And so I do believe that that's going to level the playing field for many people to have access to care so that I would say That's one of the things that I've noticed And I hope that persists after this is that we have equal access for telehealth. Yes, it's definitely a great improvement. Okay, I wholeheartedly agree about the uptake of telemedicine, but I think at the same time, and I've been practicing telemedicine during the pandemic, it's been interesting, um, to see that even though we are engaged in a lot more telemedicine, a lot of people actually don't really want it. They missed the the end person, uh, interaction and engagement, and I think that that's actually caught me off guard. It surprised me because I've always been a huge a proponent of telemedicine and because I think it's more convenient for people so however we emerge from this pandemic, I think it will be a combination digital engagement and in person engagement. But I wanna have a different comment related to your question about the action and I have the same question. I suspect there are some people out there watching this and they know me and they've heard me speak before. And so they know that I am much prefer action. It is also my concern, bevy, that this is a lot of talk and we will. We will not see much movement. So I really hope that this is a new moment. I have been asking people in my professional and personal circles if they feel like this is different and some say yes, it's very different. Um, even my my parents feel like it's different, but I think it remains to be seen because there's still a lot to do and we in many ways they're acting as if the data that have emerged from the pandemic are new or surprising and they wouldn't be too probably many of us. So let's hope that going forward we will see some drastic changes. I'm sorry, I'm if you could make it really quick because I actually have to move on to the next panel. I was just gonna say that one thing that I have noticed this different doctor, Lisa, is that people want more information than I've seen before. That people want to understand, You know? How big is this trial? What do you mean? This is evidence based. And I think that really empowering people to understand health and understand science is really important and something that we're seeing this a bit different. So that's an exciting change, I think. Yes, yes, yes. Because we're all about action. You know, we like to have these plan Aries. We love to have these important conversations, but, you know, pretty document section. I'm sorry. Bad and pretty Documents. Yes, exactly what? We want to see the action come into it. So thank you guys so much again for your time. Your work means so very much to us and to the community. And have a great evening. You know, all the things that we were talking about with cultural humility. That's something that's very, very key. I find in these spaces because we have so many people that come into these spaces who oftentimes wanna be seen a saviors and they don't understand that really health care has to be a partnership between the health care provider and also the patient. So, you know, while I do love telling medicine especially because my mom is 92 So it's very dangerous for the goingto doctors and things like that. I like that now. Her physician has been really kind of tapping in and asking us how we want to proceed. I very important also, the fact that we need more black doctors, black physicians, Um, and so you know what? I'm Rhonda. I'm gonna go back to you now in my love And let's just talk a little bit about some of the changes that we need to really see a Sfar As health care providers go in this space, Yeah, you know, one of the things that I didn't talk about, I think I may have skipped it was some of the challenges that we have with implementing cultural humility on Do you know we have the amazing Dr Lisa Fitzpatrick. We have Kendrick Clack who are great providers, but the number of providers who look like the communities that they serve are very, very limited. I know I go through my APs all the time trying to find my black doctor and how challenging that is, right? So we know that cultural humility. Part of that is about the identities that we have and how we connect with other people. And when you don't have people clinicians who look like the communities they're serving, that's a challenge within itself. But that challenge is about systems right that is, inadequate education systems in black and brown communities. That is a high suspension rates for little black boys. Um, that is not getting into, uh, schools that have great medical systems. That's only having how many How many, uh, hbcu have medical school? It's only a handful of them on DSO. You know, that's part of the systems change that need to happen. But not having um, service is not having enough providers that look like the communities. That service is a huge challenge. It also is a challenge when it comes toe mistrust, right? You know, when we have we have this huge amount of medical mistrust in black and brown communities and communities of color because, uh, path past atrocities. Dr. Lisa spoke about Tuskegee, but also current atrocities, right? You hear about ice? Potentially giving forced hysterectomies to people. Um, that doesn't make us feel confident when we go into health care systems. And so all of these things, um, really are blocks to cultural competency there, blocks to cultural humility. Um, that, uh, need change on a systems level, but systems change because of our advocacy in our actions. Individuals. Amen. Amen. Dr. Lisa, I would love to hear you chime in on this because, you know, you know, e think maybe in my entire life, I've had two female black physicians ever. Eso Dr Lisa. What? Some of the things that we could do as patients to try and find folks like you and, you know, and just really have people that can really connect with us. I mean, you know, I have several friends that are in the l g B t Q plus space, and you know, they have a hard time finding, um, doctors that are black and gay because, you know, oftentimes you're living in the south and things like that, and it's just not as many folks. So can you give us any kind of, you know, tips on how we confined folks like that. Well, this is a challenge, and and it's a challenge primarily because it's a numbers game. So while we recognize especially now, we're seeing a lot about the need to diversify the medical professional pipeline. But what do we do in the meantime? And I think in the meantime, because there aren't enough of us to go around, it's hard to find us, I think, in my lifetime. Uh, since childhood, I've probably had only one or two black doctors myself. So I think what we have to do is advocate for trainings and exposure like Miss Copeland was talking about. We have to ensure these types of principles and trainings are incorporated in the curricula for healthcare professionals, doctors, nurses, dentists and so on. Because they're just will right now for the next you know, 5 to 10 years there will not be enough of black and even Hispanic physicians and other health care providers to meet the needs of the community, and so we really rely on them to be humble and recognize they need to learn about how to provide appropriate care or underserved in black and brown communities? Yes, indeed. Uh, Kendrick, I want to ask you, how does the trauma of being black translate in the everyday lives of black communities? You know, we know that we're under much more undue stress than the rest of the population. You know, I think that when coronavirus really became such a great pandemic in our communities, we start seeing our numbers of depression like really skyrocket, right? So when I hear this question, I think about a quote from James Baldwin and it goes something like to be woke or to live in this country. Woke toe always been a constant state of rage. And I think about all the triggers that we have navigating this space in black communities. And Dr Lisa pointed to the EPA genome earlier on how these genes are remodeled throughout generations because of all this stress that we have therefore, lending to our diabetes hypertension are early deaths and things like that. So these things are not things that we make up. These are things that have been inflicted upon us time over time, and we pass those on off through generations. And so when we navigated into space. We're constantly have to figure out how to mitigate that, the trauma or the our reaction to that trauma when we go into different spaces. So I would say that when we were, um, the trauma that we have translates into always being hyper vigilant as we navigate these spaces or tinge of the imposter syndrome off self doubt asking, Do we belong in this space? But I wanna add to that. So when we hear all these conversations about the coronavirus and cove in 19 disparities, the racial disparities and then there's a quite a follow up question. Well, why is that happening? And so we come up with all these explanations. Were front line workers we can't practice social distancing, were more likely to have crowded households and so on. I haven't heard anybody talking about this issue related to how stressful it is to be a black or brown person living in America at Baseline eso. If you have chronic stressors that air unaddressed most of your life, your immune system is not as effectively going to combat something like a coronavirus than someone who doesn't have baseline high levels of stress. So I think the conversation also needs to include some interventions focused on mitigating this stress. So I want people toe, take deep breaths and practice yoga and meditate and pray and dance and go outside. So, yeah, I agree with you, Dr Lisa, I know for myself, as soon as the pandemic really hit by the end of March, I had gotten back into therapy because I knew I would need it. And thank God I did, because my dad passed away of coronavirus. So I mean, you know, and then I actually added as well. So there was just a lot of stress in my life. And then, of course, no jobs dwindle away and all that kind of stuff, But, you know, they go back to the medical professionals because I know that is such ah, big thing in our communities, you know, Oftentimes I feel like we can't attract people to come and serving our communities often enough because oftentimes we don't have the same amount of money that we can pay them. Oftentimes they're overworked. You know, as we all know, in our communities, the emergency room is often the primary care doctor, right? Eso how can we even attract the talent that we need to be in these communities. First of all, as you guys mentioned, we're not getting the same amount of doctors you know, out into the field. But then when they do go into the field, you see so many people not coming back into communities that are underserved. Mhm. Yeah, go ahead. I'll make a couple of things. One, um, I would put because this is a diverse audience, that seeing this and so I think there's depending on your identity. You have different roles to play in this. Andi, I would encourage folks who have positions of power. Um, to really think about cultural humility and reflect around how they perpetuate systems of oppression. Because that is all that we know. Onda, How do you, um, you know, if you are a white organization or led by a white person, Um, how do you think about how you get money, how you hire people, how you block smaller black and brown organizations from resource is because you have access, because you, um, have relationships that most times are based off white privilege and positional authority. And so I think that there's a role for, um, those who have white privilege to think about that in this space. And then I think, for organizations Andi people who are doing this work, who come from communities of color, that we have to start thinking about our work a little bit differently. Many times we're really just replicating what we've known. But again, we're replicating systems of oppression. And so how do we institutionalize mental health care in our organizations? You know, whether I guess I've seen innovation across the country. I've seen organizations that bring on staff therapists to do therapy with their staff to really try and support them. I've looked at I've seen organizations They're giving hazard pay toe individuals who are still doing HIV testing in community. I've seen organizations that provide educational reimbursement to really encourage their staff to go to school, to further their education, to advance forward. And so I think that we have to think about we as in black folks, we as a people of color, have to think differently about how we do this work in a way that is not based off of. You know, this kind of patriarchal. Get what you can as much as you can, but really more of a collective black space. And then I would only add to that from the from the health care provider perspective and how you get more people Thio engage in the community or toe want to serve our communities? A lot of this is a compensation in balance. So many medical students I come in contact with and I am faculty at the School of Medicine, G W mentoring medical students and a lot of them want to practice primary care. They care about this and G. W has a program that specifically introduces concepts around social determinants of health and population health to students, and many of them love it. But by the time they finished and they have accumulated so much medical debt, they go through their trainings and they see, Oh, wow, I could make this amount of money for half the work. You know, I think there's there's a challenge there, so we need to demonstrate how much we value and prioritize primary care and preventive services by paying people what we believe they their work and it's just not happening right now. So I think that's an area of advocacy that all of us could engage in. If we need Thio, we needed toe. Let the leadership of these organizations I know that it's really important to us that we have primary care providers that are not only representative of the community but that want toe work there beneath the incentive, um, toe work in our communities. Yeah, I'll just add to that also, that you mentioned the physician. But I also want to bring in the opportunity for more partnerships with nurse practitioners as well, because I know where there's a lot of state imbalance and a lot of infighting when it comes to, um, I guess, authority and agreements and things like that. So I definitely think there's opportunity for more partnerships to reach more people because there's enough people to provide health care for when it comes to primary care in this country. Amen. Yeah, yeah, very good point. Also, so many of our folks burned out as well, which, because the workload that I have several friends that are emergency room doctors and during this time I mean, I have a friend who now just took a year off because just working during the pandemic just burned out. Too much is we can burn out more than once. Yeah, exactly. Exactly. It's a real thing. It's a very real thing. So I'll find the question whether some of the best ways we can empower each other as allies to combat health disparities. Kendrick. So as I was saying, I definitely think the advocating for four practice authority in states where it may be lacking to allow more to create greater access for individuals to have primary care, I think would be a great role, a great way to empower individuals and create allies alliances among health care providers in the country. Dr. Lisa, I want to pick up on something this, Copeland said. And it was that the pandemic has created this hunger for trusted health and information. I'm very passionate about health, literacy and helping people understand health information. In fact, it's health literacy. Mom on. I think I want to make a plea to all of us as community members and to the community members we reach, uh, to be continued to be hungry toe, understand how we can help ourselves because a lot of the conversations I have nowadays or about how you know, black and brown and underserved people in this country have been struggling for for decades. And so if we want to move forward, whether it's our health or our wealth or whatever else, we have to be part of the solution. We have to drive the solution. And so I think looking after our own health, getting the information we need when we go to see health care providers, are we asking the right questions? Are we being curious eso that we have what we need to ensure were healthy? Thank you. Well, on your last but not least, my love, you're gonna call yourself. Yeah, I would say two things. The first thing. Um, I believe in black empowerment, and I believe in black leadership. And I believe that everything we need I think that we already have and so that if we is black folks, if we is the communities most impacted um, speak up, act up. Tell folks, why are there no black healthcare professionals at this place? I'm a post on the Facebook group posted on the yelp page. And I keep on telling you every time I come here and then we all have space. We all have privileged, we all have power and we all have agency that we can have to keep on acting up. This is not the time to be silent. If anything, I think one of the things we've seen over these past few months is how much can change when we want that change. When we push that change, we will allow for nothing less. And so I would say the first thing is we have that power. Let's act up in that and let's speak up all the time in every space that we're in. And the second thing is we also have to pour into each other because that takes a lot of work and burnout Israel and that we have to figure out how we can celebrate each other, how we can celebrate ourselves individually and take time. Our movement needs us on DWI can't do that when we are not okay on. Do you have to prioritize your own mental and emotional health at the same level because we want to see if we want to be here for the win. We want to be here for the success and so making sure that we make it there together is really important. And then I couldn't agree with all of you more. Thank you so much, Dr Lisa Kendrick. Rania, You guys have been incredible. I'm so sorry that we're not able tohave Karamo joining us, But I know he will come back again. But you were definitely missed. My love s Oh, thank you so much for the participation in the very honest conversation during this session. Out. Thanks. Must go to Gilead Sciences and U S C H. A have worked so tirelessly to make it all such a success. I'll go today with the highlight the need for intersectionality between the global black lives matter, movement and health care within black communities. And so I'm so glad that we have this candid conversation with medical and cultural experts to shine a light on how we can work collectively to educate black patients about health disparities and come up with concrete solutions to produce better health outcomes. And that includes self care. Right, Rana? Mm. Now, thank you for attending. Please visit the Gilead scientists exhibit booth by heading over to the lobby. Please join us now at our homecoming, Virtual Happy Hour with great music by deejay Carroll and a special performance by the fabulous Broadway star and drag race alumna Peppermint. Just follow the link in the main agenda on U. S. C. H A dot life. Thank you so much. I'm Bevy Smith. It's been my pleasure to be a part of this. Created by
