- 22 hours ago
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LifestyleTranscript
00:00on board.
00:15Welcome, everyone.
00:22We're excited to jump into this conversation today.
00:25As someone who's a psychiatrist and thinks about how we think,
00:30and our psychology, and as someone who creates content that reaches millions of people,
00:34I'm always looking at different ways to explain complex medical things to the lay public, right?
00:41So I'm excited to have this panel of professionals.
00:44We have just about every sector of health care represented on this stage,
00:49and we're going to talk about how certain policy changes impact you, right?
00:54Because a lot of times we don't fully understand what these headlines mean,
00:57and this is a way to break it down so that you can feel empowered,
01:01so that you know how to take actions that are the best choices for you.
01:06So I'm going to start with the facts.
01:08I have Dr. Mitchell here who is a leader of a major hospital health system,
01:14and, you know, a lot of times we see a lot of numbers.
01:17We don't understand how that impacts us.
01:19So please, you know, tell us about some of the important statistics that we should all know about.
01:24Well, thank you.
01:26It's great to be here at Essence in the Global Economic Forum once again to talk about the state of health care.
01:33I'm a forensic pathologist, and you may not know what a forensic pathologist does.
01:38We do autopsies.
01:40We look at death and understand life and understand health through the lens of the autopsy.
01:47I am now a hospital president, president of Howard University Hospital there in Washington, D.C.
01:53Thanks for the shout-out, that one person.
01:57And so one of the things that we have to realize is that we measure our ability to move the pendulum on health care through fatality statistics.
02:08Unfortunately, mortality statistics play a part.
02:11And so when we talk about the number one killers of our community, hypertension and cardiovascular disease is the number one killer of both black men and black women.
02:23But what's also important is that adolescent men and adolescent children and children in general, the number one cause of death is homicide.
02:33So you can't even talk about health care without talking about violence.
02:37But let me give you a couple more statistics.
02:40Of heart disease, black men are 30% more likely to die from heart disease than their white counterpart.
02:48Black women are 60% more likely to die from cardiovascular disease than their white counterpart.
02:54A lot of people don't talk about black women and cardiovascular disease, but that's extremely important.
03:00When we're talking about breast cancer, our black women are 40% more likely to die from breast cancer than white women.
03:08Prostate cancer, black men are two times more likely to die from prostate cancer than our white counterpart.
03:16And so these are the striking statistics and really a baseline of this climb that we have to do.
03:23And we need to understand that these particular statistics are things that we can change.
03:29It's so important to understand how the numbers impact us, because then it becomes stories versus just, you know, numbers that we don't understand.
03:38Dr. Janae, tell us about how the changes in health care policy impact us.
03:43You and I were talking earlier about how in the car your Uber driver was saying, wow, like, my Medicaid is cut off.
03:49What do I do next?
03:51So as someone who is a leader in policy, what should we know?
03:56Yeah, thank you.
03:57It's really just an honor to be on this panel.
03:59I'm here at Essence.
04:00You know, I'm a practicing urban ER doctor.
04:03I've worked in corporate health care.
04:05I've led state and local public health Medicaid programs and in the nonprofit space as well.
04:10And I'll tell you, I am very concerned.
04:13I'm very concerned for my patients.
04:16I'm concerned for the organizations that support the patients and their communities that I take care of.
04:22And quite frankly, I'm very concerned for my own family.
04:25And let me tell you why.
04:26We currently have, really, I would say, a perfect storm of policies that are impacting communities across the entire country.
04:36So I'll talk about some of them.
04:37I could go on and on and take up all the time, but I won't do that.
04:39But I'll just talk about a little bit, right?
04:40So let's talk about Medicaid.
04:44Medicaid is the insurance for about 70 million, over 70 million people across this country.
04:51Four in 10 children have Medicaid as their insurance.
04:54Six out of every 10 people living in a nursing home.
04:58About one out of every five people on Medicaid are African American.
05:04And so there was a bill that was just passed and is now law in the past week where it's estimated that about 17 million people will lose their Medicaid insurance.
05:15So what does that mean?
05:17Again, I'm an ER doctor.
05:18That means that people are going to forego, not get the preventive services that they need.
05:24They're not going to be going to their primary care doctor.
05:27They're not going to be getting that surgery that they needed, right?
05:30That means when they do come into the ER, which is, you know, by law, we see everyone who comes through our doors,
05:37they are going to be sicker and they are not going to be able to have a bed for me to put them in.
05:43And our ERs are going to be busier, not just for people with Medicaid, but for everyone who's coming into the ER.
05:48I talked about nursing homes.
05:50Medicaid is a primary payer of long-term care services in this country.
05:55So if you and all of us, if you live long enough, you will end up having some type of disability.
06:00You will need help.
06:01You might need a nursing home.
06:02You might need services so that you can stay in your home and live at home as long as possible.
06:08Unfortunately, with the Medicaid cuts, people are not going to be able to have those services.
06:12I don't know of anybody who can pay for all of that out of pocket, right?
06:15We also know the hospitals and the clinics that serve people, not just with Medicaid or who do not have insurance, will be impacted.
06:23And many of them actually will close.
06:26I also work in public health.
06:28Your health department is the one that is making sure your food is safe to eat.
06:34It's making sure pools are safe to swim in.
06:36It's providing those preventive services in communities to prevent chronic diseases, to prevent injuries like gun violence, drownings, falls in the elderly.
06:47I could go on and on.
06:48Those services are either being eliminated or cut significantly.
06:52So I'm very concerned.
06:54I'm concerned that the system that we are all used to working in and living in is being dismantled,
07:01is going to significantly impact every single person in this country.
07:05I'm concerned not only for black people.
07:08I'm concerned for people with disabilities.
07:10I'm concerned for the elderly.
07:12I'm concerned for the poor.
07:13I'm concerned for people living in rural communities.
07:16I could go on and on.
07:17But we are really living in very serious times right now.
07:20And I think it's very important that people understand that and pay attention.
07:24It's really helpful to understand how many different people across development are impacted.
07:30Children, elders, adults, folks with disabilities.
07:34And, you know, what you said about preventative care, I don't think many people think about these services as preventing, you know, health care outcomes that are negative.
07:44And so that leads me to you, Dr. Danielle.
07:47You work with a large organization that supports health care professionals.
07:52And we're the ones on the front line.
07:55How are these policy changes going to impact health care professionals?
08:00Yes, and I have to give a shout out to Maryland.
08:02My governor's here.
08:03My first lady's here.
08:04My mayor's here.
08:05I'm a resident of Baltimore.
08:07So I'm really excited to be here.
08:08So, and Dr. Junae, thanks for the setup.
08:13Because for me, I have the privilege of having three hats.
08:16I'm an academician.
08:17I'm an acute care nurse practitioner.
08:19And I'm a leader of an organization that focuses on the diversity and development of nurses of color that are in leadership spaces.
08:26So from my academician hat, we're seeing the disruption of an already fractured pipeline of getting the diverse talent into the schoolhouses.
08:35We're also seeing the decreases in funding and scholarship and support that eliminates those financial barriers for folks to have access to quality higher education.
08:44And then that just spirals into the shortages of having faculty and let alone faculty of color that represent the diversity that we need to keep and retain the talent within the schoolhouses.
08:57And then you add in the lack of the gutting of the research funds so that we are able to build up the body of research to inform the evidence for us to be able to teach the next generation.
09:09And so when I think about from my acute care nurse practitioner hat, I work in the ICUs.
09:14So I see the fallout from all the failures of preventative health care, from folks not getting the adequate primary health care, or losing access to safety net hospitals that are stationed in urban, city, rural areas.
09:29And so it's increasing this time of patients actually going to get access to health care.
09:36And then with this new legislation, it's going to be closing a lot of hospital doors.
09:41So there's going to be tons of hospital deserts.
09:43And so by the time they come to my doorstep in the ICUs, that roadway or that runway to recovery is drastically shortened because they hadn't gotten that immediate acute care to help them get a fighting chance to be able to move through that system.
09:58And then I think about my colleagues, COVID already amplified an already burnt out, morally injured health care profession.
10:08And so you put us in an already fractured health care system.
10:12And then we put in these policies that continue to fracture and break the system on providers that are already feeling morally distressed because we can't take care of our patients according to the evidence, according to the latest best practices,
10:25because we don't have access to the resources, and then we're seeing these patients with these multiple complex comorbid conditions.
10:32So we feel hopeless and helpless because we have the knowledge, we have the skill and expertise to take care of the communities and the people, but we have insurance companies dictating.
10:44We have the current laws dictating on how we actually implement that care.
10:48And then from my hat, leading a nonprofit called DMPs of Color, I'm the president, founder, and CEO.
10:54And so this aspect, my hat focuses on those that have gone through the education that are currently practicing, but because they have their DMP, which is a doctorate in nursing practice,
11:05it affords them a certain level of power and influence and education to be at these decision-making tables where they're calling the shots, where they're making the budgets.
11:14But now they're starting to have to make these difficult decisions of layoffs.
11:20How are we going to get funding to do research for our providers to practice at the evidence-based levels?
11:27And so it's really a profound hit on the ecosystem of health care that we know of today.
11:36So seeing it from my three hats, it's going to be a pretty profound impact.
11:40It is, and I'm glad that you brought up research because we know these policy changes are impacting research funding.
11:48And research is a way that many people access care.
11:51You know, it's not just being a guinea pig.
11:54Some of these research protocols are actually a primary source of treatment.
11:58And so I'm excited to talk to you, Dr. Lauren, about how research can bridge the gap, especially privately funded research, when health care policies may not, you know, be able to provide the care that we need.
12:13Yeah, absolutely.
12:13And it's a pleasure to be here.
12:15Thank you for having me.
12:17It's interesting.
12:18As I was listening to everyone's response, I was thinking about how all of these areas apply to drug development.
12:23And I don't think everyone, like, sees the connection there so readily.
12:28So what Dr. Roger was talking about around all the statistics around, you know, the inequities within certain disease areas, that's certainly present in many of the disease areas we study across, widely across the industry.
12:40And Dr. Jone was talking about cuts to Medicaid and the implications for that, right, for preventative services, for even testing, for the ability to us to even know the incidence and prevalence of diseases.
12:52The implications of the cuts there for us in drug development and not having a lens now into really important data that we need to make, like, critical decisions about where diseases are, where they cluster, who is most impacted by them, all the way down to workforce challenges, right?
13:12And not realizing that there's an entire ecosystem of a healthcare workforce behind clinical trials, behind drug development, that we need research nurses and clinical research coordinators and the implications for that, even for us now in drug development.
13:27And so when we're at a juncture right now where only 8% of patients that participate in clinical trials are African American, what does it mean to have all these additional, like, roadblocks now in front of trying to make a difference there?
13:42There's quite a few challenges that we certainly have to work really hard to overcome.
13:47We're working on that in a couple of ways, and being here is one way.
13:51I think, you know, sharing information in places that are community-centric, that are culturally relevant, and that present information in a very digestible way has to be a way of life, I feel like, for us moving forward.
14:05If we're talking about the state of black health, if we're talking about the state of black health, I think we have to continue to be in spaces.
14:09It's, like, now more than ever.
14:12We have to be in spaces like this.
14:14We have to share information in ways that it's easy to understand because there's such a significant effort to, like, make sure people don't have information, the right information that they need.
14:28And so, you know, I think all of those ways are ways that we're thinking about and much more.
14:33That was a very nice way of tying all of these different sectors together because, you're right, they are very connected.
14:40And it's not just the policy that's changing.
14:43Technology is changing.
14:44We all hear the word AI and their emerging tech that are creating different changes in health care and the way it's delivered, the way that data is interpreted.
14:53And so, I'm going to go back to you, Dr. Mitchell, because you see health care from this umbrella of different hospital systems.
15:01What are ways that AI and emerging tech are impacting health care delivery?
15:06And how do we learn about this so that our community is not left out of the conversation?
15:11Yeah, I'm glad that we're talking about solutions, right, because there's a lot of obstacles right now that we're facing.
15:21And it can feel daunting.
15:22It's Sunday, so, you know, I've got to bring up a scripture.
15:27In James 1 and 2, it talks about count it pure joy when you face obstacles of many kinds because it produces perseverance, right?
15:37And so, this is the climate we're in is that perseverance.
15:40I'm the incoming president of the National Medical Association, the oldest and largest group of black physicians in the country, 1895.
15:48And some of the areas that we're talking about are artificial intelligence and economics and making sure that we bring and make sure artificial intelligence is part of health care delivery no matter where you are.
16:06So, some of you right now have your phones and you're getting your labs on your phones, right?
16:11That's part of the artificial intelligence.
16:14I'm sitting next to the doc and I forgot my wearable.
16:17She has her aura ring on.
16:18We don't get any money from aura, so maybe they should give us some dollars.
16:22But everybody should, you might have a smart watch.
16:27Imagine if we were able to get wearables on everybody, right?
16:32Where your status of your blood pressure, your sleep, your numbers are at your fingertips.
16:41Because the things that we monitor are the things that we change.
16:45At the end of the day, we know that prevention is really the art of medicine.
16:51In Western medicine, a lot of the times, it's individuals that come in after something has gone so bad that now you need a surgery.
16:59And yes, that's a very important of health care delivery.
17:02But what's the most important is whether or not we can prevent it.
17:06So one of the things that we want to work on at the National Medical Association is to make sure that we have ambient AI technology for all of our providers.
17:15And making sure that our providers can carry on their phone and place their phone down and have a conversation with their patient.
17:23And that conversation shows itself in the medical record as a full note.
17:28So that way, that physician can spend more than 12 minutes with you.
17:32On average, the physician is spending anywhere from 10 to 12 minutes.
17:36But maybe they need to spend 15 minutes with you.
17:39Depending on what you have and what you're dealing with, maybe 20 minutes.
17:43So we want to make it easy for the physician to spend that time with you.
17:48These are the types of things that we need to be leaning into.
17:51Getting your wearables, making sure that you have access to preventative constructs.
17:59And leaning into the AI space, if you're entrepreneurs, leaning into the health AI space is going to be extremely important as we move into the next phase of this new health care delivery system that we have to create for ourselves.
18:14And if I can add on to what you were saying, so much has been said there.
18:20The way that AI is being leveraged even in drug development is so significant.
18:25Even like wearables.
18:27There are now clinical trials in some ways that are monitoring using wearables.
18:32And so if our community doesn't have access even to that, doesn't understand the value of that or how to even use it, it's not easy to set up a Fitbit on your phone.
18:42Everyone doesn't have a smartphone to do that.
18:44Everyone doesn't have the data, the Wi-Fi.
18:46There are large swaths of this country that still does not have Internet access.
18:50So it's a greater hurdle to have to overcome, right, as AI and, like, health technology continue to be, like, more deeply woven into the tapestry of health care.
19:03And I'll just kind of jump in, jump in as well.
19:05You know, I think it's also important, you know, in the spaces that I'm in, particularly with African Americans, there's a lot of mistrust of AI.
19:11People don't want AI being involved.
19:13It's like the boogeyman.
19:15And what I say is, to your point, we need to lean in.
19:19AI is here.
19:20It's already been used.
19:21What is AI?
19:21All AI is is a bunch of data.
19:24It's put into a computer system.
19:26That computer system, if you will, I'm keeping it really simple here.
19:29That system has been told how to interpret data, how to analyze data.
19:35And so it's basically just giving some rules.
19:36So they take your data, they apply the rules to it, and they spit out whatever it is, whether it's a prediction, analysis, what words to say.
19:44That's what AI is.
19:45And it's already here.
19:46As an ER doctor, it's already helping me think about diagnoses for my patients.
19:51I went to the doctor recently, and the doctor was like, hey, you know, Jone, can we use this app?
19:56I was like, absolutely, please, because I would love for you to just, like, make eye contact with me, right, when I'm in the doctor's office instead of looking at your computer.
20:03So AI is already here.
20:05It's being used in radiology to improve diagnostics, being able to diagnose breast cancer.
20:11So AI is here.
20:12I would encourage people to lean into it, learn about it.
20:16You don't have to develop a new technology.
20:18We can talk about Oura Rings.
20:19Just lean into it.
20:20Understand it so that when people are making policies about how to use AI, there's people with different experiences who are at the table to develop those policies.
20:30Because the challenge is, and I'll stop after this, the challenge is we know that there's already a lot of bias, and the data is imperfect, and often we are not included in those data.
20:41So bias can be spit out.
20:42But there's also a lot of opportunity, as we've been talking about here.
20:46And that's something I'm glad you brought up, the lack of trust, because a lot of people think that AI will take away jobs from healthcare professionals.
20:54And so, Dr. Danielle, if you could just illuminate us there.
20:58Is AI going to take jobs away?
21:00Is it going to help us?
21:01You know, clarify that question for us.
21:04Well, you know, AI is not going to take away the value that we bring being in the healthcare space of centering humanity.
21:10And so one of the things that I charge us to do is, as we're leaning in, we also should be leading and developing the technologies.
21:18Because I know, speaking from the nursing perspective, you know, we haven't been so, what I've observed, we haven't been kind of leading in this space.
21:28And so I think that really charging us to focus in on how we can be part of the development, leaning in on learning about the new technology so that we can use it to help supplement the work, but not supplement us in the care and the health of people.
21:44And I'm so glad that you brought up how AI is changing research.
21:48As someone who runs a clinical research lab, I work with AI all the time with my patients who participate in studies.
21:55And it is a game changer.
21:56You can collect so much information from your individual health that helps your healthcare professional to tailor the treatment to you.
22:04We only have a couple of minutes left, so I just want to ask each of you, you know, one last thing.
22:08If you could just leave us with one note about the future of health for black America, what would it be?
22:13We'll start with you, Dr. Danielle.
22:15No one's coming to save us but us.
22:17And so for me, I want to charge us as panelists, I want to charge you to find ways to leverage your collective knowledge, power, and influence in your communities to identify gaps and opportunities for you to close some of those gaps.
22:32And I'm also charging us here in this forum to really think about creative and innovative ways to invest in community from the education perspective, from the advocacy perspective, and from a community perspective.
22:47I would say from my perspective, knowledge is power.
22:50And that's why there's a concerted effort to keep us from having knowledge about certain things.
22:56So knowledge is power.
22:58Pursue the opportunity to learn.
23:00I think it's on us to create opportunities, to share information with you.
23:05But knowledge is power.
23:07And our people have been here before.
23:10We have been in worse predicaments.
23:12And I know that we are resilient and we will overcome.
23:14Yes, we will.
23:16I would leave you with that health is in everything.
23:19W.E.B. Du Bois talks about the five policy areas, education, economics, housing, health care, and criminal justice.
23:27And if he was here today, he would say environmental justice as well.
23:30So those six areas of access, advocacy, policy, preparation, leaning in, giving all of your talents, all of your time into one of those areas that you feel best about.
23:43And understanding that access to those things will decrease the burden of disease and injury in our communities if we're engaging in those six areas.
23:53So no matter what it is, engage.
23:56I love that nobody's coming.
23:58And if they are coming, they're coming to harm us.
24:01And so we have to really lean into our ability to do what we need to do.
24:07I'm calling this era the new reconstruction era.
24:10And if you know the reconstruction period, you know that that's when we were at our best.
24:14Yeah, I would just add, you know, be knowledgeable.
24:18And quite frankly, on a very basic personal level, prepare yourself.
24:22No one is coming.
24:23Get your finances in order.
24:25Whatever you can do that's in your power to stay healthy, get your preventive care services, know that things are going to be hard.
24:31Things are going to be getting really challenging very quickly.
24:33Take care of yourself.
24:34Again, I know this is very individualistic.
24:36But that is what these systems are set up is for us to take care of ourselves, to take care of our families, and to take care of our communities.
24:43So lean into that.
24:44That is very serious right now.
24:46Well, I just want to say thank you to our panelists.
24:49And, you know, the information here was very powerful.
24:52So everyone, please give them a round of applause.
24:56Thank you for joining us.
25:06We'll see you next time.
25:24We'll see you next time.
25:28We'll see you next time.
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