By Every Measure episode 6 transcript

Below is a transcript of episode six of By Every Measure, Radio Milwaukee’s new podcast exploring systemic racism in various sectors of Milwaukee, looking closely at how those systems were formed and how they can – and need – to be changed.

Trevor Noah:

The unfortunate truth is that the Black community is being slammed by Coronavirus right now.

Tarik Moody:

That's Trevor Noah, host of The Daily Show.

Trevor Noah:

So, while almost every industry around the world is shut down, it looks like racism is still considered an essential service.

Tarik Moody:

Sometimes, especially when things seem really dark, comedians can put things in perspective.

Trevor Noah:

Yes, I know this is depressing, especially right now. I mean, you don't want to deal with Coronavirus and racism at the same time. It looks like two Marvel villains coming into one movie. We don't have enough heroes.

Tarik Moody:

I'm Tarik Moody, and this is By Every Measure. We are nearing the end of this podcast series and we're talking about one of the most important things we have as people, our health. This episode is coming out during a global pandemic. So it's so relevant now to be talking about health and healthcare. At publishing time, Wisconsin, has seen a huge spike in Coronavirus cases. Made national headlines as number two state for new cases in the country. Across the nation Black people are more than three and a half times more likely to die of COVID-19 than White people, and that's according to a report from the Center for Infectious Disease Research and Policy. But the fact that these racial disparities popped up right away in the pandemic as early as March, should be no surprise. In fact, at a press conference in 1966, Dr. Martin Luther King, Jr. stated, "Of all the forms of inequality, injustice, and health is the most shocking, the most inhumane because it often results in physical death." On this episode, we're going to examine these disparities in depth. That's where we start with our cohost Reggie Jackson.

Reggie Jackson:

This is our final episode health, which is kind of a interesting way to end it because if you think about it, policing, housing, education, the wealth gap all plays a role in health. Bad housing, education, the lack of resources in the schools, racial wealth gap can cause stress and can't afford healthcare, policing dealing with the stress of being pulled over and mental health issues. All of it leads down to this. You shared a quote from MLK, that I thought was cool on your article the Impact of Racism is the other Coronavirus Crisis for People of Color.

Reggie Jackson:

For me, this article is very personal in terms of my rationale for writing it. It goes back to a story with my aunt, my mother's youngest sister, years ago. She still lived back in the hometown in Mississippi and she got really, really sick. She went to see the same doctor that she's seen for years in my hometown in Mississippi and he just kept telling her it's nothing serious. It's not that bad, blah, blah, blah, all of this, right. And of course people trust their doctors. So she just continued to deal with it and she would tell my mother what was going on. My mother is a retired, registered nurse.

Reggie Jackson:

So, my mother knows, medical stuff like the back of her hand. She's like, no, this is something very serious. You need to tell the doctor that you think it's this, right? And so she did. The doctors was like, "N, no, your sister doesn't know what she's talking about." So, finally my mother got so frustrated. She literally caught a plane and she went down to Mississippi and she forced her sister to go with her to a hospital in Memphis, which is about 70 miles from my hometown.

Reggie Jackson:

She was able to see a doctor there, and immediately based on the symptoms she had, the doctor was like, "You have cancer and you need to go see a specialist." So, he referred her to a specialist and she started getting treatment. This is like two years in. She'd been dealing with these symptoms for two years and her doctor just kept telling her, "N, it's not that serious," blah, blah, blah. And so had it not been for my mother going down there and forcing her to go see another doctor in Memphis and then getting that specialized treatment to deal with the cancer. She probably would have died from it. So, I know from research, I've done over a long period of time that Black people, we just know we don't get treated the same when we go to the doctor.

Tarik Moody:

Pain tolerance, fixed skin. It's funny how comedians can really tell the truth through comedy. I think this really drives it home.

Speaker 2:

There was a study. There was racism, there was a study and it showed that doctors, they actually prescribe opioids frequently to White people than they do to Black. They don't give us opioids. Because they're sympathetic, they're like, "Oh, this White person, they're in such pain. Here let me give you this. Let me give you these opioids. Get that pain away." I had a double mastectomy, you know when they sit my Black ass home with (beep) .

Tarik Moody:

It's sad that a comedian has to point this out and there's proof to all of this. All you have to do is look at the numbers to see unconscious bias all through our healthcare system.

Reggie Jackson:

You know, Black people are, I think three and a half times more likely to lose a limb when they have diabetes than a White person is. Black women who go and have babies are almost four times more likely to die having a baby than a White woman is in this country. We have been used as guinea pigs in medical experiments, going back hundreds of years in this country. So there's all of these factors that layer on top of each other and lead to us, having conditions that people claim, which is just nonsensical to me, they claim that we're predisposed to have high blood pressure. That is nonsense.

Reggie Jackson:

Listen, let me tell you why we're predisposed to having high blood pressure. It's because of racism, because if you go to other countries where majority of people are Black, you go to places in the Caribbean, you go to West Africa, you don't find the same levels of hypertension that you find on Blacks that you do here. In many of these places, they eat the same types of stuff we eat. The difference is, the level of stress from racism is completely different. I remember Richard Pryor talking about his first trip to Africa. He landed in Zimbabwe, in an airplane, right? He got off and he spent a couple of days there and he was like, "Man," he says, "Now I know what it feels like to be a White person. There's no stress."

Tarik Moody:

A lot of these disparities for Black and Brown people simply come down to access. Before the Affordable Care Act a lot of Black people didn't have a primary care doctor or even health insurance, which means they would go to the emergency room instead and that's only when they were really, really sick.

Reggie Jackson:

Guess what happens when you go to emergency room, they're going to look at you like, you're crazy. You're going to wait forever. They're going to look at you like, you're crazy. You're going to get a bill that you can't believe how big the bill is, right? So guess what? You're going to be much less likely to go to that emergency room the next time you're sick or your child is sick, or your husband is sick or your wife is sick or whoever. So you're going to develop this sense that like, "Man, I have to be like deathly ill before I go, because I don't have a regular doctor. I got to go to the emergency room. The bill is going to be crazy. I'm just not going to do it unless I'm like critically ill."

Reggie Jackson:

So over the course of time, what ends up happening that connects kind of intersects with this idea of the distrust that's there. Another factor here in Milwaukee that people forget is that we had two hospitals that closed in Milwaukee. St. Michael's Hospital closed shortly after I moved back from California, the early '90s St. Michael's Hospital closed. When do you ever hear of a hospital closing in a White neighborhood? Never. Right?

Reggie Jackson:

Another hospital that closed Northwest General Hospital, right up on like 53rd, 54th in Capitol closed. That's in a Black neighborhood. And so what you end up having is you have ... people talk about food deserts. We have healthcare deserts. You have to go far in why to find healthcare. If it wasn't for programs that have been set up to provide a level of care for poor people, then a lot of Black people for a long time, didn't really have access to healthcare. And what ends up happening is you don't get preventive medicine done, right?

Reggie Jackson:

So you don't go and you see a doctor and get a physical every year. So your doctor doesn't recognize that you have some ailment that maybe prediabetes, okay, let's get you on, a new regimen, new diet or whatever exercise so that your prediabetes doesn't turn into diabetes. You don't realize you have high blood pressure and you have to adjust, your diet and things of that nature. You don't realize that you have a heart condition. You don't realize you have a lot of, so you don't realize you have asthma.

Reggie Jackson:

So a lot of things that people have that should be treated early on that could, mitigate it, getting worse for them. They don't get that preventative care early on. They don't know that they're sick early on. And then there's this sense of like, man, I don't really trust the doctor. I know my wife has been telling me, I need to go because I've been having this pain in my side and my wife has been telling me, you need to go to the doctor, but I'm not going to go, I'll deal with it out. My daddy had the same thing and nothing happened to him, right. Those types of things happen. So people end up being sick unnecessarily and what happens is by the time they finally seek treatment, man, it's too late.

Tarik Moody:

I can relate. I'm just like my dad. We're very stubborn. We don't really do a very good job. Take care of the health. We wait till the last minute and I don't know why that is. Maybe that is mistrust. I can definitely see what Reggie is talking about though. And on the other side of this mistrust is clinical trials. There's a lack of diversity in medical clinical trials, the president of My Alma mater Howard University, Dr. Wayne Frederick pointed this out in an a op-ed in New York times, that we need to have more diversity in clinical trials. If you only test one demographic, using a White man, you leave out possibilities of these vaccines or medicines not working specifically on Black bodies, especially Blacks with underlying medical conditions.

Reggie Jackson:

Yeah, and that's across the board. That's been happening for so long in this country. Most of the drugs that are on the market were tested on middle class White males, is very rare for people of color, particularly Blacks to be part of medical trials. One is they don't recruit Blacks for it. You know, they say, "Well, we tried to get some Black people." Oh, well, you know what? You weren't trying very hard, because man, there's 40 million Black people in US you can't tell me, you can't find people. But secondarily, even when they're trying the drugs, right, to see the efficacy of the drugs, what they find is when Black people were part of those, have complications, they're ignored like, well, I don't know why.

Reggie Jackson:

I don't know why you're having a problem with it, the rest of the subjects are not having any problem with it. Well, the rest of the subjects are White. I'm the only Black dude. I'm having some issues, but you're going to ignore the fact that I have issues because none of the White people are having issues. So you're going to just continue with the study. And, oh, well it worked for 99% of the people that were in it, it worked, and you're not going to look at the fact that the 1%, we're all Black folks.

Reggie Jackson:

So, there's a genetic basis for how medication works. So what ends up happening, we get all of these medications that are developed billions of dollars spent to develop medications and people don't really care that, it's not working with other groups of people because it works with the majority population and that's all it really meant.

Tarik Moody:

I was reading a study that says that Black doctors could reduce cardiovascular mortality gap between Black and White patients by 19%. Do you believe that's the case that another issue that would help, whether it's mental health, infant mortality rate, anything is that we see more Black medical professionals in the industry.

Reggie Jackson:

Absolutely. That's a critical factor. I mean, it's huge. Most people don't even know that, a majority of Black doctors in this country for years all went to Meharry Medical School, right. That was really the only credible medical school you could attend if you wanted to be a dentist or doctor, psychiatrist, whatever. You didn't have a lot of options. So we didn't have a whole large number of Blacks who could get into the medical profession. But, study after study have shown and I can just say this, from just my own personal perspective. I've had doctors, I've had White doctors, I've had Black doctors. I've had some really, really excellent doctors.

Reggie Jackson:

I had some doctors that just ... they're in and out five minutes after I come into the office, they ask me a few questions and then they're like, well, okay. Well here, I'm going to give you this and that's the end of it. But the two Black doctors that I've had, two Black male doctors, Tarik when at first time I went and saw them, I literally spent an hour and a half just talking about my life and who I was with both of them.

Tarik Moody:

I can say, personally, I never had a Black doctor at any level of healthcare and just think about that, what you miss out on not having a connection over shared experiences with your doctor. That helps build a trusting relationship over time and generations.

Reggie Jackson:

These brothers asked me some deep questions. As I was their patient over the course of time, I was their patient. They got to know me, right. They got to know me, "Oh, how's your wife doing? How's your daughter." They get to know you as a person and you get that level of care where it's like, man, I really trust this individual. So, because I trust you, I'm going to tell you about that thing that I'm dealing with, that I'm really kind of afraid to talk about, but because I trust you as my doctor, I'm going to tell you, whereas if it's a White doctor who hasn't treated you in that same way, hasn't asked like, "How's your wife doing? How's your daughter doing?" How's that problem? The last time you were here to see me, how was it?

Reggie Jackson:

If you don't have a doctor that asks those probing types of questions that doesn't get to know you as a human being, you're not going to share your most intimate secrets. There's always going to be a higher level of trust I think when a Black person sees a Black doctor, because first of all, it's pretty rare, right? And you're like, "Oh man, I got a Black doctor. I saw a Black doctor." I mean, you're going to leave and you're going to go and tell somebody, "Man, I saw a Black doctor today." Right? Because it's like, out of order you ain't never had a White person say, "Oh, can you believe it I had a White doctor when I went to the hospital today." Right. They never say that. But a Black person, like "Man, I went to the emergency room and there a Black doctor that treated me." I mean, that's like they exciting for us. So there's a different level of comfort.

Tarik Moody:

Well, let's talk about the now COVID-19 Coronavirus. It has affected Black people more and are actually three and a half times are more likely to die from COVID-19 than White people. Latino people nearly twice as likely to die from the virus and then Black people seeking testing or treatment for COVID-19 were six times more likely to be turned away than Whites. One, I want to say something first that it feels like when this study, this report came out, that people took this COVID-19 less serious because, oh, this is a Black disease kind of. This is my thoughts, right? This is not ... but why it feels like, just like COVID did everything else in systemic racism, like peel the way that band-aid show the festering wound of systemic racism. Why three and a half times more likely? What's going on here?

Reggie Jackson:

Well, I think there are a lot of factors involved when it comes to the COVID. The fact that the infection rate is higher in the Black community and the Latino community, in particular is because guess what? We are in the types of jobs at a much higher rate than Whites are the types of jobs that are going to put you in a position where you're going to be exposed to people who are walking around, breathing on you, right? So you're much more likely to work in a grocery store, that you're forced to go and work in these factories and places of that nature, where you much more likely to be exposed to this virus. So obviously you're going to be exposed to it at a higher rate. You're going to die at a much higher rate, right?

Reggie Jackson:

When you look at nursing homes, and the data about the nursing homes, we all know that the rate of people dying in nursing homes were significantly higher, but guess what? Who works in those nursing homes primarily. Guess, who these CNAs are in most of the nursing homes in Milwaukee, Black people, Black women in particular, right? So, what happens is the person who's working there may not necessarily get really ill with the COVID but they're going to go home and their mom is going to get sick or their aunt or their grandmother is going to get sick.

Reggie Jackson:

So when you look at COVID here in Milwaukee County ... I track the data from back on March 19th when the first person died of COVID in Milwaukee County, the first 16 people who died in Milwaukee County were Black. And so guess what happens? All of the conversation, all of the narrative about COVID was that man is killing all these Black people. This is devastating the Black community, but guess what happened as I was tracking the data week to week. And I'm the only person that acknowledges Tarik, because I kept running into people that were talking about the narrative about Black people, Black people, Black people, Black people. And I was like, "Dude, the data is pointing in a different direction, now it's shifted." And after the first three weeks, the first three weeks, each of those weeks, majority of people in Milwaukee County who died from COVID were Black, right? But after that, every week, since then, a majority of people who have died from COVID in Milwaukee County have been White and so there's been this big shift.

Reggie Jackson:

I mean, a lot less people are dying from COVID but it shifted to being a much bigger issue for Whites over the last, however many months than it has been for Blacks. In fact, I can pull up the numbers because I just posted this to Facebook last week. I want to give you the raw numbers. So this is what happened in March. You have 17 Blacks who died, two Hispanics and one White in Milwaukee County. In April, you have two Asians, 77 Blacks, nine Hispanics, one multi race person and 72 Whites. So you already see the White people already starting to catch up by the second month, right?

Tarik Moody:

Reggie kept tracking the COVID data in our County month after month and he kept finding the same thing.

Reggie Jackson:

The last month I tracked August, there were four Blacks, one East Indian, five Hispanics, one multi race person and 16 Whites. So this is what I've been trying to tell people since very early on, as I was tracking, I saw the shift to more White people dying. I said, "Listen, the narrative has to change. If the data has changed, the narrative needs to change here locally." Now this is Milwaukee County. Whites are 52% of the population in Milwaukee County, but still when I talk to people about it, I think the impact of hearing the narrative is just about Blacks and Hispanics.

Reggie Jackson:

It makes White people relax like, oh, nobody's dying but a bunch of Black people and a bunch of Hispanic people, we don't have to worry about it. Why should I have to wear a mask? Why do I have to social distance? Why can't I go to the bar? You know, all these ... because they're not hearing about any White people dying. And when I talk to White people, I hear this. Do you know anybody who just died from COVID? Yeah, I know five people that have died from COVID. Personally five people I know personally have died from it.

Reggie Jackson:

I've had over a dozen family members that have gotten a virus, right? So I know people that have died, but a lot of White people are men. I don't want anybody that's died personally. Well, you know what? That's problematic because just because you don't know somebody, that doesn't mean people aren't dying. The only people I've heard say that COVID is a hoax, are a bunch of White people. This is why I say, Tarik that until the people in our community here, Metro Milwaukee area start to share people. The numbers that I shared, about the shift from May through August, the majority of the people who died from Coronavirus in Milwaukee County were White.

Reggie Jackson:

If White people knew that, they would be like, "Man, I better start wearing a mask. I better stop yelling at people at the restaurant who tell me, I need to put my mask on." Because it's just straight up ignorance and ignorance isn't being dumb or stupid. Ignorance is a lack of information and the fact that they're not getting the type of information. When I watched the local news, I read the newspaper. Nobody is sharing this narrative that there has been a shift in where the COVID deaths are here locally.

Tarik Moody:

Going back to my observations, which basically, you were justifying that once mainstream America, White America found out, hey, based off the data, I'm good. That basically, White America says to me, they don't really value us at all in the first place. So this whole podcast we've been talking about how systemic racism, is about valuing. We have never really, as a people been truly valued in any aspect of this country. That's what I saw what happened. People did start taking it seriously, right in the beginning, right? When you didn't have the numbers, but people were like, "Yeah, I'm down, I'm sticking in this out," but then all of a sudden the numbers come out. People are like, "I don't need to wear a mask." Because they're like, "That's Black people. I don't need to care about that."

Tarik Moody:

You're not valued in this country. And that's a very strong thing to say, but that's what I felt that COVID made me realize, which causes me even more anxiety that we're really not ... no one really cares about our people.

Reggie Jackson:

Yeah, it's been clear in the way that people reacted to COVID that the numbers that show that Blacks and Latinos and native Americans are much more likely to die from it. It goes to what you said about how we value people. If we don't value people and then we can scapegoat them, "Oh, you know, that the Coronavirus is a Black and Brown problem. Look at them they're the ones with the highest rates." Instead of us having empathy for people and saying, "Man, what is it that's wrong with our country that these people are getting exposed and dying at a higher rate. What can we do about that?" There's no empathy. Part of that goes to the fact that there's never really been a whole lot of empathy for Black people in this country from Whites.

Reggie Jackson:

I mean, if people could sit around and burn a person alive at a spectacle lynching with 15,000 people there, what makes you think they're going to be empathetic when you have the Coronavirus. Decades later when they can have the police department come out and spray you with water hoses that will cut the bark off of a tree and do this to little teenage kids. What makes you think they're going to be empathetic now? So, America has never had any empathy or real care or value for Black people above and beyond the fact that they needed our labor. So they're not really their concern.

Tarik Moody:

So, I find it funny people use America for their own purpose. Like the Black and Brown people are American. So shouldn't this be an American problem?

Reggie Jackson:

Yeah.

Tarik Moody:

But it's only an American problem, when it affects them.

Reggie Jackson:

Listen, google All American Boy and look for images and see what you see. You're not going to see any Black and Brown faces all American boy. American only means White folks in the minds of a lot of people. Captain America, Superman, couldn't be a brother, come on, man. We know how this works. So, it's systemic racism in full effect, man, and it's unfortunate that it is causing all of these issues for people, life and death issues.

Tarik Moody:

So that's the problem. Coming up in the next part of this episode, we're looking at the answers to these healthcare disparities. Since we have been talking about institutions, we're actually looking at three of them. Government, the healthcare system itself and education. We will talk to a panel of experts from the Milwaukee Health Department Froedtert & the Medical College of Wisconsin, a postdoctoral fellow from MIT and a fellow Howard University alum who are working on solutions. Next on By Every Measure.

Speaker 2:

Radio Milwaukee is on a mission, and if you're here to discover new perspectives on music in Milwaukee, then you're on a mission too. Join today, to support the programming you love. Visit radiomilwaukee.wpengine.com and click the orange heart.

Tarik Moody:

We're back on episode six of By Every Measure. This is our final episode of the series, at least for now. And since we're talking about healthcare during a global pandemic, it makes sense to go a little deeper in the solution section of this episode. We've got five experts joining us, representing three different institutions that intersect with healthcare equity. We will talk to two men of color who are working with MIT on an upcoming hackathon and throwing down an open call to the world to help come up with solutions for racism and healthcare.

Tarik Moody:

Then we'll talk to one of the state's largest healthcare providers Froedtert & the Medical College of Wisconsin. To learn about its own anti-racism efforts across its system that's institution two the healthcare system itself. But we're going to start here in the public sector. Institution number one, with the City of Milwaukee Health Department. The departments is in a period of transition right now. It's director Dr. Jeanette Kowalik recently announced her resignation, citing racism within city government. We asked her for interview, she declined, but pointed us instead to the department's Chief of Staff, Lilliann Paine. Who joins us now. We start on the topic of bias.

Tarik Moody:

One of the things we talked about is bias and medicine and How Black and Brown people are kind of treated differently systemically by medical professions, by bias. There's theories about, still in some medical books as of like maybe 10 years ago that Black people's skin is thicker. Then we also talked about, that outcomes of diseases and when a Black person has a doctor that looks like them, improves. Does the city have a role in addressing those biases and dealing with hopefully enlisting, finding more medical fashions, mental health doctors, cardiologists that reflect the community?

Lilliann Paine:

So when you think of public health, think of population health. When you think of healthcare and medical systems, think of, just what you're talking about, like who are the frontline staff, who's welcoming people into the hospital. Who's welcoming people into a health clinic. Who's welcoming people into urgent care. The health department partners with health systems and can speak to the experience that, patients may have within the healthcare system, because they interface with some of the direct services we provide.

Lilliann Paine:

I believe the health commissioner has sat on many boards and is part of networks for local health officers that have that positional power to influence and inform health systems to reconsider their hiring practices and culture and climate when serving our residents, city residents.

Tarik Moody:

Speaking of the health commissioner, as you know, due to public knowledge, she resigned due to some of the issues we're talking about right now, the racism. How do you see the health department harness this moment to move toward solutions?

Lilliann Paine:

Yeah, having the ability to implement our anti-racism plans, having the ability to work with ... Another thing that came out of the reorg and another credit to the commissioner is, the board of health. So our solution is working with our board of health to promote and advocate, the needs for the health department as well as again are residents of the city. They are appointed by the mayor and they have two year terms and they just, elected their new president and vice president after being around for a year. So that's a space, and those are power brokers, I would say that can help co-create solutions and advocate on behalf of the health department.

Tarik Moody:

Then I remember Board of Health was re-established by in 2019 and its mission is to advise the department on priorities, taking stances on public health policy issues and being champions for public health in Milwaukee. And addition to the board of health, Lilliann also mentioned another interesting effort, the City's Doula Program

Lilliann Paine:

We have Birth Outcomes Made Better, the BOMB Doula Program that's targeting specifically Black infant mortality and maternal mortality with everything going virtual this summer. Our program manager, Nicole Miles has done a great job, every meeting engaged. She created a BOMB Doula Book Club, for the breastfeeding month, she has done a great job with onboarding our Doula's and participating with national initiatives like to hear her campaign. The official launch will happen in a couple of weeks.

Tarik Moody:

BOMB Doula is one solution being developed in Milwaukee, a solution to a heartbreaking crisis, infant and maternal mortality. Wiscos continues to rank as the worst State in the country in terms of birth outcomes for Black women. According to the CDC, Black babies in Wisconsin are nearly three times more likely to die than White babies. And that makes Wisconsin infant mortality rate the highest in the country. And then look at the maternal mortality rate for Black women. It is five times higher than White women, according to a story in the Journal Sentinel. And clearly the city can't fight our state's dismal infant and maternal mortality rates alone. Next we're looking at the provider side, the healthcare system itself. Joining us now are reps from Froedtert Hospital and Medical College of Wisconsin to talk about those mortality rates. This is Shary Tran.

Shary Tran:

Directory of Diversity Inclusion at Froedtert & the Medical College of Wisconsin. I have been there for eight years.

Tarik Moody:

And Heidi Moore.

Heidi Moore:

Director of Emerging Markets and Inclusion and I focus primarily on the external stuff.

Tarik Moody:

Milwaukee has been, as far as rankings and indicators, when it comes to specifically the Black community is not very good. Matter of fact, it's been last place in a lot of indicators. And one of those is like maternal mortality rate and infant mortality rate. How is Froedtert tackling that in Milwaukee?

Heidi Moore:

When you have something like the two health conditions that you mentioned when it comes to maternal health, when it comes to the birth of our children. What was interesting for me because I've been doing, equity, diversity and inclusion work for over 20 years across different industry and sectors. So coming into healthcare that's years ago, one of the things that really stood out for me was this concept called social determinants of health and also the concept that health disparities, regardless of income, for certain ethnic and racial groups, you see the same kind of outcomes and that absolutely is true for a Black and African American mother.

Heidi Moore:

So regardless of how much money ... I went to school, I've got some degrees and I'm making a decent income, right? Regardless of that, because of racism and ... I'm not a doctor, but I have some thoughts as to why that might be the case. We still are paying the same health outcome as if someone who maybe is living below the poverty level. So it is really significant and that's why we have to address things like unconscious bias to address the type of care that everyone is receiving.

Shary Tran:

Yeah, and on top of that, it's like, we're tracking everything, right. We're looking at all of our outcomes by various demographics, so we can get a better understanding of what is the outcome because data is what's going to help us change things, right? We need to have the data to just tell us the story so we can put interventions in place to overcome some of those disparities, right? So when it comes to really having hard data, like what is the outcome for African American women who are giving birth in our organization, at our hospitals and how can we track and identify what are some of those causes?

Shary Tran:

What can we do to support organizations in the community that are addressing those things? Because as Heidi mentioned, social determinants of health happen beyond the walls of a healthcare organization, right? Only 20% of what a healthcare organization can do impacts the health of an individual. A lot of the rest of it is environmental, social, all those economics, all of those things. So how can we help support those other areas that also impact a person's health outcomes, without being directly involved, but supporting those organizations that do. A lot of what Heidi does is creating those partnerships and those relationships with organizations that help us achieve our mission for health equity.

Tarik Moody:

The other issue Reggie brought up, kind of leads into the mistrust is that there's data saying that if a Black patient has a Black doctor, the outcomes of their health would be much better. Talk to me about that.

Shary Tran:

Absolutely. Yeah, that's called concordance, right? Like patient physician concordance when there's that similarity or that familiarity, from a point of diversity, definitely increases the trust that helps with a patient identifies with their physician, they're more likely to share information that's relevant to their health. They'll be more honest about what's happening in their lifestyle or what they're doing to uphold their health. It creates a better relationship that creates better communication. It's all about that communication.

Shary Tran:

So for us, of course, education and recruitment of our staff is a key priority for us as well. We have a program right now, that's going to pay people and pay for the education of staff members who want to become search texts in organization, right. So not only do they get a free education at MHCC, they get paid for it at the same time. So it's helping create that pathway for folks to get into direct care positions and advance in the organization and more programs like that are in development in our organization right now.

Shary Tran:

Also partnerships with, HBCU's and medical institutions that help us to recruit physicians, as well. African American physicians, minority physicians, LGBT physicians, LGBTQ population, because we have a growing population of patients as well, that we want to make sure that we are meeting their needs, addressing their concerns and creating that relationship and that trust as well.

Tarik Moody:

You can read more about Froedtert plan to end racism, both inside and outside of its walls on a dedicated page on its website. You can find it at froedtert.com/end-racism. It outlines a four point approach, including reducing bias, employment, career development, health equity, and supplier diversity. We'll put a link to it in our discussion guide.

Tarik Moody:

That brings us to the third system that's attacking systemic racism and health, higher education. I read about this effort at MIT on LinkedIn, and it really piqued my interest. MIT is hosting an event called Hacking Racism in Healthcare in collaboration with Black Tech Matters, MIT COVID-19 Challenge and MIT Hacking Medicine. And on a long shot, I decided to reach out to a couple of the organizers, Dr. Freddy Nguyen.

Dr. Freddy Nguyen:

I am a Post-doctoral fellow at MIT, and I'm a Resident Physician at Mount Sinai Hospital, New York. Part of the last years, I've been part of a group called MIT Hacking Medicine at MIT which has done a lot of healthcare hackathons over the years. Recently we launched the MIT COVID-19 Challenge about six months ago.

Tarik Moody:

And Yusuf Henriques.

Yusuf Henriques:

Co-founder and CEO of Code Clear Ventures, which is a biotech company that's developing a rapid detection test for COVID. Previously I started another company that focuses on mental health around genomics, which is called true genomics, that I started three years ago. Prior background as a military, special force medic and worked in the government for quite some years.

Tarik Moody:

Where did this idea of hacking racism come from? I used to run hackathons for my program idea at the lab and people were like, "What are you hacking, what are you trying to steal from me?" Talk to me what's a hackathon and talk to me, before we get into the hacking racism. Explain hackathons, and then talk about your hacking healthcare, that program?

Dr. Freddy Nguyen:

Hackathon is not hacking for us, really, as you said, it's not about breaking into some high tech system or stealing code or anything like that. It's certainly about creative use of ingenuity and trying to bring a lot of creative ideas and people together as part of sort of our hackathons. Really what's remarkable is that the hackathon model has been able to transcend all of the barriers that you normally think of. Whether it's social or cultural or language or whatnot. So one of the things is we don't allow preform teams. We don't want preform ideas at the beginning of the hackathon. Really everybody comes in and at the same level, it doesn't matter what your day job was or what your title was or how old you are or how young you are and what your background is. It's really about the richness of the ideas and the letting the best ideas rise to the top.

Tarik Moody:

What kind of problems, structural systemic problems in healthcare, are you trying to tackle with this?

Yusuf Henriques:

One of the areas which has been huge in my areas is around research. I worked for FDA and I started to see the huge disparity and the involvement of African Americans and minorities in clinical trials. And you've touched on a little bit of the history that goes back there. Granted I wasn't here I'm a transient foreigner that came in, but understood and learned real quick about the mistrust that African Americans have. We're now at a point where if we're not involved, the future of medicine is going to be at a detriment.

Tarik Moody:

So you picked my interest and you're talking about clinical trials because I've been reading a lot of stuff from my feed. I think it was Howard University. They're trying to get more African Americans into trials. Because I remember watching, I think it was John Oliver did a whole thing on medical bias, talking about people they're developing vaccines and medicines, but the only people testing, those are usually White men and they don't know the effects on women or Blacks or Hispanics. How do you tackle that? Since this seems that's your specialty, right?

Yusuf Henriques:

Yeah, well man, look, it's going to take a village as they normally say, right, looking. Maybe it's because I'm military, I like to charge the highest steepest hills. So I've taken on this large challenge just because I've been in it and I've seen the dataset, again, 95% of trials are European White males. That's been over the last 40, 50 years. So, I mean, again, you could think about any particular drug that's come out on the market over the last 40, 50 years has been predominantly that cell population. And I think it's time for a change.

Yusuf Henriques:

So, like Freddy mentioned, the COVID situation kind of brought up those health disparities, right? Expose that people were sitting at home watching, why is that not the case? What do you mean? Where are all the Black people at? Where are all the Brown people at? I mean, they're all at home, right. So to Freddy's up to this point, that's why we focused on all those different track areas, because it all ties in.

Tarik Moody:

Who's going to be involved in this. You mentioned mentors, influencers who can take part in this hackathon. Is it a national thing or is it a MIT thing? Talk to me. How can somebody from Milwaukee get involved and ... So I'm assuming you probably do more of these, right?

Dr. Freddy Nguyen:

We're really hoping to engage anyone and everyone. Essentially anyone who's had experience with this space or who wants to make a difference in this space. And so really I think that's the diversity that we always seek for it. I talked about diversity of expertise, but then there's also diversity and personal experiences that also will be helpful as part of this process. So, we are focused mostly on individuals from the United States. This isn't going to be a global hackathon, the way most of our others have been in the most recent months with COVID.

Dr. Freddy Nguyen:

Again, really targeting the population that's had direct experience with these issues is really who we're trying to identify and target as part of the participant pool and the mentor pool and the judges and partners that are involved as well. Because we realize that it's one thing to want to make a difference, but the other is you don't have that firsthand knowledge of what that issue is. It's a lot harder and we really need to get the people who experience the problem firsthand to be there as part of this hackathon.

Tarik Moody:

After the hackathon, the top teens will get connected to the resources they need to make their solutions a reality. They will have access to mentorship, tailored to the solution they develop, plus prototype and facilities, and eventually capital. According to Dr. Nguyen.

Dr. Freddy Nguyen:

It's kind of a little bit of, playing matchmaking between both sides of the people who have the resources to provide and those who need them.

Tarik Moody:

So here are some of the solutions we discussed in this episode of By Every Measure. One, developing anti-racism programs and health care that tackles bias. More representation in healthcare. That means increasing the number of Black doctors, which help build trust, investing in programs like BOMB Doula to reduce the infant and maternal mortality rates. Finally, most importantly, we need collaboration between the healthcare industry, government, education and the community. Bring them all together to tackle these issues.

Tarik Moody:

Well, Reggie, I have to say, thank you. This is the final episode. It was a great journey. I thought I knew a lot. Now, I know a whole lot more.

Reggie Jackson:

Man, Tarik I have to thank you for the opportunity. It's been a pleasure for me to have this forum, to share these things that I talk to people about quite a bit.

Tarik Moody:

It's been an emotional journey. There's days where I just get angry and upset and I get depressed hearing these stories, right.

Reggie Jackson:

Mm-hmm (affirmative).

Tarik Moody:

But I think it had to be done because I truly believe a lot of people really understand systemic racism. And I think a lot of people, when we talk about race, I feel like a lot of White people feel like it's a personal attack, right? And then it gets very self defensive and say, "You're a racist, Reggie, you're a racist Tarik." And we're sitting there like, wait what?

Tarik Moody:

I think, doing this kind of podcast, doing these kinds of conversation, like truly trying to understand the history and having a conversation and then talking to people about possible solutions of what are people working on is a good foundation to start and hope people will see that and maybe as you say, I'm not worried about the people who just, were in the confederate flags, who already ... I'm worried about the people on the fence. And this is for the people on the fence.

Reggie Jackson:

One of the hard things about this is I say this to people all the time, man, listen, the truth hurts. What ends up happening for White people in this country. They think that we're blaming them as an individual. No, we're not blaming you as an individual. It's not about you that's part of the arrogance of people that think that it's about them. Listen, I'm not talking about you. I'm talking about this system that exists. That was here before you came and will be here after you gone. It's not about you. Don't take it personal. Just understand that what we're trying to do is we're trying to just use American history as a tool to show you what America has done and you can't deny it. I mean, you can deny it, but come on, listen, denying is not going to make you feel better.

Reggie Jackson:

Saying, oh no, America has always been the land of freedom and justice and Liberty and everybody has that same opportunity. You know that's a lie. They know the systemic racism happens because they see it way more than we do. They are the ones that are in the office when, when Tarik goes for the interview and doesn't get the job and doesn't know why and then when Tarik leaves the boss goes over to them and says, "Man, glad we didn't have to hire that Black dude." They hear these things. They know they can't hide from it. They know they hear the remarks that their peers and their family members and neighbors and stuff make, they know more about systemic racism than we'll ever know, but they don't want to admit it because guess what? It flies in the face of everything that they've been led to believe about their country and everything that they still believe about their country, because they want America to be this mythological place.

Reggie Jackson:

This utopia it's never been a utopia for people of color, never has been, never will be and the only way I can even approach being something close to that is when White people start to actually put their foot down and do some real work in this area and it's not easy work. I've wrote a piece where I said, "I'm glad a lot of more White people are woke," but being woke is one thing. Are you looking to get your behind out of the bed now that you're woke, because that's when the rubber hits the road, that's when the real work needs to be done and I think providing people with the information that we provided in this podcast, I think is a really good first step for a lot of people.

Reggie Jackson:

Now they can have different conversations, but ultimately I think that White people have to understand this very clearly by systemic racism. It hurts everybody.

Tarik Moody:

Mm-hmm (affirmative).

Reggie Jackson:

People of color more, but it hurts everybody because ultimately think about all of the human potential that's wasted by us not taking advantage of people of color. Think about all of the Black doctors and all the Black engineers and astronauts and scientists that we could have if we were to cultivate young Black children in the way that we cultivate young White children. Think about all the people from the