A health equity podcast by students, faculty and staff of Public Health and Health Professions.
Season one co-hosts Tia Palermo, Schuyler Lawson and Jessica Kruger take a deeper look at racism and health. Experts from Buffalo and around the U.S. talk about how racism negatively impacts health, groups working to address this problem, and how to make our classes and campus more inclusive for all students.
Dr. Palermo: Hello and welcome to this episode of Buffalo Health Cast. I'm your co-host Tia Palermo and today I'll be discussing inequities in abortion access with my guest, Deborah McDowell Hernandez and Lucinda Finley. Welcome to you both.
Deborah McDowell Hernandez: Thank you for having us.
Dr. Palermo: Debora McDowell-Hernandez is the senior director of public and community affairs at Planned Parenthood of Central and Western New York, where she's worked for the past three and a half years.
Lucinda Finley is the Frank Raichle Professor of Law at the University at Buffalo. Her areas of expertise include reproductive rights and justice, gender and the law, tort law and First Amendment free speech. She is the author of several books and many articles in leading law journals. She has also argued a major case concerning the clash between the right to safely access abortion services and the right to protest before the U.S. Supreme Court. She also has handled numerous cases in the federal courts of appeals.
I'd like to start today with Deborah. Can you tell us a little bit about the geography of abortion access in the United States?
Deborah McDowell Hernandez: All right, certainly. First off, I would just like to say we're in. We're lucky to be or fortunate to be in the state of New York, which has a very abortion friendly legislation or law. We have the Reproductive Health Act, which was passed in 2019, which protects our access and right to abortion. But I don't think a lot of people realize how inaccessible abortion is in many parts of this country.
And although abortion is still legal in the US, if it's not accessible, what's the point of it being legal? And according to the Guttmacher Institute, thirty four percent of women or I can say individuals ages 13 to 44 live in states that are supportive of abortion rights, whereas 58 percent of people ages 13 to 44 are in states that are hostile or extremely hostile to abortion rights.
Dr. Palermo: And when you say supportive or hostile to abortion rights, can you just tell us a little bit what you mean there?
Deborah McDowell Hernandez: Right, so when I say supportive, I mean states that have created legislation to protect access to abortion. They don't require patients to jump through hoops to get an abortion, a state that might be hostile, although abortion is legal in that state. They might have all of these laws requiring a person to get an ultrasound and then return 48 hours, 72 hours later for another appointment and perhaps require that they have biased counseling that isn't medically accurate. But just making them go through these hoops for the sake of shaming them and just making having the actual abortion difficult.
Dr. Palermo: And you mentioned individuals of reproductive age, so realizing the importance of inclusivity and how diverse our community is. What can you say about people who have abortions?
Deborah McDowell Hernandez: Well, we can say that everyone who has an abortion or who is pregnant or has the ability to become pregnant might not necessarily wish to be identified as a woman. There are many people who have children, raise children, or choose not to have children, but they are. They identify as non-binary or gender fluid. So, trying to look at this from the lens of diversity and inclusion and not excluding anyone, I might refer to folks as individuals or persons instead of always women.
Dr. Palermo: Thank you for clarifying that for us. So, Deborah, can you give us a little bit of a background on the types of individuals who get abortions, some of the statistics and characteristics of people getting abortions in the U.S., right?
Deborah McDowell Hernandez: Most of us probably know someone who has had an abortion. One in four people in the US, will have an abortion by the age of forty-five. 59% percent of people who have abortions already have one or more children, so it's not something that is highly unusual. 75% of abortion patients are poor people of all races and ethnicities, and of a variety of faiths make a decision to have an abortion. And as far as race goes, white women make up the highest percentage of abortions at 39%, Blacks at 28% Hispanic or Latino at 25%, and other races account for 9% of abortion patients.
More than half of the abortion patients in this country are in their 20s, and they are in adolescence also make up 12% of patients.
I just I don't want to drown you with statistics. Abortion rate in 2017 was 13.5abortions per 1000 women aged 15 to 44, and that was down eight percent from 14.6 per 1000 in 2014. And 18 percent of pregnancies in 2017 ended in abortion.
Dr. Palermo: Thank you for that very comprehensive overview. Drilling down a little bit, can you tell us a bit about the abortion procedure? So, when during pregnancy, do most individuals seek abortion and how risky is an abortion procedure?
Deborah McDowell Hernandez: Well, first off, abortion is a very safe procedure. It's one of the safest medical procedures. anti-abortion folks or anti-choice folks will have you believe that abortion can cause cancer and all of these other things that just are not true medically and scientifically inaccurate. But very few people have complications or serious health effects as a result of having an abortion.
So, it's a fairly simple medical procedure to have. Two-thirds of abortions occur at eight weeks or earlier, and 88% occur in the first 12 weeks. And also again, as I said, there no relation between breast cancer and abortions, even though people will try to create these false narratives. People, if you can, we have there are a couple of options. Surgical abortion is one option. Medical abortion, which would involve ingestion or taking a tablet medication, is also an option for patients.
We recently had someone from the state of Texas who visited one of our health centers and was unable to get the medical abortion. But we called out to another health center in the Buffalo area, and they were able to make space for them to get a surgical abortion.
Dr. Palermo: So, you mentioned that an overwhelming majority, so 88% of abortions occur in the first 12 weeks of pregnancy. What are some reasons women seek abortion after the first 12 weeks?
Deborah McDowell Hernandez: Well, abortion is a very personal decision. So, there are a variety of reasons that people have this as their final decision. And sometimes it's just a matter of, you know, could be for emotional reasons, financial reasons. I've heard people who decided to have an abortion because they would have felt trapped in an abusive relationship. They were being emotionally or physically abused and knew that was one way that this partner would have kept them if they were forced to have a child.
So, some people might make a decision to have an abortion simply for their own mental and emotional well-being. There are times when people might opt to have an abortion because of financial limitations. Maybe they don't feel like they have the financial means to care for themselves or another person could be other things happening in their world. Medical reasons a person might have some health condition that would make it very risky for them to continue with the full-term pregnancy and deliver. Or there could be an issue related to the fetuses’ health. So, I think there's just a variety of reasons. But the biggest thing at Planned Parenthood, we try to always respect that it's a personal decision for the individual or anyone else they want to include in their circle, be it a faith member on family and friends.
It's their decision to make and we want them to have the right to make that decision without feeling shamed or stigmatized or anything like that.
Dr. Palermo: How do people pay for abortions?
Deborah McDowell Hernandez: And again, you're going to have a variety of ways, depending on the person's own financial background. Some people are able to pay completely out of pocket if they have the financial means, they might do so in their home state outside of their home state, even outside of the country. People who don't have the financial means might do so with some government assistance.
There are states that are very hostile, and you won't be able to get any support from them, but people are able to access abortion sometimes even with the help of their home state, the help of private funds There are many abortion access funds throughout the country that are funded through the generous support of Individuals, or organizations who want to make sure that abortion is accessible to those with limited means and those with means in between. So, you have a variety of ways in which people pay.
And then if you have an organization like Planned Parenthood and many other organizations throughout the country, they might honor a sliding scale system and different people might pay different things, be it for it could be some sort of family planning, type of service or STI treatment.
So, it's not necessarily one size fits all. A lot of it, depending on where you are, the state for county in which you live in the health care provider that you are visiting might have some flexibility and understanding what you can't afford.
Dr. Palermo: So, you mentioned state funding in some states for abortion. Can you clarify for us whether federal dollars can be used for abortion coverage?
Deborah McDowell Hernandez: Well, with the Hyde amendment that prohibits the use of federal funds for abortion, but even in New York state, New York State supports costs for abortion if someone needs that. So again, when I say about depends on where you live, the state in which you reside, it could be just, as I said, an abortion supportive state like New York. Or you could be in a hostile state which might not offer you much, except for a lot of hassle.
Dr. Palermo: So, I'd like to turn now to Professor Finley speaking about payment and access and coverage. What can you tell us about what the Affordable Care Act says about insurance and abortion coverage and how does this vary by state?
Professor Finley: The Affordable Care Act does not require that insurance plans cover abortion, it requires that insurance plans cover maternal maternity care. But not abortion.
Again, some states, including New York, have state laws that require that insurance plans within their state have to offer coverage for abortion, but that that New York law is currently under court challenge by employers who are using religious objections that they don't want to be forced to provide insurance to their employees that covers abortions. So, you know that that's a potential barrier to the law any laws that require private companies to provide insurance coverage to employees that covers abortion.
Dr. Palermo: Can you take us back a little bit, Professor Finley, and talk about maybe give us a quick overview of cases important cases in the U.S. with respect to abortion?
Professor Finley: Sure. I'll concentrate on the two main ones because there are way too many to talk about in this podcast, but you know the case that everyone I think knows by name, but few know what it really said is Roe v. Wade, which was decided by the U.S. Supreme Court in 1973. And in this case, the U.S. Supreme Court held that there was a fundamental right of a woman to choose whether or not to carry her pregnancy to term or to terminate her pregnancy, in other words, to have an abortion.
And the U.S. Supreme Court said that this fundamental right was based in constitutional notions of sort of life and liberty that included a right to privacy and the privacy of one's mother making decisions about one's own body. And that was a 7 to 2 decision of the US Supreme Court. You know, people tend to forget that, you know, once upon a time, the idea of abortion becoming legal was not as controversial in this country as it as it is now.
And then in the early 1990s, the other significant case is one called Casey v. Southeastern Pennsylvania. Planned Parenthood and Casey involved a challenge to whether numerous types of state restrictions on abortion were constitutional or not. Under Roe, the restrictions involved in Casey included a waiting period where a woman had to first consult with the health care provider, then wait a certain period of time to rethink and then come back. It included a requirement that minors have to get the consent of their parents.
It included a restriction that women who were married and want an abortion had to get the permission of their spouse.
In the Supreme Court, Casey struck down the requirement that a woman has to get the permission of the spouse. But it upheld the other restrictions and it changed Roe in a significant way that made it possible for state laws going forward to become more restrictive or hostile, as Deborah said. So, Casey said that although women had a fundamental right to choose whether or not to have an abortion, the state, the state, the government also had its own right to protect potential life. And in balancing those two rights, the court said the state could put limits on abortion that were intended to protect health.
Such as you might regulate any medical procedure, but it also said it could put limits on abortion. As long as they didn't pose an undue burden on a woman's right and they defined an undue burden as a law that either had the purpose or the effect of putting a substantial obstacle in the way of women, and the court went on to say just because you make it more expensive. Just because you make it take, we have to wait longer, just because you make women have to travel further. Those aren't substantial obstacles.
So, Casey really unleashed decades of state laws in the hostile states where they said, OK, we're going to try to come up with every restriction or, as Deborah said, hoop to make women jump through that we can and see how many of them we can get away with under this new undue burden standard. And they've gotten away with a huge number of restrictions. The Supreme Court really has only found two or three types of restrictions so far to be an undue burden on a woman's rights.
As I said, the spousal consent provision that was in Casey and a couple of years ago, in a case from Texas and a similar case in Louisiana, the Supreme Court found that a requirement that an abortion clinic have to have a physician on staff that had admitting privileges at a nearby hospital was also an undue burden, one because it was utterly unnecessary. You don't need your physician to have admitting privileges to get an emergency patient into a hospital, and because you know, no hospitals in those state would grant admitting privileges. So, it had the effect of shutting down clinics. But everything else, the Supreme Court, under this undue burden standard is said, is just fine. You can, as the world said, you can impose waiting periods, mandatory ultrasounds, prohibitions on telemedicine requirements that the state can force you to have a vaginal ultrasound, requirements that the doctors have to give you medically inaccurate information intended to scare you out of having an abortion and, you know, try to basically force you just choose to carry the pregnancy to term. So, the current legal framework actually allows for quite a lot of restrictive laws that all these hostile states have taken full advantage of.
Dr. Palermo: So, you mentioned how Casey kind of set the stage for allowing increased restrictions that states can put on abortion access. What does the current trend surrounding related cases indicate for the future of abortion rights in the US?
Professor Finley: I think the current trend is actually rapidly getting us towards overruling Roe and Casey and perhaps allowing states to outright prohibit abortion. I should clarify the other key part of Roe that Casey kept in place was that prior to the point at a pregnancy that it's viable whether the fetus is capable of living on its own outside the womb, prior to that point of viability, the state simply could not ban abortion.
But now, several states and a very deliberate strategy to try to create a case that would force the Supreme Court to overrule Roe now that the composition of the court has changed under with the appointments of President Trump and the death of Justice Ginsburg, they started passing some laws, basically banning pre viability abortions, knowing that under Roe and Casey, those laws are unconstitutional.
But hoping that the cases would get to the Supreme Court and the new composition of justices they hope will overrule Roe and eliminate viability is the point before which the state can't ban abortion. So right now, pending before the U.S. Supreme Court, in a case that will be argued on December 1st, is a case from Mississippi called Dobbs.
And so, Mississippi passed a law that permits abortions up to 15 weeks. Last menstrual period, gestational age but after 15 weeks bans abortion unless necessary to save the life of the woman. Excuse me, of the pregnant person because obviously a pregnant man would not be able to have an abortion either through the Mississippi law. So that and the Mississippi specifically asked the Supreme Court to take up the question of whether, you know, the Roe should be overruled, and states should be allowed to ban abortions pre viability.
The other case that's working its way up, Supreme Court comes from Texas, everybody's been hearing a lot lately about this Texas law. Texas passed a law basically banning all abortions after six weeks post last menstrual period, a time at which most pregnant people do not even yet realize that they are pregnant. And Texas came up with a very devious, sort of shockingly devious way to try to prevent any federal court from declaring this law unconstitutional.
Normally, if the state passes a law, they designate some state official, you know, like the attorney general or somebody to enforce the law. And so, then if you want to challenge the law as being unconstitutional, the way to do it is to bring a lawsuit against the public official who has the power under this state law to enforce that law. But what Texas did with its new statute is it specifically said no state official can enforce this law at all.
We, the state, have passed along. We're saying we are going to enforce it. They said any citizen, any person, anywhere person in New York, the person in Florida person, California person in Timbuktu, it doesn't matter any person can, you know, go after any doctor in Florida who provides an abortion post six weeks and they can sue anyone who helps anyone try to get an abortion in Texas after six weeks. And that includes helping them pay for it, helping them arrange an appointment, driving them to the appointment. And so, they said, well, no one in advance of the law going into effect will be able to sue the stop law because in advance, nobody knows who the person who might try to enforce the law against them will be. And you can't bring a lawsuit against a hypothetical person. You need an actual person who's trying to enforce the law against you to bring a lawsuit.
So, currently, the Supreme Court let that law take effect. So currently in Texas, all abortion is banned post six weeks pass the last menstrual period. But the U.S. Supreme Court just, I believe, just last week quite recently decided that they would at least take up the issue of whether the United States government can sue the state of Texas to try to challenge this law, or whether no one can challenge Texas law.
So those are so right now. And so, in fact, in the next few weeks before the end of 2021, there will be two major abortion cases argued before the U.S. Supreme Court. And we may see from the questions of the oral argument some insights into what direction the court may be going. But we probably won't have a decision in those cases until sometime in the spring or early summer of 2022.
Dr. Palermo: Professor Finley, can you tell us a little bit about how this Texas law that you've been talking about might impact women and individuals of low socioeconomic status and people of color who are seeking abortions?
Professor Finley: Yes, we've already seen the impact in Texas, by the way, know Deborah, when she mentioned that Planned Parenthood of Western and central New York has already had at least one patient from Texas come to New York. I, it might have been someone who was just visiting, but I wouldn't be surprised if he was someone who was just trying to get someplace where the state law would permit them to have an abortion. So, a law like Texas or the Mississippi law, if it's upheld or any of these restrictions fall disproportionately most heavily on poor women and unfortunately, women of color are disproportionately represented among poor women.
So, you know, these laws that restrict abortion fall more heavily on poor women for multiple reasons. First, the Texas law, in order to be able to afford to travel to another state, you have to have the financial resources to do that. You have to have the ability to take extra time off from work in order to now not just travel 100 or so miles, but to another state or even to fly to a state, you know, far, far away. You have to then have extra resources for childcare, for lodging at the place you are going to travel to. And you know, all of those things cost money. And, you know, many, many lower income women are in jobs with the least amount of flexibility for time off, the least amount of ability to afford childcare or extra childcare.
And also, you know, then the extra time it takes to arrange to find a provider where you don't have all these hoops to jump through often pushes the abortion procedure later into pregnancy, which increases the cost. So, you know, women of women of means women who have flexible jobs can take time off, have private insurance or private money are always going to be able to travel somewhere to get an abortion. But women who don't have those financial resources and flexibility in their life won't be able to.
The Texas law also falls very disproportionately heavily on undocumented women. Women in prison. Women in in ice detention centers, immigration detention centers. They don't have the option of traveling to another state. And even though the federal government is obligated to provide them with an abortion if they're in a federal immigration detention center, the federal government is not obligated to pay for them to travel to another state to get it. Nor is the Bureau of Prisons obligated to take a prisoner to another state and young women, very young women who now in addition to all of the hoops they would have to jump through in getting, you know, either a, you know, a judge to approve their abortion. If the parents won't, they now, you know, just say to them, Oh fine, the judge approved it.
“Now just get in your car and drive to Oklahoma.”
“Excuse me, I'm 16. I'm not allowed to drive.”
And if their grandmother, aunt or mother helps them drive to Oklahoma, they're afraid they might get sued under this Texas law. So, it is. It is an absolute tragedy for poor women, young women and women living in carceral facilities.
Dr. Palermo: Those are some really sobering points that you're making right now. Deborah, is there anything you'd like to add about how these different state restrictions on abortion access affect lower income individuals and people of color disproportionately?
Deborah McDowell Hernandez: Well, I'll just I think Professor Finley did a great job in describing the dynamics of excess or inaccessibility, given the different states. But when you think of geography, there are other things you can think of. There are some cities. 27, to be exact, American cities are considered abortion deserts because people who live in that city have to travel one hundred miles or more outside of that city in order to find an abortion provider.
So, I mean, 27 might not sound like a lot, but within those 27 cities, if you're thinking that some of those women or the folks who are needing the abortion might be black, LGBTQ and the disabled 100 miles is a long way to travel, especially if you don't own your own car and you're trying to, you know, cover transportation by train, bus or plane and get time off from work.
So again, depending on which county you call home, you might be traveling quite the distance. And chances are, you know, if you're undocumented, documented and Latina or Latinx or black, there still might be the possibility that you might not be able to get time off from work or have the money to get to where you need to be. And then, you know, if you're a young person, you don't have that type of savings necessarily or a credit card or a job to help fund you to get you from point A to point B in the right amount of time before you exceed limits.
So, you know, when I think of the dynamics of someone who lives in a very rural area, maybe you're in a very rural county or the counties that surround you are all quite rural and you might have quite the distance to travel before you come across a medical provider. And then on top of that, a medical provider that even performs abortions is willing to are qualified to perform abortion services. And many patients who see Planned Parenthood, not just New York state, but in other states, Planned Parenthood is the only medical attention that many patients have because they don't see a doctor regularly or because they live in such a remote area, a rural community, and that might be the only time that they are getting any type of medical exam.
Dr. Palermo: Professor Finley, I want to turn back to some of the cases you were talking about, you mentioned the Dobbs case. Can you tell us about that? What is the likely?
Professor Finley: So, it's currently on the Supreme Court docket. What's the likely outcome and what would this mean for access to abortion in the US?
Well, it's always difficult to predict how the Supreme Court is going to rule, but I think in this case when you look at. The fact that there are already four justices that in previous cases have said they think Roe versus Wade is unconstitutional. And have been looking for to take a case where they could make that the majority opinion. And then you look at the fact that, you know, two of the two of the new justices added by President Trump, Justices Kavanaugh and Coney Barrett in many previous writings have expressed.
Let's just say, either in Justice Barrett's case outright, you know, moral and religious adamant opposition to abortion and injustice. In Kavanaugh's case significant legal skepticism as to whether the Constitution protects abortion.
You know, simple counting that seems like, you know, five or six votes to either overrule Roe completely or to substantially change it and permit states to ban abortion prior to viability. If the court says that states can ban abortion prior to viability. You know, that's going to open up all kinds of questions will do. They have to always allow an exception for women's health, or do they have to allow a rape or incest exception? Do they or do they only have to allow an exception when you know, several medical providers say the abortion that the woman carries the pregnancy to term, she will definitely die, and no medical provider in advance will rarely be able to say that she will definitely die if she carries the pregnancy to term. And by the time seer, the serious health complications of pregnancy arise, such as with pre-eclampsia or gestational diabetes. At that point, it may be too late to say, oh well, let's have an abortion.
You know, at that point, the severe damage to the woman's health is already done. And here I think it's also important to link, you know, whether there will be any kind of an exception to a ban on abortion to protect women's health with health equity issues for facing women of color. And for women of color, it is just tragically appalling that the well-documented serious risk to their health that carrying a pregnancy to term can entail. So that's another way in which any change in the law that permits states to further restrict or ban abortion is going to have a significantly disparate impact on the health of women of color because pregnancy is a far more dangerous than an abortion. And its pregnancy is particularly dangerous for women of color in the United States.
Dr. Palermo: Thank you for reminding us of those morbidity and mortality statistics, and as you point out, the U.S. has among the highest rates of maternal mortality for high income countries, and the disparities between groups within our country are very stark. Turning to New York state now, Professor Finley, can you tell us what legislation has New York state passed or do we have pending to safeguard the right to abortion? And how will these laws interact with the potential erode vision or overturning of Roe?
Professor Finley: New York State has, as Deborah mentioned earlier, the Women's Health Act, which I believe was passed in 2019 and it essentially codifies in New York law the holding of Roe versus Wade, namely that prior to viability, a woman has an absolute right to decide for herself whether to have an abortion, and the state cannot ban it. In New York, law post viability, if the abortion presents a risk to the woman's life for serious health impairment, the state would have to permit her to have an abortion. And yes, that that's protected by statute in New York. So, if the Supreme Court overrules Roe, it would have the immediate effect of saying it's up to each state what they want their law of abortion to be. So, New York has already said what it wants its law of abortion to be, and that is that women have the right to choose whether or not to have an abortion and prior to viability, the state cannot ban it.
But something to keep in mind. And you know, we can't forget federal politics here and the composition of the federal legislature. If you know, in any upcoming election, whether 2024 or whatever, if Republicans control once again, as they did under a little bit under Trump, the White House, the Congress, the House of Representatives in the Senate, there's absolutely nothing to stop them from passing a federal law that bans abortion in the entire United States. And then because federal law is always supreme over state.
There’s really nothing that would stop a federal government with a Republican in the White House, Republicans controlling the Senate, Republicans controlling the House to pass a federal law banning abortion and federal law is always superior to state law, so the federal law would supersede and make void and unenforceable, New York's law saying in New York, we want women to be able to have the right to decide whether to have an abortion.
So, you know, I relate this to the big filibuster debate in the Senate. You know, the only thing that would stop a Republican controlled Senate, House and White House from banning abortion throughout the entire United States would be the filibuster in the Senate. If the Republicans control the Senate with less than 60 votes, you know, so right now everybody's saying yes in order to secure voting rights and do other, you know, in climate protect the climate and other crucially important things, they want the Democrats to get rid of the filibuster. But I always say, well, OK, but remember, you get rid of the filibuster now when the Democrats are in control, just think what's going to happen when the Republicans are in control again? So, it's a really complicated issue.
Dr. Palermo: Turning to you, Deborah. Can you tell us a little bit about what Planned Parenthood is doing to ensure access to abortion in New York state as well as other states?
Deborah McDowell Hernandez: Well, I think if I could give them all the would be actions, labels, I would say advocacy, lobbying and education, education and advocacy are very important, especially now because I think many people who aren't necessarily in this circle of reproductive and sexual health or maybe who
are not activists really don't realize how great of a threat we currently have in losing access to abortion across the country. So, education is very important in getting the word out to other coalition members.
Our partners in the community, our supporters, be the donors or volunteers or activists getting out there, meeting with our elected officials to let them know how important this is to us and ensuring that we can offer our patients and the community in general, the care that they count on and realizing that many of the people that we are supporting are already in a vulnerable state, not limiting the discussion to abortion, but just simply having access to family planning, care, birth control, contraceptives, sex education in general, you know, testing for sexually transmitted diseases and treatment and things like that.
So, we take special care and making sure that, yes, we continue to provide health care to our patients, but we also need to educate the community on the on abortion, the importance of abortion access, lobby as needed to try to continue to get support from the elected officials because we realize that the true change occurs when policies change. So, we need all of the energy out there. We need our cheerleaders, attending rallies, going to marches and things like that. But we also really need the people, the cheerleaders, who can sign those bills and make them laws on our side to help support the cause.
One of the things that we're supporting right now, all of the affiliates in New York state Planned Parenthood affiliates is an abortion access fund, which would allow the average citizen to designate a portion of their income on their tax return form to abortion access. And then those funds would be distributed to different nonprofit organizations in the state of New York to help people who need funding support to pay for abortion services. So, something like that is a very basic lift.
If we can just simply have that as a box on your tax return to check off. It seems like it would be a win-win. We also inform our supporters of other abortion access funds across the country. We've even done campaigning or fundraising locally to help support many of those access funds in Texas, since the checks in patients are having the biggest struggle or threat right now. So, you know, fundraising as we are able to help Texas and other states, other hostile states since we're using that word elect. And education again and advocacy, those are some of the big things that we're taking on patient advocacy.
Dr. Palermo: Thank you for that you've given us so much to think about today. I wonder. Before we wrap up, is there anything that either of you would like to add, maybe starting with Professor Finley?
Professor Finley: I think I want to underscore something that I just said that I think don't think most people really realize how the right to a safe, legal abortion is under threat to a far greater extent in this country than it's ever been since Roe versus Wade. That is, as I said, when you ask, what did I think was going to happen in the Supreme Court, I think that, you know, by the end of by mid-summer 2020 to the U.S. Supreme Court is highly likely to have said either that Roe is completely wrong or that as long as they, you know, safeguard women's health, states can ban abortion almost at any time. And I think I particularly want younger women to think about this, what this would mean for them because younger women never lived in the pre-Roe world.
They don't know women like I do that or like my mother, you know, who had to go and get illegal abortions and what it was like and how degrading it was and humiliating and dangerous it was. And you know, just what a sort of basic aspect of your humanity gets taken away from you when the government says, you know, basically, we can conscript your body and force you to bear a child that you feel at this stage of your life you can't properly care for or support or to have would risk, you know, the safety of you and your other children because you're in an abusive environment. So, I just want to echo Deborah's call for saying, you know, education and advocacy.
If the Supreme Court overrules Roe, abortion will probably become one of the hottest issues in electoral politics at the state and the federal level, and it's going to take sustained commitment and activism from people who care about women's fundamental humanity and dignity and right to make their own decisions to fight for it. And in the states that are currently restrictive to elect people who do respect women's dignity and humanity and right to make their own decisions.
Dr. Palermo: You raise some really important points there about how common abortion is now and how we take for granted that abortion is health care and it hasn't always been that way in the US. And as Deborah told us at the beginning of the episode, one in four U.S. women will have an abortion by the age of forty-five. So, it's very common and it's a very safe procedure, and that's something that we kind of take for granted now. But it's something that hasn't always been that way and may not always be that way. But still a very common procedure that women will continue to need in the future. Deborah, are there any final comments that you'd like to leave us with today?
Deborah McDowell Hernandez: The only other thing I'd say is we're very grateful for the support that we receive from the faith community.
Planned Parenthood Empire State acts has a Concerned Clergy for Choice Group, which is a group made up of supportive clergy members from across different faith sectors, and they join Planned Parenthood and other community coalition members in advocating for sexual and reproductive health and safe and legal abortion. So, I think it's pretty powerful when you're able to have a reverend, a rabbi and minister joining you during a legislative visit with an assembly person or a senator to explain why they want the people in their congregations to be able to make the decision and not have it be made for them by a politician.
Dr. Palermo: So, thank you both again to Professor Lucinda Finley and to Deborah McDowell Hernandez for being with Buffalo help cast today. Really appreciate your time and all of your insights on this important issue.
Thank you so much for being with me today. Thank you.
Professor Finley: Thank you. Yes, thank you for having me and for bringing attention to this very important issue.
November 19, 2021
Debora McDell-Hernandez of Planned Parenthood & Prof. Lucinda Finley of University at Buffalo discuss with host, Tia Palermo, abortion access, cases pending in front of the Supreme Court & implications of abortion restrictions for poor individuals and pregnant people of color.
Hello and welcome to Buffalo HealthCast, a podcast by students, faculty and staff of the University at Buffalo School of Public Health and Health Professions. We’re your co-hosts, Tia Palermo, Jessica Kruger, Schuyler Lawson, and in this podcast, we cover topics related to health inequity here in Buffalo, around the US and globally. In this first semester of the podcast, we're taking a deeper look at racism and health. We'll be talking to experts around the US as well as individuals here on campus and in the Buffalo community who are working to remove inequities to improve population, health and well-being. You'll hear from practitioners, researchers, students and faculty from other universities who have made positive changes to improve health, equity and inclusion.
Natasha: Welcome to Buffalo HealthCast. I'm Natasha Allard, a Ph.D. student in the Department of Community Health and Health Behavior here at the University at Buffalo. I'm joined today by an amazing group of women I have had the honor of working with in my past role at Roswell Park Comprehensive Cancer Center. I've seen firsthand how passionate they are about reducing health inequities, especially among Black women here in Western New York. So, I knew we had to have them on the podcast to discuss. Today, we have First Lady Naseary Harris and First Lady Charmaine Geeter, both from the National Witness Project and Dr. Ermelinda Bonaccio, Chair of Diagnostic Radiology at Roswell Park. It is so wonderful having you all here today. So, let's start with some introductions. First Lady Harris, can you tell us a little bit about yourself and your role as a first lady?
First Lady Harris: My role with the National Witness Project is chairperson for FLOW, which is the first ladies of western New York. So, I do a lot of work with recruitment, educational programs, navigation and getting the word out to our community about the importance of early detection of breast and cervical and colorectal cancers.
Natasha: That's wonderful. Thank you so much. And for anybody who isn't aware, can you explain what a first lady is and why we use that title for you?
First Lady Harris: Yes, it simply means that we are the pastor's wife. That's how we are addressed in our congregations.
Natasha: Wonderful. Very important role. First Lady Geeter, can you tell us a little bit about your role and who you are?
First Lady Geeter: Hi, my name is Charmaine Geeter. I'm also a pastor's wife. I work alongside with First Lady Narseary Harris. She brought me in to the National Witness Project, working alongside of her with the first ladies of Western New York. I do the same thing. I help her recruit. I help her give seminars on helping to educate women on getting their breast examinations, make sure that they know what to do on how to give their self-breast examinations, make sure they get their checkups. Also educating, also educating men on making sure to let them know that they, too, can get breast cancer, colorectal cancer, HPV. We do whatever we can to educate. Our community is wonderful.
Natasha: It's quite the heavy task you have taken on, but it's so wonderful. And the work you do is so important. Dr. Bonaccio, tell us a little bit about yourself and your role at Wrestle Power to thank you for having me on.
Dr. Bonaccio: So, I am the chair of diagnostic imaging at Roswell Park. But the reason I'm here today is also for the past twenty-four years, I practiced as a breast imager, reading mammograms, doing any of the images, guided biopsies, MRI, ultrasound. So that's my clinical role, although I've taken on this administrative role and screening mammography has been a big part of my mission here and bringing that to Roswell.
Natasha: Wonderful. Thank you so much. So as many of us know, October is Breast Cancer Awareness Month, and one of the most critically important aspects of awareness is understanding how a disease affects different communities. So today we will address disparities in both breast cancer and breast cancer screening, particularly in the African American community. So, First Lady Harris, I'm going to ask you to dig a little deeper into what the witness project is and why this exists.
First Lady Harris: So, I really got involved when I was introduced to the Witness Project by Detric Johnson, who is now actually the national director. What really caught my attention is the fact that they were addressing all of the concerns about African American women, why they weren't getting mammograms, why they weren't going in for their pap smears. But what really caught my attention was that they were actually coming into the community, coming to where these women are and stressing the importance of early detection. That just really got my attention after finding two breast tumors of my own. There was nobody in my life to navigate that for me. There was nobody that I could talk to, and I was reluctant to talk about it. It was like the it was like sharing that information was taboo or, you know, I know I wasn't contagious, but it was just the fear of the unknown about breast cancer and then having friends who actually had breast cancer and died. So, it was the fear factor. It was. Not knowing, not having somebody to talk to about it, the friends that I had who actually had breast cancer, they were reluctant to talk about it. I guess it just happened to be because of being a pastor's wife, they were more safe to talk to me about it. So, this organization happened. I thought, this is amazing. And what an opportunity to share this information with other women and help navigate them and guide them through the process that I felt so afraid of and intimidated by.
Natasha: That is wonderful. I really appreciate you sharing your own personal story and your passion just shines right through. So, we really thank you for sharing that. First Lady Geeter, do you have anything you want to add about why the witness project is important to you or the work you do?
First Lady Geeter: One thing that was so amazing. The one thing that, we use a term in the church, was meeting people at the point of their need. It was like we come to you. We don't wait for people to come to us. So church is a big gathering place. It's like the family is already there. And so, it's almost like a place of trust. And the one thing that I find out, find out about our culture, we don't tend to share. So, we don't tend to find out if my grandmother or my auntie may have cancer. So that is a big factor to know what is in your blood line. So, if grandma may have had cancer, then it's good to know that I need to have a mammogram earlier than 40. So, education is the key. So, when we can bring these educational seminars or educational talks to the church, to the place where they already are, then that is the key. The key is to educate so that we will know these things so that we could do better. So, I just felt like it was just phenomenal to know that we can bring these things to where they are. So, like we say, we'll go to your family reunions. We will go to your apartment complexes. We will go to wherever you are. We will bring these things to you.
Natasha: That is amazing. I love your point about knowing your own family history and your personal risk. And you both have just made such a great point about going to where women are or where people are for screening. I think that's such a wonderful approach. So, let's transition a little to understanding disparities within screening for breast cancer. Many different studies over the years have found different racial or ethnic and socioeconomic disparities in actually utilizing screening mammography. This has changed over the years. There's been some great headway is made, but of course, our work is never done. So, we're going to spend a few minutes first diving into what breast cancer screening is and why it's important. So, Dr. Bonaccio, we see studies and health communications use terms and phrases like mammography, annual mammograms, breast cancer screening somewhat interchangeably and different ones in different places. But in an effort here today to potentially overcome health literacy barriers, can you boil down what those words mean?
Dr. Bonaccio: So, a mammogram is a type of X-ray. It's a very low dose x ray of the breast. And in general, when we talk about screening for breast cancer, we are talking about mammography. And it gets very confusing because 3D mammography or tomosynthesis or other terms that you might hear, and those are essentially a newer, improved mammogram. So, we typically talk about screening mammography when we're talking about screening for breast cancer, because that is the test that has been proven in multiple different types of studies, randomized controlled studies, case control studies over the years to lower your risk of dying from breast cancer, up to 40 percent decrease in mortality with women when women are screened with mammography. There are other screening tests for breast cancer usually reserved for women who are at high risk for breast cancer, such as screening breast MRI or for women who have dense breast tissue such as screening ultrasound. The key part of screening is a test we do on a regular basis in this case annually to look for cancer that's not symptomatic. So, we're trying to find a breast cancer before you can feel it. That is the ultimate goal of screening so that we have better chance. preventing death from breast cancer.
Natasha: That was a great explanation, it makes it a lot easier to grasp on to, I think. Can you briefly tell us what are the current mammography guidelines? So, who is supposed to get one and when?
Dr. Bonaccio: So, for average risk, women, women who do not have a family history or any of the mutations in mammography should start at age 40. And we follow NCCN guidelines, which is the National Comprehensive Cancer Network that we belong to as Roswell Park. So annual screening mammography beginning at age 40. We follow those guidelines because frankly, that saves the most lives. But as First Lady Geeter referred to, it is important to know your family history and women who have a strong family history of breast cancer or women who are known to be mutation carriers, then we will start screening mammography at a younger age and potentially do one of those other screening tests that we were I just mentioned.
Natasha: Thank you, First Lady Harris and First Lady Geeter. Do the women you meet in your work with witness project typically know these guidelines?
Natasha: Do they know they're supposed to have a mammogram but just maybe aren't getting one or do they not even know? Is the awareness not there yet about the age you're supposed to get screened?
First Lady Harris: So typically, I think the I think the awareness may be there in a lot of cases. I think the trust, but I think the fear factor. I think the lack of insurance sometimes and if there has been a family member who had it, the fear of finding out that they might have it, and that is a death sentence. So, I think knowing that mammography is helpful, the importance of it sometimes, I think is not there due to the lack of education about what why it's important and the possibility of early detection not being a death sentence for you. So, it's a combination of things. But I think by and large, mammography, the word if you say what is a mammogram and who gets it, that knowledge is there, I think more often than not. But the navigation of getting one, the importance of knowing that could possibly save your life is not always understood in its entirety.
Natasha: Got it. That makes a lot of sense.
First Lady Geeter: I also think that sometimes they get mixed signals. I think lately I've also been hearing that a woman should get their mammograms at 50. I have heard that. I've actually heard it advertised on TV. I also don't think that they always know that, that if there's a history of breast cancer, that they should get a mammogram earlier. So sometimes I think that sometimes there is different things that are being said and that causes even more of a distrust when everybody not always saying the same thing. And that's where you get that distrust -- when they hear several different things.
Natasha: Very eye-opening I could definitely see that being an issue.
Dr. Bonaccio: And the family history piece, I think is very important. More recent data has been showing that there appears to be an increased incidence in the BRCA and mutations in African American women. So, knowing that family history and potentially if it's significant, getting tested, I think is really key to potentially starting younger and doing more than an annual screening mammogram, potentially having an MRI. So that information is really very important as well.
Natasha: It's interesting. First Lady Harris, you mentioned the fear associated with if a family member had or died of breast cancer. I was just listening to a different podcast; Freakonomics episode called The Ostrich Effect. And they were talking about how specifically in African American women, but many other women as well. Studies have shown that having a close loved one who has breast cancer or even dies of it, kind of just the opposite of what you would think. It makes you not want to get a mammogram. Can you explain that a little bit?
First Lady Harris: Because, again, we go back to education and navigation. If people when they hear that, they automatically assume. So, remember early on when I said how I got involved with that, with the witness project, I found two tumors in my own body, in my own breast.
The first thing that you think is, oh, my gosh, this is a death sentence. So, when a family member is diagnosed with breast cancer and they die, people tend to…My experience has been they don't want to know they got it, if they got it, they're going to die. So let me just live my life and just the way it is, because I'm going to die of breast cancer. So, there is a fear of the unknown. There's an assumption that if a family member dies with breast cancer, that's what's going to happen to them. So, they just kind of accept it as this is the way it's going to be, which again, is why it is so important. The work of the National Witness Project, getting to those women, getting to those younger women, giving them the gift, giving them knowledge about breast feeding. We know we've learned through the different opportunities of being educated, even through Roswell and the opportunities that they've given us, understanding the importance of early detection, understanding how breast feeding in our and our community changes the risks of breast cancer. So, all of these things are important and helping them to navigate the system, understanding why it's important for you to get a mammogram, understanding that because your loved one died of cancer does not mean it's a death sentence to you if it's detected early.
But the fear is, if it happened to Betsy, if it happened to Grandma June, I'm going to die, too.
So why bother?
Dr. Bonaccio: I so agree with First Lady Harris about the importance of navigation and education. And it's not just for the screening piece of it, because a lot of the data surrounding survival disparities in breast cancer for African American women is actually even after the mammogram gaps in care following up on an abnormal mammogram, making sure that they receive adequate treatment and complete all the treatment. And when you read it, how we can improve this now, it always seems to come back to navigation, culturally competent education, exactly what you're saying. I mean, what the work the witness project does.
Natasha: Great points. I was actually just going to bring up a statistic from the American Cancer Society that Black women are 40 percent more likely to die of breast cancer than white women and are twice as likely to die if they're over 50. So, I'm really seeing that statistic kind of come to life, as you all are discussing, because you have Dr. Bonaccio, who has some of these medical facts about the importance of early detection, and then First Lady Harris and First Lady Geeter—your passion is really to get those facts to your communities and make sure people know that early detection means breast cancer doesn't have to be a death sentence. First Lady Geeter, you've brought up mistrust a few times. Do you want to talk about that a little more? Can you explain that a little more, what you see?
First Lady Geeter: Yes, our community has a lot of mistrust and it's very we're very apprehensive about taking part in studies. And I think that if we were able to get our community to take part in studies, we could probably gain and know a lot more. But because of things that have happened to our African American community in the past, it is so very hard to get us to take part in studies because as we know, that has not always been the case about African Americans having breast cancer or dying in breast cancer. We were not always the leading and death of breast cancer. If we could just build the trust in our African American community, I think we could see a change in those numbers. So we're just hoping through the National Witness Project that we can start to build trust in the African-American community to take part in studies so that we can start to see these numbers change.
Natasha: Thank you for sharing that. Here at UB we have a health disparities class within the School of Public Health. And one of the things we discuss is how race is often acknowledged as something that contributes to disparities when in reality racism should be discussed and some of these historical and current contextual reasons for this. So, would you agree that that's something you're seeing with the women you work with?
First Lady Geeter: Absolutely.
Natasha: Absolutely. So, I want to circle back a little. Everybody has brought up navigation a few times. I'm looking right now, it's a Susan G. Komen list of some various barriers that are current and tangible that they have identified existing for mammography. So, I'm just going to quickly run through some of these and then I invite anyone to weigh in, and if you have seen these as a barrier and how different organizations or policies that you have worked with are trying to overcome these. And we've mentioned a few already. So, we have cost concerns or lack of adequate insurance, lack of having a primary provider or an OBGYN to make referrals, different health literacy or educational issues, childcare issues, not being able to take sick leave or miss work, fear of bad news, fear of a painful mammogram, cultural or language differences, and then a lack of education, which we have discussed greatly. So, what does the witness project do for some of these maybe like insurance or missing work or transportation?
First Lady Harris: So as far as transportation, we provided it free of cost, free of cost.
If there is no insurance, we help them to get insurance, literally walk them through the process. If they need help with childcare, we make that happen for them, free, free of charge. Everything that we do through the project, it is zero cost to that family. We will educate them. If there are five people, we literally will do a witness project, educational program for a family. You've got your aunt, your uncle, your aunts, uncles, your grandma, your nieces and nephews, your children. We will do a live program for you. And now, because of COVID, we will even do it virtually. If they don't have access to Zoom, we use our own personal zoom to bring them in, to educate them and to navigate them. We will literally hold their hands and take them to an appointment, make the appointment and take them to the appointment. If there is a fear of that they have a bad experience with a primary care, we will assist them with finding a primary care doctor. If there is a breakdown, if somebody drops the ball with their OBGYN, we are there to navigate and help them find someone that they will feel comfortable with. So, we try to eliminate whatever the barrier is. Once it's brought to us at once, it's brought to our attention. We will seek out a way to eliminate that barrier.
Natasha: So, you really do it all. Full suite of services.
First Lady Harris: One stop.
Dr. Bonaccio: Just a couple of things to add as far as the cost concerns, even separate from our partnership with Witness, we're actually able in New York State, we have Cancer Services which will cover a mammogram for uninsured and underinsured women. So, if you call for an appointment at Roswell and you don't have insurance, we can connect you with cancer services program, which is a wonderful program. And for those that are insured in New York State, there's not even a copay for a mammogram, for an annual screening mammogram. So, because those 10, 15, 20 copays can add up. So, I think that's one thing to keep in mind. And you don't necessarily need a primary care doctor to come and have a mammogram here. So, I think that in general, we're trying to remove as many barriers as we can for screening.
Natasha: That's so wonderful. Actually, I was just going to ask this. Can you explain briefly how is Roswell connected to Witness Project?
Dr. Bonaccio: Oh, my gosh, we have such a wonderful long history with Witness project. So, Deb Erwin, who was she's a Ph.D. who was the co-founder of Witness Project in Arkansas, was recruited by Roswell to come here and then set up that program here. So, it's been a long partnership, but when we opened up our community screening program in twenty sixteen, our partnership grew and that we now navigate women to Roswell for their screening mammogram. We will have designated screening days for when this project this summer in the weekdays and summer on Saturdays to again improve access, decrease barriers. But it really has been a long and wonderful partnership.
First Lady Harris: And we certainly appreciate that. We appreciate that. And the fact that they have partnered with us for the One-stop with Roswell has been a true blessing so that we can eliminate the fears. Don't forget women that we were working with, they had a fear of going to Roswell because the only thing they thought when they thought Roswell cancer, that's where people go who have cancer and what this partnership has done, and to partner with the witness project, has changed a lot of that concern with the women in our community. Now, we have women when they find out that they can go to Roswell for a mammogram. They're eager to do it, they want to do it, and especially because of the partnership that Roswell has with the National Witness Project, see our community trust the witness project. They trust us. And so, when we say, oh, yes, you can go to Roswell, we will take you there. And then Roswell’s commitment to our community, to the people that are underserved, who don't have protection, who do face a lot of fear and a lot of rejection when it comes to the medical arena. They are helping to eliminate some of those fears and doubts about where they can go. And are they going to be treated with respect? It's a big difference. And so, we're grateful, the Witness Project. We're grateful for our partnership with Roswell and this beautiful doctor she has…
Let me tell you let me just tell you, when we went there for this last event for Channel four and Roswell, that partnership, she told me, she says, Lady Harris, I would be so honored to be a part of your presentations that you do with your congregations and with the people that you are going out to do the educational programs with, to share some more of the information and to dispel a lot of more of their doubts and fears about cancer and about Roswell and getting more educational from that in, you know what I mean, to put a friendly face to the medical side of it all. So, we are truly grateful to her. She's an amazing partner.
Dr. Bonaccio: Thank you so much for the kind words and I mean every one of them. I'm really looking forward to presenting at any of the programs where it would work for me to join. I really, I'm really looking forward to that.
Natasha: So, this is wonderful. Community partnerships like this really are encouraging and inspiring. And I love to see groups like this get together and share their passions, especially because … kind of the flip side of this. I have another American Cancer Society stat that a third of African American women have reported experiencing racial discrimination at a health provider. First Lady Geeter and First Lady Harris, is this something you are aware of? Have you seen or heard from women?
First Lady Geeter: I have heard on different occasions where they feel like they have been treated differently, don't feel comfortable. So, they just they just do not go to a doctor.
They choose not to. And it's just not a good feeling. And I mean me myself and this happened to me where I feel like I have had to change to a different doctor, especially now when I've gotten to more of a mature age where my doctors have retired, and I have to go to choose another doctor. And I don't like the way I have been made to feel and have been on the hunt for a doctor. It's very disheartening. And, you know, you know, the feeling is just something that you feel in your gut. And it’s there, it is just there.
First Lady Harris: You know, I had an experience as well with one of our friends who went to go to her OBGYN and then with, I think, her primary care as well, an African American sister, she told the doctor that she found a lump and wanted them to check for her to check for it. And they didn't do it. They told her, oh, you're fine. I couldn't believe I was actually hearing her say that. She went back again, and she said, I have a lump in my breast. And the doctor still refused to examine her. She went back a third time and said, I need you to examine me. I feel a lump in my breast. So finally, she said, Can I show you where it is? And the doctor says to her, according to her pointed out point, the area where it is, she did that. And then the doctor touched her breast and found that there was a tumor there. When I heard that, it almost brought me to tears because this happens a lot more frequently than we even know, because instead of saying something about it, the person, the woman, she just clams up and just says, I'm not going to be bothered. Why bother? And so that's very, very disheartening. And this young lady, this happened to her about a month ago. I'm not talking about something that happened last year. I'm not talking about something that happened a couple of years ago. This happened 2021. And it happens.
Natasha: First Lady Geeter and First Lady Harris. I really appreciate you sharing those really personal and honestly horrifying stories. And I'm sorry, and I thank you for bringing awareness to that and for speaking out.
First Lady Geeter: I have had an experience where I had a lump in my breast, and it ended up being fatty tissue and I actually had it removed. And when I when I had it removed, I was told that it was a possibility that it would come back, and it came back, and it was and the removal was very it was very painful. And it did come back. And I went back to the doctor because it came back so quick. And his response to me was, it's because of the kinds of food that you all eat. And I, I mean, when I talk about it tears of well, up in my eyes. Tears welled up in my eyes and I asked, did I ever give you a list of the food that I eat? I said, you don't know what I eat. And I was insulted.
First Lady Harris: I guess so.
First Lady Geeter: And I never have gone back and, you know, and it's still there and hasn’t gotten any bigger. But at this point, if I ever have to have it removed, I will search out for another doctor because I was just so insulted because I felt like he was telling me it’s the food that African Americans eat that is causing this fatty tissue.
Natasha: That is heartbreaking and unacceptable. And I honestly don't have words. I have chill as you're telling that story. It's truly an atrocity. It's truly an atrocity. When we look at addressing racism and discrimination, it's hard to even know where to start. But Dr. Bonaccio, what role do health care providers, at a bare minimum, play in addressing racism and discrimination in a medical setting?
Dr. Bonaccio: Well, first, I'm so sad to hear these stories, but unfortunately, I'm not surprised to hear these stories. I mean, I think with any problem, right. First thing we have to do is acknowledge it and talk about it. And that's why I was so glad we're having this conversation.
And I do feel like that we're having more of these conversations over the past two years in the medical community. And that is going to be a huge piece of addressing it. It is going to take time. But we talked a lot about educating African American women to have a mammogram. But we as medical care providers have to educate ourselves to learn how to address these issues to teach young physicians and practicing physicians and providers about unconscious bias, about culturally competent conversations. I mean, we have a lot of work to do. But I am heartened, as disheartening as these stories were, I am heartened by the fact that we're talking about it more so than I've been practicing for twenty-four years. And the intensity of the conversation that we're now having in the medical community brings me hope that we will then start moving towards solutions.
Natasha: Absolutely. Talking about this is so important.
Dr. Bonaccio: First Lady Geeter’s point about it's not just clinical trials, but we need research in this area as well. I was sort of as I knew this podcast was coming, was doing some research and focus group research is important, too. There was one study that showed, for example, that African American women require more education once they're diagnosed with breast cancer, more information than potentially on non-African American women do. And it makes sense to me, right. If you're not trusting of the system, if you're worried about racism, you're probably going to have more questions in the information. So, getting that information out to providers I think will help to as we get more research in this area.
Natasha: Thank you. As we come to a close today, I'm going to ask each of you to just share one final message that you would want to send either to women of breast cancer screening age or this podcast is listened to by a lot of public health students and faculty and professionals. So, either people in the field or women who need to get mammograms, what is a final Take-Home message you want to send? First Lady Harris, we can start with you.
First Lady Harris: OK, so what I would like to be able to take home with them is the importance.
Again, we can talk about early detection, how important it is to get that mammogram, how vitally important it is to talk about it in your family. It is so important. And if we could just get that message out there for the screening of breast cancer early, I think that it would help to change all. So, the statistics will change greatly, I think if we could just get that information out, the education out there about early detection.
Natasha: Thank you, Dr. Panopto. I'll have you go next and then we'll close with First Lady Geeter.
Dr. Bonaccio: One message I always like to get out when I'm have the opportunity is that most women who develop breast cancer actually don't have a family history of breast cancer. So just to remind people that our biggest risk factor is being a woman so that even if you don't have a family history, you should have your annual mammograms starting at age 40. But I like to say that along with the fact that it is still so important to know your family history for the reasons we've talked about earlier, so that potentially you can get screened at a younger age and with other studies in addition to the mammogram. But that's an important take home message for me.
First Lady Geeter: Mine is always if you're proactive now, you won't have to be reactive later.
Natasha: I love that. It's powerful, succinct, and it sums up everything we've talked about. Well, everyone, I truly appreciate your time. This conversation was powerful and insightful, and I really think it was valuable. And I hope, I know, that everyone listening to this podcast will feel the same. So, thank you very much. And I hope everybody has a wonderful rest of your day.
First Lady Harris: Thank you for having us.
Dr. Bonaccio: It's such a pleasure working with both of you. Every time I have the opportunity.
Natasha: This was wonderful. Everyone, I really, really appreciate it.
This has been another episode of Buffalo HealthCast. Tune in next time to hear more about health equity in Buffalo, the US and around the globe.
All content © 2021 Buffalo HealthCast.
October 21, 2021
Co-host Natasha Allard interviews First Lady Charmaine Geeter and First Lady Narseary Harris from the National Witness Project, along with Dr. Ermelinda Bonaccio from Roswell Park, on their efforts to overcome breast cancer screening disparities among African American women in Western New York and on racial discrimination in health care setting.
Hello and welcome to Buffalo HealthCast, a podcast by students, faculty and staff of the university at Buffalo School of Public Health and Health Professions, we’re your co-hosts, Tim Palermo, Jessica Kruger and Schuyler Lawson. And in this podcast, we cover topics related to health equity here in Buffalo, around the US and globally. And the first semester of the podcast, we're taking a deeper look at racism and health. We'll be talking to experts around the US as well as individuals here on campus and in the Buffalo community who are working to remove inequities to improve population, health and well-being. You'll hear from practitioners, researchers, students and faculty from other universities who have made positive changes to improve health, equity and inclusion.
Tia: Hello and welcome to Buffalo Health Care. I'm your co-host here, Palermo, and I'm here today with the doctor of Jericho Road. Welcome, Dr. Glick. Thank you. Here. Thank you for this opportunity to start us off. Can you tell us a little bit about Jericho Road and your role there?
Myron: Sure, yeah. My wife and I started Jericho Road in nineteen ninety seven. I'm a family doctor. And when we started, our original purpose was to provide excellent quality family health care to folks on the West Side who needed it, whether they had insurance or not, and especially Medicaid and uninsured folks. And that was back in ninety six, ninety seven. So almost twenty five years ago. Since that time we've grown a lot. And today we're a pretty large organization in Jericho and Buffalo. I'm still a family doc. See patients deliver babies and I'm also the CEO of the organization.
Tia: That's great. Yeah. Can you maybe tell us about the different parts of Jericho Road and what the different projects and locations do?
Myron: Sure. So I tell folks that we basically do five things at Jericho.
Our main thing is we provide primary health care, medical care to folks here in Buffalo, regardless of what their insurance status is. We have five health centers in Buffalo that provide primary health care and about 40 doctors and nurse practitioners. And so we see a lot of patients and many of our patients, over 50 percent, come to us as refugees and immigrants from other places. They've moved to Buffalo for whatever reason. And then we have lots of folks who grew up in Buffalo on the east and west side of Buffalo, and they become our patients.
The second thing we do is we long ago realized that providing medical care isn't really enough if we're really going to have an impact in people's lives. And so we've started a number of programs that are tied into the medical care that we provide that address or try to address some of the root causes of why people are sick and really the social determinants of health. We can't do it all. But these programs are our logit programs that really impact people's lives where they're at.
The third thing we do is we, in partnership with the University of Buffalo, have a family medicine residency training program at our site, one of our sites. So we know every year we get a three year training program. Every year we get four new recent medical school grads who want to learn about what it means to be a family doctor. And they're here for three years with us. So like right now, we have 12 family doctors in training. And that's a wonderful opportunity for us to sort of give a little bit of our DNA to other doctors. And some of them may work for us in the future when they graduate and others will go other places and make a difference and take a little bit of what they learned with us to those places.
The fourth thing we do is we run a homeless shelter called VVA. And this homeless shelter is specifically for asylum seekers who have come to Buffalo, come to this country, mostly crossing through the southern border. Many of them have had harrowing journeys that have lasted years to get here. And they're looking for a home for their families, either here or in Canada. So every night we shelter probably one hundred to one hundred and forty people at VA and we provide medical care, trauma based mental health care and legal advice to these folks in addition to shelter and the physical needs that they have.
And then the fifth thing that we do is one that I mean, they're all exciting to me because I'm involved in all of these options But we have a global health program through Jericho, where we followed some of our refugee friends back home to Sierra Leone, to the Democratic Republic of Congo and to Nepal, and we have we run we operate five health centers in those countries that are fully staffed by local folks from those countries. We provide some financial support and operational support, but it's really locally run and operated in the blood. And we're almost seeing as many patients in other countries as we see now in Buffalo. So that's sort of a quick overview of what we do at Jericho.
Tia: Right. Thank you for that. It was really great to hear you talk about the social determinants of health in our school of public health and health professions. At the University at Buffalo, we talk a lot about how social determinants of health and upstream factors really affect the access to care that people have as well as their health outcomes. So it's really nice to hear you talk about how you're bringing both sides together in the provision of health care and you're doing so many different things. It's very impressive.
We brought you here today to talk about Jericho, a Jericho Road role in the effort to assist Afghan evacuees who are now arriving in the United States. I think there's about three hundred and fifty evacuees expected to be arriving in Buffalo. So can you start out by maybe telling us a little bit about the standard refugee resettlement program? So what do refugees get when they get here? And how do refugees differ from other types of immigrants in terms of their legal status?
Myron: No, that's a good question. So refugees are folks who have had to flee their homeland because of war or some kind of horrible trauma and are now being resettled in another country. They're not choosing to leave their country. They're fleeing for their lives. Many have lived in refugee camps across the world and many have become certified by the UNHCR United Nations high command of refugees as official refugees and whereas an immigrant would be someone who chooses to come. And they're not necessarily fleeing refugees fleeing for their lives. And then you have asylum seekers who often really are refugees if they're fleeing the same set of circumstances, they just never got certified by the UNHCR. And so they have to find a different way into the country. So if you think about folks coming to the United States, I would say there's a category of refugees which are folks that the United States has agreed to take in. And when they get here and they're assigned to Buffalo, they're on a pathway to citizenship that will hopefully culminate within six to seven years of them becoming actual American citizens. And when they arrive here, they receive a significant amount of support for at least the first three to six months through the federal government. And that support is channeled through local refugee resettlement agencies in Buffalo.
We have four of them. We have the International Institute, Jewish Family Services Journeys and Refugee Resettlement Services and Catholic Charities. And those organizations get money through the federal government and through the state to resettle refugees to help them find an apartment, to help them get to the doctor, to help them apply for Medicaid and social services and find that first job. That's sort of the pathway that Jericho probably has. Ninety five percent of the folks we see from other countries come as official refugees. We step in and provide the initial medical evaluation within 30 days for these folks and then we become their medical home so that many of those you know, we're the only doctors we've ever seen and they've been here 10, 15, 20 years. We've become their home for their medical care asylum seekers. It's much different. They're coming in through a whole different pathway and they don't get a lot of the services that are offered to the refugees and then immigrants. A totally different story. The challenge with the Afghan evacuees is they're coming in on a different sort of. Under a different sort of legal status that's much more similar to asylum seekers than it is to the official refugees. And so right now they're being promised like one month of services through the federal government that will be given to the refugee resettlement agencies. So there is a real need for our community to rally around supporting the refugee resettlement agency so that they can actually provide more of a standard amount of services for these Afghan folks who are fleeing their country.
Tia: What are some examples of the medical needs of the refugees that you see in your program?
Myron: So a lot of these folks come and they maybe have had some evaluation in the last year or so, but they're fleeing situations that set them up. I mean, first of all, many countries that are coming from don't have the resources to address problems that we take for granted here. Problems like hypertension or diabetes, maybe they don't have access to insulin or medications. Some of them have had trauma because of war. Maybe they lost a limb, but they never got physical therapy or a prosthesis. Some of them, we still see people today who were affected by polio when they were kids and they can't walk or they've lost the use of a limb. So we see children that have had autism or severe developmental disabilities that never got any resources. So we see, you know, there's a real opportunity to get people plugged in to our American health care system that has more resources if you at least if you have access. And so we do that. And then we also have an obligation to screen folks that are coming here from a public health standpoint for things like TB and and HIV and all kinds of infectious diseases and offer treatment so that, for instance, you don't have someone with active tuberculosis who's in the community and potentially spreading it to other folks. And then there's just basic stuff. Getting women who are pregnant set up for prenatal care, getting folks, you know, there's children shot so they can attend school. So we it really is a big challenge for us to do that care and do it well. And given that, we'll probably be getting usually the refugees kind of come in gradually over a year basis, not 350 people at one time. So we'll be it'll be a little bit of a challenge for us, but we'll be fine. We’ll do it.
Tia: You mentioned some of the issues that you might see with people coming from different countries. So in addition, when you're providing the medical care, in addition to the language barriers, what are some of the other challenges that might be more prominent in communities that are coming to the US for the first time or that don't have that medical home that you were talking about?
Myron: You mean conditions that we see or you mean like one of our challenges to try to get them good care?
Myron: Well, I mean, I would say that probably one of the biggest challenges is helping folks recognize that the trauma that they've experienced is potentially really affecting them, maybe even causing some of their physical symptoms and getting folks to recognize what depression looks like and what, You know, post-traumatic stress disorder is. And, you know, the. From a doctor's standpoint, in many of the countries we take care of folks from, there's not a word in their language to even say what depression is like. There's not a comparable word for PTSD or anxiety. And so these folks have a whole different way that they sort of make sense of those symptoms. And so a huge challenge for us is to understand the cultural difference between how we look at mental health and how, say, someone from rural Sierra Leone looks at mental health. And if you don't bridge that gap, you're just kind of stuck because, you know, what's the use of giving them medication for and for depression or setting them up for counseling if they don't really understand the basis for it. So I think even more challenging than the language barriers is helping people understand the cultural context of the different symptoms and illnesses that we identify with. And then once I mean, once they do, then getting them good care. It's not easy to come here as a refugee or an asylum seeker or an Afghan refugee evacuee. You've seen so much trauma more than most people should have to bear. And then you're coming to a new place with a new language, you know, new weather patterns, everything's new and it's very challenging. So we see a lot of mental health illnesses down the road downstream after we start to really get to know folks.
Tia: Yeah, I think the work that your organization is doing is so amazing and important, coming to a new country and having only a few months of financial support and then having to make your way on your own and navigate new systems. It can be very confusing. I mean, I'm speaking as an American woman. I've lived abroad in another high income country. And even for me, with all the assistance and support that I had, navigating another health care system was very confusing for me. And I had a lot of support. So I can't imagine what it's like coming to a country and having to navigate that with less support.
So for your organization to come in and support these families is really amazing. One of the projects that you have is called Priscilla Project. Can you tell our listeners a little bit about what that project does?
Myron: So the Priscila project provides support to our pregnant moms, especially refugee moms who are new to this country and especially women who grew up here in Buffalo, but maybe this is our first pregnancy or there's other challenges that you're overcoming with this pregnancy. And so we surround these women with support, do home visits to make assessments, provide prenatal education, provide. Birthing classes, breastfeeding classes, those that need a doula, we provide that either in the language of the country they're from or in English, and then we provide interpreters, live interpreters at the births, which is a huge improvement over, you know, using a telephone to interpret or a family member to interpret at the actual birth of the baby. And then there's some follow up after the baby's born. So it really is a hands-on way of helping folks navigate what can be a challenging time.
We will talk about health inequity. One of the things I've looked at over the last couple of years with our folks at Jerrica Road is because we're a federally qualified community. Health Centers are 17 measures that we have to report to the federal government on every year. And one of those measures is low birth weight. So of the babies who are born at Jericho, we deliver about four hundred babies a year. How many of them have birth weights under twenty five hundred grams? And I'm very happy that we don't see a racial disparity in birth outcomes at our health center. So in other words. Black folks and white folks and refugees all are equally prone to having low birth weight babies for the most part, and that's not what the literature would show at large. And I believe that the Priscila project, along with excellent prenatal care and the kind of care that we give it, Jericho, we really go after people. If they don't keep their appointments, we will run them down, that kind of thing. I think that's why we're seeing the inequity overcome. I have no doubt that the racial inequities in health that we see if we were intentional across this country at providing the extra resources are more like equity, I think that, in other words, do not necessarily treat everyone equally, but put extra resources to where the need is. You can make up these gaps. And I think that's what the Priscila project is helping us make up that gap or close the gap with regards to the outcomes of the women that we deliver it.
Tia: That's such an amazing success story, it's so great to hear how you've identified this issue in the different ways that you've worked to empower women to have healthier pregnancies, and then you're demonstrating that it works with the hard data in these low birth weight indicators. I mean, it's great to see it all come together that way. And low birth weight is important not only for the survival of the infants, but addressing low birth weight can have implications down the road for the future well-being of children. So it's a really important program and really great to see the success of that program.
You've talked about what your organization does. Can you maybe take us back a little bit and tell us how you got started and why you do the work that you do?
Myron: Yeah, so I, I. Sort of had a long journey to come to Buffalo and to do this work, my parents were Amish and my wife's parents were Amish. We were born in Lancaster, Pennsylvania. I end up spending 10 years of my life, 11 years of my life in a Central American country called my parents were missionaries there is there that as a kid that I got this interest to be a doctor and I think I was because of exposure to the health needs in that country. So when we got back to the United States, still part of the Mennonite community, I didn't really sort of didn't have exposure to the way the poor were treated here in this country until I got to medical school at the University of Buffalo and specifically in my third year of medical school. So all along I was thinking, I'm going to be a doctor in another country and address the health needs that I saw there. But in medical school here in Buffalo, doing my third and fourth year, I was honestly shocked by the way the poor were treated on the clinical rotations that I did at EMC and other places where there's no question that there were basically three standards of care for folks in Buffalo. If you had good health insurance, you saw a completely different set of doctors and were treated differently. And if you had Medicaid, you saw residents, medical students in clinics across the city, mostly in big hospitals, never seeing the same person. The next visit will always be someone different. You'd have to wait a long time, handwritten notes, teaching opportunities all the time. And then if you had no insurance, basically didn't access the system at all unless you were really, really sick. And then you went to the emergency room. And it's a generalization, but honestly, that's the way it was. And I'd like to say that it's that much different, but they're still is a lot of that, you know, going on in our nation and in Buffalo, still twenty five years, 30 years later. But anyway, out of that experience, I was like, it kind of changed me. I got basically the call to stay here in Buffalo. I went away for residency then came back in ninety six with the vision of starting a medical practice on the West Side in partnership with the local church I was a part of. So we did that and. You know, it was that my motivation was to try to create a system where people were treated fairly and equally, regardless of what their health insurance status was, whether they're rich or poor, bring folks together and try to provide the same care. I always said whether it's the president of the United States or the Somali refugees off the plane, if they come to Jericho, we're going to try to treat them the same way. And the motivation for this is really out of my faith. I believe in following Jesus seriously and believe that at the core of my faith is this idea of I'm supposed to love God, I'm supposed to love my neighbor and my neighbor is anyone I mean, who's in need, whether here in this country or some other place. And if I you know, as a doctor, since I'm a doctor, then that means how can I make a difference medically for this person? So this idea of loving your neighbor, doing unto others like you would want them to do to you, how would you want your mom to be treated is sort of the challenge I would give folks at Jericho. And we've really tried to lead the organization that way from the very beginning. We started out as just my wife and I part time secretary and a part time nurse. First week we saw three patients, a mom and two kids, and the first 10 years were really tough. A lot of challenges financially because as a private practice, taking care of mostly folks with Medicaid or no insurance, there's not much money to be made doing that. So financially, it was a big challenge. But gradually, you know, gradually we just came together. I think, you know, some changes in Medicaid reimbursement, managed care, Medicaid, getting a bunch of other people who were mission focused like I was to join us. And I mean, the need has always been there. There's always patients in Buffalo that need this kind of care. And so gradually we grew eight, nine years ago, we became a federally qualified community health center. And that then finally solved the financial challenges for the basic stuff that we do because we get a lot more reimbursement for Medicaid and Medicare and uninsured folks now. And so it gave us that foundation to be able to really grow. And we have so and we continue to try to go after the folks who need the care the most. And we continue to try to bring people together since we have a very diverse practice. Lots of lots of you know, our staff is incredibly diverse and reflects the community that we serve. And so. Yeah, so that's why we will be celebrating twenty five years next May.
Tia: Congratulations, that's amazing and such a powerful story. Thank you for sharing that with us. Going back to the Afghan evacuees, Can you tell me a little bit about how the different resettlement agencies are working together and working with Jericho Road to address some of the needs that these new arrivals will have?
Myron: So I think it's really cool. All the refugee resettlement agencies are coming together along with Jericho Road, So there's five organizations who've come together and are intentionally pooling our resources to make this work, because like I said earlier, the federal government isn't providing much support for these folks when they arrive. And so the typical refugee resettlement process, it would be very truncated unless we all work together and unless the community really supported it. And so instead of competing among each other, I think it was very wise to bring everyone together. And so we're asking the community if they're interested in donating money or their time or resources to this effort to go to the website WNYC which is our five organizations together, and there they'll find resources with regards to how they can donate time or money or effort. And so, yeah, you know, our road specifically Jericho roads role will be to provide the medical care. The other four organizations will provide housing and get folks plugged in to the community. And so I think working together with folks will be able to do this well.
Tia: So this is really great that you're providing this information of how people can get involved, because I know our listeners are going to want to know how to help. So we will put that link up with the podcast so that people can know where to go to find you to help you and your partner organizations.
Myron: Right, so the WNYC, our ECG, would be that the right link, not so much our individual organizations with regards to the Afghan evacuees, then whoever's managing that site can can put people in the right place so that they're most successful in helping us all do this job.
Tia: Wonderful. Thank you. I know, I know people will be really excited to help.
You've talked a lot about what your organization is doing and where you've come from and how your organization has grown in these twenty five years. Where do you see your organization maybe five or 10 years from now?
Myron: What do you see Jericho Road doing? Well, you know, I've always been motivated by the need, so I think. That's going to continue to motivate us. It's not about competition or market share, It's about are there people who need excellent primary care who are falling through the cracks and how can we make a difference? Things are much different than they were 30 years ago. Twenty five years ago when we started, there's other federally qualified community health centers. There's a number of like minded organizations that are now filling in more of the gaps. So I think Jericho Road will look for opportunities where there is a need and try to fill those gaps I think will continue to grow on the east side and west side of Buffalo will continue to look for ways to address the social determinants of health, either on our own or in partnership with other like minded organizations. I don't think we have to do it all. We can work together. We'll continue to grow our global work.
We need to get better with the work that we do at VVA in terms of where we'll probably be starting a capital campaign to get a better sort of space for that work. So we have you know, we have plenty, plenty of challenges ahead, plenty of ways that I think we can grow not because we have to grow, but because there's still a need. And so once all the patients are taken care of and everyone has good doctors, and then maybe we won't grow anymore. But for now, anywhere we open a site, we start a new doctor. Within two months, they're filled. So there still is an appetite for excellent primary health care in the Buffalo region.
Tia: Is there anything else you'd like to share with our listeners about the work that you're doing or ways that people can get involved to help address some of these issues?
Myron: Well, I mean, I think it would be a whole other topic, but there's so much to be said around the inequity that we see in terms of outcomes of care and what can be done. covid has been a prime example of that. When you see we've done so much testing, testing probably thirty five forty thousand people in the last 18 months.
And it's even though you test white folks, black folks, refugees, you see inequity and who tests positive, you see inequity and who gets sick, who gets to the hospital, who dies. And that's just covid. So I think that definitely the events of the last 18 months are pushing me to think more carefully about how we as an organization can more intentionally do our part to bridge those gaps.
Tia: Well, I can't thank you enough. And it's been such a pleasure to have you join us and to listen about the work that you're doing. We will be really interested to follow up and see how it goes with these Afghan evacuees.
Thank you to you and your organization and all your partners for the work that you're doing to address these inequities in health and health. And our School of Public Health and Health Professions is here to work with you if there are ways that we can support the work that you're doing. So thank you so much for taking the time today. We really appreciate it.
Myron: You're welcome. Thank you for the opportunity. I wish you well. Yes. Let's partner in the future if we can. Thank you.
Tia: All right, take care. It's been another episode of Buffalo HealthCast.
Tune in next time to hear more about health equity in Buffalo, the US and around the globe.
Sept. 23, 2021
Co-host Tia Palermo interviews Dr. Myron Glick, Founder and CEO of Jericho Road, a community health center in Buffalo, on their work attending to the health care needs of refugee populations, including coordinated efforts of Jericho Road with Buffalo's refugee resettlement agencies to assist Afghan evacuees. To donate to their efforts, visit wnyrac.org.
Hello and welcome to Buffalo Health Cast a podcast by students, faculty and staff of the university at Buffalo School of Public Health and Health Professions, we are your co-host, Tia Palermo, Jessica Kruger, Schuyler Lawson. And in this podcast, we cover topics related to health equity here in Buffalo, around the US and globally. And the first semester of the podcast, we're taking a deeper look at racism and health. We'll be talking to experts around the US as well as individuals here on campus and in the Buffalo community who are working to remove inequities to improve population, health and well-being. You'll hear from practitioners, researchers, students and faculty from other universities who have made positive changes to improve health, equity and inclusion.
Jessica: Hi, I'm Dr. Jessica Kruger. And today, my guests are Adam Graczyk and Sidney McFoy. Adam, tell us a little bit about you and your program.
Adam: Hi, great to be here. I am a clinical assistant professor in the Department of Community Health and Health Behavior. And over the last couple of years, when I was still a student at the School of Public Health, health professionals had this week-long summer camp. It was basically high school students where students would come to campus and they would learn about public health, do a lot of hands-on experiences, take campus tours, that kind of thing.
I sort of became more involved this pre the previous year. We decided we wanted to make it for credit. So, credit offered an experience, the appropriate credit this school was going to pay for the tuition and fees. And then it was sort of my job to make the content more rigorous.
So instead of just sort of keep the fun part of it, but also put it in lectures about epidemiology of things.
So, this program was really for underrepresented minority high school students from the Buffalo area, first generation college students. And it was really introduced them all to public health.
I think maybe probably tell you this may have been one of her first or the first time she heard about what public health was and like how sort of broad it is.
We hung out and Zoom two hours, twice a week. We had a lot of different discussions and a lot of different guest speakers. I tried to bring some improv principles into the class rooms.
We would use different warm up activities, but I tried to bring in sort of the essence of improv, where it's an improv, there is no failure. And I really like that sort of comparison to the classroom, because in order to have good discussions and feel like everyone has input in a discussion, that has to be sort of like a safe space. And if you feel like you don't feel safe and you feel like failing is not an option, you're less likely to contribute to the discussion.
Jessica: So this Pathways programs are Pathways Academy sounds like a really great opportunity for students to learn about public health while still feeling that they can learn more about being a student.
So, Sydney, tell us about your experience and a little bit more about you in this program.
Sydney: I want it to be a pediatric surgeon. So, when I heard about this program, I was like, OK,
this would be a great opportunity for me to learn more about public health and public health and how it affects my community and how it helps my community and how I can play a part in public health. And so, when I took this course throughout the course, we had a bunch of different like people come in and teach us about like their specialties.
So, we had epidemiology, we had physical therapy, we had occupational therapy. We had some nutritionist come in and teach us about that. I think my favorite was probably epidemiology and much of because of the situation that we're in right now. And I just didn't really know a lot about, you know, pandemics and epidemics before I experienced one for myself.
And so, this program just gave me the opportunity to broaden my horizons and learn more about how I as an individual can contribute to public health and how it affects me and my community.
Jessica: That's awesome to hear. I can't wait to see you become a pediatric surgeon. That's going to be an amazing goal to reach for your journey. But it sounds like some of these skills have really helped you and maybe even motivated you.
Could you tell me more about that?
Sydney: So, I'm a sophomore in high school, so I'm not sure what college I wanted to go to or even now I don't know what college I want to go to. But this program really helped me, you know, like stay focused in school.
And it motivated me to they often talk about a lot of the people we saw. They talked about how important education is and how important, you know, like getting educated and going to school and having good grades and going to college. How important that is as far as, you know, individuals. And so, it helped me stay motivated in school and it helped me like it helped me want to learn.
I came to class wanting to learn new things. So, we had this one lady come in and she was she did like admissions for four. U.B. Laura, Laura Connel is one. That's great. She's taught us all about what we need, like SAT scores and stuff and like what we need to get into B and what we need to do, even as like freshmen and sophomores, what we can do to further our education.
Jessica: That's great to be able to know how to get to where you want to go. It's almost like a GPS on your way or a map that shows you to the Treasurer of Education.
It sounds like you're well on your way out to tell us a little bit more about how you instill some of these skills into students and how you kind of built this curriculum to help ensure students are successful.
Adam: We wanted to try to keep as many sorts of hands-on or different activities. We really wanted to have more group activity students, whether it was for a grade or not.
It's sort of engagement there. But we really wanted to have opportunities for mentoring.
So, we actually brought in all of the UB undergrad public health ambassadors. And we had this final project where each student would take your photo, a photo within their community that illustrate a public health problem.
And then they would talk about that problem and what they could do with a degree in public health, how you could address that problem. And the ambassadors signed on every week and work with them sort of in groups of two or three. Yeah. I mean, like Sydney was saying to I wanted to have not just talk about public health topics and health professionals, professionals come in, but also, I'd like the college prep and what it was like being a student. They had a lot of opportunity to talk to the ambassadors, be like, what's it like on campus?
What's it like being a student? And as much as I try, I'm getting further away from the age I was when I was an undergrad student. So, it's definitely more difficult for me to relate to that. But I think it was just. me, it was a great experience because like. I was able to sort of instill passion, I guess, or get them to get them excited about it, and that's what I really like doing, just overall teacher.
But they taught me a lot, too. And I really loved learning about their communities and what they would do to fix problems. And it was really we had so many great conversations.
Jessica: Sydney, tell us about what your project was. I'm interested to know about these projects.
Sydney: OK, so we had our final project and our goal, I guess, was to figure out a problem in our community that had to do with public health. And so, we had to take we had to take a picture of this problem and we had to write a report on it and then we had to present it.
So, the topic that I chose was the disregard for COVID in the Black community. And the picture that I had was a picture of a mask and gloves, a picture of gloves, and it was just on the side of the road. And so, I took that as it represented what my topic was about. And I just wanted to bring awareness to the difficulties between the black community in the medical community, why people aren't taking it as seriously as they should. And then I wrote about how, like older people in the Black community that they have, they're more at risk to get sick or to die than people of other colors or white people.
And Black people in general are more intergenerational. So, grandparents live with, you know, their kids and their grandkids. And so, if a six-year-old comes home and gets and is sick and they give it to their seven their 70-year-old grandfather, and then they get really sick, you know, then that's an issue.
And so, I just talked about how they can become more aware of it and be safer.
So, where mass social distance, follow CDC guidelines and then other things like taking the vaccine and a lot of reason that people don't take the vaccine is because they don't trust the medical professionals.
And so, one thing that I said was a solution for that was that we could have vaccine stations be at like local churches and local community centers, places that people in the black community trust, people that they trust.
Jessica: That was really profound finding. And that picture, I think, will stick with me forever.
And the representation is, sadly, we see that around more and more often.
But I think your solution to this problem is also quite innovative and something that we have started to see happen as we see people who are hesitant for their second vaccine.
So, you're wise beyond your years. This is great. Maybe you should come over to public help instead of going to that pediatric raveled. I'm sure Adam has tried to convert you too.
Adam, you want to tell us a little bit more about your main goal with this final project and how that this final project has maybe help students to really synthesize what it is to be a public health professional?
Adam: Right. So, I think I mean, it's pretty powerful. Obviously, you could describe we've described the photo, but the way we'll see it, it's pretty powerful. What just a single photo can illustrate. And the ways that you describe the problem and how you solve the problem that all stems from is the single photo.
But I think the most important thing is that she made a personal connection. It's in her neighborhood. And I think when you're able to do that, make it have a personal connection or make it more personal, you're really able to sort of embrace new ideas, new concepts in a different way than you would use just hearing about it in a lecture hall or something.
I think it's so important that we really have some of these immersive experiences for our students and get them to see the problems around them, because I'm sure, Sydney, as you were doing this, this was not the only problem that you saw within your community, but it begins to help you think about other challenges that your community might be facing.
Jessica: So, I have to ask Sydney, what was your favorite part about this program?
Sydney: I would definitely say the whole like getting to meet new people. And when we have discussions, I love having discussions. I love just like open discussion. And everyone's just throwing in their two cents. I love those. So just getting to meet new people, hearing no opinions, you know, like hearing new ideas and just, you know, open discussion with new people. It was great. That was probably my favorite aspect of it. That's awesome.
Jessica: And I, I bet it gives you a little bit of a different perspective about what college is. I myself am a first-generation student and I wish there was a program like this for me because I had no clue what college would be like.
Did you feel like this made you a little bit more comfortable thinking about colleges and being part of a university life in the future?
Sydney: Definitely. The ambassadors, my ambassadors, she was you know, she goes to UB and she just was so open about her college experience and so I could just ask questions and she would tell me about like classes and living in a dorm, having a roommate, being away from home. Just all of those things, things that I was nervous about.
She just explained it to me and, you know, kind of helped me kind of help ease my nerves about college. So, yes, I definitely feel like it has. Help me feel more confident about going to college.
Jessica: Fantastic. What was your favorite part?
Adam: It was really I would also say the discussions.
I was I was excited that I was able to do some of the teaching techniques that I do with the undergrad level. And I just I, I hadn't taught high school kids before. And it's not like, oh, well, I'll try to do similar things that what I do and at work. And I do feel like there was just such a lot of the students there to sort of embrace the material. And they asked lots of questions and it was great. They weren't shy to ask questions. I just think it was it was very rewarding.
Jessica: Yeah, most definitely, especially when you make those connections with students and can see that light bulb moment, I know this is faculty really live for that. And I'm sure you had a lot of those in this class.
Adam: Yeah. And we've got a lot of qualitative feedback. I do have a few numbers that I could share. How successful pathway's academy. So, to be at the beginning of the academy.
At the end, we gave a 15-question public health knowledge quiz, and it just basically asked different questions about public health.
And they were all sorts of topics that we were going to cover throughout the seven-week period at the beginning of the academy. The average was an eight out of 15. And at the end, the average was a 12 and 15. So we definitely saw improvement there.
We also looked at self-efficacy, their confidence in their ability to succeed in a public health or health profession. We saw almost a 10-point increase from the beginning of the academy to the end. Also saw a positive increase in public health attitudes, positive attitudes to public health, and we did see an increase in intentions to pursue a career in public health professions by the end. So just really, really good stuff there.
Jessica: Sounds like an amazing success in Sydney. Kind of highlighted some of those findings as we've been talking to her around her confidence and even knowledge about public health.
Now the nation knows what we do, the pre-pandemic, many people didn't. And so, I'm glad more students are interested in learning about this profession.
I like to wrap up with every episode with what's next. So, tell us what's next for you, Sydney, on your journey to your next step in education. What are you looking forward to?
Sydney: I will be starting. I'm almost done with my sophomore year, so I'll be going into junior year in a couple of months. I've signed up for numerous AP classes, so I'm excited for that. I signed up for was AP psychology.
And I'm very excited because I love learning about like humans and what makes humans humans and why they do what they do. So, I'm very excited for that class.
Jessica: Yeah, that's awesome. And that health, behavior and psychology are very closely related. So, I'm sure you're going to be able to bring some of that information that you learned into your next semester.
That's awesome. Adam, how about you?
Adam: I'm going to Disney World. No, I'm just kidding. I look forward to sort of growing this program. And year after year, we're going to have like this really large group of people. And I'd love to just have, like, summer. Events or something like a cookout or other events on campus and just sort of continue to follow up with all with all the students, see where they're at and what they're doing, I think it's really cool. Sounds like you made some lifelong connections here with students.
And I'm sure you'll watch them all be very successful to.
Jessica: Thank you very much. Today's guest worker, Adam Graczyk and Sydney McFoy, thank you very much.
This has been another episode of Buffalo Health Cast. Tune in next time to hear more about health equity in Buffalo, the US and around the globe.
Co-host Jessica Kruger of University at Buffalo School of Health Public Health and Health Professions speaks with Adam Graczyk and Sidney McFoy about the Pathways Academy in Buffalo. This program introduces underrepresented minority high school students from Buffalo to public health through hands-on experiences, campus tours and more.
Hello and welcome to Buffalo HealthCast a podcast by students, faculty and staff of the University at Buffalo School of Public Health and Health Professions, we’re your co-hosts, Tia Palermo, Jessica Kruger and Schuyler Lawson.
And in this podcast, we cover topics related to health equity here in Buffalo, around the US and globally. And this first semester, the podcast, we're taking a deeper look at racism and health.
We'll be talking to experts around the US as well as individuals here on campus and in the Buffalo community who are working to remove inequities to improve population, health and well-being. You'll hear from practitioners, researchers, students and faculty from other universities who have made positive changes to improve health, equity and inclusion.
Schuyler Lawson: Hello, everyone, and welcome to another episode of Buffalo HealthCast University, Buffalo's premier public health podcast. I'm your host, Schuyler Lawson. I'm a first year PhD candidate in the Department of Community Health and Health Program.
With us today is Alexander J Wright, the founder and president of the African Heritage Food Co-op. Thank you for taking the time to the interview today. Thank you. Let's go. We'll be glad to have you. And first off, can you tell us a little bit about yourself?
Alexander Wright: Yeah, I was born in Buffalo, left when I was three, came back at 12 and went away to college at 18, came back at 20, and I've been here ever since, I have a bachelor's of science business management and I have a law degree from University of Buffalo's John Law O'Brien School of Law. I've always been community focused.
Schuyler Lawson: That's what I've heard about. People always end up coming back to Buffalo in your story kind of ties into that. I've heard that quite a bit. People leave and they end up coming back. So, yeah, my next question is, so what is the mission of the African Heritage Food Co-op?
Alexander Wright: The mission of the African Heritage Food Co-op is to eliminate food deserts and combat unemployment and price gouging, the inner city in particular.
Schuyler Lawson: And it's a that's a pretty noble mission. And that kind of leads into my next question. I'm glad you mentioned your you be your juris degree from now. UB school of law, correct? Yep. So how did that inform how does that inform the creation and the management of the American Heritage of Food Co-op that that type of education background?
Alexander Wright: I think see, law school teaches you one thing for three years for research.
Right. And critical thinking. So I think one of the things that helped me to be successful is when I have the ability to read my own contracts, I have the ability to create and negotiate and a lot of ways that I learned it to be. But also it increased my networking ability.
So because I'm able to see both sides of anything, that's one thing they force you to do your first year, your third year. They make you argue size that you're four in size this year gets to enable you to be able to understand, you know. So it allowed me to relate to folks I work with a lot of people who politically don't think like me. And I work with a lot of people who don't look like me.
But I have a skill set to where I can deal with everyone on a spectrum, whether you're, you know, if you support Trump, whether you are no matter who you are, I can sit down and have a conversation with you and find common ground.
And that's one thing I had to do, working out with local farmers. And as I'm driving out and I'm seeing Confederate flags, I'm seeing Trump support, I'm seeing, you know, don't tread on me.
And a lot of ultra nationalism, which a lot of times translates into overt racism for people of African descent. But we've been able to get through a lot of that stuff and be successful.
Schuyler Lawson: It's pretty interesting. How did that level of background translate into kind of a major sort of a diplomat in ways you're able to sort of reach out to people in ways that others would probably find unacceptable or very difficult? You're able to can you be able to reach a common ground by understanding that the point of view of the other and then it leads to partnership with someone that you're you may be diametrically opposed to as far as belief systems, whether it be political worldviews.
Alexander Wright: One of the things is there's the person and then there's the idea. And a lot of times we merged the two because you have this ideal, you're this kind of person. And in a lot of times that isn't the case. I mean, sometimes it is what a lot of times that in the case, some people have ideas because they're ignorant to other ideas that are there. Some people have belief systems because they were just taught that they didn't do any research.
So, you know, I always start off with this is a decent person, until they cheat, they show me otherwise and then we just go from there.
Schuyler Lawson: Well, so far, this leads into my next question. Actually, I'm so I'm wondering, what are some projects that the African Heritage Food Co-op has recently undertaken? One of the biggest things is just fighting hunger and covid we fed or about one hundred thousand families in 2020 who were really affected by losing jobs.
Or, you know, they say when America gets a cold, you know, poor folks get the flu. So covid has been difficult on a lot of people, but even more difficult on the people who are with you had it difficult.
So we're able to partner with organizations and projects like the Buffalo Health Equity Network,
the Independent Foundation and a health foundation to western New York excuse me, and many others. And we were able to get healthy food out to folks that didn't have it, so that's been a major focus of what we've been doing while building up our Niagara Falls store and renovating and putting together our Buffalo Carlton Street store as well.
So it's been a very, very busy time for us. And we're looking forward to continuing to work because, you know, we receive fanfare and some notoriety, but none of that means anything if we don't really have a functioning grocery stores in areas that have been victim of food apartheid.
Schuyler Lawson: So I'm just going to go into a little bit more detail about the Buffalo branch that's being built for the African Heritage Co-op. I know there’s one in Niagara Falls.
Alexander Wright: So in Buffalo, we acquired through a generous donation a historically a locally historically landmark building at 238 Carlton Street. It's an air of the fruit, though some like to refer to that area as a medical campus.
But it's the truth, though. It was a fruit built before it was a medical campus through the medical campus resides in the food. And the reason I'm so specific with language there is it's like saying Columbus discovered America, you know, and people were already here right before medical campus.
What was it? You know, where people there was just this barren place that nobody, nobody was in?
No. There are people there with a long, proud history.
Right. So I like to say that because that narrative is part of the institutional racism that that plagues our city. We received fifty thousand to restore it from the Buffalo Niagara Preservation Network. We were able to pay back some of that, which is good. We’re working with architects now. We have our external drawings. We're working on our internal drawings. Once we have internal drawings, we can start our official fundraising. Our fundraising was pushed back because of like a lot of ways you can work fundraisers is by having people come see the building, getting an understanding of what's going on, you know, and then they support one that, you know, 20, 30, 50 hundred people in the building. So that's why we wanted to wait until we had our interior designs so that we now people will be able to virtually walk through and actually see everything that's going to be there.
Schuyler Lawson: And this is this is a very ambitious project. And I think it's going to be a good location that would really benefit from that type of the type of resource you have to have a sort of an approximation of when it'll be completed or did the pandemic kind of throw things into sort of more uncertainty?
Alexander Wright: Yeah, the pandemic threw everything into, you know, we wanted 2021 what built and then go in this year. But obviously that's been pushed back. We're waiting on these internal drawings, hopefully what have them. I wanted to launch a fund raiser during Black History Month but is symbolic. It doesn't look like that's going to happen. The drawings are being perfected and approved. So once we do that, then we'll be ready to rock and roll.
But maybe we can do it in April, which people don't know. Black History Month started as a week in April. And then from there, February was chosen because of the birthdays that fall within February.
And it's a big I'm a big, big fan of Carter G Woodson and what he was able to do.
Schuyler Lawson: If I recall correctly, he's a black historian, correct?
Alexander Wright: Yes.
Schuyler Lawson: I'm glad you mentioned the pandemic. That kind of ties to another question that I had. And how is the Covid-19 pandemic impacted the way that you that you all run by African heritage. How was it had to evolve and what have you had to change to keep on providing those very essential services?
Alexander Wright: So we've revamped our website so people can now order online pretty quickly. They can also call in their orders. We're not taking people in the stores right now because of covid doing free delivery. So the only thing you have to pay for is actually your items. And we deliver right to your house.
Of course, we take all of our precautions. We have visors and masks and things like that.
We are essential workers. You know, when you work in grocery work, getting food, you're essential. And one of the things that we do differently for elders, you know, we come to the door and we see an elder there. We will bring it inside if you know, if that person wants that to happen and we'll put it on their counter for them so they don't have to then try to pick it up. And everything we try to do with care and with a purpose, a community for.
Schuyler Lawson: And can you tell us a bit about what type of type of products you offer on your deliveries?
Alexander Wright: Yeah, and we can basically source anything. It just is a matter of how long it takes. So how specific you are, on basic peppers, onions, potatoes, things like that that's 24 hours. It's not a problem.
We're not at the door dash, Instacart level where you go in and you get it in two hours, but you have it the next day. And that's for 90 percent of items. If you want, you know, organic, I don't know wolfbane or something, you know, something like exotic why would consider exotic, but I understand for some people that's not so I'm not saying that it's exotic. I'm just saying for me it is. That may take a couple of days, you know, we've got a relatively quick turnaround and everything and delivered right to your house and this is what we've been doing because our not the force store, if it's huge and you just can't I can't risk the safety of our employees and I can't risk the safety of the community being bunched up in here buying stuff or, you know, because when you're looking at producer, you know, if not, it's not a bang, bang, bang thing. People come in, they want to pick stuff up, feel it or have a conversation about it. Like it's just a real communal body produces a communal thing and it's just unsafe right now with the size of our store to have people walking in.
Schuyler Lawson: Yeah, that's definitely understandable. But it seems like you've still been able to make some great accomplishments in spite of the limitations that have been imposed by the pandemic. But I have another question. We're talking about, you know, making accomplishments. What would you say is the has been the greatest accomplishment of the African heritage food crop.
Alexander Wright: The greatest accomplishment of the African Heritage Food Co-op has been a couple of things that I see.
One hope I see other co-ops forming. I see other people selling produce that weren’t selling produce before in areas that they were going into before. So that's very exciting to me. I don't see that as competition. I see that as there are, you know, three hundred thousand people who need fresh fruits and vegetables. I would love to service them all. I don't have the capacity to do it.
So if you jump in with your food cart and you're making it happen and I think the black business bazaars that we've been able to institute now, we've gone away from those, you know, in the pandemic and in our sights. But I've seen people pick it up and do something like it, actually, a lot of people. So I'm very excited about that to feel a little bit like a trendsetter. You know, the beautiful thing about the black, this is bazaar as it was.
It was giving small businesses and tabletop folks an opportunity to come out and get exposure, new customers and put a focus on economics. So I was very excited when I saw the city of Buffalo to Buffalo to a black business week, which to my knowledge was not happening before us and before we were pushing the envelope on black business bazaars. So I'm really excited about people who are grabbing on and making that happen. And I think that's one of the biggest accomplishments to me, seeing folks catch on to the idea and putting their own spin on it and making it even, you know, even greater.
Schuyler Lawson: You can take pride in, you know, being the one that got the ball rolling, right? Yeah, it's like a kind of a pioneer in that respect.
OK, so I have another question for you. Can you talk more about your collaboration with the Lexington Co-op? That's a call that I'm sure many of our listeners know about.
Alexander Wright: Yeah, yeah. Yeah. Well, there's a principle In cooperative's, where you have to help other cooperative's being like, you just have to they have held true to that even from our beginning, as far as they helped us immensely with our lawyer to incorporate. You know, they helped us with half of our consulting fee. We brought consultants in.
And I reached out to the general manager to allow a bunch when I have questions or I'm frustrated and I just want to flip the table over, you know, but not just [inaudible] co-op. Like we've reached out to [inaudible] in Pittsburgh.
We've reached out to. Co-ops in Oakland, California, visited co-ops out there. That's one of the things we did. We really did research and talk to a lot of folks, you know, and anybody who's like listening to this and starting something really, really do your research and talk to people about what? About what you want to do.
Schuyler Lawson: Yeah, yeah. I didn't know about that after the principle of co-ops had to help each other. And that's really a you know for sure.
Alexander Wright: And even just not just liked and didn't like the bread hive, which is toll on the grow operative, which is a co-op. You know, they have all done something to help us and other co-ops nationally. You know, somebody out there like I'll see a three hundred people donation some time from this co-op, most recently the Lexington they did for December.
I guess you can round up your purchases and raise money for an organization. They raised $10,000 for us. And what's beautiful about that money is. We were doing work with the county in the Buffalo Equity Network that covered until December.
So we're waiting to hear. If we're going to be refunded, well, we're just a vendor in it again and then hopefully they're funded again and they continue to use us as a vendor. But while we awaiting this, ten thousand is allowed us to keep going on in January, you know, so people didn't miss a beat while we're waiting on you hear from this funding and some other stuff, you know, to help those folks that just can't help themselves right now, OK?
Schuyler Lawson: So essentially, it's like a stopgap type of money.
Alexander Wright: Yeah, yeah. And I mean, they didn't know what to do before. We didn't know what it would before it got here. It just came right on time and allowed us to continue operations and feeding. We feed. 200-500 families, you know, and that doesn't include like our direct orders.
That's just the community stuff. And suppose that's a very generous offering.
Schuyler Lawson: I imagine it sounds more beneficial to many of the people that depend on your services.
Alexander Wright: We pull up and people are like, oh, the full people, what's going on?
Lady gave me a limbe, which is nice. If people don't know what I they are. That's flavor ice. And it's usually like for Puerto Rican and Hispanic, Latin American. Right, so we got the I got there were some photos and the lady was like, “oh, let me I got to give you something if you like.
What's the flavor you like?” I love that you really connect with folks throughout your community.
And I think that's one of the biggest things for me. When I just walk to the hood and people are like, Hey, Alex, man, you know, we appreciate what you do, and, you know, that's it, that's worth more to me than any award, you know, and being fiscally responsible, you know, for employees who are around the community like that. It's exciting to me to be able to do that. Yeah, that's, you know, it's there's only one.
Schuyler Lawson: Yeah. OK, so I got another question for you. This one's kind of broad, so I'm not, in your opinion, what are the biggest drivers of health disparities and what would it take to eliminate these?
Alexander Wright: First thing. Give the funding to the people in the community. I think one of the biggest mistakes that we continue to make is we'll give a million dollars to whatever.
OK, now they'll take that million dollars and they need a salary, somebody else's salary, somebody else needs a salary, somebody else's salary. So you mess around, you have 10 salaries out of those 10 salaries. They have one person who may represent the community and be your community liaison.
Right? Well, what happens is. That black face that they find, is rarely actually connected to the community. Right, and they just assume that because this person is black, that this person is going to connect with the community. You know, that just happened in Washington was black and that's kind of black person. A lot of times these companies, these organizations want to bring to my neighborhood and then they don't think like me. They don't have my same experience. They don't understand what's what. And then there's a disconnect. If people like, well, we hired a community liaison who we are a diversity coordinator, and they in the community and the community just doesn't want to work with them because we have this guy where you come from.
Why are you my face? What should happen is, all right, here's a problem that's affecting the community. Is there anyone in the community already working on this problem? So we're going to put funds into capacity building and helping that institution, that organization or those people build out the word continue out the work.
Right. And not just on, here's a grant that's heavily restricted. Right. Here's a grant that's not heavily restricted. You're also a CPA who is also an accountant. Right. Because the other thing that people don't help you with, you know, here's a grant, but you know what I'm saying?
Schuyler Lawson: They don't need know how to manage it. Right, in these things that you need.
Alexander Wright: Right. So, you have a lot of people who are doing good work, who aren't getting funding coming out of their pocket or they get a little bit of funding? Right. But then they're trying to figure out, OK, what's the paperwork? How can I write?
So what happens if people, again, with the education, with connections, with the application for protection and they get this lump sum of funds and they use it how they see fit? A lot of times on salary, a lot of times on just things that are going to, you know, make me look not racist because I'm going to shake hands and pretend like everything is good. Right. And our institutions do this our foundations do this a lot.
And it's one thing we do. You want to solve the problem, don't you? That's really what it feels like. You know, we spend or they'll give people give a hundred thousand dollars to do a feasibility study or here's is a hundred thousand dollars to go and do surveys in the community.
And now you're paying all the students 15 bucks an hour to go out there and knock on doors.
You're paying people to do whatever. Right. So now the money's gone and you have this data, which is great, you know, for people who are becoming PhDs, which is before schools and papers and articles and that kind of stuff. Right. So now you have this beautiful article, well written. Awesome.
Who's going to be read by academics who are going to study it, have a think tank about it, get some more funding to look at it, write a book about it. And all this time, people are dying, people are starving, people are right. So we just wasted billions of dollars on an academic boondoggle.
That's problematic, is problematic. So how we how do we change it? We start being smart who's doing it? Or if no one is doing it, who can do it? There's this documentary called Solar Mamas, Women who were from the Middle East and North Africa who were illiterate. It took them to London for six months, taught them solar power to bring back to their villages. Right. They became solar engineers, people who were illiterate. Abusing those cultures in silence in those cultures and those women became engineers, so you can't tell me if you can do that.
You can't take Leroy in the Keysha who made it to high school. Right. Teach them give them an opportunity to do the same thing. Right. They can bag up produce, they can weigh produce, they can deliver produce, right. We don't need an organization to come from somewhere else into our neighborhood to do that. Put the money into the people who are already there, allow them to build themselves up. That's how you change the community and that's how in the health. Is it just. My body, if it's connected to me economically, so now, OK, he should keep his job, my daughter Keysha’s job is to do fruits and vegetables.
OK, I'm a it. I know that she gets paid. I'm a go ahead and get some right here because we're going to do the same things. Other people actually do the same thing. Oh, man. All right. Well, support. We got to support our own line to go, OK.
So that's one now you get grandma to throw some of those things in the pot. Whip it up right now. Oh, man, this is good, Grandma. This is what is this kale? What is what is this?
So then you have the economic portion that you have the portion of somebody cooking it, making it taste good. Right. And you start with the fruits and vegetables that people are already eating. What happens is, is we roll up with the acorn squash boom, acorn squash or like what the what?
I don't. I don't. What is this? I don't cook with this. Right. But if you're a culturally relevant culturally, if you understood, you might. OK, what can you do? The sweet potato? What can you do with a regular white potato which everybody eats. Right. What can you do with a green pepper, which everybody how does onion. Everybody like those onions. So there's things that everyone does, the things that are more culturally relevant. So figure that out, which isn't hard. Call me. I'll tell you right for me, call Alice, call Rita Hubbard. Robinson, call. There are people who are doing this food work.
Right, right. So I don't want to come off as frustrated because I'm not necessarily, well, a little frustrated. But I just see, it's like if you see the solution, right, I really feel like I have the solution. You work with the people who are here, but because those are the people that are going to stay.
Right. That's the same thing with the solar mom thing.
Schuyler Lawson: The reason for the true stakeholder's right, the reason they dealt with women,
because women stay in the village, raise their family, they're going to be here. Right. So that's what the same thing you do, these folks that are here, because we're the only folks that can do it with any longevity.
What happens is you have a great executive director of a great foundation, right? And until that person runs for senator or until that person wants a family or until that person, whatever that person does, everything seems good.
But because it's not in the next person who doesn't see the community focus or what happens is there are hot items. So one year is full justice. Next year, it's human trafficking. Next year, you know, it's STEM programs, right. So what's hot and what's funded, you know, that goes around, but it doesn't go.
OK. Oh, we fix food insecurity. So now let's move on, nothing gets fixed. Nothing gets fixed.
Nothing. That's the problem, man, like we throw money at this thing, we take pictures, we write journals, and then we blow away as if people who were struggling aren't still struggling.
Schuyler Lawson: Yes, so I see this all essentially a lack of continuity.
Alexander Wright: Lack of continuity and a lack of proper placement of funds. You know, and when they do give someone who is in the club some funding, it comes with zip ties, handcuffs, ropes, oh, you know, oh, well, if you spend $10,000, then we'll give you $10,000.
If I had $10,000 to spend. Why would I be here? Anyway, next question, I think I've been on this, I've harped on this one a while.
Schuyler Lawson: So this response, the kind of I mean, it's not something that can be necessarily summed up in just a few sentences, and I think that sort of passion to try to encapsulate it all, the kind of the continued failures of institutions to address the issue properly.
We thank you for your response. So I'm hoping that at least to my last question. Is there anything else that you would like to share with our listeners? Anything.
Alexander Wright: Yeah. There are a lot of things you can do to help. But always help in dignity. People that you want to help are not children, they don't need you to change them and wipe their bottoms and come to them with a with a condescending tone or attitude. This also doesn't mean that you have to walk on eggshells. Be real, be authentic, be upfront with your ignorance, because you have some, I promise you, and be willing to learn from the people you're trying to work with as you're trying to impart whatever you're trying to impart.
Schuyler Lawson: Wise words.
Alexander Wright: So that's it. OK.
Schuyler Lawson: Thank you. Thank you for that reply and thanks again for taking the time to be on our podcast. We want to we hope to have you on again to discuss your future projects.
And is there any way, is there where our listeners can learn more about the African heritage food co-op?
Alexander Wright: Definitely can. You can check this out at https://myahfc.com.
Check us out on Facebook, African Heritage Food Co-op. We're the only one.
And the new initiative for Legacy Farms, where we're leasing out plots of farmland for community folks to come out and grow in. The co-op is going to purchase the stuff that they grow to do an economic infusion into those homes. And you can find out about that. Legacy farms, that or legacy farms on Facebook.
Schuyler Lawson: Again, the only one thank you for sharing that has been another episode of Buffalo HealthCast. Tune in next time to hear more about health equity in Buffalo, the US and around the globe.
July 15, 2021
Alexander J. Wright, JD is a University at Buffalo School of Law alum. He is the current President and founder of the African Heritage Food Co-Op, a non-profit organization created to address food insecurity in the city of Buffalo caused by systemic racism.
Tia Palermo: Welcome to the Buffalo HealthCast, I'm Tim Palermo, one of your co-hosts. And I'm very excited to be here today with Dr. Terri Watson. Dr. Watson is associate professor of educational leadership in the Department of Leadership and Human Develop at the City College of New York. This year she is also a Center for Diversity Innovation Distinguished visiting scholar at the University at Buffalo. She holds a PhD and educational leadership, and her current research agenda examines parent engagement in urban schools and communities. Her aim as a scholar activist is to improve the educational outcomes and life chances of historically excluded and underserved children and families. I'm really excited to have her on our podcast today. Welcome, Terri.
Terri Watson: Thank you very much. Thank you for having me. I'm looking forward to this conversation. And I'm excited to be here.
Tia Palermo: So, as you know, this podcast is broadly focused on racism and health. And I invited you here because of your work with historically excluded and underserved children.
Can you tell us a little bit about this work and what brings you to this work?
Terri Watson: Well, thank you. So a big part of the work, I guess, for us as scholars is who we are. And as a black woman born and raised in Harlem, which is a historically black enclave in New York City. My work is for and about, you know, people of color in general and black people more specifically. And my I guess my reason for being here is to bring our realities to the table.
I think oftentimes what happens in communities of color go unaddressed because the people advocating on our behalf do not live in their respective community.
And so, you know, coming from Harlem, living in Harlem, working in Harlem, I think it's important that I represent this particular reality, you know, in the K through 12 pipeline, our institutions, if you will. So that's why I'm here, to see what we can do better and more meaningfully and thoughtfully to improve the realities of all children.
But I'm most concerned with children and people of color because historically our needs have gone unmet.
Tia Palermo: That's great. Thank you. So when you work with these communities, can you tell us a little bit about what you see in how racism and health interact in the families and communities that you work with? And how does this affect their education and their opportunities in life?
Terri Watson: Well, I guess, you know, bring it back to the personal. So although I was born in Harlem Hospital and raised in Harlem, I spent my early years in the South Bronx. So the zip code is a one zero four five four. That is the poorest congressional district in the United States.
And unfortunately, the asthma rates are particularly high. Gun violence premature were many of the realities that this particular community faces and others like it faces that there are health disparities that simply go unmet or unchallenged because families do not have access to health care.
And oftentimes, when you do go to the doctor, per say, let's say, you know, it's the emergency room instead of going in for, you know, annual checkups and physicals. So the bills that are encumbered on behalf of health care usually can go bankrupt and already challenged, financially challenged family and or community and like education.
You know, many of the opportunity gaps present in education are are systemic, meaning the problems are deeply rooted in the system in itself. So there's nothing wrong with the people per say. It's the systems that we are forced to function in. That does not prioritize the health and the educational needs of our children. And so the unfortunate connect between education and health care is that in both instances, you know, communities of color have little to no to no access to no meaningful educational outcomes or needed medical attention, be it, you know, mental health, the dentist, you know, general health care like those those those things are lacking in communities of color across across the nation, not just in the South Bronx or Harlem, but, you know, there's a Harlem and South Bronx and every state across the the landscape.
Tia Palermo: Yeah. You talked about access to health care and you've talked about educational opportunities. And in 2020, we've really just seen these inequities exacerbated with parents struggling to help their children through school at home. And also, we're seeing disparities in infection rates and access to treatment. Are you seeing any of this with the communities that work you work with? And how is this playing out?
Terri Watson: Oh, yeah, I'm definitely seeing it. And in many ways experiencing it. As you know, I'm Covid-19 disproportionately affects, you know, communities of color, you know, black folks in particular. And even now in New York City. And we're in just earlier this week, many schools that were were shuttered due to Covid-19 baby open. And this is interesting, despite the fact that New York's public schools.
Over one million children are primarily black around. What we found earlier this week is that 12000 more white schools returned, I'm sorry, 12000 more white students returned to previously shuttered schools than black children.
And while, you know, remote learning was considered and is considered less than ideal for all children, many communities of color are afraid to send their children back to school for fear that not only will they get Covid-19, but let's say if they don't and they will bring it home. And as you know, in urban communities, many of our households are intergenerational.
So even if the child said she alive, you're going to infect your grandmother, your uncle, or even an older family member. So, you know, the way this pandemic has impacted education will be felt for years to come. But on the bright side, what I'm hoping to come out of it and learn from this is that even in this pandemic, communities of color have always come together because this isn't the first time this has happened.
You know, if you look at our nation's history and, you know, like 1863, 1964, those were all pivotal years in our nation's history. So what I'm hoping is that in this pandemic in 2020, not only is it, you know, the Covid 19, but there's an attack on democracy.
And, you know, the Black Lives Matter movement is now global. I'm hoping that we come together as a nation and as a people and find some real grass roots ways to address the inequities, not just in equity, not just in education, but to address the inequities in health care.
So even now that the vaccine will soon be distributed in the United States, you know, who will have access to, you know, who's on the first line? And in many communities of color are afraid to take the vaccine. Right. So if you think, back to the Tuskegee experiment. If you think about the side effects and the long term impact of this vaccine that was newly developed, so many, many communities of color are hesitant to take the vaccine. Rightly so. So I know health care providers are really trying to go out and push for people to take it in. I will. And I hope that as a people and community, we do.
But I can understand one's hesitance. And we have to find, you know, better ways to to not only inform, but to do our due diligence, making sure that we are not selling communities of color, a bill of sale that we can't uphold. If those two doses. So if you give the first dose. Make sure you give the second dose. And then how do we follow up for the long term impact of this vaccine?
And will they give the same care to communities of color that they give to, you know, other stakeholders in this, which is, you know, by large, no white middle class America.
So will we get the same, you know, options and priorities in this drug, in treatment, in battling not just Covid-19, but other issues that are prevalent in our community? There's so much to unpack there. Yeah. You talked about the racial disparities in the reopenings of schools in New York City and here in Buffalo.
I have to say that we're seeing the same thing. So the Buffalo City schools, which are predominantly black and brown, have not gone back to school in person at all, while the suburbs, which are whiter and less diverse, although some of the suburbs are diverse, but much less so than the Buffalo City schools, and they have all to some extent return to hybrid or in person learning. So here in Buffalo, we see a very stark difference in the reopening of schools, which, as you have said, is going to have long term input packs for the foreseeable future.
Tia Palermo: And you also talked about a lot of these disparities in access to health care and how these structural factors really influence. So it's not necessarily always decisions and behaviors at the individual level. Only people are being influenced by these much larger influences in their lives that we don't always recognize and name. So here in Buffalo, we have a long history of redlining, which has contributed to scarcity of resources in certain communities.
We have health disparities where we see differences in life expectancy based on which side of Main street you live on. And there's a lot of factors at the structural level that have led to some of these disparities. And just in normal times, we see how these contribute to differences in health outcomes and access to services for help. And it's going to be really interesting to see how it plays out with the access to the vaccines.
And also, as you mentioned, the follow up for care and the two doses, interestingly enough, here in Erie County, of which Buffalo is a part we don't actually see disparities by race, ethnicity in mortality took at 19 like has, which has been seen in other areas of the country.
So that is kind of interesting and maybe speaks to the work that a lot of community organizations and Department of Health. I've been doing to ensure access to services for our various communities. So I want to turn a little bit to some of these larger structural issues that factors that you've been talking about, which influence these outcomes at the edge in terms of education, in terms of health.
So you were recently on a podcast with Sheldon Eakins. And it was entitled Being Kind Is Not the Same as Being Anti-racist. And thus was a leading equity podcast. You were talking about the media and the importance of seeing children, seeing people who reflect them, who look at them. So here at the State University of New York or SUNY, we are the largest comprehensive university system in the United States.
We encompass 64 institutions. And according to our University Systems Prodigy Web site, there is a pronounced gap between the racial and ethnic diversity of SUNY faculty members, where the nine percent are underrepresented minority, whereas in our student body, almost one in three underrepresented minorities. So can you talk a little bit how this what you were talking about in terms of children and schools? How is this important in a university setting? And why is diversity of faculty important?
Terri Watson: Right. Well, diversity of faculty is really important because. You can't be what you can't see. You know, much of the work we do as a person of color, I can say is just simply showing up like in many spaces. My my presence itself is liberating. Not only does it say, you know, there's diversity and inclusion literally, you know, in place. But more importantly and hopefully a diversity of ideas. And in terms of potential for young people, what you can be and see.
And so what I found that I shared I just left the faculty meeting, you know, over 100 faculty members in the school of Education. And as I look across, kind of, you know, the panels, the lack of diversity was palpable. And when I thought about, you know, these white voids, I thought about I hope the scholarship does not mirror this meaning. Are we considering the realities of people who look different than us?
I know as a as a black woman, it's important that I put, you know, the realities and experiences of black folk, you know, in the forefront of my work and scholarship. And I wondered, you know, how often is that lost in these spaces and not just for black folks, but for diverse people?
You know, it's important that people of color are represented because as the nation browns, there will be a need to increase access and make sure that schools become equitable spaces. And I think what happens in higher ed, because, you know, in many ways we inform the next generation of scholars by sharing our ideas and perspectives.
And if they are not diverse, then we are simply repeating systemic inequities. And so it's important that institutions, particularly one as big, big as SUNY, that we are intentional in diversifying, you know, who are students. See, because oftentimes there's a cultural disconnect, in fact, between the professor and the student. And so various realities and experiences do not go unpacked or dressed.
And students often feel, you know, alone or ignored. And you think about attrition rates, you know, who stays and who becomes successful and more importantly, who return back to the academy. As a professor, no, we won't see diverse people if we don't nurture diverse minds and talents and thoughts that are contrary to our own.
And the I guess the downside of this is that oftentimes institutions as big as Buffalo, you know, we function in silos, meaning we don't talk across the board. What happens in education doesn't make it over to the school of medicine or to the law school or even to psychology.
So it's important that we come together and realize that the problem we have while it's in our institution, but it's also inherent in America. So how can we begin as a place of learning to write these long held injustices like what can we do as people concerned with the next generations, not just generation, but generations of scholars? And how can we make sure that we are encouraging and nurturing and respecting diversity if we don't hire faculty members who look like our student body and if we don't nurture those diverse members of our student body, if we keep relying on the canon and, you know, like what a professor should look like, you know, an older white man in a cardigan sweater.
That's not what I see, that that would never sustain or nurture me. So how do we make sure that we are meeting the needs of our students? You know, in a real and meaningful way.
And part of that is simply listening to them and having faculty that looks like them, that comes from those communities and neighborhoods. And because New York is so diverse, you know, how how is that being lost in Buffalo?
What are we doing to encourage diverse people to want to come to Buffalo to do their work? Because Buffalo looks a lot like New York City and in these inequities will not, you know, write themselves if we don't take specific and targeted actions to increase the pipeline.
So I'm hopeful that Buffalo remains the least a leader and is and really, you know, looks at those numbers from that website and ask, what can we do better? What have we done? What haven't we tried? Because the talent is out there.
But we have to have the moral and political will to to make the change that we know we need. Absolutely. And speaking of making those changes, you often talk about deconstructing and reconstructing. So can you talk a little bit about what you mean by those generally? And what would this look like here at Buffalo or here at SUNY?
I think in terms of deconstructing, looking at policies and practices that. In many ways, we're marrying theory to practice, like, you know, is one thing to espouse something. But how do you put it in action? And by doing that, we have to kind of reflect on what we do, like really take apart what we do and understand the rationale behind it and then say if we want change, well, we have to kind of you know, people talk about the system, right? We are the system.
So if you want to change that, we have to start with ourselves. So part of deconstructing, you know, any person, place or thing is to take it apart, to see what makes it tick, what matters. And if we say that justice matters, then we have to ask ourselves, you know, let's say as a scholar, what in our scholarship or practice, you know, embodies justice. What does justice look like to us? And if we see that although we espouse justice, but we are not doing that justice work, then we have to change the work that we do. And we can only do that by deconstructing what we do, kind of analyzing ourselves, that critical reflection that we can say, you know, we are not who we say we are.
And what do we have to do to change? And I think if you can look at yourself and say, you know, I'm not who I say I am and I need to make a change, then you have to make the change.
And if we have to do that as an individual level, you know, in small groups and then as a system. But it starts with the personal. I am part of that is, you know, I do think that we're, you know, by and large that we are morally sound and good people.
But how do our actions and practices and the policies that we uphold? How do they reflect that? And if they don't, then we have to ask ourselves, why not? So you can't be anti-racist and and be a part of the committee where, you know, it lacks diversity.
But, you know, you say you're anti-racist. You know, being an anti-racist is a verb. You know, you have to do it. You can't just be it. You have to embody. You have to act on it. And then you have to hold people accountable to to being anti-racist is not just for yourself, but it's for everyone. So we have to kind of stand behind the ideals that we espouse and in real ways, and that's it is asking a lot. I said I was in a faculty meeting earlier and I said, you know, race is oftentimes a four dirty four letter word.
People don't want to talk about it. But if we don't address it, then it will, you know, continue to permeate, you know, systems, societies and places.
So we have to talk about the problem. America know that the Boyce noted in 1983, you know, the I know the color line, the problem with race and how we see racist practices, you know, reinvasion and reimagined again and again and again. And we hadn't really taken the time to seriously deconstruct, you know, just what does racism look like? Like, how does it play out? And then how do we write it? How do we make sure that, you know, we're being equitable and representing diverse voices and perspectives?
So I think it's important that we deconstruct our realities, who we say we are. And then, you know, rebuild ourselves, reconstruct, you know, because because we can change but changes a lot. And and it's difficult and it's it's scary. But I don't think we can continue like this.
I think the pandemic has shown us that, you know, we need one another and and we know who all we know who the vulnerable members of our community are. We know who is most impacted by the pandemic, by school closures. We know who didn't have even access to health care to get a ventilator or even could afford to stay home, like we say, that are essential.
Workers matter, but many of them are underpaid and overworked. So how do we put our money where our mouth is? If they if they're essential, then how do we treat them?
No, we being just have we looked at the policies that have created this underclass. And many times it's purposeful. So how do we make sure that everyone makes a living, not a minimum wage, but a living wage, and they have access to health care.
So when we deconstruct and reconstruct our realities, we have to make it personal. We have to look at, you know, our place in that and then we act accordingly and we stand on the side of justice, of righteousness. And that's what anti-racist is. You know, you have to act on it's not just saying no wearing a T-shirt and saying Black Lives Matter.
How do you showed up? How does your work uphold those, you know, those ideals that black lives do matter? So I love what you're saying about the need to be critical of our ourselves and our system and the processes that we're working within and our institutions. You've given us some ideas of how we can be critical ourselves. And I like what you say about. You said earlier about 2020 being a pivotal year.
So we're hoping that part of this podcast will help spur some of these critical takes and dialogs. And these ideas that you've been talking about are how we as faculty and how we as a as a university can be critical of ourselves and critical of us as a system. You've also in the past talking about or talked about from a student perspective that you want children to be critical consumers of their reality. So can you talk a little bit about it from that angle? I think especially with students, we have to make it grassroots. We have to study policies that impact our lives. And when I say that, I mean that, you know, the personal that I you have to, you know, go into their neighborhoods, you know, in many urban communities. Unfortunately, there are food deserts.
You know, you find, you know, liquor stores and corner stores, you know, on every block.
So we have to ask ourselves, you know, is there access to no fresh fruit and vegetables?
How many agencies are available to give people different options or to offer resources and what's not being provided? And so when students can see how oftentimes their neighborhoods are are meant to, in many ways know entrap them, you know, they're they're not given other options, meaning there's no fresh fruit, vegetables. Look at the air pollution levels. Look at even in their own schools.
How many teachers are qualified? How many teachers are meaninglessly qualified? They're not teaching in their subject area or they don't have a masters degree or they're not, you know, content specialists like in which districts do we have, you know, highly qualified teachers?
And then where do we have, you know, teachers who lack credentials and then look at suspension rates, then look at access to health care without with that data, looks like so is making students aware of the systems that in many ways encourage in and frame their realities and giving them the tools to deconstruct it. To say that, you know, I notice in my school, you know, we only have, you know, out of 100.
We only have 50 qualified teachers. But in other districts know they're at 80 or 90 percent or even, you know, the racial diversity. We said diversity matters. And, you know, what does the teaching staff look like and why is it important that school leaders are, you know, really do their due diligence in finding, you know, diverse teachers and bringing in appropriate professional development and finding ways to connect communities to resources that are needed for those students and families.
And so is simply making students aware of, again, the school community, their neighborhoods, you know, arrest rates, just kind of like what's happening in a real in a real way that affects them. What's the crime rate like? Was the unemployment rate like, you know, who's hiring?
What are the services being provided and offered to the community? And how does that differ from what happens in other parts of the state or in, you know, in New York, see of the burrow, you know, or even, you know, in the in the surrounding states, in areas making students aware of there is an equity around us. And what will be our role in changing that? Because, you know, we're doing this not just for us before our children would be doing it for tomorrow.
And we do that today by by attacking those problems head on and looking at the facts, you know, looking at the details, because that's where the devil is, you know, best where, and that's where the inequities lie. How do we address that and bring that to the forefront of our politicians and policymakers and elected officials? And that's why voting is so important. So letting them know we know which candidates are best representing their interests that are looking at, you know, the food deserts, the crime rates, the unemployment rates.
Who's advocating on our behalf and who's not, you know, who who earns our vote and who doesn't? Who do we need to change? You know, New York City, we had mayoral control. Maybe that's it in what has the mayor done? Let's hold him accountable for what's happening. You know, the hiring rates of teachers, retention rates, graduation rates. Who's moving on to the next grade level? So we're just looking at again.
The reality is that students must contend with in giving them the tools to make sense and to know what they need to be successful. You know, you need to have algebra one. In ninth grade, you know, and even if you don't want to go to college, you have to be prepared. You should by 12th grade, your reading levels should be at a certain place. You should have a certain amount of, you know, sciences with labs. Your school should have appropriate materials and curriculum and faculty. And if you don't, then know that these schools are not created with you in mind.
You don't want to see you win it. But we're winners. And what are we gonna do about it?
You know, and that's what we have to kind of know, feed the next generation, that they are critical consumers, but also that they can deconstruct and reconstruct their own realities to bring about change because change will have to live with young people. You know, every movement started with young people. We have to remember that and give them the tools to continue to lead.
Tia Palermo: Wow. Yeah, those are some really powerful thoughts. So what I'm hearing you say is that we as educators have a really important role in helping young people to see these realities. In terms of the statistics that you were talking about, these are things that people may not be aware of. And so how can we help raise awareness among our students of these issues?
But you've also talked similarly about reconstruction of curricula. So how at the university do you kind of see this playing into what you're talking about here and helping that next generation become more critical about their reality?
Terri Watson: Right. I think at the university level, one ways to reconstruct curricula is by simply revising our curriculum. Now, oftentimes, particularly at the university level, the curriculum would require no death. So how can we introduce new and different perspectives and realities to push in and challenge students to think outside the box?
We can only do that by introducing different thinkers like an education. Yeah. Doing is important, you know. But would Dubois, who is the father of sociology. What about Edmund Gordon? Like we have some thinkers, you know, who are like Edmund Gordon, many of us, you know, are still alive, that we have to look at those people who are advocating for change, whose scholarship is founded in the struggle. And that's who we study because this is a continuation of a struggle, you know, in many institutions, particularly education, if we're free to push thinking forward, then we have to use forward thinking scholars and many, many of those dead white men we study. We're very much about upholding the status quo. You know, they they regurgitate old ideas.
We have to go back. I think looking at, you know, black education and in looking at diverse scholars and I just know black books. But across the board, like, we have to ask ourselves, aren't we talking about who's missing from this, who's not at the table? What what idea was contrary? You know, who said something different? And all oftentimes those people with different ideas probably look different and had different realities. And that's what we need to hear from what would have made would have made of scholars said about this. You know, what has no Hispanic scholars or Mexican scholars or just people who don't look like us?
What have they said about it? Because the problem hasn't changed, but it's how we look at the problem and then how do we reconstruct, you know, the future? And I think we have to do that with diverse ideas and thoughts. And we can only get that from diverse people with diverse experiences. So I think the scholars we have to welcome, you know, just different trains and thought leaders.
That's what's going to show us forward. That's great. So a call for us as educators to diversify our curriculum, to listen to scholars of color and people with different perspectives. So thinking about how and again, this is kind of along the theme of how these are structural issues which are leading to these and equitable outcomes at the individual level.
On the podcast, what Sheldon and you talked about the structural problem of racism, but how many of the answers to the problem are proposed at the individual? So in terms of teaching young people kindness, mindfulness, resiliency, so why are these types of solutions a mismatch between, you know, what the problem is and these solutions that are being proposed?
I think in particular, when we teach particularly kids of color and talk about teaching kindness and mindfulness and resiliency, I think in many times we are assuming that they don't they aren't kind, that they don't already have resiliency or that they're not mindful.
I think the fact that they come from challenging environments, you know, they don't need resiliency there. They got up and came to school. That in and of itself is resiliency and kindness, especially, you know. Why do you assume that young people are not coming? I know now people say kindness matters or they have. They made kindness like a this kind of benevolence that, you know, is like you are doing an act and you're doing it for a reward.
You want a button or sticker order to check a box. But in many, particularly communities of color, we are community, meaning we trade on kindness that but to not be kind does not even into the paradigm. So to assume that people and children of color are not kind or that's missing in their community.
And I think we do them a disservice. And again, from mindfulness, you know, it's like thinking critically examine what you do. I think the fact that in many urban households, families are struggling to make ends meet, that they're, you know. On budgets and, you know, intergenerational and even housing arrangements like, no, that is mindfulness, they've thought deeply about it. They haven't just, you know, just kind of made this a one off.They have thought critically about how to make sure that, you know, the children are OK.
So to assume that no kindness, mindfulness and resiliency is not a critical part of who they are already, I think we do them a disservice. So I ethnic instead, we should ask them about their realities and experiences and learn and build on that. We have to look at communities in children of color as asset rich people in contexts and learn what they're doing because that's what you know, the cultural disconnect is really palpable because we don't know enough about them to know that.
Of course, they're resilient. Of course they're mindful. No kindness. No, let's say this. I know growing up, it was, um, I'm the youngest of three children. And so, you know, my brother often work my sister and I to school. So he made sure, you know, we crossed this street safely. We came home together.
He waited for us. He asked us about homework like kind fullness and mindfulness and resiliency was was a part of us growing up. Now, we looked out for one another. We know we took care of one another. We were latchkey kids. No. So we not only went to school and came home, but oftentimes you came cable to an empty house. We had to do our homework and have our snacks and wait for our mom to get home.
So to assume that, you know, you need to teach us how to do that. Look at what we do already. And that's what we celebrate and reward. And maybe, you know, help us improve in some way. But to assume that, you know, it's not already there. I think I think it's simply not true, particularly in communities of color where resources are scarce, where we are forced to be creative. You know, like we we are a genius people by design.
We've always made something out of nothing. So instead of assuming that we we need you to teach us not, you better look at what we do already. And that's what we marvel. That's where the the the I think best practice should come from.
Yeah, so I think what I want to do is I want to go back to this idea of I think you've talked in the past a little bit about how, you know, students of color come from these situations and these, you know, backgrounds where they actually do have a lot of resiliency.
So how do you have any thoughts or suggestions of how, as university professors and college professors, that we can recognize those and things that we can do in our own classrooms to recognize the strengths that students are bringing to the table and maybe tailor our courses better for the diverse voices that we have in our classrooms.
I think is simply listening to your students. I think too often, you know, I'm thinking about the work of Pablo Creary.
We assume that our students are empty vessels waiting to be filled without realizing that they're actually quite full already.
And we're simply enhancing was there. So I think we do that by simply engaging in conversation, by being transparent and telling people who we are. Like sharing, opening up, using the eye, you know, talking about, you know, your experiences growing up in and finding ways that, you know, your realities in many ways intersect.
Because what I found particularly teaching diverse students, is that I have far more in common with them than one would know that each of us probably thought, you know, on the onset.
So simply finding ways like when I said, you know, I don't know about you, but I'm the youngest of three. You know, I grew up in a single parent house. So I'm first generation.
I know what it's like to, you know, to come home to an empty house because my mom worked two jobs. I know what it's like to tell my mom that come to the PTA meeting because, you know, she she had to work.
In fact, my mother told us just the opposite. She told us that if she had to come to school for us, a we we'd have a problem. So when teachers thought that, you know, oh, well, this young mother doesn't care, it's quite the opposite. Not only did she care, but she told us if we did not act accordingly, that, you know, we would have a problem. So the good behavior that teachers saw, that was parent involvement, because I knew that if I acted any other way, that my mother would not have that.
So I think, you know, it's looking at the inherent cultural wealth that's in every child in the classroom. Now, we have to assume that they come from loving and caring homes and that our job is to celebrate that to to make them proud so that they know that I never once the mother didn't care. I knew she was working two jobs to make sure we were OK.
So let's celebrate my mother and in shame on those system that underpaid her, that she had to get a second job at that first job. She couldn't make a living wage to take care of us. So wasn't my mother.
But it was the system she was working against. And I understood from her, you know, resiliency, you know, kindness, mindfulness, the fact that, you know, she called us when she thought we should be home and asked us what we were doing and how she found the time and her work day to check in on us.
And she had to come home early. She did. But it was understood that she was losing money. And so we really tried to lessen the burden of, you know, taking care of us.
We knew that in school. We could, you know, we could do our work. We could be, you know, upstanding citizens. And she believed in us. So we worked together. So if that's not community, if that's not kindness and grit, then I don't know what is. But when teachers say that, you know, students need that, particularly students of color, that you're not looking at the cultural wealth of that child and his or her family.
So I think the best ways for professors to kind of unpack the cultural wealth that's already in their classroom is by simply talking to to their students in real ways and finding out who they are and why they are even in college and what they hope to gain from this experience. And I think once we have that relationship, then the learning can happen. But if you don't know who your students are, then how can you reach them?
How can you speak life an agency and and let them know that you care about them and that we have this, you know, this community that we form? You know, the heart of that is relationship. And we do that just by by listening to one another. We'll have to do that. I love how you're talking about this culture of, well, that kind of turns on its head.
Another ideology you've talked about, which is deficit ideology is where we often look and see problems. So kind of similar to that. What do you think we can do in our own work to challenge this idea of deficit ideologies? I think we have to you know, we have to mine for gold. We have to go in assuming that, you know, all parents care about their children, that that and that kids want to learn.
And more importantly, they have the capacity to learn. Our job is just to find new and creative ways to learn and grow with them. And that while we're teaching, we're also learning and growing. And we have to be graceful, not just with our students, but with ourselves.
And I think we do that by, again, looking at our students as as goldmines in our our our real challenge is how do we. How do we find that goal? What can we say to spark the conversation and creativity? Because it's there, but it's our job to try to make it shine, to bring it out and to show them how to move in the world, because particularly as a scholar, color a big part of what I do.
Simply telling my story, you know, so that you can notice this. You know, we in many ways we demystify the academy. You know, I'm first gen. I know what it's like to be counted out. I know that when I told my colleague, my, um, my advisor in high school that I wanted to go to St. John's University, he was like, oh, you'll never get in.
She didn't believe in me. So part of my job was to make sure that I got in and came back to tell her, oh, guess where I'm going. You know, in the fall, because I knew that, you know, she didn't think that I could do it. So I think a big part of what we do, is that that we are dream keepers.
You know, we have to harvest and keep young people dreaming. We have to dream with them, believe in their dreams. So when I tell you what they will be, you buy into that. You don't agree with them. Tell them, yes, you can, and then show them how they can do so.
Tell your story and help them find their own story. But our job is to nurture, to care and to dream, you know, and I think that's missing in many communities of color.
We stop dreaming with young people. We stop believing in young people. We don't see that they are gold mines literally in our presence. We think that they are broken and we need to fix them. Young people are not broken. We have to fix our mindsets and move away from these deficit ideologies that we've been taught in the academy that these are broken or disease people.
No, not at all. We are rich and resilient people. And I think well, maybe. Sorry. I think maybe that comes from also how we're always having to frame a problem, right. So with that search, we also we always need to see what the problem is and how we can generate evidence which helps provide solutions to these problems. So I like how you're challenging us to think about this. You know, it's interesting you should say that because the Spencer, they just released the funding opportunity and the funding opportunity.
It's a racial equity special. Right? A racial equity special research grant initiative. So they're looking for ways to do that. They're looking for ways to fund promising directions for engaging and supporting children, families and communities. And I think the best way to do that, like in solving any problem, we have to go to the people who are most impacted by the problem because they are working on solutions and real meaningful ways because, you know, their lives depend on it. And I think that's why we have to go back to the community, go back to the people and see what they are doing.
You know, in real time. And that's what the solution is. Too often we come at problems with this top down perspective, because if you don't live in these communities and how can really understand or even frame the problem, to say that it's a problem because what you think is a problem may not be for that particular community, could be something totally different.
And what you're seeing is a an outcome of the problem, but not the problem in and of itself.
So even defining the problem, I think we have to go to the community and ask them what do they feel the problem is and how have they thought about addressing it?
And then how can we lend our intellectual talent to marry what they are already doing?
Like, we have to go to the community, like they already have the answer, because, again, they are closest to the problem because their lives depend on it. So they have a vested interest in solving the problem.
And for I think we search as many of us, we don't live in the communities that we study are a part of it, know we are outsiders. And that's bad in so many ways because then becomes you know, we come in at a handicap, like we're doing this community a favor or, you know, they are a problem and we are here to fix them without realizing that you don't think they care like you think it doesn't matter to. Of course it matters to them. Of course, they've tried addressing it and I'm delighted to see what have they done.
And then what can we do together that may improve it? Like, how can we add to an already rich resource and it's just how we frame it. You know, we have to you know, too often we think that we are the light and we're not. And many times, you know, I think we don't celebrate the community enough. But this is a really I call this is really a call for more community based and participatory research methods.
Exactly. Too often we are outsiders studying the problem at a very esoteric level. We have people who are living with their day in and day out and trying any and everything.
And that's where we really need to lend our intellectual talents to work on them. I want to tie this back to something you said earlier when you were talking about community involvement and service and how as universities, we need to make our institutions relevant. Can you talk a little bit about how maybe some of this community and service work can help make our universities more relevant to the communities that we're trying to serve? I think that for many of us, we have to reframe.
You know, unfortunately, in the academy, you know, we are very ego driven. We don't want to be you know, we want to be the biggest and the best and the smartest. But you know what we learned in leadership and I think you said this, but leadership must be embedded in service.
And if service is beneath you, then leadership is beyond you. So if we are to be forerunners, then we have to ground ourselves in service. And that means not working for the community or speaking to the community, but as working with the community and speaking with the community and more importantly, becoming part of the community.
Like we have to truly invest in those, you know, we claim to want to serve because what we do, particularly if we are to change, you know, change lives, you know, its service. But in changing lives, there's reciprocity in it because we become better, our scholarship becomes more informed. But we have to, again, go back to the community because that's what's going to make us better.
And part of that is being humble, saying what we don't know and understanding the community and the challenges they face. Looking for ways collectively and collaboratively to address those problems. But too often, as researchers, we come in with the answer. You know, we have the funding and we're going to throw money at it. But that's not really addressing deeply rooted problems.
And we can only do that by being in community and understanding kind of, you know, what's exacerbating the situation. And then, you know, how can we, you know, think with them to address it? Like we don't have the answers that that's not that's not the right framing of the problem.
You know, here's the situation and then we have to look at the participants in and see how we want to change the outcome and the reality. And that has to be a conversation that has to be about trial and error. It's not a one and done. You're not going to come in with, quote unquote the answer and then, you know, magically, you know, the situation is is right and that's not going to happen.
I think you're right that as researchers, we do kind of have these big egos. And I think even if you're a person that's not necessarily has a tendency to have a big ego going into it, the way that success is measured and the way that you kind of go through the system, it makes you kind of be that person that pays attention to, you know, these measures of success. So thinking about how we measure success as academics, you know, it's really about publications and grant.
Yeah. So what did you as an individual? How much money are you ringing in and how many publications did you have this year? So thinking about the criteria in which we judge academics. Do you have any thoughts about how we can move the dial on these criteria to maybe make it more engaging or recognizing some of the very important and time consuming work that scholars are doing?
Younger scholars, scholars of color? How can we recognize those efforts to make them successful in the system? I think we have to revise the standards for tenure and promotion. You know, too often is about quantity. It's like how much money, you know, how many publications. Instead of looking at the qualitative aspect of it, like where is the work, you know, seated? Who are you working with? And how are the outcomes applicable to real, real world problems? You know, oftentimes, you know, we're so theoretical. Our work is sometimes so absent of practice, not across the board.
But what I found by and large is that, you know, we all have these grand, grandiose ideas that we we speak about and create this utopia without looking outside our windows. And in many of these institutions are, you know, so removed from, you know, everyday people, particularly those who could really use our scholarship.
So I think what would makes it I guess what makes the academy or doing this kind of qualitative, meaningful service, deeply rooted in service work in studies, is that, you know, you won't get the big bang, you won't get the you know, the publication in a you know, a tier one journal or you won't be at an hour one.
I think we have to look at not what we do, but why we do it and ask ourselves how how does this leave not only the people that we hope our research will impact, but how does we must better make are we more thoughtful? Is our scholarship, you know, does it really matter like this? It's like I'm pretty sure that you're someone is going to be fine. And I know my daughter just graduated from Tufts University, so that's cool. But I'm not really trying to talk to you. I'm trying to talk to the people in those mom and pop stores who live in food deserts who are first gen.
Like, that's where the real change is going to happen. So oftentimes, you know, the academic journals that we publish in and the conferences that we go to talk about our work.
They don't affect the people that we care most about. So I think if we're really to to change the focus of the work we do, then, you know, unfortunately, we can have to change the guidelines for tenure and promotion. We have to see. No. Why do we give you know, like we talk about service, you know, service.
Where is it? A university committee or service in the community? You know, like how is how do we define service and what does it look like in a publications should be published in a tier one journal or should it be a a union newspaper or for public consumption?
You know that we really talk to people who don't have PTSD, who aren't, you know, whose university does not subscribe to this particular journal, you know? Is it a grass roots community based Forward-Looking publication or is it, you know, written with academic academic standards that, you know, the common person just won't get?
And I know from myself one of the things that I promised myself, that if my mom with a with that with the high school graduate high school degree, like if my mom can't read it, then I should write it. I want people I care about to be able to understand, you know, the ideas and thoughts and methodologies that I'm using and writing about and spending so much time on. So people I care about can't read it and I don't want to write it, that I have to find ways to make my language accessible and more importantly, that the work I do matters for those I care most about. So we have to kind of reframe even, you know, tenure and promotion and what's quote unquote research.
Tia Palermo: Absolutely, wow, you've. You've given us so much to think about today.
So what I want to do is I want to give you an opportunity to just maybe follow up or or, you know, is there anything that you want to say that you haven't been able to say?
And I just again, I just want to thank you for being with us today. It's always a pleasure to talk with you.
The first time you and I met, you were giving a talk to a group of faculty, and it was VSL in a breakout session. And I was having a rough week and it was a Friday afternoon.
And you just gave such a fiery and inspiring talk. And it was similar about, you know, doing work that's meaningful and being true to yourself and making a change in your community.
And it was really just what I needed to hear at the right time. And so it's been such a pleasure to talk to you again. You've given us so much to think about and unpack and ways that we can be critical in our own lives and our work with students and how we can really make small changes that can make big differences. So I really do thank you for everything you've said today. I just want to give you an opportunity, you know, if there's anything else that you want to tell us before we have to go today with those kind words.
Terri Watson: And I just remember that conversation and, you know, I guess I practice what I preach, you know, what matters, matters in everything, matters like something always matters to someone. And I never I never disregard that. So I tell people, you know, do what matters for you. You know, speak like speak truth and make sure they all reflect and resonate within you, because then it will always matter and our work will never be in vain. We spend a lot of time doing this work.
A very big portion of our lives is scholarship, is the reading, is the writing, is the, you know, unpacking what we've learned. And if we're not, it doesn't matter. Then why are we doing it? You know, like who does it change in? And if it's it's not changing and changing.
If it's not improving, then the realities in life outcomes of people and communities that we care most about, then it's all for not in my perspective.
So for me, I always ask myself, you know, is it important? Is it important to me? Doesn't matter. And nine times out of ten, nine times out of ten it does. And so I put my heart in it. And I think we have to go back to that. I think we have to put our heart in this world, you know, like I I love people, you know, and I love black people in particular.
So I'm going to do my best not to show up and to speak life. I'm going to speak love and win.
And even if it doesn't work, know that I cared. I tried. And this is my best. And I feel good about it, you know, and every grant that goes unfunded, every project that goes left know that I came in with an open heart and my job was always to be of service.
And I tell people that, like, that's that's what I'm looking for. Well, I'm looking for the asset.
I'm looking to celebrate the good work you already do. So it's never a aha moment.
You know, I don't I don't. Do we call it deficit data? I'm not here to tell particularly black, black and brown people that they are broken. That's not my job. That's not what I do.
I'm here to tell you that you're awesome, that we are awesome in this research will simply highlight the good work you already do. If my people can't read the work that I do, the why am I doing it? Because, you know, I am my people, you know. And that's important. We have to remember the communities that we come from, particularly ourselves, sellers of color.
You know, we didn't get here by ourselves. I come from a long line of beautiful black people, and my work will always reflect and celebrate that. And that's important. And I hope that others find a similar, you know, important. It's an agency in their own work. You know, find the beauty, find a true speak like, you know, speak life for people who care about.
Tia Palermo: Love you through this because that's how we got here. Dr. Watson, and it's been so fabulous talking to you today. You've given us so much to think about. And as always. Just very inspiring. So I really thank you for your time today and for our listeners.
Dr. Terry Watson is associate professor of educational leadership and the Department of Leadership and Human Development at the City College of New York. You can look up her work there. And this year, she is also a Center for Diversity Innovation, distinguished visiting scholar at the University at Buffalo.
So, again, Terri, thank you so much for being with us today. Thank you.
June 24, 2021
In this month’s podcast we have a conversation with Dr. Terri Watson about the importance of diversity and representation in academia.
Hello, and welcome to Buffalo Health cast, a podcast by students, faculty, and, staff of the University at Buffalo School of Public Health and Health Professions. We are your cohosts Tia Palermo, Jessica Kruger, and Schuyler Lawson.
Schuyler Lawson: In this podcast we cover topics related to health equity here in Buffalo, around the US and globally. In this first semester of the podcast we’re taking a deeper look at racism and health.
Jessica Kruger: We’ll be talking to experts around the US, as well as individuals here on campus, and in the Buffalo community who are working to remove inequities, and improve population health and well being. You’ll hear from practitioners, researchers, students and faculty from other universities, who have made positive changes to improve health equity and inclusion.
Schuyler Lawson: All right, so hello, hello, everyone, and welcome to another episode of Buffalo Health Cast, I'm your host, Schuyler Lawson, first year Ph.D. candidate in community health and health behavior.
With us today is Stan Martin with Cicatelli Associates, Inc. and and Ebony White with the African-American Health Equity Task Force. Thank you both for taking the time to be interviewed today. Yes. It's good to have you. Can you tell us a little about yourselves?
Stan Martin: Sure. Well, sure. Why don't I go ahead and start of off? Thank you. Schuyler for offering the opportunity to be a part of the podcast and share our program.
Once again, my name is Stan Martin. I'm a project director at Cicatelli Associates.
I'm a native son of Buffalo, I like to say so. I’ve been away for a few years and recently moved back home back to coming back to Buffalo, the place that I love, and that's near and dear to my heart. So looking forward to having our conversation today and sharing some of the work that we're doing here personally as well as professionally.
Schuyler: Thank you. Right. Right
Ebony White: I'm Ebony White, and I work with the African-American Health Equity Task Force. Sorry, a lot of acronyms out here. And I have been working in a community for over 10 years. Most recently, I do a lot of work with the barber and beauty salons. That's where people first were introduced to me, doing my work and spreading all the education and knowledge to build health knowledge and building the capacity in our very own community. And I am a native of Buffalo, New York. So thank you this morning for having me.
Schuyler Lawson: You're very welcome. I was going to ask you about being a Buffalo native majority. You already answered that here.
Yeah. Yeah. You know, I'm I'm pretty fond of Buffalo, too, even though I'm not a native. I'm you know, I'm actually an Alabama native, Birmingham, Alabama.
Stan Martin: All right. We will hold it against you. No tie.
Schuyler Lawson: It was all about a worry. Got it. Yeah. Yeah. So. So now I have another question.
This one's more for Stan. So what is the mission of your organization? CAI?
Stan Martin: Yes, I actually it's not my organization. I wish it was, but CAI was founded by Barbara. She could tell me over 40 years ago where headquarters, our headquarters in New York City. We obviously have an office here in Buffalo, New York, Albany, New York, Atlanta, Denver, Denver, Colorado, as well as L.A. And we also have several satellite offices in Latin America, the D.R. and El Salvador. So a lot of our work that we do is on global and not just domestic.
And the our mission is really to utilize the transformative power of research and education to foster more aware, healthy, compassionate and equitable world. So some pretty lofty goal. And yet still, it's something that we try in terms of working towards. And look forward to doing on a day to day basis. So I'm very proud to work at the organization, I’ve been with them for all the action going on 10 years now. So it's very rewarding, gratifying.
Schuyler Lawson: I think it's impressive. Those are impressive goals and that's also a very impressive tenure of 10 years.
Stan Martin: Very nice. Yeah. Yeah. You know, especially when we are reaching out, I should emphasize that our focus is on marginalized communities in particular who have, you know, on some of the greatest needs and the least amount of resources. So now, given all that's happening in the world today, it is very gratifying.
Schuyler Lawson: That is definitely an important group to focus on. Know still a lot of work that needs to be done. Actually, it actually is kind of a good segue to my on my next question. CAI recently received two million dollar grant from the U.S. Department of Health and Human Services Office of Adolescent Health to focus on improving the lives and opportunities for adolescents by facilitating and resourcing a community driven response to reduce teen pregnancy in select zip codes in Erie County.
Can you tell us more about how these zip codes or communities were chosen and also what barriers those adolescent space to getting accessible sexual and reproductive healthcare services.
Stan Martin: Well, thanks for the question. I think I should probably, as we say, utilize the Sankofa principle. Let's look back to the not to go forward.
So actually, the grant itself that you're referencing, our teen pregnancy prevention grant through the Office of Population Affairs now, actually started five years ago. And it was really focusing on nine zip codes that had high rates of disparities of teen pregnancies as well STIs. And I want to preface this by saying not that not that there was something going on in these nine zip codes that weren't going on outside of these nine zip codes in terms of adolescent health and reproductive services. The the the important element for my in my opinion was that, you know, having access or, you know, access to information, having access to resources and dealing with the root causes of your teen pregnancy and also STIs, you know as well.
So when we look at the root causes, you know, then that allows us to not only look at why why someone is getting pregnant or we are getting STI, but what is what what is is that have precipitated that that experience. So looking at education, looking at access to housing, not looking at believe it or not, like I said, housing.
Looking at, you know, employment opportunities. Looking at the social determinants of health as the root causes of some of these issues that we're facing as opposed to looking at from the opposite lens as being a teen parent or teen father and then resulting into some of these other social determinants.
So having said that, when we started the initiative, we really went to the community and wanted to ask the community, you know, how could we implement this program in a real, authentic, participatory way? And after doing several listening sessions, conversations, a community, one of the things that resonated with the community, came out of those discussions was hope, you know, and the buffalo's at that time was in the middle of this renaissance and people were feeling like they weren't a part of this renaissance.
So and hope actually stands for health, making sure that our adolescents and adults have access to quality healthcare services, opportunity, the opportunity to receive quality education and opportunity for job employment, you know, for placement and prevention. And we can look at the root causes of some of these factors and where we could prevent it and promote a healthier lifestyle. What we as some large families. I eat for equitable is not being on. It's not all about being equal. It's about addressing the health disparity through a lens of equity or being equal equity, so to speak. So that that that came from the community.
And utilizing those concepts and those principles actually provide us opportunity to create a brand, you know, in terms of hope of law for adolescents, for adults to wrap their arms around services to adolescents and build a stronger, healthier, thriving community. So which led us to get refunded, Just this past July for a second round of really looking at how do we look at system change, policy changes that reinforces the environment that I just described to you, where every child has the opportunity to see and access to quality health care and services.
Schuyler Lawson: Given that you've been refunded, I, I assume that there's been some some progress made in addressing this particular issue.
Stan Martin: Yes, you know what? When you look at, you know what, cry from our five year program, my first initial cohort nowhere crunching the numbers right now to look at, you know, where we are in terms of our nine zip codes, because we know that their overall that our teen pregnancy rates are the lowest that they've been in 30 years. You know, which is which is saying a lot. And we also know that, as you mentioned earlier, Schuyler, that there's still a lot of work to be done.
So, you know, we we're proud of our successes in terms of, know, being able to refer and make you move to services to partner with other community organizations, including the Buffalo Public Schools. And you look at the enrollment of the of the Buffalo public schools over 50 percent. I think cost is 70 percent of the students, you know, live in poverty or at the poverty level. So it's very important that we are engaged, you know, in the conversation, in addition to work on healthcare providers, making sure that are meeting with meetings, students, adolescence where they're at now. And that is sometimes a challenge. And yet still not to go there.
Understand that as adults now our children have rights. You know, especially here in New York State, we consider reproductive health and human services and privacy and confidentiality. So we still have a lot of work to do. And I look forward to coming back on many other shows and reporting and sharing some of those numbers with you.
Schuyler Lawson: Absolutely. I look forward to that, too. So many projects that those organizations are doing. So I would definitely probably constitute multiple episodes to this adequately cover them all.
So so now. I did have a question about you. I think you mentioned social determinants of health, and that's that's a great that's a great on topic. That's that's business talked about a lot. And, you know, UB School of Public Health.
So with regard to this particular project, what what what have you found are some of the social determinants of health that are sort of easier to address? Like, for example, your housing may be a heavier lift as far as maybe I'm addressing that, but are there some others or that are that it's kind of someone that wants to focus on more readily because they're maybe maybe they're, so to speak, like a lower hanging fruit that can be modified.
Stan Martin: Well, you know, this work is this work is very complex, you know, so I don't know, let's say if I would use the term easier. What I would say what's really important is that the youth in the community are involved in everything that we do and every decision that we make.
You know, from branding, to the The delivery of interventions need to know how things are marketed. So I think that is that is a critical point, the critical piece that I would like to really shine a light on, because when you look at COVID 19, you know, when you look at, you know, where we are today and how that has shined a light on the disparities that are impacting our community in terms of health and chronic disease, et cetera, essential workers. You know, it's very important to have, you know, those who those, as we say, those contacts, those with those real life experience at the table, and that they are involved, you know, in the solution.
They're not always seen as a part of the problem. So that has been, I would say, very important in our move to address the social determinants of health and then to, you know, eliminate some of these disparities that we know that we've talked about thus far.
Schuyler Lawson: Thank you. So so my next question is what what is the tobacco free coalition and what role does CAI play in it?
Stan Martin: Well, you know, what can I table that question for a moment? I really want to know.
I would like to invite Ebony into the conversation. You know, she you know, she can speak for herself and has a lot of experience, you know, at the individual at the community level as well as the, you know, the policy level as well. So, Emily, if you want to chime in, share a few words in terms of working with adolescents in this area or in our community, your experience of addressing yourself determines how please feel free.
Ebony White: Absolutely. So what I will say, in reference to addressing social determinants of health generally, we have focused on education, transportation, access to adequate health care, and primarily I've worked between adolescents and adults all the way to geriatrics. So trying to make sure working through community health workers have been pivotal in actually being boots on the ground and coming back and helping us develop strategies that really assist to minimize those barriers. A lot of barriers, of course, are in education around it, in trust issues with our health care system.
So I think I spend a lot of time getting word of mouth right from them, and I'll show back up at a meeting table and say, hey, listen, that didn't work. A strategy didn't work. It missed the group that we were attempting to support. So that's why I think it's very important to have those listening sessions, those focused groups come back to make sure that everything that we're doing is being helpful, you know, I want to be going in the right direction. People improving health as it pertains to chronic diseases.
So as I mentioned in my introduction, I spent a lot of time in hypertension, assisting with hypertension in a barbershops. We just started the conversation in those barbershops and salons and that conversation kept buzzing around. And just how important that is, it is the same way, currently, we're dealing with starting those conversations about our initiative.
And I think we're going to segue right now to start talking about the REACH initiative and all of those other things. So that's that's most of it. I'll get right to the people to make sure we were getting the appropriate question, are we addressing those barriers and those misunderstandings, if you will.
Schuyler Lawson: I like that you've gone to the barbershop. That's a that's a that's an interesting that's a good social location to reach, you know, African-American men. And I think it's a really novel approach that I'm trying to do outreach as opposed to some of the more traditional approaches. Have you found that to be more successful? I've found it to be very successful.
Ebony White: So we we were able to do it in Erie County as well in Niagara County. What we found is those barbershops held those very intimate conversations. But we wanted to make sure that they had the right information and we were able to work with another federally qualified entity to navigate individuals there, because sometimes the health care provider wouldn’t know some of the issues that men and women were having, but their barber. So it was intriguing.
So my job was to make sure we gave them all the right information, gave them all the right tools to navigate to health care, to get their needs met.
Schuyler Lawson: Yeah, that's. That is a great segue into our next question. Let's take a look here. So so CAI and the African-American Health Disparities Task Force both received an annual grant funding through 2023 from the CDC to address health disparities in our rates of chronic disease. And this project is known as our racial and ethnic approaches to community health outreach, REACH for short. Can you you both tell us more about this ambitious project.
Stan Martin: Sure, you know, I think you hit the nail on the head earlier in your introduction, you know, our reach is funded by the CDC. And when you look at health disparities, you know, here in Buffalo in particular, we're one of 30 or more recipients from across the country, you know who that's that's working on reducing chronic disease among African-Americans as well as, you know, I would say communities, communities of color, you know, specifically.
So we look at everything about cancer, diabetes, asthma, hypertension, you know, who are who are those individuals, those communities that are most affected by it. So here in Buffalo, our selected area, or as we like, say, our area of focus, not just in terms of ethnicity, looking at geographically, you know, is across five zip codes here, 14208, 209, 211, 211 five communities.
And those communities in particular and we look at chronic disease, you know, astoundingly, you know, are 300 times more likely to have or, you know, to to be impacted by one of those chronic disease, if not more so, as opposed to those, you know, who live outside of the community in particular, you know, whites, white people.
So, you know, therefore, in order to address that health disparity, you know, we've partnered no to African-American health taskforce to look at not just how we can address those health disparities. As I mentioned earlier, how can we eliminate those health disparities by focusing on the root causes of something not like to use the analogy that some people may have heard before was, oh, you know, like, you know you know, you have this community that's impacted by, you know, these health issues. And when do we finally say, for example, what's in the water? You know, what is it that they're drinking? What is it that they consume? Before we finally actually go to the well and look in the well, what is the root causes, you know, utilizing that analogy?
They say that we have to start, you know, going to the well and saying what are the root causes, you know, addressing not to eliminate them alternately. No. For communities that are disproportionately affected by that.
So Ebony would probably like to share some of her thoughts as well. So I'm going to continue to pass the time to you.
Ebony White: Oh, I totally agree with everything Stan has shared. Definitely getting to the well, our listening sessions are opportunities for us to get to the well and figure out what's happening in within our own culture, within our own behaviors, in those particular zip codes and trying to shift, trying to change many of our behavior patterns as it pertains to cardiovascular health, diabetes, cancer, all of those things that plague our community.
Year after year, and there is more and more data that says you, I’ll give you this. I was sitting in a meeting and they were showing some data about if, you are at this age, you won't live to this age because are more than likely be impacted by this, this and this and thinking, wow, they can literally project that I'm going to be a goner because I live a particular way and I live in a particular zip code. Wow. I just didn't feel comfortable. And that was my push to educate my community more.
Someone is sitting in a room and they based upon your behavior, you're going in the direction that you will be gone before you're 62 versus your counterparts that live in different zip codes. That was my aha moment that someone had that ability, that power because of my behavior or in people, you know, just where I lived, that that would be the outcome for me.
Then I said, not so. Not so. So I do everything I can to educate, whether it's in our faith community or our medical community, our our small groups, our pockets, our barbershops, our salons, our businesses, to make sure that is not the narrative from our community. So REACH is an acronym, but it's a beautiful word. So I'm reaching over, I'm reaching and I'm going deep. I'm going under. I'm going high to doing everything I possibly can do. Our strategies and innovative ways to get that communicated to our community members, our concern for them overall.
Stan Martin: And if I could just ask, I think Ebony, on some of those strategies, know that we're doing implementing.
Think about increasing access to food and nutrition. You know, addressing the issues of food deserts that are in our community. And how do we work with those businesses, those retailers, those mammoth shops that are in our community to ensure that they are or capable have the ability to provide access to fresh fruits and vegetables.
So food and nutrition. You know, almost one of our strategies, our area of focus. And then another component of that that we don't oftentimes think about on that has huge implications on one's development is breast feeding.
You know, something that really early on from onset, you know, from from the cradle through maturation now has, you know, significant, you know, health benefits. So educating the community on the benefits of breastfeeding and providing access to those peer groups so that women as well as fathers can be a part of the conversation to encourage healthier, a healthier lifestyle.
Also, we're working closely with health care providers, you know, to improving our community and clinical linkages on relationships. You know, there's a lot of historical trauma. We look at black and brown communities. You know, that really presents a barrier for us to have bi directional a two way conversation. So how do we create an environment where there's trust within us, rapport where it's authentic, that we can have these open conversations and that doctors are physicians, health care providers are meeting their patients know where they're at. You know, and not close and keep little at least align their communications open for that behavior, change that Ebony to described.
In addition, you know, we're you know, we're not there's no secret from my for my lens that, you know, there's disparities in terms of tobacco use. You know, those who, you know, live a certain lifestyle and in terms of income and education are disproportionately affected by tobacco and alcohol. And tobacco is also heavily market or advertise in communities color, more so than in other communities. So how do we not only reduce the prevalence of tobacco use, but also increased access for those who want to quit to quit in terms of tobacco sensation?
So we're trying to create change at the individual level. Also, we have to also address, you know, the built environment. The environment has to change that supports that behavior change. And it's something that Ebony always, you know, oftentimes talk about how do we provide opportunities to maintain and to sustain that over a longer period of time or lifespan. So those are just some of the strategies that we're or areas that we're focused on to improve health and wellness.
You know, for residents who who reside pretty much along the fairy street corridor from Balian Ferry to the foot or ferry or as some say today, Brother Park, you know, a 4.4 miles, a lot of fear core and eastern, north and south of our ferry as well.
So it's roughly like four point four mile radius.
Schuyler Lawson: Thank you both for providing your detailed descriptions of the REACH program and the extent of its reach to this, which is now quite remarkable. I have another question. I'm about about the REACH project. Did you have any notable milestones, as you'd like to report? As far as the progress of the REACH project.
Stan Martin: In tons and tons of milestones, I would like to say, due to our partnership with the African-American Health Equity Task Force, we've been able to be recognized by the CDC, you know, for for our work as a model.
Within a short period of time, we're actually a year three of a five year grant. And because of this partnership that we have with the task force and the community, you know, we had an opportunity to apply for some supplemental funding to address the disparities surrounding flu vaccinations.
So if you don't mind, you know, Schuyler, once again, I'd like to pause and, you know, just ask Ebony to talk a little bit more about that from her perspective. And, you know, to me, you know, I think that's a price that we both are very excited about. And then we have some things that we're working towards that we want to share with folks.
Schuyler Lawson: Yeah, it's very pertinent to especially this time of your flu season.
Ebony White: That's correct. Correct. So that supplemental funding as it pertains to flu vaccination has given us the opportunity to partner with a Dr. Vasquez in an urban family practice different pharmacies, faith communities, and one of a large business entity that has kind of showed up in the city of Buffalo has given us the opportunity to work with their mobile unit to actually get access for flu vaccinations and give education around flu vaccinations.
We are at a pivotal time at a time we've never been in a pandemic. So we have COVID 19 and then we have the flu. So what we're trying to do is educate our community about the importance of having the flu, making the choice. So I want to give you the education, but it's always a choice. But when you do it and you make that choice, you're doing it with you in mind, your family in mind and your community in mind. And I think that is a conversation that. May generally have not happened, you know, around flu vaccines. People are asking more questions and questions are good. Why do I have to have it every year? Why? Why? You know, I feel like I see more signage about it.
Why? Because it's important because we're in this this different time. This pandemic time. And we want to keep you safe. We already have adopted a lot of safety measures, handwashing, masks. We've been giving out food and nutrition actually during those mobile unit events. We've been to some of the faith communities all the way in Lackawanna. And a couple more in the city of Buffalo distributing flu vaccine, shingles shots. People are asking questions and trying to get back on track with their medical care. So what we look forward to doing is making sure as that if that is the intersection that we meet in our mobile units, we want to make sure we give you the education to move forward in maintaining and to make use of your health care going forward.
So in the upcoming months, we are and we're actually we're embarking on the peak of flu season, which will start December six. So we are encouraging people. I know this is a really hard time. You're telling people to socially distance but nobody wants to flu.
Covid has impacted pretty much touched everybody's home one way or another. You know, somebody it may be you that has been impacted by it. So what we're trying to get the word out as much as we can for her, just for our community. We don't want we know what Covid did to our community. It impacted our black and brown communities much at a much higher rate than it did our counterparts. So we want to bring that down. We want to bring that down. We want to change that. The man at the direction that the data is showing if we don't. So we want to make sure it's about education. It's about your choice. It's about your family. And it's about your community.
So Stan you want to jump in?
Stan Martin: I think I think, you know, I think you hit the nail on the head, you know, like you say, you know, we do our listening sessions, you know, having conversations that no, everything has meant with the community. You know, they said that, you know, they felt as though it's important that the community have this information that people recognize that, you know, they do have a choice. And what we've heard, as Emily eloquently, no share, was that people aren't only concerned about themselves. They were concerned about others. And that message of not having love for your family and for others, your community is something that they thought that they could champion and rally behind.
And just some of my, as I like to say, my one show surveys and talking to pharmacies and providers that they are seeing, you know, more people getting vaccinated. So we're looking to continue to match our campaign on our conference meeting campaign through platforms such as this radio, TV, as well as in print and then in the weeks ahead and even into the new year as well.
So stay tuned.
Schuyler Lawson: All this is very encouraging, and I really do hope that it leads to higher vaccination rates. Know know I was marginalized groups.
Stan Martin: Well, you know, sculler, as we mentioned earlier, you know, we really have to address, you know. You know, the the trauma. You know, when people say that, you know, I had a a a reaction towards getting shot. People aren't aware that, you know, also there's a nasal spray that's available or, you know, is this someone 65 and older? You know, there is a different vaccination. You know, that they receive as opposed to someone younger, you know. And it's, you know, one of the things that prevalent and I hate to pick on Ebony is she always remind us of if Mama say it or grandma said, you know, that, you know you know, their opinion matters.
You can't go against Grandma, against Mama because you know that that you know that, you know, shuts down the conversation. How do you how you have that conversation in a in a respectful way. You know, that really says, okay, I'm I'm not you know, I'm not doin grandma, your mom under the bus. And, you know, I want to recognize that, you know, providing information that dispels some myths, you know? And, you know, that's that's you know, that's that's critical in terms of people making that change. You know, and it may not happen right then and there.
And I think what we say saying, like different points of [inaudible], you know, is occurring that, you know, we're we're encouraged by knowing that and having those trusted and having those trust, having Ebony, having a Dr. Vasquez,to meet someone in a barber shop or a salon or where there or a place of worship. Not on their day, not on their Sunday, though, but to meet them in their comfort zone and share information in a nonjudgmental way.
This is important.
Schuyler Lawson: It appears that like a threat that I'm seeing for all of these projects is the importance of meeting people where they are and having, you know, sort of a community participate, participatory approach at Mitra's, addressing these very unique issues.
Would you would you both agree?
Stan Martin: Absolutely.
Ebony White: Absolutely.
And you know, I mean, I believe every scholar and a community participant, poetry practices and approaches. And now we also utilize, you know, collective impact as a part of that, you know, collect for those who may not be familiar, you know, having a shared agenda, you know, bi directional communication, a combination of coordinated strategies, having a backbone organization, you know, CAI and the task force, African Equity Task Force, working collaboratively together and being able to provide resources, you know, and utilize science and data in a manner that we aren't weaponized or victimizing and traumatizing, you know, those we're trying to reach.
Now, those are critical elements, you know, on to moving from, you know, implementation to creating a movement, you know, create. And that's, you know, any movement that's successful, in my opinion, including the Black Panthers. You know, you have to start, you know, at the grassroots level, you know, and you have to have the community's trust in reporting that. And those are just some principles and frameworks that we embed in all of our work across the board here in Buffalo.
Schuyler Lawson: Thank you both for sharing. No more information about this.It's very, very important project. D Anything else you want to speak to all this, particularly about the vaccination initiative?
Stan Martin: I want to say, get a shot. You know, if you have it already, get, you know, get vaccinated, get the shot, you know, to protect yourself, your families, your loved ones.
Schuyler Lawson: And yes, to all our listeners, please get your shots. It's not just about you. It's also about, you know, everyone else as well. Please, please get vaccinated. So I'm in. Want to move on to the next question now for both of you.
So in your opinions, what are what are the biggest drivers of health disparities and what would it take to eliminate these drivers?
This is a this is a very you know, I mean, it's a very it's a very complex question. There's no simple answer but your viewpoints.
Ebony White: What I would say is education.Education around. These are the impacts of these chronic diseases, the impacts that they have on our community wide spread in how they are connected to our behavior. So when I think about what is so Stan was talking about previously, you know, they advertise more cigarettes, they advertise more alcohol in our community. What are we messaging? You know, so if you're the consumer, we have to understand, if you're the consumer and someone wants to sell something to you, you have to change what your, what your desires are, what you want.
So we have to really get into our thoughts process, how we value our sales and what our desires are for our lives that we can change what is happening on the outside, what is being offered to us. If I say I don't want chicken, I don't want a bunch of cigarettes. The person that wants to come in and they have to dig a little bit deeper and find out what is the fact that they're trying to sell me and what I want.
So really, I, I think that education, widespread spending that that time building that trust in our community, apologizing for stuff that you may not have done, you know, you may have apologized for some things, but still standing, not running away from the pressure of, you know, the complexity of everything. You know, people always have a lot of complaints, but we really start to be solution focused.
I hear you. I heard you acknowledge it. And how can we change this? So really, for me is education and more education. And it's going to take time. It's going to take a little time to change overall everything and finally eliminate it. So we have to change the minds of our community.
Stan Martin: Thank you, Ebony, I agree with you. And I would add that, you know, the elimination of poverty. That's lofty. That's my vision. You know, I think that's the vision of a shared vision of others as well. To eliminate poverty, if we eliminate poverty, know, then really the essence of when we talk about where you live, where you work, where you play. And even pray and learn, you know, then every child area, adult, you know, every person now has the opportunity to reach their fullest potential, their fullest ability, whatever that means to that person.
In addition to that, I think that we have to address using the same cultural principles, we have to address, you know, racism in this country, the racial injustice or injustices that have happened. You know, we have to move from addressing that to really a point of being anti-racist. We have to dismantle those systemic institutional racism.
You know, that that really appears in every aspect of the work that we do and, you know, until we do those things, I think that we will continuously revisit, you know, revisit, you know, revisit those things in one shape, form, fashion or another.
And I take that, you know, really also we're in a climate of social justice and unrest. And a lot of that is due to not focusing on being equal, but focusing more so that we need to focus on equity in order to make equity you know, is the denominator or the lens that we that we should look at promoting health and wellness from. So to address it at every level, when you look at those social, ecological, at a beef last philosophical, but at the individual level, the community level, at systems and policy changes and not have policies just exists on paper. You know what is. Have them come to reality to actually change, you know, to being a social norm, you know?
So that, you know, like I say, everyone, it becomes our way of life, you know, in a healthy way.
Schuyler Lawson: So thank you for the question. Thank you both for your thoughtful responses. Much appreciate it. So now we're you know, we're nearing the end of the podcast. So my last question is, is there anything else you'd like our listeners to know?
Ebony White: Get your flu vaccination again, I'm going to repeat it, do it for yourself, do it for your family and do it for your community and continue to wear your mask. Practice social distancing. I know you miss all your friends, but please, let's not do that. Let's take care of each other just for this period of time. And I'm hopeful that we'll get through this, but we want to make sure we're doing everything that we possibly can. Good handwashing, social distancing wear your mask, get your vaccination.
They are available. Stan will provide you with the Web site to get a flu shot. Then your local pharmacies if you have a primary care doctor. If you don't have a primary care doctor, please get one home. Go have your flu shot this year and take care of each other.
Stan Martin: Yes, definitely. I echo these sentiments, you know, get a flu shot if you don't know where where to go, you can if you have access to the Internet, you can go to getmyflushot.org
You know, and and then you put in your zip code and they'll give you information on where you can go locally at two supermarket pharmacies or at different clinics in your area, you know, to obtain the know the vaccination. So and thank you, Skyler, for the opportunity to share this information with you and your audience.
Schuyler Lawson: Very welcome. Again, thank you both for coming on onboard and to join us to be willing to be interviewed. I hope this reaches a wide array of our listeners. So, so, so, you know. Thanks. Thanks again to you both for taking the time to be on our podcast.
We we hope to have you on again to discuss your future projects or, you know, ongoing project to see how things are going. You know, and listeners.
Stan Martin: I’m sorry. Getmyflushot.org
Schuyler Lawson: OK. Thank you for the correction.
And so, listeners, if you're interested in learning more about CAI and other great work that they do, visit and visit CAIGlobal.org.
Ebony, is there a Web site that the listeners could visit to learn more about the African-American Health Equity Task Force?
Ebony: I would just direct them CAI.
Schuyler Lawson: Good. Good. Yes, great. You're welcome. Thanks for listening to another episode of Buffalo Health Cast. Take care and be well.
May 20, 2021
Stan Martin, Cicatelli Associates, Inc. and Ebony White with the African-American Health Equity Task Force. They discuss health inequities in Buffalo's Black/African American communities in the COVID-19 era.
April 15, 2021
Adia Harvey Wingfield is the Mary Tileston Hemenway Professor of Arts & Sciences and Associate Dean for Faculty Development at Washington University in St. Louis. Her research examines how and why racial and gender inequality persists in professional occupations.
Hello and welcome to Buffalo Health Cast. A podcast by students, faculty and staff of the university at Buffalo School of Public Health and Health Professions, we are your co-hosts, Tim Palermo. Jessica Kruger. And in this podcast, we cover topics later, the health equity here in Buffalo around the U.S. and globally. And this first semester of the podcast, we're taking a deeper look at racism and health. We'll be talking to experts around the U.S. as well as individuals here on campus and in the Buffalo community who are working to remove inequities to improve population, health and well-being. You'll hear from practitioners, researchers, students and faculty from other universities who have made positive changes to improve health, equity and inclusion.
Tia Palermo: OK, Hello and welcome to our SPHHP podcast. I'm here with Adia Harvey Wingfield, Associate Dean for Faculty Development and Professor of Sociology at Washington University in St. Louis. Adia, I'm delighted to be speaking with you today.
Adia Harvey Wingfield: Thank you for having me. I'm happy to be here.
Tia Palermo: This year we've launched a new podcast for the university at Buffalo School of Public Health and Health Professions, or SPHHP. In the first year of the podcast, we are broadly focusing on the topic of racism and health. And today I want to talk to you about one aspect of racism in academia. The hiring of faculty.
You were recently involved in hiring several faculty members for a new Department of Sociology at Washington University in St. Louis, an effort that you detailed in your article in the Harvard Business Review, which was entitled ‘We built a Diverse Academic Department in five years, here’s how’ can you tell me a little about these efforts?
Adia Harvey Wingfield: Sure. So I should say that when I came to Washington University in 2015, I was actually hired as part of a small cohort that was tasked with building the sociology department from the ground up. The university did not have a department prior to my arrival with my two senior colleagues, and our job primarily was to change that pretty much and to built to do the work of making sure that the department grew into a top sociology department.
And one of our shared goals early on in those stages was that we really wanted to be indicative of the fact that departments can be really strong academically. They can do a great job focusing on research and teaching, but they also can do so in a way that prioritizes both excellence and racial diversity. And that contrary to what some might think, it's not impossible at all to meet both of those goals and to set those standards.
So our focus was on making sure that we certainly built an outstanding department, but that we did so with an eye towards what it would mean to be a racially diverse department in the university and in the discipline. And that's driven a lot of our focal points on hiring and outreach and building over the last five years.
Tia Palermo: That's great. Thank you. So how did your own research background examining how and why racial and gender inequality persist in professional occupations inform these efforts in building this Department of sociology?
Adia Harvey Wingfield: That's a great question. I would certainly say that my own research gave me some insights into the types of pitfalls and challenges that many workers of color encounter when they are in spaces where they're in the racial and or gender minority. I know a lot about that experience from the work that I've done in identifying what those challenges look like and some of the processes that workplaces and organizations engage in that can be unwelcoming or hostile to communities of color.
But I have to say that it wasn't really so much an issue of building from my own research as much as it was working collaboratively with my departmental colleagues and university administration, all of whom were very supportive and enthusiastic and shared this goal of wanting to make sure that we did have a racially diverse department. It was very much a team effort at a variety of levels, which is really critical and important for being able to achieve these goals.
Tia Palermo: When you and colleagues decided that you wanted the new hires to be racially diverse, did you face any pushback? So you talked about how you had support at multiple levels, but was there pushback from any corners and how did you overcome this?
Adia Harvey Wingfield: Again, luckily we all were of the same mindset and the fact that we believe that racial diversity and really working to achieve it was important. So there were not issues internally around why this mattered or if we could do it or if it was something that we really wanted to focus on, or, again, this false dichotomy between diversity and quality. None of that was an issue at a department level, and certainly it was not an issue at the administrative level either. We were really very fortunate and supportive of that. Excuse me, we're really very fortunate that we were very clearly supported in this goal by the administration and the workers that we dealt with that level, the dean, the provost, the chancellor at the time, we're all very much on board with this being an important factor for us, which is part of why I write in the article that for these types of initiatives to succeed, I believe it's really critical to have support from multiple levels of leadership.
I think it would have been a lot more difficult for us to achieve the diversity that we did. If I were alone with making this argument in a department with colleagues who did not share this principle, similarly, I think it would have been very difficult for us to achieve the outcomes that we did if as a department, we had to face a lot of headwind from the administration, if we were working with leaders who did not share our commitment to these values and see this as important. I think that my experience shows that the synergy along those lines indicates that change certainly is enabled when it comes from the top, but that that change also has to have Buy-In at what you might think of as middle management levels as well. But when you do have those synergies lining up, that's it really opens up a lot of potential doors and opportunities for what you're able to build and accomplish.
Tia Palermo: Thank you. When you were going through the hiring process, what efforts did you make for the candidate when they were visiting? Both so that they would feel that Washington University in St. Louis was a welcoming environment for them, and then once you hired candidates, how did you make them feel? Welcome and supported once they arrived on campus as new hires?
Adia Harvey Wingfield: Yeah, that's a great question. So when going through the interview process, I think it's really critical to make sure that people get a feel for what their experience on that campus will be like should they decide to join the department. So you have to make sure that people see that there are opportunities for them that relate to the things that they want to pursue.
If you have a candidate who might, for instance, be interested in studying issues related to immigration, it's important to let that candidate know that not only rebuilding that in our department, but there are other people on campus that you might want to connect with who are doing this kind of work. We're talking about attracting faculty of color. It's critical for faculty of color to see that they won't be alone, isolated or excluded in everyday campus interactions and deliberations.
So I think it's really key to make sure that when you are trying to recruit underrepresented minority faculty, it's important to make sure that they see other people on the faculty and that they have a chance to talk openly and candidly and privately with them about what their experience has been like, rather than having simply people tell them this is a great place for scholars of color and people are really happy or that doesn't carry as much weight unless you hear it from the scholars of color in question who can tell you again in a private setting where they can speak honestly whether or not that's that's actually true. So when we were recruiting candidates, we made sure to try to show them that there were links between their personal and professional identities that the university recognized, respected and wanted to support so that if they accept an offer and they joined us in the university community, they would have a view from their interview with that with that experience would look like for them up front.
When it comes to people actually being here, I think if you want to build on the groundwork that you've laid through the interview process to make sure that once people have accepted the offer, you can't then pull a bait and switch and have them in an environment where they and their work are not supportive and are not respected or treated equitably and fairly. So we obviously have a pretty robust system.
Obviously, we have a pretty robust mentoring program in our department to make sure that everyone has access to mentors and support and people who can guide their careers, particularly for assistant professors who are going through the tenure process.
But we also make sure that assistant professors, particularly underrepresented minority faculty, continue to remain aware of and feel connected to the life of the university, whether, again, those are through initiatives and groups that speak to their personal identification and or things that speak to their professional research interests.
Tia Palermo: So it sounds like you had a lot of support systems built in in this department from the beginning. Do you have any examples of cross campus initiatives that help support those incoming candidates?
Adia Harvey Wingfield: Sure. Well, so our pro vice president provost for diversity and equity and inclusion actually runs a number of initiatives that are designed to reach out to all areas of the university and provide those kinds of supports. There are informal activities. There are more formal activities. There are monthly lunches for women. At the university to make sure there's a sense of camaraderie in cohort building.
There are also leadership development seminars for faculty of color who may be interested in pursuing those types of initiatives there. So this isn't just one office. So there are a number of programs on campus that are in place to draw attention to the fact that if WashU is going to be a place that does want to take seriously these imperatives of diversity and equity and inclusion, it's not enough simply to say that that has to be matched with clear, robust directives that speak to acknowledging those issues, tackling them head on and making sure that the university is working to do all it can to support faculty who are underrepresented.
Tia Palermo: Thank you for that insight. Have you seen the success that your own department effort has had influence other departments or initiatives university wide in their hiring practices?
Adia Harvey Wingfield: It's a little hard to measure just because there's so much variance across arts and sciences and there's so many different disciplines within the one that one college alone that there's a lot of range among them. But I will say that I think that the fact that we have been so successful and done so well in building a racially diverse, academically strong department in a short period of time has certainly been recognized in the university community. And I think serves as a clear message, an indicator to other departments that, again, this is something that's possible to do with the right programing plans, commitment and initiatives in place. I will say that I do think that the work that we have done that functions to show that this is a step that that departments can take, to to follow this lead.
Tia Palermo: That's great. And it really is an impressive group of scholars that you have in your department.
Adia Harvey Wingfield: Thank you.
Tia Palermo: You have a recent paper entitled ‘Getting In, Getting Hired, Getting Sideways Looks, Organizational Hierarchy and Perceptions of Racial Discrimination’ The participants in that study were from the health care industry, not academia. But in this work, you demonstrated that position in the organizational hierarchy is linked to perceptions of racial discrimination, whereby individuals at the top of the hierarchy so examples in that study where doctors reported fewer individual incidents of racism but identified more structural and organizational discrimination as compared to individuals lower in the hierarchy. Examples of structural discrimination included the education pipeline, hiring decisions in developing a mentoring relationship, something you spoke about earlier. What parallels can you draw between that study and implications in academia, given that academia is also vertically ranked in terms of students, professors and hierarchy among professors?
Adia Harvey Wingfield: So that's another great question. And I first want to offer the caveat that the study, as you mentioned, is focused exclusively on health care workers. So I think that there likely are some parallels, but I don't want to give the impression that I'm speaking from data. When I answered a question, I did not interview primarily academics. So I cannot say with certainty that the patterns that I described among health care workers would necessarily be present among people in academia. But that said, I do think that it's at least likely to I think it's safe to hypothesize that there may be some comparable outcomes and there might be some some parallels. Right. So by way of example, when we think about how academia is hierarchically organized and how it's very hierarchically structured and ordered in a lot of ways around similar ideas of status and prestige, I think that it may certainly be the case that for faculty, the experiences that they cite with how race has an impact on their work may certainly be more likely to include more structural processes as well as the more interpersonal ones, which was what I found with with actors in my study.
They cited that there were some cases when they had interpersonal experiences with race, racial discrimination. But as you mentioned, by and large, what stood out for them were the structural barriers that made it difficult to advance into and thrive in in medicine and in physician work in particular. I think it's not difficult to speculate that similar processes might be true for black faculty and certainly for black administrators in ways that I think might reflect different outcomes. If we're talking about black employees of a university who are in staff positions, particularly if they maybe a lower level staff positions that don't offer the same autonomy or status or ability to shape one's work environment.
That, I think, is certainly true for professors. So I think that there are likely some comparable outcomes that we would see between academia and the health care industry. Even though the study didn't focus on those fields, I think it's a I think it's safe to guess at least and hypothesize that the higher one is positioned in the organizational hierarchy. The more impact that may have on perceptions of racial discrimination in academia as well.
But that's a question for maybe a future graduate student to just study a little bit further and to see if my hypothesis is correct.
Tia Palermo: That's great. We're exploring ideas for future research here. Thank you. Can you say anything about the resistance to hiring more than one underrepresented minority in a department or what's sometimes termed as the ‘only one’ syndrome? Have you seen this played out?
Adia Harvey Wingfield: Fortunately, in my current department, that's not an issue that we have.
Like I said, we've worked hard to make sure that we do have a racially diverse department, both among our top ranks of faculty who are full professors, and that that continues throughout the department as well at the untenured ranks as well. But I will say that this experience of being the only one or organizations that seem to feel as though hiring one person at a high level ranking is sufficient and gets the job done is not only something that exists, but something that is inaccurate in terms of the ability to really diversify an organization or or a level of an organization.
Research indicates pretty clearly and conclusively that when workers are people of color or women. But when workers are white women or people of color and they are underrepresented in positions to the point where they are the only or one of very few at that organizational level, they’re are a lot more likely to be mistrustful of the organization's commitment to equity and equal opportunity. They are, if they are women, more likely to experience sexual harassment, they are more likely to consider leaving and they are less likely to be satisfied with their employment in that company.
So organizations in many cases may see this idea of this only hiring phenomena as progress. Right, that we've got one person in our C suite and we've done a great job because we've got one person at this executive level so we can brush up our hands and say we've found that diversity problem. But again, that's short sighted and it's not correct. And it comes with creating an environment where in the short term, you may be able to say that you have this one person filling this role, but that one person's experiences are likely more challenging than they would be if they had a cohort of a cohort experience of more robust representation. And if ultimately what that leads to is that person not producing as well as expected or that person looking for other opportunities or that person being disengaged from the organization. The organization is not really winning if they're not maximizing and making full use of that person's talents and opportunities.
Tia Palermo: That's a really great summary of how the challenges that the individuals can face, but also how those challenges can play out in adverse ways for the organization as well. What would your response be to people are departments who say we've tried to diversify our hiring, but qualified scholars of color either aren't accepting our offers or they have too many offers to choose from. They don't want to come here.
Adia Harvey Wingfield: Yeah, I would. One wants to know what exactly trying to diversify your hiring looks like. Does that mean making an offer to one person? And then when that one person. If and when that one person declines, not trying again, does it mean trying to hire someone that you know is already in demand from other places who has multiple other options and then saying, well, we made an effort, but this person just doesn't want to be here? These people don't want to be here. There not much more that we can do. Does it look like that?
If that's the case, I would not really find that to be such a compelling argument. I'll put it that way. Right. I mean, we know if we look at data that they're in most cases, research indicates are more candidates of color available for positions than there are actually positions. So given that mismatch, it's not that we see the glut on the supply side. Right. The issue is not that we see the narrowing on the supply side, more so on the demand side. And if that is the mismatch, then it strikes me that most departments, if they really have the will, if they really have the interest, if they really want to put the work into finding really strong candidates of color. This this is achievable. And I think that my department and the success that we've had indicates that this is achievable.
Right. But it may mean not simply going back to your networks of people that you already know and looking for candidates through them, it might mean looking for candidates through other networks that are specifically inclusive of and designed to include candidates of color. Right. It may mean reaching out to people and explicitly saying that you really want to have a racially diverse applicant pool and asking your connections and your networks to make sure that they mentioned that you have an available job and encouraging candidates of color that they may be advising to apply for this position on top of using the top of the accessing list serves and professional organizations and things like that that are made more that are more racially diverse.
Those might be critical steps that organizations have to take when it comes to hiring. But I believe that doing so really has implications for what the applicant pool looks like. I'll also say that taking those first steps should not be the sum total of what those efforts to racially diversify look like, looks like because if organizations take those early steps and build an early pool of candidates that are racially diverse, but then as we go through the whittling process, somehow it just happens that you happen to whittle out all the candidates of color.
You want to be a little bit more reflexive at that middle stage about what you're a long short list is looking like or what your fly out list is with like or whatever you want to term it. So I would say that I don't really think in this day and age when organizations or departments say that they've tried, but they are simply unable to to hire candidates of color. That makes me wonder what processes they are using to engage in hiring, because it makes me suspect that perhaps it's those processes that are returning a dearth of strong candidates of color, more so than a lack of strong candidates of color really being out there.
Tia Palermo: There's some really great recommendations in there about directly reaching out and, you know, exploring new networks and making sure that the early steps in the process are not just where it ends. So those are really great suggestions. Thank you. What advice do you have for departments? Probably some similar advice along those lines, but advice for departments who are aiming to diversify but perhaps can't do so as rapidly on the scale that your department did.
Adia Harvey Wingfield: So that's a great question. And one thing to acknowledge about our department is, like I said when I started, we were brand new we knew that we had to build we had support for from our administration for doing a lot of hiring in a short period of time because we, we had to. Right. And I obviously recognize that every department is not going to be in a position where they are granted 10 hires in the state of three years. I think most departments are not going to be in that position. Right. Again, that said, that does not necessarily mean that it's impossible to achieve these goals. Right. And the fact that our department had these hires didn't necessarily automatically translate into making sure that our hiring process would turn out to be racially diverse.
That didn't happen just because we had hires. That happened because as a department, we made an explicit, intentional commitment to making sure that that was the outcome and that that commitment was supported by administration. Had we not had that commitment and had administration not been supportive of it, we could have fairly, very easily not had a racially diverse department. I could have not written that article at all because there wouldn't have been anything to talk about. Right. So I say that to make the point that most departments are not going to be in a position where they're doing that much hiring that quickly.
However, I recognize that we're in a pretty difficult situation now for many universities where budgets are lean and positions may be cut, but knock on wood, eventually we've got to get to another side where universities and departments do begin hiring again. When we do get to that point, I think that any department is in a position where they can follow these steps. Think about how you are initially seeking candidates for open positions in your departments. Are you simply posting an ad on a list serve and waiting for people to come to you? Or are you actively trying to cast a wide net so that you can attract candidates of color to want to apply to your department once you are going through the applications that you have, are you doing so with an eye towards making sure that you are not somehow systematically weeding out candidates of color from those who make the initial applicant list to those who make the long shortlist?
Are you doing the same thing when it comes to your your fly out list, when you do bring in candidates, if you do bring in candidates of color, are you making sure that on the campus visit you are not creating an experience that is alienating? Are you making sure that they have access to or have a window into what their experience of campus life would look like were they to be hired?
And if you ask yourself that question and the answer is that the window of what campus life would look like for a candidate of color is campus life would be pretty bleak. That's a point. Some bigger issues that could be useful to reconcile. What would it take to make your university campus? One that is approachable and welcoming and inclusive of a variety of candidates of color if that's something that is a sticking point at that point, it's useful, I think, to have a bigger conversation to raise these bigger questions of how the university at large may want to change, to be a place that is more attuned to the importance and need for more racial diversity on campus.
Tia Palermo: Thank you for that. So we've been talking a lot about the hiring side. But let's flip it. And do you have any advice that mentors and advisors should give their underrepresented minority PhD students, when they're going on the job market in terms of finding an environment that's a good fit?
Adia Harvey Wingfield: That's a great question. Again, I think that it's useful to look at the experiences that faculty in a place already have a place. Right. So if you are a mentor or an adviser to a person of color who's going on the job market, I think it's useful to encourage them. And they may already be thinking this. But I think it's useful to encourage them to get a sense of what life in that department and in that university would be like if they are applying to departments where the department in question hasn't time tenured any faculty of color. Are they applying to a department where the department in question hasn't ever hired any faculty of color? Right. Those are things that are going to matter, and those are things that the faculty of color have to navigate when making employment decisions and weighing particular particular options.
So I would encourage mentors and advisors to make sure that they are assisting their advisees in doing the legwork of finding out what the general climate and experience for them is going to be like. You don't want, in my view, simply to say that you want to send someone to a top rate program in whatever field is being in that environment is going to be miserable for that person. And my view, that is simply not worth it. Other people may think differently and probably do think differently. But I think that that's not a fair trade off to ask junior faculty of color to make when they are looking for for employment.
So I think it's important for advisers to make sure that they take into consideration that advisers of color have a relatively unique experience and that they consider what the entirety of department and university life will be like for them as people of color in these settings, and to make sure that that is a factor that they weigh in determining whether to apply for positions and ultimately whether to accept some really great advice for advisors and PhD students on the market.
Tia Palermo: This has been really insightful. Is there anything else that you'd like to share with our listeners about the topics or related topics that we've been talking about?
Adia Harvey Wingfield: I believe I would just add that I think this is really a critical moment for universities right now for a lot of reasons. We are seeing the ongoing protests for more racial equity and an end to systemic racism in society right now.
We are at a point where the nation is becoming increasingly multiracial. Students of color are growing numbers of those who are attending universities. The numbers of faculty of color have not necessarily shifted in commensurate ways.
And this presents a real problem that I think universities need to devote some time and energy and effort into tackling that kind of mismatch. In my view, does not bode well for outcomes for students. But not only that, it doesn't necessarily bode well for universities as we move into continue to move into the 21st century and becoming a more racially, more multiracial society. I believe that universities will be largely better equipped to come to terms with those demographic changes if they actually reflect those demographic changes. So I think it's really critical to grapple with these questions of how best to do that in ways that make sure that both students and faculty are adequately represented and completely included in environments that have a long history of being very extensive and unwelcoming and alienating and hostile.
Tia Palermo: Adia, this has been so insightful and really a pleasure to speak with you. I really just want to thank you for sharing your insights with me and with our listeners here at SPHHP.
Adia Harvey Wingfield: It's been really great to talk to you. Thank you. Thank you for having me. I'm happy to do it.
Hello, and welcome to Buffalo Health cast, a podcast by students, faculty, and, staff of the University at Buffalo School of Public Health and Health Professions. We are your cohosts Tia Palermo, Jessica Kruger, and Schuyler Lawson.
Schuyler Lawson: In this podcast we cover topics related to health equity here in Buffalo, around the US and globally. In this first semester of the podcast we’re taking a deeper look at racism and health.
Jessica Kruger: We’ll be talking to experts around the US, as well as individuals here on campus, and in the Buffalo community who are working to remove inequities, and improve population health and well being. You’ll hear from practitioners, researchers, students and faculty from other universities, who have made positive changes to improve health equity and inclusion.
Welcome to the buffalo health cast. I'm your host today. Jessica Kruger, and I'm joined by one of our amazing three plus two students in the Department of Community health and health behavior tomorrow across tomorrow, will you tell us about yourself.
Temara Cross: Sure. So hi, everyone. My name is Tamara as she said, I'm currently in my first year of the CH HP program. I'm also pursuing a bachelor's and African American Studies, I was born and raised in Buffalo involved in several social action organizations in Buffalo, and my free time I my free time I say with air quotes I enjoy giving back to my community singing with the gospel choir at UB, going to church and also playing basketball. So that's a little about me.
Jessica Kruger: Fantastic. Well, thanks so much for joining us. I'm really interested in learning more about your internship that you're currently in with REACH buffalo. Could you tell us about your role in that internship and a little bit more about REACH?
Temara Cross: Sure, yeah. So REACH buffalo stands for racial and ethnic approaches to Community Health and this initiative was funded it is funded by the CDC. We're in year three now.
And the primary goal is to reduce chronic disease and in our target population. Our priority population which is our residents along of Ferry Street which is East Ferry and West Ferry and also we kind of like try to focus on five zip codes which is 14208, 14209, 14211, 14213 and, 14215.
Temara Cross: So that's our primary goal and we we make sure that we whatever programs that we implement we make sure that we have community voice. So we have community wellness champions.
And then just several people on the team just working together, but my specific role is a reach program intern assistant, intern, slash, Assistant. So I'm helping out on various projects are not just one focus area.
We have different focus areas, by the way, one is community clinical linkages and other one is nutrition and another one's tobacco. So yeah, we're Focus, focus on all of them. And we also received a supplemental grant this year because of covert, of course, but we're our main goal is to promote and educate the community about the flu vaccine and just making sure the community knows that they had the opportunity to take it and yeah so that's what I'm doing.
Jessica Kruger: Sounds like a really exciting project and group to be part of. Could you give us an example of maybe something specifically that you've worked on with the program?
Temara Cross: Sure, I'll talk about how I hit the ground running. So I started in August of this year and soon as I got my laptop. They were like alright so black breastfeeding week is coming up in two weeks. So we want to we want to start some programming, but we don't obviously we had restrictions because of Kobe. So we did stuff virtually so we are. We broadcasted chocolate milk, which is a documentary about black women who breastfeed.
We so we did that, we had like a discussion, like a forum about partners, how they feel when they're like when they're supporting mothers who breastfeed. And yeah, we just had like discussions about black mothers who breastfeed and how they felt about that. All virtual.
Jessica Kruger: Wow, sounds like a huge undertaking that you definitely rose to the challenge for. In your internship. What, what are the most valuable things that you feel like you've learned so far?
Temara Cross: That's a great question. So I would say the most valuable thing I've learned and that is being it like in practice, I would say, is like really actually appreciating community voice because we might have X amount of years in a community, we might live there, we might know someone who lives there. We might have been in the field for so long, but if you aren't living and going through certain things you really don't know how other people like perceive what you might think is the best for them so I've just really learned to appreciate community voice and really use that as like community assessment, you know, really taking that like not just checking off a box like okay we listened to the community, but we're still going to do XYZ know like really taking that into consideration that was something that I found really valuable and really helpful because again, they don't even have to be taking their time out to help us, you know, mitigate chronic diseases in that area, but they're still contributing and we appreciate them for it.
Jessica Kruger: And that's a really important part of public health that sometimes often, like you said, as a check mark right but we really, really need to think about who we're serving and how we serve them I I heard a quote “Not about us without us.” Right? And that has really stuck with me and how you work with the community and work with the community, not just for a community.
Temara Cross: Exactly.
Jessica Kruger: So thanks so much for telling us about your internship. But I want to know more about you. In particular, you have a really interesting background in some of the areas that you have studied. So you're a major in African American Studies and you minor in anthropology. Can you tell us a little bit about why you have chosen those and how they flow into your work in public health?
Temara Cross: Of course I'll start right back to 16 year old me junior year of high school, I knew I was going to be a teacher of some sort. Didn't know what but I was just going along at Hutch Tech. That's where I went to high school here in Buffalo.
And I we had majors in high school like certain concentrations. I was in biochemistry. And I was like, I don't know what I'm going to do, but I'm going to do something and it's going to be teaching and November comes around and my I find out my grandmother's really really sick. She had like kidney failure, and congestive heart failure. So I'm like, What is going on and I will before she lost a, you know she was able to speak with us anymore. I was asking her, you know, why can't you, why didn't you like take action sooner gramma. Why weren't you like talking with the doctors really doing what you had to do.
And I mean, she was obviously but um she really stress the fact that, you know, she was tired of seeing other doctors all like different doctors all the time because you know she had different different organ systems require different doctors right and so she was tired of seeing different doctors and then like when she she had to keep explaining her story to different doctors. So there's that. And then not seeing doctors who looked like her. And that was really the big thing that stuck with me.
Temara Cross: You know, in the, the distrust that we see in the medical industry. And that was just really like my first hand, like, Wow, this really exists so after she passed away. I was like, you know, is this really reoccurrence like in my community. Is this something like is it, is it just her or is it, you know, so as I'm like observing how like asking my community members asking my neighbors. So my family, my immediate family, you know, how do you guys feel about going to the doctor and they're like, we don't go there unless we absolutely have to. We don't go, we're not we're not speaking to these people, these, these people air quotes but again, that's when I realized, you know the best way I could serve my community, because I'm always very community oriented. But the best way I could was to serve in the health industry in the medical field. And so I decided that I would pursue medicine eventually and then launch a health facility in the side of Buffalo. So with that, it's kind of real it all in.
So I'm majoring an African American Studies, just to kind of gain more history like a historical point from like like get more of a historical like better understanding of why you know the why, because we're not learning that and that's another thing with we're not learning that in our general education courses we know it's like briefly talked about, but we're not learning about Tuskegee as much as we should be when I learned about Samuel Cartwright all these people who have used black bodies for the advancement of medicine.
We're not talking about that as much as we should be. So that's why I decided to major in African American Studies and then with an anthropology, um, I just kind of wanted to pick something up to learn more about why people do what they do, as far as culture. I know.
Like my, my, like, I've, I've had the opportunity to go to like a more diverse high school, so I was exposed to, you know, different cultures, but not really understanding why people do what they do, like how cultures are formed and things like that. So that's why I decided to just minor an anthropology, you know, get the best of my money's worth.
Jessica Kruger: And such a moving story that how you took a very traumatic event in your life and turning it into something positive. I'm right there with you. I also have a minor in anthropology for my undergrad and I think it's pivotal to begin to understand the perspectives of others and how that's created and You know, you bring up a really good point about the culture, the historical relevance of events that we really need to integrate into our curriculum. And think about, you know, we can't move forward. If we don't understand the injustices that have occurred in the past. Do you have any advice of of how we can begin to make some of those changes?
Temara Cross: Man, you know, I'm not going to speak too too much, you know. Can't let all can't spill the tea. But I'll say Black Council is in the works of really redeveloping and redesigning the undergraduate curriculum, just to kind of expose people to have a course where not only, of course, but also, like, make sure this is a design where it's throughout all courses but really understanding how to be anti racist because I know from personal experience, a lot of my friends from like Williams were Orchard Park, like they have never had to have those experiences and they have never had to have those conversations. So coming to you. Be I we as Black Council and also personally, we believe that it's, it should be up should be held accountable to provide courses like that and be able to input that into correct themselves required for students. Not so. Oh, I'm going to check this box for diversity because I took a class and diversity.
And it's not it's not like that. It's a you really have to be. You don't have to experience it, but you have to have training of some sort, and you really need to be exposed to it, how to be anti racist because being complacent is just as bad as being racist.
Jessica Kruger: Wow, that's, that's a really important point that you're making. Right. It's not just one class that changes you, right, it's it's being open to continually learning being open to hearing diverse voices and viewpoints. And being uncomfortable. Right. Some of this can be very uncomfortable to learn about especially. We know that in the history books that you're taught through school. It's from a very white lens. And so how can we begin to change that. And I think you've come up with some really great idea. So tell us more about the the Black Student Council.
Temara Cross: Right, so I actually saw, I saw that you look for it on UBLinked yet, and we're not on UBLinked yet. I don't know what we're doing, but, where you see the Black Council is a coalition, I would say not coalition, but it's comprised of all the black organizations that you be so we have Black Student Union a Caribbean Student Association African Student Association, UB gospel choir representative of that organization.
So many of us, but um so we came together. It all started back in 2019 February, where there was a town hall meeting, just as we were really upset about the budget cuts to or to organizations that really aim to ensure black student success. So like Educational Opportunity Program C-Step, and there's a town hall and we had a rally. And we were like, You know what, since all of us think alike. Why don't we just come together because, you know, we have all these different black organizations, but we all feel the same way. So we came together and wrote a couple proposals wrote a couple demands and you know we just hit the ground running from there and you know as people graduate as people and move on. And, you know, start adulting we have to like pass the torch and stuff.
So our main goal right now is just kind of sustainability of the Council and just making sure that we continue to increase the momentum and push the administration at UB just making sure that we keep that going. Despite having online classes in these unprecedented times, you know, it's really hard for us to come together.
But when we do, we're trying to make sure we you know, really hit the ground running in hold up accountable for ensuring black student success, but a few of the things I'll just mention.
So one of the things we are really looking forward to making sure we work to increase the minority admission or acceptance rate. And one thing that resonated with me when I read that demand was how so I serve on this as counsel I you'd be the scholarship you be which we just ensured the students at say at UB who received scholarship or us as students so they don't have to get the scholarship, but they graduated from a buffalo public charter school. So our goal is just to make sure that they have the resources they need at UB and one thing I learned was that the emissions that you'd be goes to certain high schools. They don't go to all the high schools in Buffalo.
And like, looking back like it. This is why like sometimes I just wish I knew all these things when I when I was in high school, but you know, you learn as you grow, and as you get older, but they only go to like Hutch Tech the high performing high schools City Honors, Da Vinci.
And it just goes to show you know not like they're not the students in the other high schools aren't even given the opportunity of exploring what's out there of not not just the other local colleges, you know, so it's really because this is like, you know, the university and for them.
Not to do that is alone is really like systematic. It's really a systematic and it's really something we wanted to address because the, the population of black students at UB is so small proportion is so small. So we want to just hold you be accountable, such that they really strategically seek out other students of color for to be a, you know, have the opportunity to obtain a degree there.
And yeah, we'll also, you know, we're also looking at increasing black faculty. We know that
while black faculty are recruited and, you know, they come along. A lot of times they leave because of the climate of the institution. So that's one thing that we feel like they should address
again, another thing I'll mention is like the curriculum development really making sure that it's not just one class that addresses racism and discrimination but it’s implemented throughout all fields, especially STEM fields. We have one of our members, she shared a really touching story about, you know, she came in and her advisors really discouraged her we're discouraging her from taking African American Studies courses because you know it's not you don't have space for that and all attest to that because I came in as biomedical sciences.
And it was a really rigid curriculum. I couldn't take what I wanted to take so so those are just a few of the things that we want to address you know we have we fought we're finding out as we go along that a lot of people think the same way we do so.
There's power in numbers, as we know, democracy, so we're just working together working, finding the connections, where we can but we all, we always need support. So if there's any students up there any organizations that want to get involved. Black students you can hit us up on Instagram, Twitter UB black council. I'm just like, promoting here.
UB Black Council you can hit us up and find out ways you can get involved. But yeah, we're just trying to really hold you be accountable to, especially given the climate now. And I always say this and I'll continue to see it. It's it's unfortunate that it took the death of a man for the country to realize how oppressive black people have been for over 400 years but it's time. And, um, yeah. With that, I'll, I'll stop. I'll get off my soapbox but yeah that's that's what we're doing. So, yeah.
Jessica Kruger: Well, it sounds like you're using a lot of your public health skills to, you know, organize and break down some of these systems, it's it's really powerful to hear how much you're doing as a student. You want to kind of tell us a little bit about how your work with the Black Student Council relates to your, your overall public health, you know, lens or how you kind of view things?
Temara Cross: Oh yes, I'll just say like, I don't know, every week going through at least with I don't, even an undergrad, like every week. I'm just finding how public health is my life. I won't speak for anyone else but like how public health is every day is something and I'm just like, it was a couple. I think it was last week we learned about negotiation in our one of our leadership courses in the in the CHP program and I was like, this is really like applicable to my life, it’s not just public health and they say they gave us examples of how negotiation is using public health, you know, I'm negotiating with a state about like funding for vaccines, stuff like that. And I'm like, Well, you know, we have to negotiate on a daily basis. So it's not just
From a public health lens and I'll say my internship with REACH is so it's like I'm literally taking what I learned in the class. I know this is like the purpose, but it's like I'm scooping what I learned in the class and putting it right in the internship and it's like it's like vice versa. Like I'm taking what I learned the internship and really applying it with the coursework and it's so I'm so grateful. Like I'll shout out to Heather Orom for really cheap. She was the one that emailed me was like this is for you. So, um, I thank her for that.
But yeah, it's really just so applicable and I'll just go back to the black Council on like the negotiation. That's just one primary example like really negotiating such that, you know, administration. I'm grateful for what, you know, you'd be administration has done thus far.
For some things I'll say, but, um, you know, that's a long way to go. But again, it has to be negotiation, it has to be communication consistent discussions and yes, so that's just one thing that I've learned like primarily in my program that I was able to like directly apply, but there's so so much so much
Jessica Kruger: It's so great to hear, it sounds like you're really taking what you learned and applying it exactly as you know an internship is is planned and I love how you can really translate this into multiple areas of your life, not just your internship or your professional career, but also how this you're taking some problems that are very apparent of the university and using those skills and knowledge to make some of that change. So bravo to you!
Temara Cross: Thank you.
Jessica Kruger: Tell me what's next.
Temara Cross: Oh, man. You know what's crazy is I have all these post it notes on my wall. And I said, I never put any posting notice so disorganized, but every idea that pops in my head. I just put it on my wall and I've eventually I want to go to med school. And I was like, do I take a gap year do I, what do I do because this semester alone was really like, how can I study for the. I was like, what, how can I study for the MCAT, With all this going on?
But I was thinking, okay, maybe I'll take my break considering we have an extended break take my break to study for them cat. So I guess. Next, aside from, you know, actually, finishing my master's program. I'll be starting to look at med schools and I don't want to leave buffalo, but you know, I'm a homebody but you know exploring other options. I'll say. So that's what I'll be doing. I'm just chugging along with my Social Action organizations open buffalo. Buffalo transit writers united, you know, and obviously being a student, too. But yeah, really, just chugging along but also taking days to myself. Like I said, I'll be eating a lot tomorrow with thanksgiving. I'll be eating so much but yeah, making sure my cup is full. I'll say that. That's my primary next step is making sure that my cup is full. So I can do what I want to do and give back to others.
Jessica Kruger: And still care is so important in our field. Well, I can't wait to see all that you accomplish in your program. So thank you so much for being a guest on Buffalo HealthCast today.
I'm sure all of our listeners have learned so much about reach, but also some opportunities in which we can make change and support students and making change.
Temara Cross: Of course, of course. And if you guys have any questions feel free to email me firstname.lastname@example.org find me on Facebook, I post memes mainly, keeps me sane.
Jessica Kruger: With the contact information in our show notes. Thanks so much for tuning in.
Temara Cross: Of course.
Schuyler Lawson: This has been another episode of Buffalo Health Cast, tune in next time to hear more about health equity in Buffalo, the US and, around the globe.
March 25, 2021
Born and raised on the east side of Buffalo, New York, Temara is a first-year graduate student at the University at Buffalo, majoring in African-American Studies and pursuing a BS/MPH in Public Health, concentrating in Community Health and Health Behavior. She is involved with organizations such as Say Yes Buffalo and Open Buffalo, actively working to achieve educational, socioeconomic, and racial equality.
Hello, and welcome to Buffalo Health cast, a podcast by students, faculty, and, staff of the University at Buffalo School of Public Health and Health Professions. We are your cohosts Tia Palermo, Jessica Kruger, and Schuyler Lawson.
Schuyler Lawson: In this podcast we cover topics related to health equity here in Buffalo, around the US and globally. In this first semester of the podcast we’re taking a deeper look at racism and health.
Jessica Kruger: We’ll be talking to experts around the US, as well as individuals here on campus, and in the Buffalo community who are working to remove inequities, and improve population health and well being. You’ll hear from practitioners, researchers, students and faculty from other universities, who have made positive changes to improve health equity and inclusion.
Schuyler Lawson: Hello, everyone, and welcome to another episode of Buffalo Health Cast,
The University of Buffalo Premier Public Health podcast.
I am your host, Schuyler Lawson, a first year PhD candidate in community health and health behavior. With us today is our Reverend George Nicholas, co convener of the African-American Health Equity Task Force and a member of the Concerned Clergy Coalition of western New York. Thank you for taking the time to be interviewed with us today.
Reverend George Nicholas: Well, it's certainly an honor and a great opportunity to be with you today.
Schuyler Lawson: All right, great. So first off, for our listeners, can you tell us a little bit about yourself?
Reverend George Nicholas: Yeah, I'm from Buffalo. This is my home grew up here and then went to Ohio State University for undergraduate and then came back to the area, have a graduate degree from the University of Buffalo and had been working, doing various jobs, doing things, I’ve owned companies I was CEO of Geneva B. Scruggs Community Health Care Center at the time, and then I decided to answer the call that the lord put on my life many years ago, to go into ministry full time. And I did that. And it was pastoring Rochester for about 12 years. And then, you know, the Lord called me back to Buffalo. I've been here since I've been back here since 2012.
Schuyler Lawson: A lot of history in Buffalo.
Reverend George Nicholas: Yeah. Oh, yeah, yeah, it's home, and, you know, I've seen the ups and the downs and, you know, I think we have an opportunity to really do something transformative right now. And it's necessary because, you know, I've seen out Black Buffalo really hasn't progressed.
You know, I mean, some of the things that in terms of, you know, we have less businesses now, we have less community based organizations. We're so vulnerable. I mean, we used to have, well, the Geneva Scruggs Community Health Center, which was a community health center that served this community, we had the St. Augustine Center, which is a tremendous community based organization on Fillmore Avenue. They're no longer there. The Langston Hughes Cultural Center, which was at 50 High Street was a tremendous cultural center. The Friends of the Elderly, and there were a number of programs and that were run by black people and that address the needs of black people.
And over time, these things have not been supported by the, you know, the existing political establishment. And they've gone away. And so and you certainly on the business side. You know, we had tons of cleaners and restaurants and all kinds of things, you know, Jefferson Avenue, Fillmore Avenue, parts of Genesee, they were bustling with black owned and operated companies. And so and then finally and I know when you get to these questions, but I think it's important to put things in a context.
You know, my you know, when I'm 57 and, you know, when we were coming up in their area, the notion of, you know, black kids not graduating from high school wasn't even a conversation. You graduate from high school. And you know, it was, you know. And so but now, you know, we have folks struggling just to graduate from high school. And then even as they matriculate on to the campuses at the University of Buffalo, it is probably is probably less black students from Buffalo there now than there was fifteen, twenty years ago. And so we have to we got to turn this thing around, Schuyler. We're not going in the right direction. And so we'll talk about that a little bit later, too, if you want to.
Schuyler Lawson: I agree with you. I agree with you. And like you said, even though even though, you know, the current you know, the current situation appears to be bleak. You did say that there is an opportunity for transformation and hopefully lasting changes, which is which is a great segue into, you know, about the into the African-American Health Equity Task Force, which appears to be a force for good with respect to the issues that you mentioned.
Reverend George Nicholas: Yeah. Yeah. So we've been working really hard since it started off with a conversation with just a few of us.
This woman, Mary, was at the time working, I think, for the Heart Association or the Red Cross, one of those places, and she wanted to engage some black clergy in conversation about colorectal cancer. You know, there's a disproportionate amount of black people who suffer from that.
And so I challenge the group to think bigger and to look at, you know, the overall health of black buffalo.
The factors that were driving high colorectal cancers are the same factors that are driving diabetes and heart disease and asthma and all kinds of things, hypertension. And it's the social determinants of health.
There has to be a shift. Between thinking about and looking at black health and putting all the blame upon the behavior of people in the black community, that old adage, well, you just eat too much fried foods and all this other stuff. Well, that's part of that. That's part of the equation. But when you look at what you know, the reputable organizations that deal with public health, the World Health Organization, the Center for Disease Control, the National Institute of Health. And every reputable organization that focuses on public health will tell you that the driving factor, the most influential factor out there that impacts the health of an individual are the social determinants of health. The lived environment, the economic status, educational attainment, interfacing with the criminal justice system, the air and water quality in the neighborhood, the quality of your housing stock.
These are the things that that that drive health outcomes.
And if you live in a community where you have access to the things that you need to maintain good health, then your health outcomes will be significantly better. But if you're living in a community where you don't have access to fresh fruits and vegetables because there's no grocery stores that are within a close distance proximity to your community, it makes it difficult for you to purchase the things that you want to put in your refrigerators and on your dinner table that are healthy.
And if you're living in a situation where your economic status is such that you have limited income and limited resources, then you know, the food choices that you make for you and your family are going to be influenced by your income, not necessarily about what's always healthy, because healthier food is more expensive in a lot of places
And then we'll say, well, why don't you just change your economic status?
Well, you know, if the job opportunities are not available for you and your community or if the jobs are there's a lot of jobs and Grand Island and places like that. But if there's that transportation and you don't have means for that transportation, then that creates a problem for you.
And so, you know, these are the things that drive these what we call the social determinants of health. And when so our work, our mission with the African-American Health Equity Task Force, it started off calling ourselves the African-American Health Disparities Task Force.
But we wanted to shift our thinking to a more aspiration. We want to talk about where do we want to be.
Right, and where we want to be is health equity. And so we we're we're unapologetic, concerned with the health conditions of black people. This is not a minority thing. And not to to take hits or slights.
But there are unique set of circumstances that are attached to the enslavement of the African people really in this hemisphere. Starting in 1519. When you look at the you know, the slave trade by the Spaniards and the Dutch and other those in and in the French in the South and Central America, and then escalating in to around 1619, migrating up north to what is called what they called North America. But it was a land that was inhabited by the indigenous people.
And then so this whole Notion of the enslavement of African people in this region has from beginning begun the process of the social determinants of health.
Right, because the lived environment, economic opportunities, housing rights.
And from that moment. African people living in America were at a disadvantage. And that continued throughout generations.
So you have slave enslavement from 1619 to 1865. But even longer than that Schuyler, because when you when you with the enactment of black codes and African American men forced to work in steel mills and coal mines in Alabama, Tennessee and other parts of the South after being arrested for vagrancy.
Right, and then the inability to get to accumulate wealth through to the sharecropping system and just the debt that was begun to just weigh upon freed African people living in America. And so that just, you know, from generation to generation passed on.
And then even as we began to migrate into the north and beginning to fill these some of these jobs in during the industrialization, but then as these jobs became unionized and into the migration of those from Western Europe, began to come in from Italy and Ireland and other places like that. And Poland, they took those jobs. They displaced folks who were who had migrated from the south and moved up to the north.
And so then, so this whole economic disenfranchisement of African people living in America has created such a wealth gap that even today in the year 2020, for every dollar of wealth a black person has in America, a white person has eighteen dollars. And so, you know, the medium, I believe, you guys are students, so you will look up this data. But it's about African-Americans who have about eighteen thousand dollars of wealth versus over a hundred thousand by whites. And I talk about income. I'm talking about wealth.
Well, and why is that?
Well, post Second World War, and the beginning of it, when soldiers began to be able to purchase homes as a result of the G.I. Bill. They were they were pushed into communities, segregated communities. And then and red lines were drawn and soldiers couldn't even use their G.I. Bill that they had earned on the battlefield, fighting for freedom for other people and forced to live in communities that, you know, just to create an economic disparity. And then as banks over time, as banks value property. Right. Because your biggest asset is your property. Right. And one of the factors that they put into in terms of valuation of your property is the demographics, let me say, of that community. So black folks living in black communities, buying homes, investing in homes, but then getting less equity out of their properties than white people in white communities.
Right. And then you have what I call ghetto taxes. If you have your car insurances is going to be higher if you live in a black community, then if you live in a white community, life insurance, higher premiums, if you're black than if you're white. So all these things, they just, they just suck the well out of black communities and then finally the interaction with the criminal justice system. Where, you know, black people are disproportionately arrested and convicted for crimes. Higher bails, longer sentencing.
And so what happens when a young black person gets in trouble with the law?
Well, it's grandmama and them that have to dip into the savings, the dollars that they began to generate wealth with or that they would want to pass down to their family members. Second mortgages taken on that house that they finally paid up to pay to pay legal fees and things like this.
And so this whole this whole cycle, it just, again, sucking the wealth out of the community, which creates and feeds into these disparities. And so this is the level of how we want to attach this these issues of health inequities or health disparities as opposed to just doing what the traditional health fairs and giving people balloons and coffee mugs and thinking that that's going to change outcomes.
Schuyler Lawson: in light of this, you know, the daunting challenges that you listed, what is what is the African-American health equity task force some factor in alleviating or kind of even, you know, solving the problems caused by this multi generational structural damage that's been brought upon the black communities?
Reverend George Nicholas: Well, it starts with, you know, truth telling. Right. It's you can't you can't address problems that you don't recognize are problems, so we want to change the narrative about why these conditions exist and to focus more on systemic changes, and looking more at systemic causes so that that out so that our solutions are will impact the systemic causes mean.
Let me put it this way.
One of the things that, you know, I'm not critical of it, I'm just trying to make an analysis is that one of the things that happens every year is the beginning of the school year.
People who where we speak, and I use this analogy all the time, is there's always this big push to get kids backpacks through and to give kids bread brand-new backpacks. Yet there's no data, that says the reason why Black children are underperforming in an urban schools is because they don't have a backpack.
Right, and so the remedy, has nothing to do with the problem, because if the kid, if the child, is still going to a failing school in an at risk neighborhood, and if mother and father still don't have the kind of economic opportunities, the air and water quality in their community, and all these other factors, if that has not been impacted, then the fact that this child has a new backpack, really will have a limited, if any, impact upon their ability to achieve academic excellence.
Not talking about passing right, we shifted our thinking and I’m so proud, brother, that you work on your PhD, but the thought process that we're just, you know, think about this man. We're putting a lot of energy in, if necessary, because of what the current reality is to get kids. Our children just to pass. Right.
And what we really should be pushing is, is scholarship and academic excellence.
Right. Right. If you if you would, you have to get a 70 or 65 to pass, say, 70 if you get a 70. That means that 30 percent of the information that was provided for you you didn't get. 30 percent. That's a sizable chunk. That's right.
Right. So, our work is to look at systemic issues, raising concerns, and then them bring forth community collaboration's to bring community based solutions. And then engaging partners, institutional partners to invest their resources and to the solutions.
Whether, whether it be financial resources, whether it be intellectual capacity, whether it be access to information, whatever these institutions have that could be available to them. We're saying, use those resources and invest to invest this into to create a problem solving as it relates to the issues in the African-American community.
Schuyler Lawson: Thank. Thank you for your response. It helps our listeners understand the breadth of what the African-American Health Equity Task Force does.
I do have a particular question on what have been some of the approaches that the task force has taken with regard to the COVID-19 pandemic?
Reverend George Nicholas: Yeah. Well, there, we have a good news story there, Schuyler Good. And it shows it's actually proof positive to our hypothesis of the importance of community collaboratives. And supporting black leadership.
And let me let me frame this for you.
So since we have been doing so, we put out there our report in 2015 about the conditions of the African-American good health conditions, which show that you can people can have access to these reports at BuffaloHealthEquity.org, and in our at our initial report, just using state and county data and concentrating on five or six zip codes where the predominant number of African-Americans live on the east side, us, we found that that in terms of just looking at chronic disease, that an African-American who lives in one of those communities has a 300 percent more likelihood to have a chronic disease than a white person who lives outside of the area.
Schuyler Lawson: So we're talking about. Very stark.
Reverend George Nicholas: Right, right. And it translates to about [inaudible]. Right. And so we're at work, we were equipped with the data.
And so when and so when COVID-19, emerged, we knew that as because of the high rates of diabetes, asthma and heart disease, which are three comorbidities that make it individual more susceptible to COVID-19, that the African-American community would be hit the hardest.
Also, would you put on top of that?
We know that a lot of the essential workers who work in these health care spaces, health care aides, security people, people who work in dietary and environmental services, as well as the nursing in the medical area.
There is a high concentration of people from our communities that live with that, that are employed at those other level jobs.
And so they would be coming into these environments where, you know, Covid was present and then going back into their communities, sometimes using public transportation, sometimes catch it, arrive with the uncle and them.
And so and so we know that there was a real potential.
So we reached out to back in March to the county executive and the health commissioner and some other leaders in the health care field with leaders from our community, Dr. Vasquez and others. And we said to them, say, listen, what's your plan? What's the plan? We know this is coming. We laid out, you know, the possible vulnerabilities of our community.
And at that moment, they really hadn't thought began to think about those things in those terms. So what we said to them said, listen, we're going to come back to you with a plan, a plan on how we're going to address this issue and we need you to resource it. We need you to support it, right, because these are our dollars as well. And so and so after some going back and forth and what have you, we were able to use some of the Medicaid reimbursement moneys to the district, the Millennium Collaborative Care through Erie County, being able to to stand up what we call the COVID-19 response team.
And what we did Schuyler, we put, we've got fifteen churches on the eastern west side. And we developed these Covid response call centers, and we got we got lists from the Board of Elections and other sources. And we had our targeted area and we hired a lot of younger people who a lot of them were home from college, you know. Got them an iPhone, got them a laptop, got them a list. Dr. Vasquez and his team through [inaudible] had developed this tremendous I.T. system that allowed for our responders to actually make appointments for people right there, from where it right from their call center, what have you. And so we literally called people in our community.
And then we learned to they were there's still a percentage of people in our community that don't have a cell phone or landline. So we engage the National Witness Project who are already doing some community engagement, community health work type stuff and we said to them, ‘knock on these doors for us because we can't reach these people’.
And so why were we reached out to them?
Well, we want to find out one, you know, if they had any symptoms, two did they have access to a test, three, do they have a primary care physician, four do they have some food, a food insecurities, five, how are they doing mentally, so we ask these five questions pretty much.
And we were able to not only ask those questions, but to give some kind of response to attaching people to help. Right. So if you're you know, if you're having this some of these symptoms or what have you. Hey, you know, get to your get your primary care. Oh, you don't have a primary care. Well, we'll you know, through our network, we've got [inaudible] and we've got Jericho Road. Good lead up. We can plug you in to a primary care physician or you need transportation.
We'll get someone to come pick you up, you need food.
We engage with that, Alex, over at the African Heritage Food Co-op. Tremendous job. And we said to him so, to Alex, here's a chunk of money, get what you need and then let's set up a delivery system. Right. And so when people needed food, we were able to get it to them.
We work with Best Help if they're people needed some mental health stuff because people are dealing with a lot of stuff. Make you make that appointment for you. And then when we learned that there weren't enough testing sites within community, we were able to stand up the testing side at the Leroy Coles Library. We said to those who had access to testing, we need tests at our community health centers because the people at the Community Health Center, people, Jericho Road, the people at [inaudible] Medicine, those sites, they're already dealing with people in our community prior to Covid. So they need to have access to the resources in order to get them some help.
And so, you know, it wasn't easy, but we kind of put this plan together.
So here's the good news, so when we started the project in March, April, and the first data started coming in, now nationally, African-Americans are dying in about two and a half to three times their population rate as it relates to Covid. Erie County African-Americans make up 14.6% of the population in Erie County. The early data was showing that about 33 percent of the fatalities were from the African-American community. Which was trending pretty much at the national level. But then, as we did our work, made our calls, connected people to resources. Gave people access to PPE and others, and not only us, but there were other partners in the community. So what happened is we were able to stimulate and generate some energy that not only our project was having an impact, but it loosened other resources and other things within community where others were doing some really great work as well.
Right. And. And so. Ah, so as the data began to come back, we saw it trending downward to the point where in June, only 16.7% of the fatalities. In Erie County were from the black community. And to make it even better, the latest data we got just this week, even in the midst of the second wave and the trending upward, that only 14.7% of the deaths are from the black community, which was right in alignment, statistically in alignment with the population.
We're one of the few cities in America that can make that claim.
Why is that?
Black leadership with a vision.
We're already working in community with these around these issues, connecting with resources and systems and institutions that have an obligation to serve the black community. Right.
If you're the county health department. Well, the last I heard, the black community was in Erie County, and so you so you make these systems do what they are designed to do, what their mission is.
And then other health care providers and institutions, insurers and others collided and say, listen, we need you to invest your resources and help, help us get this thing done. But also critically following the leadership of health care professionals they were already operating with in those communities. Guys like Dr. Vasquez. Guys like [inaudible]. Right. Women like Dr. [inaudible] and Dr. Ansari, right, who are already there on the front lines, so they have to be resourced and equipped so that they can do what they need to do.
And the results are undeniable. Data speaks for itself.
Schuyler Lawson: Yeah. I mean, it's so good. Compared to nationwide data, that's I mean, it's an anomaly. You know, the work that you that you described is just amazing that the coordination and just the scale of it to achieve that type of outcome compared to like your national statistics where, you know, blacks make up, blacks pick up a significant portion of the significant and disproportionate compared to their population, a portion of the COVID-19 deaths, that’s commendable.
Reverend George Nicholas: And shout out [inaudible] who provided great leadership on this and others with our team ,Dr. Underwood, Rita Robinson, Kelly Wolfrey, we are just such a wonderful team of people who have been I worked tirelessly on the issues of health equity. Right. And so but what we can't do is, is because really what our our vision with our powerful Center for Health Equity, the health of the African-American Health Equity Task Force, and then the university having its community research institute under our CTSI under Dr. Murphy.
And this is another really great outcome is that, standing up that institute, and the system in an embedded in the university that is focused and its mission is to look at health disparities and to research and then not only research, but to come up with remedies and engaging not only the medical school, but the other academic disciplines, school of Education, a school of law, the School of Management, the School of Nursing, the School of Social Work.
They are all partners with us in this work, so that when we start coming up with solutions, then we're able to draw upon the expertise that operate within these schools to come up with innovative and creative responses to some of these issues that are that are creating these health inequities.
So it's a really it's you know, it's Dr. Tim Murphy has been fantastic, who is head of the CTSI. Dr. Margaret Grimsley, Dr. Henry Taylor. Dr. Heather Orum. They've all just been great partners with us in this work to the point right now where we were able to get through the School of Nursing where we’re able to get a grant a grant from what they call the grant, where we're going to be actually looking at how the impact of mental health has on these communities.
Post Covid. Right. And from what I understand is, one, the first kind of community university kind of collaborations to look at issues that are specifically designed to provide information, but also support for issues in our community.
So we're making some progress and we're really excited about it.
Schuyler Lawson: I'm excited about it, too. And it's great to hear that this is an all this progress made at the community level and different types of institutional levels we're dealing with beyond every county Department of Public Health and also to, you know, getting our U.B. on board, which is located within the community. So we might as well have a stake and open the ability.
Reverend George Nicholas: I mean, universities have a responsibility, ability to do problem-solving. And, you know, what's the point of doing all this research and having all this knowledge if you don't take the research and knowledge to better humanity?
And, you know, it's so that message has been heard, and the university, an institution has been very responsive and we're very hopeful in the future or at about the future, about the work we we're going to do together.
Schuyler Lawson: So I have another question. So what is what is The Concern Clergy Coalition of Western New York, and how do you how do they relate to the issues of equity that you that you mentioned?
Reverend George Nicholas: So Reverend Pointer and myself and a few others were kind of the ones right after the death of Eric Garner, and we organize clergy, about 90 clergy in there in the area to begin to start having conversations about those issues and and how they, what's happening here in Buffalo. And we began to start talking about, you know, thinking about how we can provide leadership around health, economic development, criminal justice and, something else, I forgot, but and so I've kind of education, school education and and so I kind of grab the health piece and we've been working, you know, ever since on those on those issues.
The Concerned Clergy represents, there are about five or six different ministerial groups in the black community. And so they all kind of came together under this banner of Concerned Clergy, and we're working on these kind of social justice type issues. Doing our best to present a united front, even though we differ, in some ways on issues theologically and doctrinally, but there's agreement that that we must come together to work for the betterment of the conditions of our people. And so we we've been we've been functioning, you know, pretty, pretty well.
It's difficult because, you know, historically, again, you know, there hasn't been this kind of unity amongst Black clergy., but we're not as divided as people think, but we're not as unified as we should be. So we're a work in progress. But, you know, the concern clergy has been functioning and certainly Reverend Pointer has been a leader in that group. And, you know, so so we've been really spending a lot of our energies around health issues. Bishops NAME, a lot of energy around education.
And so, you know, we're trying to span out our influence in in these spaces.
Schuyler Lawson: Thanks. Thanks for providing that background. I have another question, so has the as the Contents Concerned Clergy Coalition of Western New York played any roles and say I'm addressing in addressing the issues surrounding the pandemic.
Reverend George Nicholas: Well, yeah, I mean, it's, so I wear a lot of hats. Yes, so when I'm operating in these spaces, concerned clergy, I'm representing them.
You know what I mean? So, and every report back, we have conversations about things.
And, you know. I know I can always depend upon these guys and ladies for support. And so and so the the efforts around the pandemic have really been channeled through our work to the Buffalo Center for Health Equity and African-American Health Equity Task Force. Right. So so the Concerned Clergy are are part of that work.
And so then when other churches and other groups try to do things, we will support them and resource them, you know, and and work sort of works works that way.
One of the things that, though what if we did this this week? Was began to start educating the community around the pending vaccine.
And we had a conversation. I believe it was Wednesday with Dr. Alan Lessie, who is an epidemiologist at the university and really an expert on on these issues of infectious disease. And so we this issue with the vaccine because of our history, we know that the data show it about, only about. Well, 43, 44 % of black people who have been polled so far, have said that they would be willing to to take the vaccine.
And I understand those low numbers. There's a historical context. There's a rationale behind Dr. Michael Eric Dyson would say that black people are not skeptical of science, we're skeptical of scientist. And so we have to get over, I shouldn’t say that. I say this we have to enhance our understanding and knowledge around issues as it relates to research. We have to have more black folks involved in research. We have to engage in participatory research. And we have to engage more with institutions that have access to data and have conversation.
So that we'll operate with a greater knowledge base around this vaccine. So that's what we're trying to do. The fact is that the FDA and the CDC have put the, you know, Pfizer, Moderna, and all the companies that are developing the vaccine through a rigorous four step process that would certainly maximize the probability that when the vaccine comes into the public that it will be safe.
And in fact, I believe one of the lead scientists in the development of the vaccine was an African-American woman.
Right. And so and so when the vaccine emerges, we have to the decisions that we make and whether or not we're going to take it have to be based on facts and knowledge.
Right. And we need to hear from, I know that Morehouse and is going to play a role in in in in in the investigation and disseminating information into community about the vaccine, so we need to hear from black doctors, about this, you know, and it locally, you know, hearing for me from Dr. Vasquez and Dr. Underwood and people like that in community who I trust.
And if they say, hey, this will be something that'll be beneficial to our people and to our community, I will follow that leadership.
But we have to be very, this is a very delicate situation because and we cannot be dismissive of people when they express their reservation and concern about that, about the vaccine. And we should listen to their concerns and answer any and all questions with the hope that that that if the vaccine is going to be beneficial for our people, that everyone in our community does take it.
But we also have to be in, involved in the process of distribution, so what good would the vaccine be if it's gone through all four phases of approval, but yet, it’s not available to people within our communities?
So we have to continue to advocate and be at the table and say, OK, you know, we're high risk, We are already struggling with a lot of issues, we got a lot of our people who are working as frontline workers in these health care facilities, so we want to make sure that people within our community have the information about the vaccine and also access to the vaccine when distribution begins.
Schuyler Lawson: Those are those are very important issues, and I imagine that the task force and the clergy coalition are going to play a big role in trying to have a plan for Buffalo's black communities as far as like, you know, equitable distribution and also to make certain information campaign to build, to build trust and address the roots of the historic roots of the mistrust towards our scientists we have.
Reverend George Nicholas: And what's one of the things that when the outcomes of our project is we've developed just piles of data now, I mean, we've made, you know, I think over a hundred thousand contacts with people and so on and so on. Each one of them is a data point. And so we're going to be able to, as one of the outcomes of our project, be able to really make some really strong programmatic and policy recommendations about how do we can better serve the African-American community based on that, based on the data that we're collecting.
And so we strongly believe that research, we'll give you data, data will inform policy and then policy will bring resources. And so we have to make sure that we are very aggressive in those are four those phases.
Because really what's happened Schuyler years is our people have been measured and surveyed and queried and but and then institutions have have gotten tremendous grant and funding opportunities to do that, but then once we compile the data then and identify these these issues, there never seems to be a follow up of policy recommendations to address that.
It’s one thing the survey of people and say ‘Y'all got a lot of diabetes’,
But then, OK, this next step is now here are the programmatic things that we're going to put in place to address those conditions, but that has not happened at the level that we needed to happen.
So that's one of the reasons why we you know, it's very important that we have this collaboration with the university and others around research.
Research is critical. And we have this. One of my goals is to have research to no longer be a bad word in our community. Right. As we know and I understand. But now. But we understand, though, that the importance of research and importance of research being done right and making sure we don't take the data from the research to weaponize our people, but take the data to to be a bridge, to getting resources, to change the condition of our people.
And that can only happen when black leadership involved. I mean, and that's got to be real about that, we need to insist that black leadership is involved and we have to make sure that black leadership is black leadership, meaning not just black people in leadership is not black leadership. There's a difference between there. And so we have to have black folks who are in positions of influence and leadership to be unapologetic advocates for the conditions of their people.
Right. And not, you know, not get tied up in the semantics of whether you should say, defund the police or not, that's the absolutely wrong conversation to have. And it's an unhelpful it's unhelpful critique for people in leadership to to to critique that phrase without looking at, but without putting your energy around the issues or why people are saying that. And so we have to understand the nuances of how can you be an advocate for black people?
You, the only way you can do that is to listen to black people. Right. And to and to share their concerns in an unfiltered, unabridged way, so that we can really begin to start getting up to move.
You know, and there's a generation, your generation I have four sons and one daughter and your generation is very clear of the directness, you know.
And so I am grateful to see the kind of the shift things like, you know, that the unwillingness to play semantical games and to appease white institutions, but to say, listen, you know, there we have a right to be in this space and we have a right to advocate for our people, and we have a right to use the knowledge bases and the things that we've learned from these institutions to better the condition of our own people. And that is a critical, critical piece that I think we got, we have to see it in terms of shifting in our approach in our community.
Schuyler Lawson: Very well put. And I'm actually leads to, I have a final question, is there is there anything else that you'd like to share with our listeners? Any kind of, you know, I know. I know you've said a lot and I'll put you on the spot.
But anything else before you conclude our interview with you?
Reverend George Nicholas: I just that, you know, I guess a message I'm sure a lot of students listen to this, the issue around race, I think this is our season to really engage in real, meaningful conversations about it.
And I'd like to say, put it this way, to take the power of racism or to diminish the power of racism in our culture. While, as a theologian, I would I would be hopeful that we could eliminate racism, but also as a sociologist, I would degrees sociology as well, understanding that I think are our best hope is to be able to diminish the power of racism and the power of white supremacy and the ideology of white supremacy and its influence on institutions.
To diminish that power that it has, I think is something that we could, which is a realistic goal. And I think it happens through, you know, people engaging in transparent and honest conversations about the history and the present practice of white supremacy and systemic racism and to engage in conversations that would define allyship in the terms that centers the needs of black people in that allyship work and to and to be cautious in our conversations about intersectionality to the point where we I believe that we do that, but not at the expense of the needs of black people.
And I think what has happened historically post, since I know we've run out of time, but post civil rights, I think that at times, our desire to do intersectional work and to do coalition work has at times put the needs of black people secondary. Right, though. And so we have to be, you know, smart, cautious. Learn from our past practices and then to be innovative.
I mean, do to recognize that there has to be new approaches to things. I think folks of my generation have to make spaces for sunsetting some activities in organizations that may have been effective for a season.
But, you know, there's a new opportunity as a new opportunity here. And I think we need to make room and spaces for the next level of leadership. But I also will caution the next level leadership to not discount the wisdom of the elders. Right. And so one of the things that that diminishes our strength, is when we have conversations like pushing the old folks, old guard out the way and, you know, this is our time. Right. I think we by doing such, you diminish the opportunity to glean wisdom from folks that have been on the battlefield and can maybe give some wise counsel on how to deal because the enemy is wise, and the enemy does not separate generation the enemy.
The enemy passes down the wisdom of how to maintain power and control down to the next generation. And that's why there's been so much success tick to keep this generational dominance. And so those are the things that the final things kind of I would like to share with folks and then just inviting people to engage to log on to our Web site, BuffaloHealthEquity.org. And then when you see activities and things going on around campus, around community, around health that could be around justice, get engaged, you know.
Don't wait for somebody else to do this. This is your season, your responsibility. And if you're your personal good conscious and there's so much happening right now, it's a great opportunity for you to get engaged and to begin to shape the society in a way which we want to be. And it's only going to happen if we get engaged.
Schuyler Lawson: Thank you for those thoughtful parting remarks, and so thanks again for taking the time to be interviewed on our podcast. We hope to have you on again to discuss future projects, for example. You know, no one wants the vaccine becomes available. You know how things are gonna go with the task force in the coalition. We're helping out with distribution in the information campaigns. We definitely want to follow up on that.
And now you add a question, is there a way for that? Our listeners can learn more about the task force and the coalition?
Reverend George Nicholas: BuffaloHealthEquity.org, Health equity data, all the information. And if you want to send us any questions or anything like that, we will, we have a way to respond.
Schuyler Lawson: And for our listeners, are there any volunteer opportunities?
Reverend George Nicholas: I think so. I'm not sure right now, I know that we have some students doing some academic stuff, some you know, I think one thing, too, is, is checking with people like Dr. Heather or Dr. Grimsley, Dr. Taylor and Dr. Murphy and Dr. Leslie or your professors and Heather Abraham over at the law school.
Reach out to them and say, hey, you know what you know, ask, are there some things that I can do, too, in terms of supporting your connection to the task force?
And we're always open. We're looking for, you know, ideas, you know. I mean, well, you know, it's what I want. We want to be a place to support and convene new ideas. So, I mean, there is base maybe some things that I had a conversation with oh, oh, oh, young lady, they want to do some internship work. And I said to work, so that's great. So she said, well, what will we do? I said, I want you to tell me what you want to do.
You know, you come up use out. I mean, I'm interested in your creative ideas, but I don't want you. I don't we don't need you. I just come run copies for us. Right. I want to I want to mine the intellect.
Of young and young people in mind, their ideas. Do you mean as opposed to just giving up some task.
Right. Right. Because I think that's where the power is.
And so I would just encourage people we will welcome ideas and thoughts. And, you know, let's see what can we come up with.
Schuyler Lawson: OK. And again, listeners, that is our BuffaloHealthEquity.org, correct?
Reverend George Nicholas: Yes. BuffaloHealthEquity.org.
And also we got another Web site of a project we're working on called Pride in Place, Buffalo, Pride in Place, Buffalo. And it's a collaboration with Lisk and AARP where we're actually going to be doing some creative things that just about celebrating and loving our folks in our communities.
It's going to be real artsy and just really is really just trying to lift get out, what's been a big deal with this trauma, right? And we got to learn how to celebrate ourselves, celebrate what's happening in our community that's good. Celebrate the artists, the people you know, we're working with folks with like from the Wakanda Alliance.
And then, you know, there's some folks that are just doing some so great things on the ground and we need to support them and we need to resource them.
And so you can and if you go to Buffalo Health Equity, talk there, I think there's a link to it but otherwise it’s called pride in place, Buffalo, Pride in place, Buffalo. And you'll see some exciting things and there'll be some things we're looking for artist. We're looking for all kinds of folks in there. So that would be a place to kind of link into something.
Schuyler Lawson: OK. Thank you very much. And again, I'm Schuyler Lawson. Thank you. Thank you all for listening to another episode of Buffalo Health Cast. Take care now.
February 25, 2021
Reverend George Nicholas is an active member of the Concerned Clergy and co-convener of the African-American Health Equity Task Force.