Transcriber: Mia Tran Reviewer: Sebastian Betti
So, what if you had the opportunity to pick your parents?
I know it sounds insane, but just think about it.
What are the characteristics, what are the determinants?
What would you outline,
that would create this beautiful family for you?
Things like income, ethnicity, you know, what part of the country,
education, maybe they should be college educated.
Because those things make a big difference.
You know, one of the myths of health care
is that it is about what’s happening at the hospital.
But it’s not about the hospital and the doctors, offices and the clinics.
It is about those things
that really directly affect your quality of life.
Like those things you just thought about in you choosing your parents.
So what would you choose?
Would you say, “I want to live in a certain part of the country”?
Would you say “I want to be white in America”?
Would you say, “I only want to be Christian”?
Some people would say that.
Those things are called social determinants of health.
They tell us about our quality of life, daily.
They tell us about our life expectancy.
So I wonder how many people who is hearing this
would raise their hand to say “I’ll be black”.
So what's wrong with being black? I mean, I'm black.
I grew up in Williamsburg County, in South Carolina.
It’s the poorest county in South Carolina
and South Carolina is already at the bottom.
My parents, I did have both of my parents in the household, which was fabulous.
My dad, I guess,
went to about third grade because he was a farmer
and my mother did finish high school, which was, phenomenal,
for kids in Williamsburg County.
One of the things they taught me was that
it’s very, very important to focus on education.
But even beyond that, it’s not just education,
it's the whole support system within a community.
You need a village to raise a child.
You need love and support to raise a child.
And it’s hard to do that
when there are certain kids that are disadvantaged.
That are forgotten. That are ignored.
That are set aside because of one aspect.
They didn’t even pick it.
I mean, who decides? You just come in, you’re here.
We're one big family.
When you take away all of all of this. We're all connected.
We’re all one big community.
So how does all of this affect health?
If you’re living in some of these red line areas, and,
redlining is something we set up,
we decided that everybody could not live together,
certain people needed to live here and other people needed to live over here.
And then those people who lived over here, the schools weren't as good.
Maybe there was healthcare.
There were chemical plants.
The water systems. Parks and recreation.
So how do we decide to equalize all of these things?
Because these things do determine your quality of life
and your life expectancy.
1964 civil rights. I was born in ’69, so not so far away.
I’m 51 years old.
We’re still trying to figure out this whole thing with civil rights,
and how do we know?
Look at 2020.
And let’s look at it from the lens of health care, COVID.
COVID came in with a bang. I mean, I wasn’t even scared.
I had already gone through AIDS, bird flu, swine flu.
COVID was totally different.
COVID was unprecedented. It changed our whole country.
And not only that, it changed the world.
Here in the United States of America, we have about 400 million people
and 20 to 40 million are black, which is 12 percent of the population.
A third of those black Americans, black and brown folks,
ended up with COVID, being hospitalized with COVID, or died.
It was a disproportionate focus.
The black community was hit severely by COVID.
And why? A couple of things. Number one.
When you think about the in-the-context of social determinants of health,
pre-existing conditions.
Number one, if you have hypertension, diabetes, obesity,
those are things you really have to manage very, very closely.
Because they will lead to very, very negative outcomes.
But however, if you’re living in households
where there are multi-generations, there’s overcrowding,
you’re living in what we call ghettos.
You’re living in these areas of town that are disfavored,
the areas of town that no one wants to even be part of.
You end up with a very, very specific quality of life.
So when you’re not getting the healthcare access,
and preventive care that you need, it exacerbates,
and your quality of life decreases.
Blacks in America have the lowest quality of life in any other race.
Number two, your job, where do you work?
I mean, that determines a lot.
I mean, some people have all this generational wealth.
Most black people do not.
So we need a good job.
But most of us are working in very low level positions.
Entry level positions.
In restaurants,
front-facing, what they call ‘essential workers’ in grocery stores,
maybe even doing manual labor.
Some of those jobs are not full time.
There are no benefits. So you don’t get paid time off. What is that?
There's no retirement plan. There's no sick time.
And there may not be even any health insurance
that’s connected to that particular job.
So what are you left with?
How are you going to be moving forward?
So it’s very, very important for all of us to really think about,
why people are in certain jobs
for their entire careers or their entire lives.
Because that determines your healthcare status.
You need resources to be well here in America.
It’s not just going to happen.
And even if you have Medicaid, you still have access issues.
You’re in these red line areas that are probably far away from the main drag.
So you need resources.
That are really, really close clinics that are right within arm’s length.
Because as these diseases exacerbate,
it’s really hard to correct and bring things back to normalcy.
It's almost impossible, so we end up seeing these marginalized populations,
they come into the ED close to death.
They end up in the ICU’s.
And even if they make it out of the hospital,
they still have to go through rehabilitation.
And maybe live a life that’s not very full.
So what I say to all of you,
is that we need to figure out how do we change the narrative.
How do we make things better.
Even if it’s not for me, for my children
and for your children, and for the future of our country.
Because just automatically making assumptions
about individuals is not right.
Because at the end of the day, it affects their health care.
Because those same people that are working in the hospital,
those same people, they are doctors and nurses and techs,
and they still have that unconscious bias
about who they feel black people are.
So, I want all of us to become activists,
by just getting approximate,
just really getting to know people.
And it can just be one person that you see,
or a person at a school that you decide
“I’m going to adopt. I’m going to transform.
I’m going to look at this and empower myself to look at this differently.”
Because you can’t do it from afar.
You really do have to get close
to understand the nuances of what’s going on.
But the problem is we all live so far away from each other.
Up the track, you know, back the track. People live on the side.
Sometimes you know, their income issues
that come up about living in certain places.
But we’re going to have to figure out how we make a difference.
You know, I was one of those poor little kids.
And, through education, I ended up doing really, really well.
And I'm always mentoring. I'm always in schools,
always teaching in colleges to make sure that they know.
And they being all of us. That it takes a village.
And the reason why
I am just so enamored by this,
so dedicated to it?
Because I’m part of the broken.
I know what it feels like not to have anything.
I know what it feels like.
So I don’t want it for other people.
So I’m going to dedicate my time,
and I’m going to celebrate others.
Thank you.