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LifestyleTranscript
00:00Thank you, Dr. Lynn, and thank you all for being here.
00:12We're excited to be here today, and I'm excited to be here.
00:16We're even more excited that Dr. Courtney Phillips is with us today.
00:20Welcome, Dr. Phillips.
00:21Thank you, Michelle.
00:24Dr. Phillips oversees one of the largest state agencies in Louisiana, $14 billion budget,
00:32and more than 6,000 employees.
00:35She actually started as an intern at the Louisiana Department of Health.
00:39So tell us about your interesting career journey.
00:42Yeah, absolutely.
00:43So as Michelle said, I started as an intern.
00:46I didn't think my time in healthcare would always be in government, but once I started
00:51at the Department of Health, for me, that was an opportunity to serve, and I think once
00:56you go into service and you have a service heart, you have the opportunity to touch so
01:00many people.
01:01And so once I got there, I was struck by it.
01:03I had the opportunity to serve in various roles in Louisiana's Department of Health, from the
01:07Medicaid area to behavioral health.
01:10You name it, I did it.
01:11I served as chief of staff and then as a deputy.
01:13I had the opportunity then to serve as the CEO for the Nebraska Department of Health, and
01:19then moved to the state of Texas.
01:20And so it was very interesting going to two different states and then coming back home
01:24to sit in the seat where things started and to be able to give back to an agency that gave
01:28so much to me was an opportunity I just couldn't pass up when Governor Edwards offered me that
01:32opportunity.
01:33So I'm thankful to be back.
01:34I will say I was expecting a different kind of party when I came back.
01:38I was expecting hurricanes, just not the type of hurricanes that we had here in the last
01:42two years.
01:43When I accepted the job, COVID was just not on the horizon.
01:47And so coming back in April, March, April, it was an interesting timeframe and still has
01:52been over the last two years.
01:53So Louisiana gave me a great welcome party.
01:56Definitely.
01:57She says many times that she was bamboozled when she got here in April of 2020.
02:03So how does it feel now to be at Essence Festival 2022?
02:09Yeah, I think it's exciting.
02:10I mean, I will tell you, you know, last night I was like, ah, driving in and getting here
02:15and seeing all the people, all the buzz around town.
02:18It just makes you feel like we are back.
02:21It's been such a rough two years.
02:23I know for me personally, I'm sure for many in the audience, it was a rough two years.
02:27Sometimes it felt like four years, five years in these two years, we've had a lot of loss,
02:32a lot of heartache, a lot of trials that we've gone through in the last two years.
02:36So seeing everybody buzzing around, being able to be back together, not on Zoom, it's
02:41a nice feeling.
02:42It's almost, you know, Essence is a time for us to celebrate.
02:47It's an opportunity for empowerment.
02:49It's an opportunity for us to tell our testimony over the last two years.
02:53And I think we each have a testimony both individually and collectively in terms of what we have been
02:58through.
02:59And so I'm excited for us to talk about the specific topic of healthcare and that journey.
03:04And so I think, you know, folks being here today, seeing folks, and the fact that Essence
03:08created a health component, I think is pretty telling.
03:11The fact that we have folks between the Wellness Hub and the Health Hub, I think is telling in
03:16terms of us recognizing the importance of healthcare in our culture, in our life, and going forward.
03:23And so for me, it's a great opportunity.
03:24Good, good.
03:25I think everybody would say that it's good to be back outside again, right?
03:28All right.
03:29Yes.
03:30Let's give it a round of applause for being back together.
03:35Now, talk about COVID.
03:37Two years ago, more than two years ago, COVID changed our lives forever.
03:41And Louisiana was one of the hardest in states in the nation.
03:46Considering where we were then and where we are now, we've made great strides.
03:50Talk to us about what you attribute to that.
03:53Yeah.
03:54So Louisiana was, as Michelle mentioned, on the cusp of COVID.
03:57If you guys remember, March of 2020, we were leading the cases worldwide in terms of our
04:03growth of cases.
04:04And so we were the hotspot.
04:05While we may not have been the first case in the U.S., we had the highest growth rate,
04:09not just in the U.S., but in the world.
04:11And so it was all hands on deck in terms of our response.
04:14I think one of the things that COVID brought to light, and while we're talking about Black
04:18health in America, is the disparities.
04:20And many say, you know, wow, these things came to fruition.
04:23These things that come to fruition, they always existed in our healthcare system.
04:27COVID shined a much-needed light.
04:30Many of us in the Black community are already aware that those disparities and inequities existed.
04:35I think the healthcare system overall knew that these existed.
04:40I think society knew that they existed.
04:42But I think they had the opportunity to pull the covers over it and not address it.
04:47And COVID forced us to address it.
04:49Individuals asked for data.
04:51They wanted transparency.
04:53Too many of our loved ones in the community were dying, and it caused attention, much-needed
04:58attention.
04:59And it was in such a short timeframe that we saw the loss of lives.
05:03And so I think that was an opportunity for us to take a step back, to say what is happening,
05:07why is it happening, and to use that to push forward.
05:11I think in Louisiana, what we saw—and we saw this across the nation.
05:14It's just that our numbers were so much higher early on because we were at the start of it.
05:19We saw Black Americans, Black Louisianians, catching COVID, contracting COVID at a much higher
05:25weight than our white counterparts.
05:27We also saw the death rate of Black Louisianians at a much higher rate than our white counterparts.
05:32When you look at what those rates were in March of 2020, when you look at per 100,000,
05:38Black Louisiana residents were dying 16 per 100,000.
05:42Our white residents were at four per 100,000.
05:46We were dying at a four times higher rate than our white counterparts.
05:50And then the average on the national average was close to it.
05:53Now, again, what was attributing to that?
05:55We know there are so many underlying things.
05:57But again, the call for action made us push forward.
06:01Governor Edwards here in Louisiana enacted immediately a health equity task force.
06:05We put up a transparent dashboard in our state so folks could see where they stood by parish,
06:11understanding the race elements behind it, both for cases, tests, vaccinations,
06:17that information we continue to build out.
06:19And I think that's important because when you see where you are, it's pretty telling.
06:23That data makes you take pause.
06:26And that's what happened in our nation.
06:28We took pause and said, what can we do?
06:30And I think, frankly, we had had enough of our loved ones dying and not at an equal rate.
06:35And because of that, many things had to go in place.
06:39And I'm excited to say that here in Louisiana, one life loss is one too many.
06:44But if you look back in between March 2020 and where we are now,
06:49we continue to see Black Louisianians' rates for COVID still are higher.
06:53But what we don't see is that disparity between the death rates.
06:57So remember what I said, it was 16 cases per 100,000 that we were losing white—I mean,
07:02Black Louisiana residents, in comparison to 4 per 100,000 for white Louisianians.
07:07Fast forward to January of this past year, when we look at where we were,
07:12for Black Louisiana residents, we were a little over 4.79 per 100,000,
07:18in comparison to the 16 per 100,000.
07:21That is a massive reduction.
07:24We are now dying at a less rate than our white Louisiana residents.
07:28That is absolutely amazing.
07:30And we don't see that in any other health indicator here in our state.
07:34And I will tell you, it was not easy.
07:36Many told me that it could not be done.
07:39We would have that disparity.
07:41But we couldn't have that disparity.
07:43When we look at the peer data in terms of the number of lives lost in our community,
07:47Black children across the nation, they were losing more grandparents,
07:52more parents, and more loved ones and caregivers in comparison to white children.
07:57We were losing one out of every 310 children lost a loved one,
08:01in comparison to one out of 738 for white children.
08:05That's a loss that we're going to feel in our community for generations to come.
08:10We are not prepared to deal with that yet.
08:12That number hasn't set in.
08:14We will have so much work to do.
08:16And so when we talk about the data, and I talk about the numbers and the number of lives lost,
08:22and the change in the death rate, I smile because when we went from 16 to 4,
08:29think of the number of grandparents, parents, uncles, aunts, cousins, family members,
08:36friends, co-workers that we saved here in Louisiana.
08:40That is absolutely tremendous.
08:43And it wouldn't have been—it wasn't just the work of the Louisiana Department of Health.
08:46It was all of the health system, all of our community workers,
08:49the executive branch, the legislative branch, public, private, nonprofit sector,
08:53that came together and said, OK, we're going to do this.
08:56But you asked, what do I attribute this to?
08:58I will say, one of the things I think we could really lay our hat on,
09:02and we're still working on the data analysis,
09:04is our vaccination rates and how we rolled out here in Louisiana.
09:08Every state had the opportunity to do it different.
09:10And for us here, for me, this was an opportunity for us to take a step back
09:16and to say, this is a fresh start in terms of our health care and our programming.
09:20We could have been quick.
09:22We could have pushed everything out immediately.
09:24But if we had done that, we would be no different than where we are in every other health outcome.
09:29And so we took a little bit more strategic approach.
09:31We took a step back.
09:32We looked at zip code data.
09:34We looked at where we had physician offices, where we had community clinics,
09:39where we had pharmacies.
09:40And in zip codes that we did not have those, we created those opportunities.
09:45We partnered with churches who did mass vac sites.
09:48We partnered with our Councils on Aging who did robocalls, hand-holding,
09:52transporting our elderly population.
09:54We worked with barbershops.
09:56We worked with everyone.
09:58We brought in minority and clinicians to help us to understand how do we reach the population.
10:02We did this on the front end.
10:04And because of this, you will see that our rates in terms of vaccination efforts match our demographic here in the state.
10:11So Louisiana is 33% of black residents.
10:14When you look at our vaccination rates, we are 33% of all vaccinations initiated for COVID here in our state are to African Americans here in Louisiana.
10:23More than 50% of our black residents here in our state are vaccinated.
10:27Again, that was not easy, but it was intentional.
10:30This was an opportunity that we say, if you start from the beginning and you're intentional, you will see the results and they will pay dividends.
10:38And these were dividends I couldn't even imagine.
10:40I knew we could make a difference.
10:42I knew we could decrease the inequity.
10:44But I did not think we would reverse the rate and have a less in terms of death rate for black Louisianians.
10:51And so, to me, that was a phenomenal undertaking that we did here in our state.
10:55Definitely making great strides.
10:58And like you say, it's very intentional, very strategic in doing that and got the results that we really wanted.
11:05You also said earlier about the health disparities that affected the black community were there long before COVID.
11:12And so let's talk about some of those chronic illnesses in the state of black America's health.
11:17Where do we stand?
11:18Well, I'll tell you, we have some work to do.
11:21But just think if we put the work that we did into COVID and solving some of the inequities that we saw, if we put that same effort, passion and that energy into the current existing health care infrastructure, we can make the strides.
11:36It's possible.
11:37So when we talk about heart disease, we're leading the way.
11:42When we talk about cancer, we're leading the way.
11:45And I don't mean in a good way.
11:46I mean in terms of the prevalence and death rates.
11:49When we talk about diabetes, we are leading the way.
11:52Let me get a little bit more specific.
11:54Let me talk to black women in the room for a second.
11:57When we talk about cancer, looking at black women in general, we have an 8% less prevalent rate than our white counterpart.
12:06But yet, when we look at our death rate, we are much higher, 19%.
12:12Why so?
12:13It's because we are not getting screened early enough.
12:16Our diagnosis is happening much later stages, which means our chance for survival has been reduced.
12:22That should not be—if we have an 8% less prevalence, our death rate should be much lower.
12:28Let me talk to the men in the room.
12:30You have a 6% higher prevalence than white men, but yet you are dying at a much higher rate.
12:37Again, that's because we don't get screened.
12:40And when we do have a screening, we don't go back for the follow-up care.
12:44This is an area of opportunity that we have.
12:47It is critical that we do take that step.
12:50I'm going to shift to black women again and give you another example.
12:53I'm going to talk about breast cancer, because that's something that we highlight across the nation
12:57and have put a lot of education and resources into.
13:00But when we look at breast cancer, black women—we usually fall below white women in terms of prevalence,
13:05of how much we're contracting breast cancer, that disease prevalence.
13:09But we are 41% more likely to die from breast cancer.
13:14So let me say it again.
13:16If we compare ourselves to white women in that population, we have a less prevalence of breast cancer.
13:22Yet we are 41% more likely to die from it.
13:26This is something that we can help assist with, getting our screenings, holding ourselves accountable.
13:31And the list goes on in terms of stroke, obesity, of where we stand.
13:36We have work to do in terms of our chronic disease in the black community.
13:40Yeah, we have work to do.
13:42We're making some strides, but certainly have a lot of work to do there.
13:46You talk about the physical health of everyone and the chronic illnesses.
13:51But we know that mental health is just as important for everyone—our mental health and our mental state.
13:57Talk to me about how COVID impacted mental illness in the black community,
14:02and what can we do in that area to help improve it and to help dispel many of the myths around mental illness in the black community.
14:11Yeah, you're right.
14:12In the black community, we often talk about chronic diseases, our physical health, and we shy away from the mental health component of it.
14:20I think part of what we have to do is to take a step back to understand that mental health is impacting us.
14:25We are not immune from it.
14:28When we look at our rates, we're 20% higher in terms of mental health illnesses in our community.
14:34But yet we don't talk about it at all.
14:36When we look at suicide rates, there was a study done from 2003 to 2017.
14:41Our black youth increased their suicide attempts by 73 percent, in comparison to a little over 7 percent by their white counterparts.
14:50Our children don't know where to go.
14:52We have not created an outlet for them to feel comfortable sharing their feelings, their thoughts, and their concerns.
14:59Because we ourselves, as black adults, have not supported or wrapped around the need for mental health services.
15:06I'll say this. We just talked about how hard the last two years was.
15:09At this point in time, we all could benefit from some mental well-being after what we've been through the last two years.
15:15So, as our community, we have to take a step back and not shy away from the mental health conversation.
15:20When we're talking about cancer, when we're talking about heart disease, diabetes, mental health, maternal health have to be in that conversation.
15:28It should be hand-in-hand woven in.
15:30It should not be a separate conversation.
15:32When we talk about being the well-being of ourself, it's physical health plus mental health that increases our whole health.
15:39Until we have opportunities, the stigma in our community has to stop.
15:42Instead of us talking about, oops, why did Courtney go to therapy?
15:47What's happening to her?
15:48Why does she need therapy?
15:50All that shoo-shoeing we do in our community, we should stop that.
15:53We should give a round of applause for the person who does say, you know what?
15:57I'm not worried about what my community says.
15:59I'm worried about my well-being and prioritizing my health so I can take care of my family.
16:04We should applaud those folks for saying, I need to be well in order to care for others.
16:09We have to change the dynamics of the conversation in our community.
16:12We have to be okay with not being okay.
16:15Absolutely.
16:16Look, we're never okay on every single day.
16:18It is okay.
16:19Definitely.
16:20Definitely.
16:21Now, we've talked a lot about the challenges facing the black community.
16:25Let's talk about some of the solutions.
16:27What can we do to improve our overall health and to make our communities healthier?
16:32Yeah, I do want to, before I jump into some of the things that we can do, because oftentimes
16:36when we talk about health, and you start to see this more that folks are talking about
16:39the social determinants of health, because we know you can't talk about health in isolation.
16:43It's not in a vacuum.
16:44And so, some of these disparities and inequities that exist, they have been longstanding because
16:49of institutional racism.
16:51They are longstanding because of institutional bias.
16:54And so, we have work to do in terms of that piece.
16:56It's not just about the health service.
16:58We can look at where you were born, where you grew up, where you live today.
17:02Where did you go to school?
17:04Did you have access to clean water, nutritious foods?
17:07There are a multitude of things that play into your health and your health today.
17:11And those are the things that we absolutely have to focus on and to gear up to where we
17:17need to go.
17:18But let's talk about what are some things that we need to do.
17:21And oftentimes, when we say we need to do, we're talking about an individual.
17:25So, let's switch it up a little bit because the onus is not just on us.
17:28I'm going to get to us individually in a minute.
17:30But there are other components of the health system that we need to step up.
17:34So, the systems and organizations, we need them to step up.
17:37The reality is our systems and organizations at every level should represent who they are serving.
17:43And so, while we're talking about we want more clinicians of color, we need more CEOs of color.
17:48We need more chief operating officers of color, more chief financial officers.
17:52Because at the end of the day, those individuals are making policies and programs that impact us.
17:57And without that lens of representing us, we are missing an opportunity for the best service.
18:02And so, oftentimes, we have organizations—and I'm talking about public, private, nonprofit—we
18:07say we want to go into this community and we want to help solve the inequities and the
18:11disparities that exist.
18:12But I'm a firm believer that if you don't clean up in your own house, then you can't
18:16go into somebody else's house.
18:18And so, until you do that organization review and you put on that lens to say, are we where
18:23we need to be in terms of diversity and inclusive, you cannot go out to help another community
18:29because you don't have that perspective in the community in your organization.
18:33And I'm not saying because it's not best intentions, because many times organizations
18:37are well-equipped and very invested in trying to do the right thing.
18:42But if you don't exactly know what the right thing is, how can you do it?
18:46And so there's many things that an organization can do.
18:48But let's shift to healthcare professionals.
18:50Again, there are biases that exist, and they have to recognize that biases exist in terms
18:55of the practice.
18:57One of the things that I think we do need to do in this nation and in our state is to
19:00increase the number of clinicians of color.
19:04We don't have enough.
19:05When we talk about mental health, we know that there are only 2 percent of black Americans
19:10that serve as psychiatrists, 4 percent of psychologists that are black.
19:15So if I'm looking for someone that may have relevance of understanding my culture and my community,
19:20I'm going to have a hard time finding someone that looks like me and may understand my journey
19:24and what I'm going through.
19:27And that's the same thing when we talk about other clinicians of color.
19:29I'm talking about doctors.
19:30I'm talking about nurses, nurse practitioners, therapists.
19:33Across the board, we need to increase in that and invest in it.
19:37And that doesn't just start with someone graduating out of the university.
19:41That starts early on in the education system, making sure we have investment in STEM programs,
19:46making sure that we identify students and give them the resources to support to move forward.
19:51And once they get into these curriculums of healthcare, we have to make sure they're supported.
19:56Oftentimes, we are the first in our families to either go to college or into this clinical program.
20:01So we don't have a cousin or a mom to call back and say,
20:04I'm struggling with this particular coursework.
20:06Can you help me?
20:07Oftentimes, our counterparts can call back into generations of their family who serve in that.
20:12And so, again, it's the onus of us stepping up and fixing the system along the way.
20:17Now, in terms of the individual, what can the individual do?
20:20Lots.
20:21We see where our health outcomes are.
20:24We need to invest in ourselves.
20:26Preventative care is key.
20:28It is absolutely key.
20:30Making sure you get your screenings on time.
20:33Having those conversations about healthcare in an everyday setting.
20:37I know for me, when we talk about individual, I need more of a group.
20:41I'm one of the ones who I know my screening is due, but everything pops up.
20:46Everything comes to fruition.
20:48I have to take my kids to do this.
20:50I have this for work.
20:51And I'm going to put it off.
20:52I'm going to put it off to next week, the following week.
20:54And before you know it, it's two months later and I have not had my mammogram.
20:59And so, create a group structure where you all hold each other accountable.
21:02Instead of going on a happy hour, go to happy health conversations.
21:06Do a happy walk conversation.
21:08It can be done.
21:10We have to push each other and support each other.
21:12The other piece I'll say in terms of the individual is that we have to take a step back,
21:17again, for self-care.
21:18That could be anything from long walks, bubble bath, quiet time.
21:23Those things are important.
21:24It's important for us to forgive ourselves.
21:26We will make mistakes.
21:27So, when we talk about mental health and the burden, a lot of times it's the onus of responsibility
21:32that is on us, that weighs us down.
21:35And I will also say part of what, for an individual, is starting.
21:40Start today.
21:41Don't start when you leave Essence Festival weekend because you want to eat all the good
21:44food in New Orleans.
21:45We have healthy options as well.
21:46Start today.
21:47Don't wait until after summer, because before you know it, then you'll be saying, after Thanksgiving,
21:52after Christmas, and then you'll say, I'm doing it for my New Year's resolution.
21:56And then, all of a sudden, next year I'll be looking at you in the same room, 2023, and
22:00you'll be saying, what should I do?
22:02Should have started.
22:03But I'm going to encourage you to start next year, too.
22:05But we have the opportunity.
22:06We just have to come together to make it happen, to make it work.
22:10The other thing I will say in terms of an individual is that if you know you cannot advocate
22:15for your health and you are a little bit milder in personality, bring a friend along with
22:21you for some of your appointments.
22:23There is nothing wrong in the event that if your provider is trying a regimen and a course
22:28that isn't working, for you to say, can you refer me to a specialist?
22:32We are less likely than our white counterparts to be referred to a specialist.
22:36Ask for it.
22:37It is okay to have someone advocate for you, especially black women going through pregnancy.
22:42We all know someone that has had a challenging pregnancy.
22:46Black women are three times more likely to die during childbirth.
22:50If you don't think you're going to be able to do it, have somebody with you who can advocate
22:54for you to make sure your concerns are articulated and heard and combated.
22:59And so, again, I think we have so many opportunities that we come together to really make that work.
23:03Definitely.
23:04It's about making yourself a priority and not at the end of the list, which is, a lot
23:08of times, women do.
23:09We put ourselves at the end of that list instead of the beginning.
23:12Absolutely.
23:13We have just a few minutes more.
23:15Anything that you want to say that you haven't had an opportunity to say or really want to
23:22leave with the people of Louisiana about taking care of their health and leading healthier lives?
23:27I could go on forever, but I would say we have one life.
23:31It is best for us to live it and to enjoy.
23:34And in order to have that longevity, we have to invest now, not just for ourselves, but for
23:39our children and our grandchildren.
23:41Healthy children become healthy adults, and so investing in them early on until they have
23:46that forthcoming will be a takeaway for us.
23:49The other thing I would say is that we have health hubs all across this convention center
23:54providing screenings and education.
23:57Please go visit them.
23:58It's important that we get this education in our community.
24:01And as it relates to COVID, I would encourage you to stay up to date on your vaccine series
24:05so we can stay safe, because none of us want to repeat the last two years.
24:09So thank you all for coming.
24:11I want to thank the Department of Health, Governor John Bel Edwards, and all of the entities
24:17who participated in making the Health Hub a success this year.
24:20So thank you.
24:21Thank you so much, Dr. Courtney Phillips.
24:23Secretary of Louisiana Department of Health.
24:26Isn't she amazing?
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