0:01

The legacy of racial segregation

0:04

as relates to the COVID pandemic is

0:06

that hyper segregated cities

0:09

served as ground zero

0:11

in terms of the mass spread of

0:14

COVID nineteen in America.

0:16

If we didn't have American

0:18

apartheid, if we didn't have racial segregation

0:20

to that degree, it would have made it much harder

0:23

for COVID to really pick up and

0:25

spread in a mess kind of way. That's

0:29

Dr Lawrence T. Brown, director

0:31

of the Black Butterfly Project, Drawing

0:34

on as many years of social science research,

0:36

policy analysis, and archival

0:38

material, Dr Brown recently published

0:41

his first book, The Black Butterfly, The

0:43

Harmful Politics of Race and Space

0:45

in America, a fascinating look

0:47

at the ongoing historical trauma caused by

0:49

a combination of policies, practices,

0:52

systems, and budgets which are at the

0:54

root of uprisings and crises

0:56

in hyper segregated cities around

0:58

the country. But there is reason for hope,

1:00

as Dr Brown offers up a wide range

1:03

of innovative solutions to help heal and

1:05

restore redlined black neighborhoods

1:07

across this country. We

1:09

also hear from Dr Brian Smedley, co

1:12

founder and executive director of the National

1:14

Collaborative for Health Equity, a project

1:16

that connects research, policy analysis,

1:18

and communications with on the ground activism

1:21

to advance health equity. In this

1:23

role, Dr Smedley oversees several

1:25

initiatives designed to improve opportunities

1:28

for good health for people of color

1:30

and undo the health consequences of

1:32

racism. The way that healthcare

1:35

resources are distributed here in

1:37

the US is deeply inequitable. Often,

1:39

those communities that are sickest and in greatest

1:42

need of access to health care

1:44

services and culturally appropriate services

1:47

in their community simply don't have that

1:49

access. So the big takeaway

1:51

for me is that nations

1:54

that cooperate together, that show

1:56

a level of social cohesion and

1:59

solidarity, will do much better

2:01

in stopping the spread of the virus than

2:03

those communities characterized by deep

2:06

divisions, such as here in the United

2:08

States. I'm

2:12

Justin Beck, founder and CEO of

2:14

Contact World. I'm here with my co

2:16

host Katherine Nelson and dep Pava,

2:19

and over the coming months we'll be talking to scientists,

2:22

researchers, celebrities, experts,

2:24

anyone who's been affected by COVID and

2:27

getting to the bottom of how we can improve public

2:29

health together. We may not have all

2:31

the answers, but you deserve to understand what

2:33

goes on in your neighborhood and the decisions

2:35

that will affect you and your family's health. Welcome

2:41

back everybody to Contact World. So

2:43

today we're gonna hear from Dr Lawrence T. Brown

2:45

and Dr Brian Smedley. Previously,

2:48

we've talked about, you know, the political

2:50

determinants of health and the way

2:52

that politics have influenced public

2:55

health. But it was interesting to learn

2:57

how segregation in America

2:59

has actually caused this proliferation

3:01

of COVID nineteen. It makes

3:03

a lot of sense that we're in the position we're

3:06

in because things that affect

3:08

marginalized communities affect everyone. And

3:11

it was interesting the intersection

3:13

between these two conversations because on

3:15

one hand, we don't have data because we've

3:18

been trying to ignore the data, right, we've

3:20

been trying to sweep it under a rug, because

3:22

our country has an absolute history

3:25

of racial segregation and

3:27

it has caused a lot of the problems

3:29

that we're experiencing today.

3:32

Justin you bring a very interesting point

3:34

that I found personally very revelational.

3:37

In the midst of the crisis, our

3:39

understanding of this inequity was delayed and

3:42

remains limited because many

3:44

health care institutions, as well as state

3:46

and the federal government, they were still

3:48

to capture the demographic information on

3:51

COVID nineteen because the health equity

3:54

data was not available. And

3:56

one of the most crucial things is a

3:58

data to an approach that can be used

4:00

to address this very racial disparity

4:03

in the health care outcomes. And

4:05

data does make a difference because unless

4:08

you can measure something, how can you even

4:10

think about solving that? Right? Yeah,

4:13

and I agree with you, but I think there is

4:15

some sort of acknowledgement, especially

4:18

by the current administration. And

4:20

what I enjoyed the most about both interviews

4:23

is that they both had

4:25

some positive policy changes

4:27

and that's where we're going to see the difference. And

4:30

one example of that is the Health Equity

4:32

Tracker project that Daniel Dawes

4:34

was leading, and they're starting to tackle

4:36

the data issues surrounding

4:39

the pandemic and health equity

4:41

and it does really start with a commitment

4:43

to saying, hey, we have to find the data

4:46

in order to address the problems. It's

4:48

was one into transparency in my open and

4:50

it's really about transparency and having

4:53

integrity that you will not use the data the way it

4:55

should not be used, and again

4:57

building trust within the governments, within

4:59

the healthy institutions, within public institutions.

5:02

But one has to acknowledge

5:04

that segregation by design is happening,

5:06

and only then we can make afoot towards

5:09

conquering this problem. We're

5:11

in this position because we defunded

5:14

public health and yet we expect these

5:16

heroes to perform more than a

5:18

miracle and trying to get us out of this situation.

5:21

But the concept of a community health workforce,

5:23

I think is a really strong one because

5:26

if we're expecting marginalized communities

5:29

to strictly sign up online and

5:31

that's the only way that they're gonna get vaccinated, we're

5:34

missing the point that these

5:36

digital divides are going to continue to create problems.

5:38

So community health workforces,

5:41

whether it's through the Heroes Act or

5:43

whether it's through Biden's new executive orders

5:45

around improving public health infrastructure,

5:48

is really exciting to think about. Yeah,

5:50

and also it conveys the seriousness

5:53

and it's less remote when you tell

5:55

someone you have to log into a website

5:57

and you know, I'm sending my information over

6:00

the airwaves. I don't know where it's going to home.

6:02

But if there's an actual human knocking

6:05

at my door, speaking to me directly, then

6:07

I'm more inclined to cooperate.

6:10

It conveys the seriousness but also the human

6:12

interest. You know, whoever is

6:14

in that community is going to feel looked

6:16

after and cared for, as opposed to

6:19

the desensitized way of your on your own

6:21

you go and you know, register and if

6:23

you don't, then good luck. If

6:25

you don't have a computer, or if you don't have access

6:27

to the internet, I guess you know, you

6:30

just drew the short stick there. I

6:32

love your comment. You're cutting and that reminds

6:34

me of one of the conversations that I've had long back

6:36

with the last Smile health care worker, and

6:39

he told me that, you know, sometimes

6:41

we just talk about technology all the time solving

6:43

these issues. There are places and there are

6:45

people for them. Even pen

6:48

and paper is technology, and

6:50

humans are capable of using that

6:53

and bringing that access.

6:55

We are trying to achieve through technology.

6:58

So if there is a hybrid solution that we can come up

7:00

with, that's what is going to solve the problem

7:02

in a sustainable way. All right, let's

7:04

dive into these powerful conversations and hear

7:06

from two of the most knowledgeable experts

7:09

in this field. Hello,

7:21

Dr Brown, it's a pleasure to meet you.

7:23

Hello, thank you so much for taking the

7:25

time to talk with me today. And can

7:28

you tell us a little bit about your background

7:30

and what led you to write The Black Butterfly.

7:33

Well. I was born in

7:36

well Memphis, Tennessee. We lived in West Memphis,

7:38

Arkansas. Left there my

7:40

family. We went to the Houston area,

7:43

went to moor House after graduating in

7:45

nine seven and major

7:48

in African American studies. And across the

7:50

street from moor House was a public housing

7:52

development called Harris Holmes

7:55

and they were in the third phase of uprooting

7:57

people as a part of Clinton's Hope six

7:59

project, which involved demolishing

8:02

about a quarter million public housing units.

8:05

And so I think it was there that I really

8:07

sort of begin to question policies

8:10

of displacement and how

8:12

and why African Americans are being uprooted,

8:15

and I wanted to know more about, like how

8:18

government played a role in that. So my

8:20

master's degree was in public administration

8:22

at the University of Houston, where I

8:24

picked up that thread to try to understand

8:26

a little bit more about community development. And

8:29

then I got interested in the health

8:31

angle of community development.

8:33

So I went to University Tennessee Health

8:36

Science Center where I obtained my doctorate

8:38

and health outcomes and policy research. After

8:41

finishing it led me to Morgan

8:43

State University in Baltimore, where I

8:45

worked on my post arctro fellowship became an

8:47

a social professor. My research

8:50

kept looking at, you know, how neighborhoods

8:52

impact health outcomes, and that whole

8:55

through line really led me to this book,

8:58

right, And was the initial

9:00

interests to satisfy personal curiosities

9:03

or did you already have a plan in

9:05

mind that this is something that you're gonna work on

9:08

and educate the public as you are doing

9:10

right now. I mean, I think it more

9:12

or less developed organically. I don't

9:14

think I had a master plan in mind, but

9:16

I think you can see how

9:19

one interest, one degree

9:21

kind of led to the other. You know, I

9:23

grew up well, my hometown West

9:26

Memphis, Arkansas's is small. It's

9:28

like thirty thou folks, and the

9:30

county is rural. Arkansas is very rural

9:33

state. And so it's just thinking about

9:35

the impact of space on people's

9:37

health and the impact of how

9:40

space is racialized and how that

9:42

impacts people's health was something that

9:44

I think was there from

9:47

the beginning, just in terms of always being interested

9:49

in, like urban policies, what makes a

9:52

space, you know, be the way that it

9:54

is now. And so with all of the

9:56

cities that I lived in, you're talking about Baltimore,

10:00

Memphis, or West Memphis, Arkansas, Atlanta,

10:02

Georgia, Houston, Texas, and

10:04

so it's just you know, really sort of getting a good

10:06

sense of how these

10:09

different cities meant you have

10:11

different outcomes, and then if you lived in different

10:14

neighborhoods in those cities, you had different

10:16

health outcomes. You know, my background

10:18

and my intellectual interests led me to

10:20

this work. And through your work, how

10:23

do you see the legacy of racist

10:25

policies in cities throughout

10:28

the nation as a contributing factor

10:30

to the disparities of experience throughout

10:33

the COVID nineteen pandemic. Well,

10:35

I mean the biggest contribution

10:38

of urban policy to the current

10:40

pandemic is the municipalization

10:43

of racial segregation. So the ways by

10:46

which racial segregation was

10:48

shaped in urban areas. Baltimore

10:50

Mayor John Barry Mohole, he passed the

10:52

first residential racial zoning

10:54

law in American history on December nineteenth,

10:57

nineteen ten, and so you

10:59

have cities in

11:01

the early nineteen hundreds, they

11:03

were still building out their sewer systems, they

11:06

were still building water filtration to

11:08

clean water, they were still connecting

11:11

water lines. Many

11:13

homes they didn't have plumbing, they didn't have

11:15

clean water, they didn't have sewer systems,

11:18

which meant that they were breeding grounds

11:20

for infectious diseases like influenza

11:23

or like tuberculosis, especially

11:25

yellow fever cholera. So those are

11:27

diseases that were high at the time. But

11:31

the way in which municipalities

11:34

were allocating resources

11:36

to white neighborhoods and white blocks

11:39

and not allocating those two black neighboroos

11:42

or black blocks at the time, that

11:44

had a tremendous impact on the

11:46

infectious epidemics then, and

11:49

then you go further in time

11:51

to where we are today, it has a big

11:54

impact on the COVID

11:56

pandemic. Now, do you think

11:58

these allocations were in sorts

12:01

intentionally depriving

12:03

the minority communities or

12:05

was it maybe disproportionately done

12:08

Well, it was absolutely intentional. Number

12:10

one, race was the reason. Like

12:12

in Baltimore, you saw in the Baltimore Sun,

12:14

I talked about in my book, how the Sun

12:17

kept putting this headline out and their articles

12:19

Negro invasion. There's a Negro

12:22

invasion homebuying while black black

12:24

people are coming. And so they weaponized,

12:27

they used propaganda to

12:30

cause white Baltimoreans to

12:33

engage in the counter offensive against

12:36

black homebuyers. And you see

12:38

public health actually being used

12:40

as a rational for racial segregation.

12:43

The fact that black people had a higher

12:45

rate of tuberculosis and

12:47

other diseases, that was a reason

12:50

to then segregate them. In effect, it

12:52

was a neighborhood quarantine.

12:54

So you see in the Baltimore Sun again

12:57

and other newspapers, how the

13:00

discourse of data and the way

13:02

in which Black people were stigmatized

13:05

and demonized based on these health

13:07

disparities. Given the

13:09

intentionality that you see

13:11

both with newspaper headlines with

13:14

the implication of public health, with

13:16

other media that we're really spreading

13:19

about the time, like the Birth of a Nation by

13:21

D. W. Griffith, which glorifies

13:23

the Kukus Klan, you can

13:25

see how race is intentionally

13:28

being used as a ration

13:30

now to effectuate racial

13:32

segregation. And then if you want to look at Jessica

13:34

trouns Things book Segregation

13:37

by design. She shows empirically

13:39

that that more racial segregation that

13:41

you see in the city, the less

13:44

public resources, the fewer public goods

13:46

are being allocated per capita

13:49

in those cities, and definitely in

13:51

those cities to black neighborhoods. What

13:54

would you say has been the most profound

13:56

impact of these type of policies

13:58

on health vector is during this pandemic.

14:02

Firstly, we had the introduction of the virus,

14:04

so you had California, I believe Seattle,

14:07

if I'm not mistaken, cruise ships they

14:09

sort of brought the virus to the

14:12

nation. But after the virus

14:14

arrived, then it hit hyper

14:16

segregated cities the hardest. New York

14:19

is a Category four hyper

14:21

segregated city, and I used category

14:23

like a hurricane as an analogy. Detroit

14:27

was hit hard, Chicago was hit hard. Those two

14:29

are Category five hyper segregated

14:31

cities. That's the highest form of racial

14:33

segregation that we have, and

14:35

so these cities were hit really

14:37

really hard early on. If you recall March

14:40

in April of last year, hyper segregated

14:42

cities were the first hit. So the

14:45

legacy of racial segregation

14:47

as it relates to the COVID pandemic is

14:50

that hyper segregated cities

14:52

served as ground zero in

14:55

terms of the mass spread of COVID

14:57

nineteen in America. If

14:59

we didn't have American

15:01

apartheid, if we didn't have racial segregation

15:04

to that degree, it would have made it much harder

15:07

for COVID to really pick up

15:09

and spread in a mass kind of way.

15:11

What else have you seen as far as the tangential

15:14

consequence of lockdowns depleted

15:17

economies? For example, you mentioned

15:19

the city's Chicago and New York,

15:22

the lower opportunity streams on these

15:24

communities of colors throughout this crisis.

15:27

There should have been universal basic income.

15:30

There should have been a massive infusion of

15:33

resources from the federal government that

15:35

would actually have allowed people to stay

15:37

home then in a

15:40

concentrated way. Instead, we had a

15:42

president at the time that was

15:44

talking about reopening by easter and

15:47

that the deaths would be under a hundred thousand

15:49

or under sixty thousand at first, and here

15:51

we are now approaching five hundred thousand.

15:54

We didn't lock down long enough. I

15:56

argued that capitalism was going to actually

15:59

work against our ability to fight

16:01

this virus. We needed to develop

16:04

a strong response that was gonna

16:07

help renters, help forty

16:09

million people that were thrown into unemployment.

16:11

Initially, we need to have a

16:13

strong response to effectuate the type

16:15

of lockdown that was needed, and we did not

16:18

do it. So that is what has

16:20

set up the tangential impacts.

16:22

We did a half hearted lockdown, and

16:25

we haven't really made any sort

16:27

of strong effort around economic recovery.

16:30

We had a lot of big businesses spelled

16:32

out, but in terms of regular people,

16:34

they got that one two thousand dollar

16:36

infusion, I believe back in the summer

16:38

of last year, and that just wasn't

16:41

enough. And so we're

16:43

actually, I think getting ready to

16:45

see much more economic

16:47

impacts that are going to be destructive

16:50

in so many lives for a long

16:52

period of time because we did not

16:55

arrest our instincts to be

16:58

this capitalist country at the outset,

17:00

and so we're gonna deal with the issues on the back end

17:03

with the new administration. What are your thoughts

17:05

on, you know, the direction that we're

17:07

taking now. Do you feel that there are appropriate

17:10

measures being taken? Well, I mean,

17:12

certainly the new administration is, you

17:14

know, a breath of fresh air. You know, they's just getting

17:16

their feet on the ground. But I think there

17:19

has to be a lot more again, I think they're talking

17:21

about maybe four hundred or adding four hundreds

17:23

to the six hundred in terms of the next

17:25

COVID stimulus package for people that's

17:28

not universal basic income. Universal

17:30

based income is two thousand a month,

17:33

so I'm talking about universal basic income to

17:35

access secure people's financial

17:37

needs. And then, even though there is

17:39

a rental moratorium,

17:41

I believe that President Biden is trying to extend

17:44

now past the March deadline. You

17:46

know, I think we need to go a lot further because

17:48

not all states are honoring that rental

17:51

eviction. Their courts are not honoring it. So

17:53

we need to really have a strong,

17:56

nationwide you can't get out

17:58

of it strategy that allows

18:01

people to stay where they are, not be put

18:03

out of their homes. I think you've got to

18:05

put things in place to really stabilize

18:07

housing and stabilize

18:10

people's income so that you

18:12

don't have I think the wave of desperation

18:14

that's going to come after that moratorium

18:16

is lifted, because the rent is going to be

18:18

do and you're gonna have an eviction

18:20

crisis. And then if

18:23

everybody is vaccinated at that point,

18:25

you're going to see a spike in COVID.

18:27

So all of this has to work together otherwise

18:30

we're never going to get this virus under control. Right,

18:33

And you speak of desperation,

18:36

do you feel that some

18:38

of the communities of colors are in

18:40

essence feeling desperate

18:42

for the help that they should have gotten, with

18:45

the help that they should be getting, and

18:47

how do they take steps to get

18:49

that help. I think there is

18:52

desperation, but in

18:54

many ways, community of color are

18:57

really masters of resilience, and

18:59

so you may not see it. And

19:01

the fact that people are dealing with deaths and

19:04

contracting COVID. I know my family,

19:07

I've had over ten members in Southern

19:09

States, you know, contract the virus, including

19:11

my two grandparents. So it's

19:13

hard to be engaged, I think on the policy

19:15

front side of it while you're

19:18

dealing with folks that are in the hospital,

19:20

dealing with folks in your family that

19:22

are you know, passing away,

19:24

whether it's due to the disease or in the aftermath

19:27

of it. So we're trucking

19:29

along in terms of the room

19:32

and the space to deal with the policy front.

19:34

I don't know that the advocacy is

19:37

as much there as

19:39

it should be. But you know, in the middle of a global

19:41

pandemic. When you're at the bottom of the social

19:43

hierarchy, you know, that's gonna be tough

19:46

to do now. At the same time, there

19:49

was the action that was taken on election

19:52

day. So

19:54

you did see black voters in cities

19:56

like Atlanta, Philadelphia, Chicago,

20:00

Pittsburgh, Detroit come

20:02

out and support a new administration

20:04

in part because they wanted a better

20:07

COVID response. You know, you saw Latino

20:09

voters in Nevada and Arizona.

20:12

Native American voters in Apache

20:14

County and Navajo County in Arizona

20:17

helped put President Biden over the top.

20:19

So there was maybe

20:22

to even counteract my own point, there

20:24

was that movement to actually

20:27

say, hey, we want a different president in part

20:30

because we want a better COVID response.

20:32

There was that policy push. I want

20:34

to make sure I highlight that. Yeah, it's

20:36

that resiliency on top of their their

20:38

own survival instincts. Yes, how

20:41

do you see the terrain ahead for vaccine

20:44

distribution, contact tracing

20:47

and other interventions? And

20:49

I know this is just kind of broad, but you

20:52

know, how do we build trusts with our communities

20:54

of color, How do we establish

20:57

fairness in the distribution of the

20:59

vaccines? Tell me your thoughts

21:01

on those. Well, what I'm seeing

21:03

right now is a failure to engage

21:06

in vaccine administration equitably.

21:08

You have white people coming in from

21:11

other neighborhoods into black and brown

21:13

neighborhoods to get vaccinated before the black

21:15

and brown people that live in those neighborhoods.

21:18

That story you're seeing in Detroit and Philadelphia.

21:20

They gave a twenty two year old white gentleman,

21:22

they gave him a contract to deal with COVID,

21:25

and they skipped over the black doctors

21:27

who have their own organization that I have

21:30

built trust and that should have gotten

21:32

a contract like that. So you're seeing

21:34

the administration of

21:36

the vaccine this inequity

21:39

in terms of both whereas being

21:42

distributed. If you look in the state of Maryland,

21:44

demographically wider counties are getting

21:47

more vaccines per capita than demographically

21:50

blacker counties. Then you have the

21:52

fact that the primary mode of vaccine

21:55

administration is to have people sign up online.

21:57

Then those people living in those redline

22:00

marginalized sub prime communities

22:03

that are dealing with digital device they're

22:05

going to be left out. So I foresee

22:08

the continuation of what we're seeing

22:10

now vaccine apartheid unless

22:14

we actually engage in the strategy that

22:16

I think we should do, which is

22:18

I believe the Heroes Act from

22:20

last year should be passed the creation

22:23

of a national Community health worker

22:26

workforce. I would hire a

22:28

hundred thousand community health workers

22:30

and I would have my community health workers working

22:33

with nurses and physicians, medical

22:35

professionals going out to

22:38

communities, not waiting until people

22:41

come into the hospital, come into the

22:43

vaccine site, come into

22:45

you know, the stadium where you have it set up,

22:48

or drive through when everybody don't have a car.

22:50

You need a group of folks gonna

22:52

go out and I don't care if they have to go door

22:54

to door. You should have people going

22:57

out to make sure the vaccine is a ministered

23:00

in those communities that are really struggling,

23:02

making sure they have the access that they need,

23:05

and build trust along the way because

23:07

a lot of people they may say

23:09

no right now, but that no could

23:11

be a wait and see. I'm gonna wait and see,

23:14

but maybe in three months I might say yes.

23:17

So that's another reason you need to community health

23:19

work is to be out communicating, out

23:21

discussing, showing their face,

23:23

having conversations. That's the

23:26

kind of interaction, that

23:28

relationship building that's

23:30

gonna be needed, and you need people to do that,

23:32

not technology, not the

23:34

internet. The way we're doing it now is not gonna

23:36

cut it. Yeah, I understand that. In

23:39

our previous episode, we're talking to

23:42

Dr Yasmin and she was explaining how

23:44

there needs to be some level of atonement and

23:46

acknowledgement of wrongs from the

23:49

past in order to build that trust.

23:51

As you mentioned, Absolutely, I

23:54

wanted to ask you about you

23:56

kind of touched on it a little, but you've

23:59

had family you who have been hospitalized

24:01

because of COVID nineteen. First

24:04

of all, has everyone recovered to

24:06

my knowledge, yes, everyone has recovered.

24:08

Like I said, my grandmother passed several

24:11

months later, and I understand it was from heart

24:13

failure, not COVID. Sorry for

24:15

your loss. Absolutely, I

24:17

celebrate her life. And even

24:19

though she recovered and died

24:22

later. You know, COVID still

24:24

has impacts people in their cardiovascular

24:26

system and many systems, even

24:28

the neurological system.

24:30

My grandfather when he was hospitalized,

24:33

he didn't remember who his wife

24:35

was, for instance, and later regained

24:37

his memory. So we're very thankful for that. We've

24:40

heard that you've described the medical system

24:43

as raggedy throughout your experience.

24:46

Can you elaborate on that? Yeah,

24:48

I mean the home health care workers you have to

24:50

call in Arkansas, I had to call

24:52

to you know, arrange that and make sure

24:54

that took place. You know. It's also the case

24:56

where in those smaller rural

24:59

counties like Lee County, Arkansas

25:01

doesn't have a hospital. The hospital

25:04

in Critton County where my grandparents

25:06

lived, I think had six beds for

25:08

I see you cases. So these

25:10

are rural counties that you know, if you get

25:13

ten cases, that's a spike that

25:15

a lot of counties cannot handle if they don't

25:17

have that real health infrastructure. And this

25:19

is America, the wealthiest country on Earth, and

25:22

we can't have health care infrastructure

25:25

for our people. That's why I

25:27

called it ragged. It's a shame and it's

25:29

a hot mess trying to compensate

25:33

as an individual for these systemic

25:35

failings and lack of funding.

25:38

You know, there's been the discussion the

25:41

protests over defunding the police,

25:43

and what I want to point out to

25:45

a lot of people is that we've been defunding

25:48

public health for decades and

25:50

that is why we are in a situation

25:52

now where we're relying on private

25:55

corporations like a Walgreens and

25:57

the CVS to minister vaccines.

25:59

Why do have to rely on them if you have a good public

26:01

health system? Because we don't, and

26:04

not because it's not good as in the people

26:06

aren't trying hard. Is that we deeply

26:08

underfunded, We defund public

26:10

health in this nation. You know,

26:13

if you just dropped in from another planet,

26:15

if you look at COVID data, you would

26:17

say, well, America is the developing country.

26:19

There's no way it could be the most advanced,

26:22

wealthiest country on Earth. But in

26:24

fact it is. Based

26:26

on your background and everything that you've described that

26:28

you've done, you're an expert.

26:31

So what would your top list for policy

26:34

initiatives be at addressing

26:36

the issues and the disparities that

26:38

we've seen so far? Okay, Well,

26:40

for COVID, I'm looking at spatial equity

26:43

testing early on and the vaccine

26:45

administration. Now, if your main

26:48

locations are in wealthier,

26:50

wider communities, that's

26:52

not spatial equity and racial equity.

26:54

You can't have racial equity without spatial equity because

26:56

America is so segregated. So

26:59

where are your testing sites? Where are your vaccine

27:01

administration sites? If they're not in red

27:03

line sub prime low income

27:06

communities, you've already failed

27:08

spatial equity in the response. Like

27:10

I said earlier, Number two, community

27:13

health workers, community health workers. Community

27:15

health workers got to have an outreach

27:17

component, not just to come see us component.

27:20

And then number three is that internet

27:23

can't be your only strategy.

27:25

In fact, I'm not sure it should be much

27:27

of a strategy at all,

27:29

given the way we've seen people gain the

27:32

system, people coming from wealthier,

27:34

wider communities, colonizing

27:36

the vaccine supply, gentrifying vaccine

27:39

administration. Those are the top three

27:41

things that I would look at shifting from internet

27:44

to person based through community health workers

27:46

and with a spatial equity approach, those would

27:48

be my top three for COVID overall.

27:51

You know, health equity is

27:54

important, but alongside health equity,

27:56

we have to have social solidarity.

27:59

And what is that social how there is realizing

28:01

that this whole country is in this

28:04

mess together. Even though the

28:06

deaths are disproportionate among communities

28:09

of color, you still have a huge percentage

28:11

of white people dying from this, and so

28:14

the thing is we're all in this. So whatever

28:17

good programs and strategies

28:19

that we need, universal basic

28:21

income, this community health worker core that

28:23

I'm talking about, having spatial

28:26

equity in the response. These things

28:28

are going to be helpful to everybody.

28:30

So so this just has to be like

28:33

a strong mutual aid outreach,

28:36

you know, working to get folks vaccinated

28:39

and in a holistic way that when you're

28:41

dealing with people on the COVID

28:43

front, you're also checking to make sure that their

28:46

other needs are being met. You know, how

28:48

do we set up a strategy where everyone's

28:50

going to be having their needs

28:52

met holistically? Absolutely? Dr

28:55

Brown, It certainly has been an enlightening

28:57

conversation to speak with you

29:00

and care about the work that you've done and

29:02

how you're shedding much light to a

29:05

lot of important areas and key

29:07

issues. Do you have any final thoughts

29:09

to share with our listeners. The

29:12

biggest thing is, you know, our issues

29:14

as a nation right now are really rooted

29:16

in American apartheid, and

29:19

American apartheid is a system

29:22

that was set up via racial segregation,

29:25

colonization, uprooting communities,

29:28

particularly Native American, Latino

29:30

African American communities. So we

29:32

have to have equity, we have to center

29:34

equity, but at the same time we

29:37

need to also uplift, social

29:39

solidarity, the fact that we are

29:41

all in this together. White people are dying too.

29:44

We want to make sure that every community has

29:46

what it needs, and if some communities

29:48

need more, we need to allocate more to

29:50

those communities. So COVID then

29:52

can be a turning point

29:55

for America where we recognize what

29:58

is really bedoubling us, what is

30:00

really destroying so many lives in this

30:02

country. Because even when you get rid of COVID,

30:04

you're still going to have those other epidemics.

30:06

You're still gonna have deep poverty,

30:09

You're still going to have the four regions in our

30:11

country that are really struggling, the

30:13

Southern Black Belt. You're still gonna have Appalachia

30:15

struggling. You're still gonna have Native American

30:18

tribal lands in the US Mexico

30:20

border counties. So these are all racial

30:22

geographies where

30:24

we have tremendous inequities, and

30:27

you realize that Appalachia means

30:29

a lot of poor white people are in

30:31

that mix. And so that's what we're saying.

30:33

We're saying everybody, everybody

30:36

needs to be on board if we're

30:38

gonna make this country the country that it should

30:40

be instead of lagging behind

30:43

in so many indicators. Very

30:45

well said a great summary. I love

30:47

what you said about social solidarity. I think

30:49

that probably should be one

30:51

of those buzzwords out there that we should all

30:54

be adopting and talking about. Thank

30:56

you for taking the time. Thank you, Bye

30:58

bye. M What

31:01

an honest and insightful conversation

31:04

with Dr Brown, and for anyone

31:06

who needs to understand why communities of

31:08

color in this country continue to struggle

31:10

for access to some of the most basic health needs,

31:13

health needs that so many of us take for granted,

31:16

I encourage you to order his book, The Black

31:18

Butterfly. Now coming

31:20

up, we'll hear from Dr Brian Smedley, another

31:23

torch bearer and lifelong advocate

31:25

for health equity. Hi.

31:38

Brian, it's a pleasure to have you on our show

31:40

today and thanks for making the time so.

31:43

Brian, you are the co founder and

31:45

executive director of National

31:47

Collaborative for Health Equity, a

31:49

project that connects research, policy analysis,

31:52

and communications with on the ground activism

31:54

to advanced health equity. And

31:56

you have been carrying the torch

31:59

for actually said every years now on

32:01

undoing the health consequences of

32:04

racism. Tell me something

32:06

more about your personal motivation

32:09

to start this health equity initiative

32:11

in general, and also what got

32:13

you working on these topics. What's your personal story.

32:16

Well, first, thank you so much for having me. You know,

32:18

health equity is something that we should all

32:20

be concerned about, but I'm personally very

32:22

deeply invested in it. I come from a

32:25

line of people who have committed themselves

32:27

to racial justice work. My mother

32:29

is the late anthropologist Dr Audrey

32:32

Smedley, who wrote quite a bit about the concept

32:34

of race and how it originated here

32:37

in North America, essentially to subjugate

32:39

and exploit, of course, indigenous

32:41

populations and then enslaved Africans

32:43

and so forth. So that's really

32:46

the roots of today's

32:48

health and equities, and given

32:50

my mother's scholarship, given the kinds

32:53

of things that I've observed in my lifetime, such

32:55

as being born in Detroit in

32:58

the nineteen sixties, a city that was going

33:00

through considerable demographic change.

33:03

When I was a little boy, we moved

33:05

to a neighborhood on the west side of Detroit

33:07

that was somewhat integrated, but

33:10

like a lot of other cities in the United States,

33:12

as African Americans began moving into the

33:14

neighborhood, white people began to leave

33:17

in significant numbers to the suburbs.

33:20

And that's the roots of modern

33:22

day racial segregation, which I have

33:24

focused a lot of my work on because it's

33:26

actually at the root of many

33:28

of the health and equities that we see, particularly

33:31

those inequities between

33:33

African Americans and whites. Most

33:35

people don't recognize the role

33:37

of residential segregation as

33:39

being foundational to health inequities.

33:42

And moreover, most Americans don't recognize

33:44

the role of government and actively

33:47

segregating and separating different

33:49

racial and ethnic groups and perpetuating that

33:51

segregation up until nineteen

33:54

sixty four when those practices were

33:56

finally outlawed. So really my

33:58

work is about addressing that asking legacy

34:00

of a structural form of racism,

34:03

which is residential segregation, and

34:06

the role of government and many other actors

34:08

in creating and perpetuating that segregation,

34:11

right, I mean, it takes me to one of the common

34:13

topics we discussed with Dr Brown on our

34:15

podcast as well, the impact of housepiece

34:18

that is racialized is impacting

34:20

people's health. And there's also I think a book which is

34:22

Segregated by Design that really examines

34:24

exactly the topics that you're kind of talking about, and touching

34:27

on you're also

34:29

the Chief of Psychology and the Public

34:32

Interest with American Psychological

34:34

Association, and you're leading

34:36

a PAS efforts to apply the science

34:38

and practice of psychology to fundamental

34:40

problems of human welfare and social justice. What

34:44

would you like to touch upon these

34:46

topics being kind

34:49

of used in terms of the context

34:51

of the pandemic right now, you know, in the last year,

34:53

and how they may be different than what it

34:55

used to be in the past in terms of

34:57

how you've been doing your own work and the challenge

35:00

to sit on deck. Well, we're

35:02

certainly in in our lifetimes unprecedented

35:04

times with the pandemic. We've seen

35:07

that the pandemic has upended so many

35:09

aspects of life and tragically has

35:11

cut many lives short. The

35:13

pandemic really just reflects existing

35:16

inequity. Those populations

35:18

that have been marginalized politically, socially,

35:20

economically typically are most vulnerable

35:23

to infection. They have higher mortality rates.

35:25

So here in the US context, African

35:28

Americans, Latin X populations, American

35:30

Indian populations, and many others

35:33

have been hit particularly hard by

35:35

the pandemic. So our effort

35:37

at the American Psychological Association and other groups

35:39

working in the racial equity and health equity

35:41

space is to simply uplift

35:44

this inequity. It's my contention

35:46

that we will not get out of this pandemic

35:48

unless we center and prioritize

35:50

equity concerns. No reason for this

35:52

is pretty simple. You can't leave any community

35:55

behind and expect that we're all

35:57

going to be okay and healthy and

35:59

that we're going to ltimately defeat the virus. If

36:01

we leave behind those folks

36:04

who are frontline essential workers, folks

36:06

who are working in nursing homes

36:08

and other settings, who are disproportionately

36:11

themselves black and brown immigrant folks,

36:14

if we leave these communities vulnerable, then

36:16

we will all ultimately be vulnerable.

36:18

So we need to address the needs of those most

36:20

marginalized in those most at risk,

36:23

and to prioritize how we

36:25

go about reducing risk. So

36:27

we know, for example, that we all have to practice

36:29

good public health practice wearing masks, washing

36:32

hands, physically distancing, but in

36:34

some cases, in communities of color, for

36:36

example, those are very difficult to do, particularly

36:39

if you have overcrowded housing or

36:41

people working in settings where it's difficult

36:43

to physically distance. We have to prioritize

36:46

the concerns of those communities if we're

36:48

going to ensure that none of us

36:50

are at disproportionate risk and that we can

36:52

all ultimately come out of the virus

36:54

healthier and stronger. Right, I

36:56

mean, the topics you touch upon a very valid and

36:59

actually quite and focus in news

37:01

these days as well. And and I believe

37:03

one of the missions of you know, your Health

37:05

Equity Collaborative is to set up a

37:07

promote health equity by harnessing data.

37:10

And I just want to bring that aspect of data

37:12

here. And you know, I read a federal study

37:15

that found that raise and ethnicity

37:17

data is missing for nearly half

37:19

of coronavirus vaccine recipients,

37:22

and this lack of data is leading to an inequitable

37:24

response to the pandemic, which is

37:26

of course, you know, continuing to undel your burden communities

37:29

of color as well. In fact, the

37:31

Biden administration created COVID

37:33

nineteen Health Equity Task Force has

37:36

also an ambitious promise there of

37:38

an expansion of equity data collection.

37:41

So, first of all, your thoughts on that, and

37:43

secondly, do you see these solutions to

37:46

such challenges in terms of equity data collection,

37:48

which has a major role to play here. Yes,

37:50

that's a wonderful question. Most folks

37:52

would wonder, well, why data collection doesn't

37:55

sound very sexy? How does that help solve

37:57

this problem of this virus epidemia?

38:00

Oology one oh one tells us that we need

38:02

to collect data, very thorough and comprehensive

38:04

data to understand where the virus is spreading,

38:07

which communities are getting hardest hit.

38:09

And unfortunately, when the pandemic

38:11

hit, we had a very weak and ineffective

38:14

federal response. It left it to many of the

38:17

states to be able to forge

38:19

strategies going forward, particularly with respect

38:21

to data collection. We have fifty

38:24

plus different approaches to data

38:26

collection being used among the states, but we

38:28

need comprehensive and complete data

38:31

collection on things like demographic information.

38:33

We need to know who's testing positive

38:36

by race, ethnicity, socio economic

38:38

status. Data such as income, our education

38:41

would be helpful. Where do people live

38:43

places obviously critically important to understand

38:46

the distribution and spread of the virus.

38:48

Are folks with disabilities disproportionately

38:51

affected? Are people who are gender

38:53

or sexual minorities disproportionately

38:55

affected? We simply don't have the

38:57

data, but we need to know this information

39:00

so that we can target strategies to

39:02

help communities to reduce their risks.

39:04

We need data on who is getting tested,

39:07

who's testing positive, who's

39:09

getting hospitalized if necessary, and what

39:11

kinds of treatments might they be receiving.

39:13

We need data on vaccines. We know

39:16

that vaccine acceptance there's

39:18

quite a bit of variation across different communities,

39:20

and there's a long history. That's a whole another story.

39:22

But unless we have the data to understand who's

39:25

getting vaccinated, again, it makes

39:27

our public health response ineffectual.

39:29

It makes it difficult for us to target strategies

39:32

to ensure that we're getting vaccines,

39:34

for example, where they're desperately needed.

39:37

Again, this is something that's going to ultimately

39:39

be of concern for all of us if

39:41

we want to contain the spread and ultimately

39:43

defeat the virus. Right, I mean,

39:45

all of that makes complete sense in order

39:47

to be able to understand the population, to be able

39:49

to address the solutions towards it. Right

39:52

to that extent, would you have any examples

39:55

or maybe initiatives or something that is

39:57

in the planning where you could talk about

39:59

data to and innovations in this health equity

40:02

space to understand

40:04

how communities are responding to vaccine

40:06

availability. We need data. We need

40:08

to be able to understand new

40:10

applications such as artificial intelligence.

40:12

How does that help target vaccine

40:15

distribution where it's needed. For example,

40:17

in some cases, artificial intelligence

40:19

may be not helpful, particularly in the racial ethnic

40:21

context, as there's some data to

40:24

indicate that artificial intelligence

40:26

may be operating differently on the

40:28

basis of race ethnicity in the

40:30

US. We need to be very clear about

40:32

how we can best harness technology

40:35

and where there may be risks with new

40:37

technologies such as AI, other

40:40

than the commonly talked about issues like lacking

40:42

data and infrastructure. Because of the inequities

40:45

in the system, What fragilities

40:47

have highlighted or exposed most

40:50

within these martialized community ecosystems

40:52

during the pandemic In specific,

40:55

how do they relate to psychological

40:57

well being of people. We've

40:59

seen that the pandemic has exposed

41:02

so many inequities and so many risks,

41:04

but the psychological risks are profound.

41:06

We have a combination of economic

41:09

anxiety given the economic disruption

41:11

of the pandemic. We have fear

41:13

of infection or transmission of the virus

41:16

to one's loved ones or family members or

41:18

others in the community, and then

41:20

we have had accompanied with the

41:22

pandemic a resurgence of

41:24

intolerance and expressions of hate. The

41:27

Asian American community here in the US,

41:29

for example, has been disproportionately targeted

41:32

and victimized with assaults

41:34

both a verbal and physical in

41:36

both virtual and physical spaces. Clearly,

41:40

we are in a very stressful time at

41:42

the a p A. We've been predicting a

41:44

mental health tsunami emerging

41:47

as a result of the pandemic and the associated

41:49

stresses, and what it highlights

41:51

for us is the need to rebuild

41:53

the mental health infrastructure. Sadly,

41:56

over a number of decades, we have disinvested

41:59

in the public health and of structure and mental health

42:01

infrastructure here in the US, and

42:03

so we need to rebuild that because clearly

42:06

the mental health consequences that

42:08

we're experiencing right now are deep and profound

42:11

and could have significant implications

42:14

for the overall health status of populations,

42:17

for our ability to recover from the economic

42:19

downturn, and just to be resilient,

42:21

to have our communities be able to draw

42:24

upon sources of strength and resiliency

42:26

to help them emerge from the pandemic stronger.

42:29

So the mental health consequences

42:31

have been significant, and we are

42:33

desperately in need of ways to improve

42:36

our ability to provide services. You

42:38

asked about innovation and technology earlier.

42:40

One such innovation is the increase

42:43

in telehealth and tele mental health

42:45

here in the US, whereby

42:48

people who are seeking psychotherapy,

42:50

for example, can find a provider

42:52

and can interact either over a

42:54

video chat or telephone line. And

42:57

this significantly reduces geographic

42:59

barriers to accessing therapeutic

43:02

services. But it also from an equity

43:04

standpoint, reduces many cultural

43:07

and linguistic barriers. So if a

43:09

person is seeking, for example,

43:11

Spanish language mental health services, but lives

43:13

in a community where no such

43:15

providers are available, that person

43:18

can simply look across

43:20

the state where they live in and attempt

43:22

to access services from qualified

43:24

providers. So it opens up new

43:27

opportunities for seeking

43:29

assistance, and from an equity standpoint,

43:31

that kind of innovation is critically important.

43:34

Yeah, you bring in a lot of interesting topics

43:37

here, but one of the things which

43:39

often strikes me is US is

43:42

facing public health crisis on a level

43:44

not experience for more than a hundred years

43:46

now, right, it should be reasonable

43:48

to expect that all citizens

43:50

can rely on their government and health

43:53

institutions to protect them. But

43:55

for many Black Americans and communities

43:57

of color trust in the girl and

44:00

does not come easy. That you kind of touched upon it as

44:02

well, right, What would

44:04

you say is the reason for that? You

44:07

know, we have a long history and a sad

44:10

history here in the US of abuse

44:13

at the hands of the scientific and medical establishment.

44:16

We've seen that African Americans have been

44:18

abused in public health research,

44:20

such as in the infamous to Skegee

44:23

experiments, where African American

44:25

males who had contracted syphilis were allowed

44:27

to go untreated so that researchers

44:29

could understand the long term effects

44:31

of syphilis. Clearly unethical

44:34

and something that should never have happened

44:36

and should not happen today. So you

44:38

have that history, plus you have

44:40

the fact that there are so many

44:43

structural inequities. The way that healthcare

44:45

resources are distributed here in

44:47

the US is deeply inequitable. Often

44:50

those communities that are sickest and in greatest

44:52

need of access to health care

44:54

services and culturally appropriate services

44:57

in their community simply don't have that

45:00

excess. Adding on top of that, the

45:02

fact that the United States remains a nation

45:04

that is focused on market based healthcare

45:06

delivery. That means we have no uniform

45:09

national strategy for providing health insurance

45:11

coverage. We have no uniform national

45:13

strategy for looking at where

45:16

we need to have our doctors, nurses, clinics,

45:19

hospitals, etcetera. So we in

45:21

fact have multiple systems, many

45:24

of which merely replicate the inequities

45:26

that already exist. So there

45:29

are many lessons to be learned about

45:31

the proper role of government and

45:33

ensuring that we all have a basic level

45:35

of protection. And I'm very hopeful that

45:38

despite the tragedy of the pandemic, that we

45:40

will learn those lessons that there

45:42

is a role for government to ensure a basic

45:45

level of access to health care and

45:47

basic level of public health services,

45:50

and many other countries of course ensure

45:52

that all populations have at least some minimal

45:55

level of access to care. Right.

45:58

I mean, it's very relevant point that you talk

46:00

about the role of government and how they can make

46:02

it more accessible in the health care.

46:05

But this brings me to another very important point,

46:07

the fact that marginalized communities

46:10

and the communities of color are more

46:12

than ever now aware

46:14

of these disparities in the health care system,

46:17

and now they're more than ever are aware that

46:19

they receive lower quality of care. Right

46:21

and during the pendiment, we often heard voices

46:24

coming out and speaking about the topics.

46:26

So this is not only the mistressed

46:28

part, but it's also a level of awareness

46:31

and retaliation at times even right,

46:34

So, is there a way we can manage

46:36

and handle this mistrust, so to

46:38

say, fear among these communities through

46:42

better engagement, better communication.

46:45

And here I would in particularly like you to leaven

46:47

into your expertise in psychology

46:49

and behavioral science as to how to take

46:52

corrective measures here. Sure,

46:55

to your point, we know that there are steps that

46:57

we can take to ensure that people have

47:00

reliable, trustworthy information

47:02

about the vaccine. So, for example,

47:04

given high levels of mistrust in the African

47:06

American community of the medical establishment

47:09

and many other communities as well, we know that

47:11

there are some things that we can do. First, begin

47:13

to work with trusted community leaders

47:15

and advisers, folks who are working at

47:18

the grassroots level, be they working in

47:20

community based organizations, nonprofit

47:23

organizations, civic organizations, faith

47:25

institutions, and many others. Working

47:27

with our trusted leaders to provide

47:30

accurate information is critically

47:32

important. We also need to ensure

47:35

that we're working closely with community groups

47:37

to understand what are the concerns that

47:39

communities may have about accessing the

47:41

vaccine. We need to better understand

47:44

how do we ensure that we're meeting

47:46

other needs that communities may have. It's not just

47:48

related to vaccines. We need to

47:50

ensure, as I mentioned earlier, that we're all

47:53

adopting good public health behaviors,

47:55

and so all of this is tied together

47:58

in terms of understanding trust not

48:00

just in government, but in all of our civic

48:02

institutions. So that's why it's important

48:05

to begin to work with those trusted

48:07

leaders that are already present in communities

48:10

and are already drawing upon sources

48:12

of strength and resiliency that

48:14

already exists in these communities. It's important to

48:16

note that even though we're talking about

48:19

communities that are in many cases politically,

48:21

economically, and socially marginalized,

48:24

these communities have tremendous sources

48:26

of strength and resiliency that

48:28

we need to draw upon in times of

48:30

crisis like this. As very

48:33

often it's said that you know, you often listen to

48:35

the voices of your own communities, and you have to tap

48:37

into that rather than coming it as

48:39

top down and personally. I work a lot

48:41

in human centered design, and I also believe

48:43

that you have to also tap into the moral intuition

48:46

and values of these communities to be able to communicate

48:48

with them in what resonates

48:50

with them best. Right, let's think

48:52

about COVID as a trigger, you know, right

48:54

now, I mean since March last

48:56

year, a few things changed. The nature of work

48:59

changed, onto exchanged. We

49:01

know that people of color and marginalized people

49:03

were, you know, disproportionately impacted. It's

49:05

a known fact now, partially

49:07

because they were the essential workforce during

49:10

the pandemic and they were vulnerable to this exposure.

49:13

Another thing that changed was the nature

49:15

of education. We move from in

49:17

person to remote learning, and then the

49:19

differential access to broadband

49:21

and strong technology, you know, that enabled

49:24

people to connect and learn differently, where

49:26

marginalized populations again got left behind.

49:28

Right now, this is systemic and

49:30

I am just trying to bring that to the health

49:32

equity perspective here in the context

49:35

of vaccine distribution. We

49:37

see this trickle down in the way the vaccine

49:39

distribution is being done at this point in time, where

49:41

there is a digital divide. Now,

49:44

where does the entire health

49:46

equity initiative can play

49:48

a role here in terms of reaching the

49:50

people where they are who

49:52

have very limited access to technology.

49:54

For instance, do you have any solutions there? This

49:58

is such an excellent question because you're hying

50:00

together again many of the pre existing

50:02

inequities and disparities

50:04

in terms of access to broadband internet,

50:06

for example. These are all issues

50:08

that were critically important before the pandemic,

50:11

and we're seeing how much worse it's gotten.

50:13

You mentioned things like children

50:16

learning remotely. There's some evidence that

50:18

the kids are falling behind, and again

50:20

this disproportionately falls on the

50:22

backs of children of color. When

50:25

we're talking about health, generally, the

50:27

best predictor of your health status as an individual

50:30

is your educational attainment, your educational

50:32

level. And so we have left these children

50:35

behind who are most vulnerable at

50:37

this time and who experienced

50:39

many challenges to remote learning. In

50:41

some cases, we have challenges

50:43

with family care and child care that may interfere

50:46

with children's learning, inequitable access

50:48

to broadband as you mentioned, and then

50:51

the challenges of children not

50:53

having adequate nutrition. In many cases

50:55

we have children receiving breakfast

50:58

lunch at reduced or low cost

51:00

or no cost. So these are all deeply

51:03

tied together, and you've asked

51:05

about solutions. There are some really

51:07

interesting innovations happening in terms of

51:10

remotely bringing broadband to

51:12

those communities that lack that access,

51:15

ensuring that children can go to centers

51:17

in communities, for example, where they can much

51:19

more easily access broadband

51:22

and at the same time get some of the

51:24

nutritional and social services that

51:26

they might need. So even though in

51:28

some cases schools are not open

51:30

or are on a hybrid schedule, or

51:33

in other cases schools are just now

51:35

returning to in person learning,

51:38

we have to ensure that we're addressing

51:41

the gaps that have occurred in the time

51:43

where students have been out of school, so

51:45

ensuring that their opportunities for remediation

51:48

and helping children to get caught back up. All

51:51

of these things pose tremendous

51:53

risk for these children individually in terms

51:55

of their opportunities in life and

51:57

their health outcomes. Broadly, but at all so

52:00

affects all of us as a society, as

52:02

a community because again, to the extent

52:04

that we leave these kids behind is

52:06

to the detriment of the entire society.

52:09

Tell me one think, how could

52:12

you or how we as

52:14

a system rethink race

52:17

or racism in the context of health equity,

52:19

and in particular use of

52:21

psychology to make a positive impact

52:23

on these critical site issues. First,

52:26

we need to acknowledge the global presence

52:28

of the belief in human hierarchy, a

52:30

false notion that assigns value

52:33

to some and denies value

52:35

and opportunity for others. And here in the

52:37

u S context, of course, European

52:39

descendants are considered to have value.

52:42

The reality is that as a society,

52:45

we allocate much more in the way

52:48

of societal opportunities to

52:50

children of European descent, while

52:53

systematically posing barriers

52:55

to opportunity for kids of color. Psychologists

52:57

have been studying this phenomena

53:00

for many years, and of course, psychologists have pioneered

53:02

the notion of implicit bias, the

53:04

fact that people, even those with egalitarian

53:07

views and who are deeply anti

53:09

racists, may harbor biases

53:11

that they're not consciously aware of that are automatically

53:14

activated when we're confronted

53:16

with difference, whether it's difference on the

53:18

basis of skin color, gender, language,

53:21

or any number of other factors. So

53:23

psychologists have tried to help the general public

53:25

to understand how these processes operate

53:28

and to help us understand that race is

53:30

in fact a social construct, but

53:32

racism is very real because

53:35

of the tendency for humans

53:37

to believe in forms of

53:39

hierarchy. These, of course, are ideologically

53:42

driven. No child comes into the world

53:44

believing that one group is superior

53:46

to another, but rather how we allocate

53:49

socidal resources, the cultural narratives

53:51

that we hold. The kind of world

53:54

that we create for kids of color is

53:56

often very different for white kids, particularly

53:59

here in the United States, and these children see

54:01

that they understand who

54:03

is valued and who's not when they see those

54:05

kinds of conditions. So we need to do much

54:08

more to help people to understand the fallacy

54:10

of race. There is no biologic or

54:12

genetic underpinning to the

54:15

notion of race. These so called

54:17

races that we have identified are purely

54:20

social myth. But rather, what

54:22

we have done is to create a society

54:24

where people are valued differently

54:26

on the basis of things like skin color, hair

54:29

texture, et cetera. Children see

54:31

that it's reflected in the inequities

54:33

that we see across a range

54:35

of different outcomes, and it's

54:37

my firm belief that we are making progress

54:40

towards helping people in this society

54:43

understand the fallacy of race,

54:45

but the reality of racism

54:47

and importantly how destructive racism

54:50

is for all of us. I believe if

54:52

we keep pushing to raise

54:54

this level of awareness, ultimately

54:56

this will help us to lay a

54:58

foundation to create it a more egalitarian

55:01

society, as we have stated, that

55:03

is our goal. So true, Brian, I

55:05

mean, I agree with every word you said

55:08

right now, because it's really the biases that you've

55:10

kind of built in. And one is working on the systemic

55:12

and the infrastructure part of it and the government role

55:15

that is to be played here. But I think the other

55:17

part is also really the biases

55:19

that we have to fight from within. And in

55:21

the context of all we've talked about

55:23

today, does any you know initiative

55:26

from government or local level,

55:28

federal level, state level, or any other

55:30

country in the world you have witnessed

55:33

where the government has

55:35

risen to the recent challenges in particularly

55:38

productive way. Well,

55:40

we've certainly seen wide variation

55:42

globally in how governments are responding.

55:45

We've seen wide variation in the

55:47

pandemic spread. We all

55:49

can learn quite a bit from New Zealand,

55:51

which has had great success

55:54

in first getting the

55:56

inhabitants of the country to cooperate

55:59

to work together other to do those

56:01

public health behaviors that we

56:03

know from science are important, wearing

56:05

a mask, washing hands, physically distancing,

56:08

and yet we still have resistance

56:11

to that science. In the United

56:13

States, we have people who believe it's a matter

56:15

of their personal freedom to

56:18

not wear a mask, you know, that

56:20

kind of stance. While it may be ideologically

56:23

comforting for some flies

56:25

in the face of science, and so we have to

56:28

come to a reckoning. We can either hold

56:30

onto our ignorance and be willfully

56:33

proud and demand that we have our so called

56:35

freedoms to behave as we

56:37

wish, or we can recognize

56:40

that our behavior affects

56:42

others in our communities. So just

56:44

as we have certain freedoms, we

56:46

also have many responsibilities to

56:49

understand how our behavior affects

56:51

others in our community. Same

56:53

issue with vaccines. The more people

56:55

that we can get to accept the vaccine,

56:58

the more progress we will make toward reducing

57:00

the spread. But the big takeaway

57:02

from me is that nations

57:05

that cooperate together, that show

57:07

a level of social cohesion and

57:10

solidarity, will do much better

57:12

in stopping the spread of the virus

57:14

than those communities characterized by deep

57:17

division such as here in the United

57:19

States. I mean, you touch to a very

57:21

interesting topic here, and I'm forced to ask

57:23

this question, which is around

57:25

science. Right, it's absolutely critical

57:27

in the pandemic response that you know, this

57:30

push against science, anti

57:32

access movement for instance, or also

57:34

not people not wearing masks, or some even

57:36

believing that COVID nineteen doesn't even exist.

57:38

Right, So this scientific fact

57:41

versus misinformation leading

57:43

to apprehensions. What is the

57:45

rule of psychology here? And I mean the

57:47

psychological dimension of the pandemic.

57:50

You know, there are a number of psychologists who have studied

57:52

public health communications. How do we

57:54

ensure that our messages are being

57:57

heard accepted, and that we

58:00

are conveying accurate information?

58:02

Who needs to convey that message? There's

58:04

quite a bit of science on this topic, and so

58:07

we need to be prepared to deploy

58:10

those lessons learn from that science.

58:13

We know pandemics tend

58:15

to elicit some of the worst

58:17

aspects of our tendencies as

58:19

human beings. Pandemics create anxiety,

58:22

They tend to turn neighbor against neighbor.

58:25

They tend to make us distrustful. And

58:27

if we already had a level of distrust in our

58:29

institutions that tends to get worse during

58:31

the pandemic. So understanding

58:33

that yes, we are going to have

58:36

factions, we're going to have divisions during

58:39

a time of extreme anxiety, but

58:41

understanding that there are ways that we can address

58:43

that anxiety and come together,

58:45

and again understanding that our

58:48

ability to cooperate, to work

58:50

together toward our goals as communities,

58:53

as a society is going to be far

58:55

more constructive towards

58:58

flattening the curve. As we say, then

59:00

the divisions that we've seen, so

59:03

this is often hard to convey, and those

59:05

sentiments that are solidly

59:07

anti science, as you've indicated, are

59:10

difficult to change. But if we can

59:12

help people to understand again our collective

59:14

responsibility and what we need

59:16

to do to protect each other, our families,

59:19

our communities, most people would

59:21

be motivated by that kind of information

59:24

and would take the kinds of steps that are needed

59:27

to ensure that we understand our responsibilities

59:29

to each other right totally.

59:32

Bang on, the strategic health communications

59:34

is something that we need to invest in, Brian,

59:37

there were amazing insights. We're very

59:39

interested in humanizing our shared

59:41

experiences, and here, beyond

59:43

your academic work, how

59:45

has the recent pandemic affected you,

59:47

your family, your friendships, any

59:50

stories there. Sure,

59:52

for my family, as with many other families,

59:54

it is challenging. Right. We're unable

59:56

to travel, we're unable to see friends

59:59

and family as we once did. But those

1:00:01

are relatively minor concerns compared

1:00:04

to what some other families have gone through. So many

1:00:07

families have tragically lost loved

1:00:09

ones or have had people get very

1:00:11

sick in their families. I'm so fortunate

1:00:13

that we have not had that experience in

1:00:15

my family, and my heart goes out

1:00:17

to those who have had those kinds of tragic

1:00:20

experiences. The best thing that we can

1:00:22

do for each other is to understand that even

1:00:24

though we must be physically

1:00:26

distant, we need to be socially

1:00:28

together, and thankfully there are many

1:00:31

many ways to do that with technology

1:00:33

today. We need to ensure that

1:00:35

we are expressing care for each other.

1:00:38

We need to ensure that we're communicating

1:00:40

with each other, checking on what we might

1:00:42

need. Again, even as we're

1:00:44

physically distancing, we need to be

1:00:47

socially showing solidarity.

1:00:50

Right. I love the message they're like, we need to be socially

1:00:52

together and that's what is important in these current

1:00:54

times. Thanks Brian for your insights

1:00:56

and for all the work you are doing that

1:00:58

contributes to building the capacity for public

1:01:01

health to advance equity. And I'm

1:01:03

particularly a fan of one of your

1:01:05

initiatives within your Health Equity Collaborative,

1:01:08

which is the Culture of Health leaders. I

1:01:10

mean, we need this foundational leadership

1:01:12

development for people who want to advanced

1:01:15

health equity, and and we need to prepare

1:01:17

and inspire people to provide this transformative

1:01:20

leadership to address health equity in these communities.

1:01:22

So thank you, thank you for doing all the work,

1:01:24

and thank you for speaking to us. Thank you so much

1:01:27

for having me. Racism

1:01:32

is a public health issue. It's

1:01:34

been a humbling experience to talk

1:01:37

about issues of racial segregation and

1:01:39

health equity in America through contact

1:01:41

world truth and health. We

1:01:44

can't hide from truth. We

1:01:46

can't hide from these issues or pretend they

1:01:48

don't exist. Black and brown people

1:01:50

are disproportionately affected by disease

1:01:53

because our system designed it that way.

1:01:56

If I hear one more white person say

1:01:59

all live matter, as if anyone

1:02:01

said or suggested otherwise, I'm going

1:02:03

to pop. While I'm embarrassed

1:02:06

about some of our history, I'm equally

1:02:08

passionate about doing my part and

1:02:10

our part as a company with Contact

1:02:13

World to fix a broken system.

1:02:16

We have to improve health equity in this country,

1:02:19

and most of what's broken comes down to racial

1:02:21

injustice dating back more than one years.

1:02:25

If you deny that, you're part

1:02:27

of the problem. If you allow racism,

1:02:29

even passive racism, to happen

1:02:32

around you, you need to stand up

1:02:34

to it and speak out against it.

1:02:36

Being silent is being complicit.

1:02:40

I'm proud to be part of this movement to reduce

1:02:42

health disparities and eliminate structural racism

1:02:44

in this country. Thank you for being

1:02:47

a part of that too. We'll see you

1:02:49

next time on Contact World Truth and Health,

1:02:51

We're going to talk about data genocide

1:02:53

with a troublemaker who speaks

1:02:56

on behalf of our American Indians and

1:02:58

Alaska Natives. Listen

1:03:03

to Contact World of podcast on the I Heart

1:03:06

Radio app or wherever you get your podcasts.