- 8 months ago
Johnson & Johnson Senior Medical Director Dr. Robyn Jones and trailblazing journalist Mara Schiavocampo get real about the trials of Black maternal health in America.
Category
🛠️
LifestyleTranscript
00:00Hello, Essence Festival of Culture. I am Mara Schiavo-Campo, and we're here now to talk about
00:11a really, really important issue in our community, and that is the urgent need to address healthcare
00:18disparities that are affecting us, Black women, and also what we can do to advocate for ourselves
00:24when we are receiving medical care. So I want to start with some statistics that highlight
00:29the issue of these healthcare disparities, and they are stark, starting with maternal mortality.
00:34Black women are three to four times more likely to die during pregnancy and childbirth than white
00:40women, three to four times. More than 60,000 women a year suffer severe complications that may have
00:45lifelong effects on their health and well-being, and chronic conditions like diabetes and hypertension,
00:51as well as mental health and substance abuse are all contributing to these problems, and now
00:55we're seeing how COVID-19 is exposing these healthcare disparities even further.
01:01So joining me now to discuss all of this is Dr. Robin Jones. Dr. Jones is a board-certified OB-GYN
01:07with degrees from Brown University and Temple University School of Medicine with specialty
01:12training at the Medical College of Pennsylvania. Dr. Jones is also an integrative health coach
01:16trained at the Duke University Integrative Medicine Center and the Jefferson Health Mirna
01:20Bryan Center for Mindfulness. Her industry experience includes over 15 years at Johnson & Johnson,
01:27where she is currently Senior Medical Director of Women's Health, and most recently, Dr. Jones
01:32has been on the front lines of helping to combat disparities when it comes to the COVID-19 crisis
01:37in the Black community through her volunteer work with the Black Doctors COVID-19 Consortium.
01:42Dr. Jones, thank you so much for being here.
01:44Hi, Mara. I'm happy to be here.
01:46So I would like to talk about some of the ways that we're seeing these healthcare disparities
01:55manifest in the Black community. Now, I spoke about some of the statistics, but that's just
02:00a small slice of the full picture. How have you seen these healthcare disparities show themselves
02:05in the Black community?
02:08So healthcare disparities, it's not a new notion. We're just recently speaking more about it,
02:13but they've been aware of when we think about healthcare disparities in the Black community is
02:23what is it that is causing these disparities? And some of the things that have been looked at are
02:28what's referred to as the social determinants of health. And social determinants of health are where
02:32we work, where we live, where we play, where we learn, and where we age. And all of those things are
02:39related to how healthy we are, or even how we access healthcare. And if I was going to say something
02:47more about the social determinants of health, just a little more detail, let's take, for example,
02:51the fact that in the Black community, we're less likely to have continuous insurance or any health
02:56insurance. We may have inadequate access because of transportation or because of trust issues that
03:02we have with the healthcare system. We may be more likely to have serious underlying conditions,
03:08such as high blood pressure, diabetes, heart disease, obesity, asthma, all of which we've
03:14heard before. But those conditions do make a difference in how healthy we can be in the long
03:18run. There's also the stigma of systemic racism. So how does that fall into play with the social
03:25determinants of health? I mentioned previously about trust. We have a lack of trust reaching back
03:32generations in our healthcare system. And more recently, what we found is as we access the healthcare
03:37system, we're not heard. We speak and we're not listened to. Perfect example, Serena Williams
03:44knew that she had a repeat of a condition. She'd already had a pulmonary embolism. And they really
03:50attributed her reaction or her response, her trying to tell them what was wrong with her to her pain
03:56meds, said she was confused. Okay. That probably would not have happened had her skin been that of a
04:02white woman. The other thing that happens to us as Black women, particularly, is stress. And stress
04:09impacts our immune system. And there's examples of that. There's a theory called weathering.
04:15And what happens with weathering is that there is a physiologic burden that we experience from the
04:23everyday stress of being Black in America. It has to do with us being marginalized, not respected,
04:31not listened to. And that everyday stress impacts our wellness. In fact, it's been shown that for Black
04:39women, regardless of economic status, if you take two women at the same age, one Black, one white,
04:46we usually have seven and a half more years added to our age because of the stress we undergo,
04:51because of the racism that we experience every day, and that we have to react and respond to
04:56here in the United States. There's also the environment. We're more likely to live in older
05:02housing, densely populated, more likely to have to take public transportation. And if we live in rural
05:07settings, there may not be any public transportation for us to access our healthcare system. We're also
05:13more likely to be in situations where the water quality and the air quality is inferior. And we all know
05:18about Flint, Michigan, and what's being done and not being done about that situation to this day.
05:24And then there's the whole thing with our community safety. There's more violence in the Black community.
05:31There's, without goes without saying, the social and economic factors. We tend to overall earn less
05:36money. Our educational system is not geared to advance Black people in the United States. And then just
05:44some basic healthy behaviors that we can do better at. But I think a lot of that is education,
05:49just diet, exercise, drug and alcohol use. All of that is related to our health and is part of the
05:57social determinants of health.
05:59I want to get back to stress in a moment because that is such a huge part. It plays such a big role
06:05in our health. And like you mentioned, there are so many unique aspects of being a Black woman that
06:09lead to a more stressful life. But first, I want to touch on the COVID-19 crisis, which we're seeing
06:13right now. We're seeing record spikes in a lot of states. This is by no means over. When we talk about
06:20all of these health disparities that you just mentioned and the way that they're affecting the Black
06:23community, how are we now seeing that play out within the COVID-19 crisis?
06:30I think the thing about COVID-19 is that it's taken the covers off the health disparities. As I said,
06:35they've been here for decades, but now we're really seeing it. In the United States, Black people are 13%
06:40of the population, and across the country, we're 25% of the deaths. You take some states where we're
06:46six times our own population rate is our death rate. And that would be Kansas. Other states where
06:53we're five times, four times. You take cities like New York, where we're three times as more likely to
06:59suffer death from COVID-19 as compared to others in the population. The other thing that happens with
07:05COVID is we are likely to have frontline jobs. So what do I mean when I say frontline? We're
07:11essential workers. We're delivering packages. We're working in supermarkets. We're driving
07:16transportation. All of those things are essential workers. We're also a huge portion of practical
07:23nursing staff. So we are more likely to be exposed to individuals that have COVID-19 and less likely to
07:29be tested. Access to testing has been a huge problem with COVID-19 ever since we've finally
07:36took action. So let's just to backtrack a little. China told the world about COVID-19 New Year's Eve
07:422019. World Health Organization declared a pandemic March 11th, and the United States declared a national
07:50emergency on March 13th. And subsequently, we shut down, or most states did. There's exceptions,
07:56and we know that, and we're seeing the result of those that didn't shut down then or that opened
08:00too soon now. So the testing, what testing can do is let us know where the disease is. Because with
08:08testing, then we can do contact tracing. We can educate in terms of how do you self-quarantine,
08:14what should you be doing, not be doing, sharing information with families, making sure that you do have
08:20medical coverage, giving you information about medical insurance, so that in this, the light of
08:26COVID-19, you have all the tools that you need to really be able to survive this infection. And it is
08:32a matter of survival, because we're the ones dying. Well, to that point, can we just be clear about one
08:38thing? How important is it to wear masks in preventing the transmission of this virus?
08:43So when we initially started talking about wearing masks, and I have a smile on my face,
08:50we really weren't so sure about what mask wearing could and couldn't do. The main reason for wearing
08:56masks still is prevention. There may be some degree of protection for the mask wearer, but really the
09:03main reason for wearing masks is prevention of transmission. And the difference between wearing
09:09the mask and not wearing the mask and preventing you from passing it on to someone else may be a
09:16difference of 0% to 70% prevention from passing on COVID-19 to someone else. We've heard over and
09:23over that it's passed in respiratory droplets. Well, respiratory droplets don't just come out when you
09:27cough and sneeze. They come out when you talk. They come out when you laugh. If you're talking louder,
09:32there's more respiratory droplets. And so that's how we're getting infected. So that mask contains the
09:38respiratory droplets. Right. So this should not be a political issue. Wearing masks protects others.
09:44Not at all. And I'm glad to hear you on that. So I'd like to turn to the focus of your work at Johnson
09:51and Johnson, because as we mentioned in the introduction, you've been there for a number of years doing some
09:55very important work. What is the primary focus of the group at Johnson and Johnson? And how are you tackling
09:59these issues of health disparities? So I work with, I work with the women's health team. And we have this
10:07vision of bettering the health of women for now and future generations. And how do we want to do that? We want
10:13to impact women by delivering some life-changing healthcare solutions. You know, the title of this refers to
10:20maternal mortality. And I think it's important that we speak to maternal mortality. We, Mara already shared that
10:27in this country, three to, black women are three to four times more likely to die in relationship to
10:33childbirth. There's a number of reasons for that. Some of the risk factors are certainly if you enter
10:40a pregnancy and you already have chronic illness, but the reasons that women die, they die from
10:45cardiovascular disease. They die from hypertension related diseases, and they die from hemorrhage or
10:53bleeding after you deliver. The number one cause is the cardiovascular disease. And in most instances,
11:00instances, it can be prevented. And when I say prevented, the death from that disease can be
11:06prevented. So it's identifying it early enough. And it just so happens with the cardiovascular deaths,
11:11they can happen anywhere, certainly during the pregnancy, as well as up to 12 months afterwards.
11:17And what my team is doing, we're working on a project currently to really address maternal mortality
11:23in this country. We are the only developed country in the world where maternal mortality continues to
11:30increase. And we have the worst maternal mortality rate or death of moms in the world compared to other
11:37developed countries. And these are things that can be addressed and should be addressed. And a lot of it has to do
11:42with the social determinants of health and the fact that we don't have access, that we don't trust, that there are a
11:47number of factors in our lives that cause us not to get the adequate prenatal care and postpartum care
11:53that we deserve. So my team is working on that. We've also been a partner in developing the Equitable
12:01Maternal Healthcare Coalition, working with partners both in advocacy, in public health, as well as other
12:09universities. So we're working towards that goal really, really hard. And we're looking at different
12:16programs we can put in place and looking at specific counties where that maternal mortality rate is
12:23highest. In some of the states it's highest, and you'd be surprised. New Jersey's in the top five and
12:28other states, which you maybe are, they're still alarming, but maybe not so surprising because we're
12:33always hearing about inequities in the Deep South. And certainly Georgia and Alabama and Mississippi are
12:39in that top five as well.
12:40And talking about some additional support when it comes to closing these gaps in health care, what role do non-clinical
12:51workers like doulas and community health workers play in improving health outcomes?
12:57So let me explain what doulas are. Well, first of all, both doulas and community health workers are lay individuals
13:05who are either paid for what they do or they volunteer. Doulas work specifically in the arena of support for a
13:12pregnant woman during the pregnancy, specifically during childbirth, and to some degree postpartum after
13:18she delivers. And they're focused on the needs of the mother. So after birth, not so much the needs of the
13:25child, but the needs of the mother. Community health workers can provide what I would refer to as culturally
13:33competent information and support and outside of pregnancy. It could be any, for any medical
13:39condition. They're called other, they are referred to as other names. They are recognized by the NIH as
13:46valuable. Some of the information about doulas and about community health workers are that doulas, since
13:52doulas have really become more popular in this country, a woman is less likely to have a child that's low birth
14:00weight. She's more likely to breastfeed. She's less likely to experience a complication related to
14:07the birth directly. And it may increase the mother's ability to understand just what it's like to be a new
14:15mom and taking care of yourself during the pregnancy, as well as after the pregnancy.
14:23And those are certainly very, very important roles.
14:25As we wrap up this conversation, what do you want women to leave this panel with? What information do you
14:32want them to take away today?
14:37I think one of the main things is really taking care of ourselves and becoming our own advocates.
14:43It is important that we increase our health literacy through whatever means possible. And when I say that
14:50there's information available in libraries, there's information available on the internet.
14:55There are resources through different community organizations such as, for instance, the March of
15:01Dimes, Black Mamas Matters. They can provide information about pregnancy specifically. And then the Black
15:09Women's Health Alliance, for instance, can provide information about your own personal care. The other thing we
15:14need to do is we need to either be advocates in the community or supporting those who are advocates to
15:22really fight these health disparities, to really change the inequities so that women, and particularly
15:28pregnant women and moms, don't have to go through the risk of maternal mortality because our system is
15:35changing. And we as lay individuals can be supporting that system change by seeing what the policies are,
15:42advocating for policy and advocating for change. And when you go into a healthcare professional's office,
15:49don't just listen to what they're saying. Ask questions. If you're not comfortable doing that by
15:54yourself, bring someone with you. It's really incumbent upon us as well as the healthcare system to share
16:02and giving us our best lives.
16:09And when we're speaking to this unique moment in history where social justice is taking center stage,
16:15and you talked about the stress and the effect of stress on Black women, you do specialize in
16:19integrative medicine. What takeaway can those watching take when it comes to the holistic approach to
16:25health? In managing the stress of being a Black woman, of dealing with social injustice on a daily basis,
16:30what are the holistic ways that we can take care of mind, body, and soul?
16:35So holistic medicine, and I like to think of it more as integrative medicine, and that's the
16:40training that I have. It integrates conventional medicine, which is the care you receive if you go
16:46into a conventional hospital and you're being taken care of RNs and MDs, you are being treated with
16:52conventional medicine. Complementary medicine are the things such as mindfulness, acupuncture,
17:00botanical therapies, nutraceutical therapies. All of that is complementary, and together when they come,
17:06it's integrative medicine. And there are places for both in your wellness toolkit.
17:13One of the things that we need to do in this time, because we are experiencing so much stress,
17:18again, it's that whole self-care. And so we should be thinking about, are we resting?
17:24Are we getting enough movement or exercise? Are we eating well? And when I say eating well,
17:31I know that in certain scenarios, what's available may not be the healthiest, but it's still making
17:37every effort to eat what's best for you. And I like to say, when you go into a supermarket,
17:42shop the outside aisles, because most things in the inside of the supermarket are made in a plant
17:50and don't come from a plant. So you want to be shopping the outside aisles of the outside perimeter
17:57of the supermarket, because that's where the foods are that are more natural, that don't have a lot of
18:02chemical additives that haven't been processed. The other thing you want to do is you want to look at,
18:07okay, what do I need to accept? What's in my control and what's not in my control?
18:15A lot of what's happening during this COVID crisis in 2020 has been some year, and we're not even at
18:21July 1 yet. But a lot of it's not in your control. So one of the things you want to do is try to focus
18:29on what is your control and also realize that you're not the only one going through this. It's not
18:34personal. It really isn't. We're all in this together. And if you're not personalizing it,
18:40that also helps you to suffer less impact from it. And realize that trying to have some
18:47inner sense of calm is going to be important, very important for you taking care of yourself.
18:53And the other thing to remember is for all of us as black women, this ain't our first rate rodeo.
18:59Okay, we have had crises in our lives over our lifetimes. And we are very, very resilient. And
19:06we sometimes are our best under a crisis. But always remembering, because we are the
19:11ultimate caregivers that we are, how important it is that we're taking care of self.
19:17Absolutely. Dr. Jones, very well put. We are resilient, but we're also kind of exhausted right
19:21now at this point. So self-care is very important and very necessary. Thank you for sharing this important
19:27information. Thank you for teaching us how to be our best advocates. And thank you for the work
19:31that Johnson & Johnson is doing around maternal health. I don't think there's anything that's
19:35more important than supporting black mothers and black babies. And thank you to Essence for providing
19:41this amazing platform to have this conversation. Have a great afternoon, everyone.
19:45Thank you for the time. Thank you.
Comments