Partners for Advancing Health Equity Podcast: Recent Episodes
Thomas LaVeist
Welcome to Partners for Advancing Health Equity. A podcast bringing together people working on the forefront of addressing issues of health justice. Here we create a space for in-depth conversations about what it will take to create the conditions that allow all people to live their healthiest life possible.
In this episode of the series, Pathways to Health Equity, we speak with Dr. Paula Braveman, Professor of Family and Community Medicine and Founding Director of the Center for Health Equity at the University of California, San Francisco (UCSF), about her life experiences and their influence on her path in the field as well as her thoughts on the past, present, and future state of health equity. For more than 25 years, she has studied and published extensively on health equity and the social determinants of health. For her full bio: https://profiles.ucsf.edu/paula.braveman
Papers discussed in this episode:
Systemic and Structural Racism: definitions, examples, health damages, and approaches to dismantling. Health Affairs 2022 https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2021.01394
Paula A Braveman, Shiriki Kumanyika, Jonathan Fielding, Thomas LaVeist, Luisa N Borrell, Ron Manderscheid, Adewale Troutman. Health disparities and Health Equity: The Issue is Justice. Am J Public Health 2011
[00:00:33] Thomas LaVeist: Hello and welcome to the partners for advancing health equity podcast. I’m your host, Thomas LaVeist Dean and Weatherhead presidential chair in health equity at the Tulane University School of Public Health and Tropical Medicine.
[00:00:45] This episode is part of our pathways to health equity series. Here we talk to those on the front lines of health justice. From pioneers in the field to those currently creating path forward, learn how their life experiences have shaped their journeys to health equity. They’re defining contributions and solutions to improve the lives of those impacted by social injustices.
[00:01:06] This episode is part two of our conversation with Dr. Sherman James, where we continue our discussion of his defining contributions and next steps necessary to advance health equity.
[00:01:16] Thomas LaVeist:] So that essay was on skin color. but then your work evolved and this is 78. So shortly after that, your work really began to evolve into this concept of John Henryism, which really, I think is the thing you’re most noted for. Talk to me about how you developed that concept. Where did that come from?
[00:01:33] Sherman James: So I met a man by the name of, John Martin in the summer of 1978. I did not know that his full name was John Henry Martin, when I first met him, but I met him in July of 1978, the editorial essay, blood pressure and skin color was published in December of 1978.
[00:02:01] So my speculations about why dark skin color, particularly in black men, Because that was where the association between dark skin color and higher blood pressure was stronger. so those speculations that I offered at the end of that editorial about the physiological cause of chronic struggle against discrimination against structural racism, those speculations were informed by the meeting that I had with Mr. John Henry Martin four or five months prior to the time that we actually wrote that editorial had I not had that encounter with him. I don’t know that I would’ve brought that perspective to bear, but, let me tell you now about that encounter because it was life changing for me, John Henry Martin in 1978 was 71 years. Age. He was born in 1907 in a farming community, just north of Chapel Hill in Alamance, County into a sharecropper family. Uh, his father was not a slave, but his grandfather was enslaved. So, John Henry Martin was born into a sharecropper family, dirt poor in 1907. And as he grew up, he could see how his father who after sort of early in his own adulthood became a widower.
[00:03:04] He lost his wife in 1919. So he was a single parent. John Henry Martin’s father was and a sharecropper and he had to raise four or five children. And John Henry Martin saw how he would work himself. Night and day trying to get ahead, but half or over half of whatever he earned. he would owe to the owner of the land, for whom he was share cropping.
[00:03:27] So he could never get ahead. And John Henry Martin decided that he ever got, this is almost a direct quote. He said, if I ever get to be a man, if I ever get to be grown, I’m not going to be a sharecropper. I’m going have my own land. When he did become an adult and got married to a really wonderful woman, eventually, after a decade or more share cropping themselves and he was becoming more and more incensed at the exploitation of his labor because he was an uneducated man.
[00:03:52] He only was able to only go to second grade because he had to help out on the farm. so after about a decade and a half of being a share cropper himself, he and his wife decided that they were going to, take out a loan from the bank to purchase some property. And he did so with great trepidation because he was very concerned about being in debt to anybody or to anything, including a bank, because he saw what indebtedness did to his father.
[00:04:19] So he resolved to, to take out a loan to purchase 75 acres of fertile land. And he had a 40-year mortgage to pay for it, but he didn’t want to take 40 years to pay for it. He said, I want to pay it off in year. there was no way. Of course, he could pay it off in one year, but he were the support of his wife worked night and day, six days a week, sometimes six and a half days a week.
[00:04:41] And they managed to pay off that 40-year mortgage in five years just by working himself, literally to the bone. and after about two hours of listening to his story, his wife came to the door and she said, John Henry, for lunch, bring your guest with you. So, I looked at him, I said, name’s John Henry said, yeah, John Henry, Martin.
[00:05:00] I thought, holy cow, John Henry Martin, because in the course of the conversation, he told me. The reason why he felt that his health was so bad, he had high blood pressure. He had a case of peptic ulcers disease that required that 40% of his stomach be removed. And he had a case of debilitating osteoarthritis.
[00:05:19] He could barely walk. Remember I said, at the outset, he was only 71 years of age. And he had, and the onset of these conditions occurred beginning in his fifties. And he said, I think the reason why my health is so bad and that my legs are all outta whack is because I pushed myself too hard in the fields.
[00:05:36] So when his wife said John Henry time for lunch, bring your guest with you. Is my mind went immediately to the legend of John Henry, the steel driving man.
[00:05:45] Thomas LaViest: Yeah.
[00:05:45] Sherman James: Who. Engaged in this epic struggle against the machine who refused to be defeated in this epic contest, steel driving contest against Stacey seated and beating the machine in terms of drilling further in the face of the mountain than the machine did, but then he dropped dead immediately after his victory from complete mental and physical exhaustion. So, he won, but he paid a high price. And so, I began to think the connection between John Henry Martin’s story and the legend was really instantaneous.
[00:27:30] but then I thought, my dad was a brick Mason bricklayer. My mom was a factory worker. They were not well educated people, in a formal sense. But they had all of these sort of prototypical health problems that affect working class, black people, high blood pressure diabetes.
[00:06:16] Sherman James: And my dad died of congestive heart failure. My mom, high blood pressure diabetes. And now by this time, this is five years. This is 1978. So, by this time I have become pretty well informed about how widespread the epidemic of high blood pressure and heart disease and stroke, is in the black population.
[00:06:49] And I was already aware that this was epidemic in my own family. So, John Henry Martin’s life story seemed emblematic not only of the legend of John Henry, but really emblematic of black people. My family members included. So, I thought that there is something here. There is something here that needs to be interrogated that needs to be understood.
[00:07:11] Could it be that this incessant struggle to overcome these various manifestations of structural racism, whether it’s the sharecropper system, whether it is, not having, the opportunity to go to school, to graduate from a decent, high school, to live in a, a community that had lights, paved streets, these different manifestations of structural racism that impacted the black working class, Southern population all over the south.
[00:07:41] Could that be part and their struggle to overcome those conditions, to realize their potential, to get somewhere in life. Much like John Henry Martin struggles to do. Could that be part of this epidemic? Could that be the psychosocial piece, the stress and coping piece that needs to be understood?
[00:07:59] here again, I was drawing upon my background and the social sciences, humanities, my understanding of the lived experience of black people and my advanced training in psychology to weave together, if you will, the beginnings of a theory about how it is, that refusing to be defeated, refusing to give up in the face of this systemic oppression and actually moving forward many times, but at a cost, is that part of what we need to understand about this ongoing epidemic of.
[00:08:32] Sherman James: High blood pressure and related cardiovascular diseases in black America. So that became the John Henryism hypothesis, which I then needed to figure out how to test empirically.
[00:08:43] Thomas LaVeist: This is, just fascinating. so this John Henryism concept, is this a personality characteristic, or is it a cultural dynamic? Is it something endemic to the person or is it something you acquire, through life?
[00:08:56] Sherman James: I think that’s a great question. there was one paper, I don’t know if this’s ever been replicated or not, but it was a study done on twins, looking at the contribution of let’s say genetic variation and the environment through John Henryism scores and so many other.
[00:09:13] human characteristics, right? 30% of the variation in John Henryism, the scores, according to this particular group of researchers had its origins and some genetic factor, but the rest was the environment. So 30% can be accounted for by genes, if you will, whatever those genes are, 70% by the environment, which you find yourselves.
[00:09:33] so I think that there’s a huge cultural, uh, component to this. I think that the way African Americans are, as children are socialized about how you have to deal with, racial disadvantages, [00:31:00] structural disadvantages in American society. There’s this notion of the Negro theum, which has been around for a long time.
[00:09:52] Sherman James: And it goes something like this, that as a black person in America, you have to work twice as hard as a white person to get half as far as a white person. So the emphasis is on work and the emphasis is on tenacity and the emphasis is on determination. This is something that is deeply embedded in African American culture.
[00:10:11] You don’t give up in the face of adversity. You persist, you know, that you are going to have to work hard oftentimes twice as hard in order to get ahead because the deck is stacked against you. And so black boys and black girls, these historically, you could make the case that this is problematic, but at least historically black boys and black girls were socialized, into that sort of.
[00:10:32] Way of thinking that kind of understanding of what you have to do as a black person in America. You just have to work hard in order to get ahead in order to provide something for your family. And in order to leave something behind for the, next generation, which is something that John Henry Martin said was a big part of his motivation.
[00:10:51] Thomas LaVeist: Yeah. So just looking at your life story, obviously you worked very hard to go from where you came from to accomplish what you had been able to accomplish throughout your career. So what is wrong with hard work?
[00:11:03] Sherman James: Nothing.
[00:11:03] Thomas LaVeist: Why is that a problem?
[00:11:04] Sherman James: it is not a problem. it is not a problem. But if you don’t have the resources, right? if you keep the accelerator all the way to the floor, all the time. And you don’t modulate that you don’t pick your battles. You don’t take time to rest, to recover, to play right. Then your cardiovascular system is going to be in fight or flight mode, if not all of the time, too much of the time.
[00:11:18] So that when you lay down at night to rest, to go to sleep, instead of your blood pressure, being able to dip down to a level that becomes restorative, right? That gives your system all of your different systems, a chance to recover. Then you going to arise and enter the world the next day, without the kind of restorative, Strength that really, permits long term resilience at the physiological level.
[00:11:56] So it’s a question of of self-regulation, but also modulating your expenditure of energy being aware of the circumstances around you, picking your battles, mobilizing your support, right? Don’t try to do it all by yourself, but mobilizing a support system, a social support convoy as a colleague, has put it as a way of minimizing those physiological costs that attend having to work twice as hard. Because you’re black in order to get, half as far.
[00:12:27] Thomas LaVeist: Yeah. but what if you are working that hard and you’re succeeding, what if you are advancing and that hard work has been efficacious, does it still have the same deleterious health impacts?
[00:12:37] Sherman James: Yeah, I mean,I think the case of John Henry Martin is a illustrative as is the case of my own father, who started out as a peak and shovel man and became a general foreman of the construction company with only in ,eighth grade education
[00:12:47] And his story is directly analogous to the story of John Henry Martin success at a high price legend John Henry success, but at a high price. So yeah, you can advance, but unless you really pace yourself and mobilize, those resources that are going to. Ameliorate some of the more adverse consequences of stress on your various systems, whether it’s the reproductive system in the case of women, cardiovascular system, also in the case of women, but certainly men, immune system.
[00:13:19] So it’s a question of pacing yourself. taking time to rest, taking time to relax instead of just going all out, without taking care of yourself. and so I think that this is something that, many working class, African Americans, at least historically, when they had jobs, when they had jobs that required hard physical labor, whether it’s share cropping, whether it was factory work, whether it’s construction work, when those jobs were there and black folks.
[00:13:46] Were able to take advantage of those kinds of jobs. And they worked hard because they wanted to advance, and they wanted to leave something behind for their children. And if didn’t take time to replenish their resources, then the physiological cost could be considerable.
[00:14:01] No the contrast, this contrast, that set of circumstances with middle class black folks, because you have this social class gradient in terms of cardiovascular disease among African Americans, just like you have it among whites, that social class gradient is not as steep for African Americans as it is.
[00:14:19] White’s because the health returns in time. I know, this, the health returns let’s say on high education or higher income, for black Americans are not as great as they are for white Americans. So, you get this sort of leveling off of good health returns on high educational, achievement, and income, because it takes a lot for black folks just to get into that range of the social class spectrum to begin with.
[00:14:38] And then once you get there, there are all these sort of subtle, complicated stressors that are oftentimes very difficult to decode and figure out how to respond to it. And so the wear and tear among that better educated, better, more well off African Americans, and the daily wear and tear on their various physiological systems would be greater than it is for the white counterparts because they’re dealing with different kinds of social environmental stressors that said those social environmental stressors.
[00:15:03] aren’t nearly as great in magnitude And, compromising in terms of health as operate on working class and in poor African Americans, if they engage in what I call John Henryism. So what’s common to both of course, is this desire to move ahead, this willingness to work hard, but the playing field is a little bit more level for better educated blacks than it is for working class blacks.
[00:15:28] Sherman James: That the mountain that working class and poor blacks have to climb that mountain is steeper than it is for middle and upper middle-class blacks. But the mountain that middle and upper middle-class blacks have to climb is steeper than even the mountain that working class whites have to climb.
[00:15:45] So that we have a lot of data showing that for things like high blood pressure, infant mortality, less well educated, white have a better health profile than do middle class, college educated black folks. Again, it’s because I said that the, the struggle, to make ends meat to, to get ahead,is differential by both race and by social class.
[00:16:06] Thomas LaVeist: so how do we address this? do we tell people, that it’s important that they rest, that they work hard, but they also have to, kind of balance that out with restorative activity. Do we change the culture and say that. You don’t have to work twice as hard to get half as far, or do we change the, broader culture? And how about get rid of the impediments to people’s progress? Or is there something else
[00:16:32] Sherman James: number three on your list, change the culture, do something about, structural racism. now that’s easier said than done as better than most of us. because the machine now going to evoke, the legend of 19 year again, the machine of structural racism, because if you really think about what that legend is really telling you, it’s really a story about structural racism.
[00:16:51] the deadly exploitation of black labor. But at the same time, the refusal. Of black folks to give up, to run away their determination, to confront the machine. I argue that determination is cultural, and it plays out in what I call John Henryism. And, under more favorable circumstances, meaning if you can get a good education, you can get a good job.
[00:17:13] Sherman James: You can surround yourself with allies as I was very fortunate to be able to do. And they part of my career, which I think has more to do with the success that I had than any individual talent that I have, because there are a lot of highly talented black folks out there smarter than me. I was lucky I had a strong intellectual and social support system from senior people.
[00:17:36] When I began my career. Made all the difference in the world. How do we put that in place for more people that involves changing the culture so that you level the playing field so that this work ethic, which I think is a core part of black culture, I’ve seen it all in my life.
[00:17:52] it’s there. Black people are not lazy. Black people are not criminal. And yet the racist culture lifts up like criminality as if it’s somehow characteristic of black people, particularly black men. And it’s not anybody who knows anything about black Americans know that is simply not characteristic, but it’s all a part of systemic manipulations.
[00:18:15] Sherman James: to keep black people in their place. and the manipulation of these systemic forces, plays out in the educational arena, plays out in the labor arena, plays out in mass media, plays out in the cultural arena, this depiction, this stigmatization of black people. so that’s what I mean when we say change the culture, or when you talk about changing the culture, I’m talking about changing the culture, both in terms of labor relationships, educational opportunities, the way that black students are treated in predominantly white universities, the way that black professors are, the way that black executives or black staff people are treated in the corporate world.
[00:18:51] I’m talking about all these institutions that make up, let’s just say American culture, right? We need to change those things. and then this desire for upward social mobility, this desire for self-fulfillment to realize your full human potential black folks and other people of color, particularly those who really other people of color, not just those who are really poor disadvantage, but all people of color and particularly African Americans, right?
[00:19:17] Sherman James: Who are subjected to these forces of systemic racism, cultural, economic, political, we can level the playing field a little bit. If we can remove some of that pressure, then the same hard work ethic that we’ve been talking about, the same desire to be successful can be realized without the associated physiological costs.
[00:19:37] That mounting evidence, not just my work. But evidence coming in from a variety of directions, right? People are calling it by different names. but it’s the same phenomenon. It’s the same underlying phenomenon. Whether you’re talking about skin deep resilience, talking about weathering, you’re talking about, diminished health returns, on educational advancement.
[00:19:56] John Henryism is all the same phenomenon, just going by different names. And there’s a convergence. It seems to me, toward the same conclusion that is really these systemic forces that operate on people of color, African Americans, particularly in the Shelby site. At least that’s what I know best. that is resulting in too high of cost.
[00:20:15] Thomas LaVeist: Yeah.
[00:20:16] Sherman James: As people tried to pursue, shall we say the American dream try to make something of themselves
[00:20:20] Thomas LaVeist: So, the partnership for advancing health equity is all about bringing together these same sectors. You just talked about, academia, community-based organizations, civil society, government philanthropy, private sector, to all work on health equity, all of whom are doing things in health equity.
[00:20:37] But what we’re trying to do is bring these coalitions together to build synergies and to create a more common agenda around addressing, the health equity issue. Talk to this coalition. what would you say to people from these variety of backgrounds who are all looking at ways to advance health equity? what would you want them to know?
[00:20:55] Sherman James: What I’m going to share Tom, about that important question, may or may not be helpful but here’s my thought about it and it is one thought with multiple facets.
[00:21:04] I think that our children are in trouble. American children in America are in trouble, irrespective of race, ethnicity, and social class children in America today are under tremendous stress. Yes. And I’m alluding down to the school shootings is a source of toxic stress, and that’s a respective of race and ethnicity or geographical location,
[00:21:25] but then you have, when you think about poor children, poor black and brown children and poor native and poor children from indigenous communities who are born into poverty and who suffer from intergenerational poverty and who want to make something of themselves much like Martin wanted to make something of themselves much. Like I’m sure the people that, children who come from less advantage in home environments and neighborhoods that you well have known that you’ve studied, who want to make something of themselves. And yet as they apply themselves, as they work hard, as they try to overcome those obstacles, try to get a decent education.
[00:22:03] in under resourced schools, worry about getting to school safely and getting home safely, who worry about being over policed, who worry about just not being able to realize their dreams for a variety of reasons. My thought then is that if we, as a society could coalesce around an agenda to protect and promote the health and wellbeing about children, and look at that agenda from the point of view of what do we need in the area of housing, what do we need in the area of education?
[00:22:37] Sherman James: What do we need in the area of job training? What do we need in the area of healthcare? What do we need in the area of more effective policing? So we have these different sectors is there a way to bring these different sectors together, to focus on the children of America, to alleviate some of the toxic stress that is undermining their health, that is driving increases in suicide and suicidal ideation.
[00:23:05] The community-based organizations have been in this business, many of them for a long time, but they just haven’t had the help that they need from the corporate world. I would argue from religious institutions. Certainly not from the political institutions. And this is something like this, it seems to me could bring together partners at various levels of government, local state, and federal who could be opposed to, an agenda focused on improving the health of children.
[00:23:32] It seems to me that would be one way to try to get some traction in order to move forward on a number of interlocking issues that cut across sectors and that tap into the agendas, into the portfolios, into the mission statements of these different sectors. so that’s my thought about that question.
[00:23:48] Thomas LaVeist: and I did have one final question. Okay. As you are an accomplished, research scientist and scholar, I’d like you to address the next generation of health equity scholars, what would you say to them? What advice would you give them for how they can pick up the mantle and continue excuse my mixed metaphor here. Continue pushing that Boulder up that hill
[00:24:10] Sherman James: I think, knowledge is power. Knowledge is power, and we will come to know different things only by asking different kinds of questions.
[00:24:18] Sherman James: I was fortunate early in my career to stumble upon a different kind of question, which I pursued for decades. And I was able to do that because I drew on my life experiences. I drew upon what I saw around me, what I understood about the people, who raised me in the larger community. And I received very effective mentoring early in my career, made a huge difference.
[00:24:42] So now we have Tom, as you all know, as the Dean of a major school of public health, we have a more diverse student body than we’ve ever had. we have young people who are bringing in incredibly rich life experiences, global. What a laboratory, what a learning laboratory, right? To learn from each other, where some different questions can be asked.
[00:25:02] Some different questions can be asked that are tailored to the material, the social culture, the economic, the healthcare needs, or specific communities. But at the same time, tell us something really powerful about the human condition. So, we can begin to ask unique kinds of questions, different kinds of questions, exploiting the diversity of backgrounds and life experiences that we now have available to us.
[00:25:27] But when we add them all up, the sum is greater, than the parts, because now we’ll come to understand what it really means to be human. What it means to be human and what it what it will take for more groups that have been historically marginalized to flourish. We won’t get there until we start asking some different kinds of questions. And so the beauty is, as I said, we’re now in a better position than we’ve ever been to start asking some different kinds of questions.
[00:25:48] Thomas LaVeist: Thank you for that, Dr. Sherman, James, thank you so much for this great conversation as always. It’s been a pleasure talking with you and also thank you to our listeners. We hope you found this engaging and we look forward to having you tune in to our next episode.
[00:00:33] Thomas LaVeist: Hello and welcome to the partners for advancing health equity podcast. I’m your host, Thomas LaVeist Dean and Weatherhead presidential chair in health equity at the Tulane University School of Public Health and Tropical Medicine.
[00:00:12] This episode is part of our pathways to health equity series. Here we talk to those on the front lines of health justice. From pioneers in the field to those currently creating path forward, learn how their life experiences have shaped their journeys to health equity. They’re defining contributions and solutions to improve the lives of those impacted by social injustices. This episode is part one of our conversation with Dr. Sherman James, where we discuss his life experiences and how they shape his commitment and work to advance health equity.
[00:01:16] Thomas LaVeist: I’m honored today to introduce our guest, Dr. Sherman James, Dr. James is the Susan B. King distinguished professor emeritus of public policy in the Sanford School of Public Policy at Duke University. Dr. James is among the most impactful health equity scholars and has a point of personal privilege. He’s one of my former professors during his time at the University of Michigan, his research focuses on the social determinants of US racial, ethnic, and socioeconomic disparities of health and healthcare.
[00:01:45] He is the originator of the John Henryism hypothesis, which posits that repeated high effort, coping and chronic stress and economic stressors rooted in systematic racism contributes to the early onset of hypertension and related cardiometabolic diseases and African Americans for more on his career and work. You can follow the link in his bio, on our website. Thank you Sherman for joining us today.
[00:02:10] Sherman James: Thank you Tom. For inviting me
[00:02:12] Thomas LaVeist: Sherman. I’ve known you for many years now. but it occurs to me that I don’t know a lot about your background. where are you from? Where’d you grow up?
[00:02:20] Sherman James: I grew up in a small ,town in rural South Carolina, in the 1950s. And during that time, during my boyhood years, I think the population of the town was maybe 5,000 people, about 2,500 black [00:02:00] folks and 2,500 white folks. I think today it’s now the metropolis of, 7,500 people. so it’s a really small town. It’s located about 70 miles Northeast of Columbia, and about, 40 miles south of the North Carolina South Carolina state line. So really small town. I’m a small town guy.
[00:02:50] Thomas LaVeist: You didn’t say the name of the town what’s the name of it?
[00:02:53] Sherman James: Hartsville. H A R T S V I L L E
[00:02:55] Thomas LaVeist: Hartsville. South Carolina. And your parents, are they also from that area?
[00:02:59] Sherman James: well, my parents grew up, on farms, in and around Hartsville and, so we trace our roots, back to, pre-emancipation, in South Carolina. So generations and generations.
[00:03:09] Thomas LaVeist: So tell me about your journey. So you grew up in Hartsville, South Carolina in the 1950s, and I look at the arc of your life and someone who grew up there and now, what you’ve accomplished. tell me about that. how did you get out of Hartsville? what was the impetus for you to leave and where did you go? What did you do?
[00:03:26] Sherman James: Yeah, well, after graduating from high school in 1960, I attended Talladega college in Talladega, Alabama [00:03:00] Talladega college is an historic black college, founded in 1867 by freed slaves. It’s one of the American missionary association, churches and I attended Talladega from 1960 to 1964.
[00:03:44] I went to Talladega on the advice of the pharmacist that I worked for, in the small town. there was one black pharmacist, one black doctor. One black dentist. And, I worked for the pharmacist as a, you know, do it, everything kind of, uh,guy from the time that I was 12 years of age until I went away to college at almost 17.
[00:04:02] And, the pharmacist went to a historic black college, himself, um, right after world war II, he was a war II veteran, went to Claflin and his math teacher was a graduate of Talladega and he was just so impressed with her. And he knew I was a serious, student myself. And he said, I think you ought to go to Talladega it would be a good place for you.
[00:04:20] So it was on his advice. that I applied to Talladega along with other schools, all historic black colleges and universities at the time after all, this was the late 1950s when I was looking around, for colleges, but [00:04:00] Talladega gave me a full ride and I went there and I spent, really four. Transformative years at Talladega, I should have mentioned that Talladega college is just 50 miles east of Birmingham, Alabama. And I reiterate I was there in near the 1960s.
[00:04:48] Thomas LaVeist: Oh yeah.
[00:04:49] Sherman James: Yeah. So it was a very heavy time to be a, black college student in the south in the early 1960s. one might say in the belly of the beast,
[00:04:58] Thomas LaVeist: Tell us about that. What, anything you want to share about those experiences?
[00:05:02] Sherman James: I went to Talladega with the idea of maybe going into medicine because I hung around these black health professionals, you know as a boy and I looked up to them, I liked what they were doing and I liked the debates that they would have about everything under the sun.
[00:05:15] And that was a kind of a parallel education for me. Because they were worldly men and there were role models for me, but at Talladega, I learned that, I enjoyed social sciences and humanities more than I did. the natural sciences, even though I was a, decent enough student.
[00:05:30] I just really liked the social sciences and the humanities got involved in the theater in music. , and I just enjoyed history. I enjoyed psychology, enjoyed, sociology, the languages, and then wound up majoring in psychology and philosophy. That was my undergraduate major, at Talladega.
[00:05:45] Sherman James: And I was involved in protests and we had our own, city movement and tried to desegregate some of the local churches and so on. And some of us were thrown in jail and some of us were beaten severely. So it was a transformative experience. the civil rights movement had a, had an enormous impact on me.
[00:06:00] And, as I neared graduation, I knew that I wanted to do something, that would enable me to, to carry on, the struggle, for black first class citizenship. because I had plans to go to seminary. Actually, that was something that I had decided I wanted to do because after all, many of the frontline, civil right leaders, were men, who were part of the clergy.
[00:06:20] Of course we often overlooked, the pivotal role that black women played, in the background. But, the black males, Martin Luther king, junior, Ralph Patna and so many others. I admired them. I admired them in the same way, if not more so. And I admired. the black male health professionals, who really, taught me a lot about the larger world, but I decided, in my senior year that I didn’t really want to go to seminary, that I wasn’t sufficiently committed to that as a career path, to do that.
[00:06:45] So I took some time off and, went into the air force, became an air force. Officer spent four years in the air force. This is 1960, early, 1965, early 1969. And of course, everyone, I decided to go into the air force, no one had ever heard of , the Vietnam war occurred after I had been commissioned as a second Lieutenant.
[00:07:03] And there I was, in the military with this, immoral war raging, And I had a crisis of conscious, as you might imagine, based on what I’ve told you about, the kind of person that I was before going into the air force, but managed to get through, those four years in the air force without having to serve in Vietnam.
[00:07:21] Thank God. So, I decided I had to go to graduate school in psychology, went to Washington University in St. Louis got my PhD in psychology with a concentration on personality, social psychology. and that was interesting enough. Tom, but it didn’t really speak to me, in a deep way and to my great good fortune one day out of the blue, I got a call from a chair of a search committee, uh, in the department of epidemiology at the school of public health at University of North Carolina Chapel H Chapel Hill This is late 1972 I’m in my final year. at wash U working on my PhD. And he asked if I might be interested in talking with him about, going to the Chapel Hill to join the epidemiology department, I said, what is epidemiology? And, so he did his best to explain it to me. It was all pretty opaque.
[00:08:04] but the chair of the search committee had spent the first five years of his academic career on the faculty in anthropology at Washington university in St. Louis. So, when the two psychologists that had been on the faculty for a decade, say 1960 to 1972 decamped to Boston, they said, let’s see if we can find, another psychologist to, do what they were doing.
[00:08:25] Sherman James: And so this is the early 1970s and University of North Carolina. Chapel Hill. Is taking baby steps to desegregate the faculty. So they were now looking for black faculty and the chair of the search committee decided that he would call up Washington University, the psychology department to see if there were any black psychologists about to get their degree.
[00:08:45] So yeah, there was this guy, Sherman James. And so they gave him my phone number and he called me up. And as I said, epidemiology, what? he said, come on down, come on. And let’s have a, conversation and see what you’re thinking and you get a chance to look us over.
[00:08:24] And I thought, Chapel Hill, it’s just like three hours from where I grew up. So they wanna fly me down to Chapel Hill, free of charge and wine and dine me. Then I can go see my parents, who am I to refuse such an invitation? okay. I went down to chapel hill and I had no interest whatsoever.
[00:09:13] when I first arrived and the first people that I, spoke to parapsychologists and virologists, and they were talking Greek as far as I was concerned. and I know that, oh yeah, this is just not going to work. The fit is not good. let me just get through this experience. At the end of the first day of the two day visit, I had an interview with John Castle, who is chairman of the department of epidemiology, a world renowned social epidemiologist. I didn’t know any of this because I didn’t do any homework whatsoever. for this visit, he was just giant
[00:09:44] Thomas LaVeist: for the record. You don’t recommend that do you?
[00:09:46] Sherman James: . I don’t recommend that.
[00:09:47] Thomas LaVeist: okay.
[00:09:47] Sherman James: I think you’re going on a job interview. you want to at least find out who the people are, that you might be meeting with. But John Castle was a physician epidemiologist, from South Africa. And when he was in South Africa, he, and a group of other, South African physicians, all white, obviously, provided healthcare to a community of Africans, Zulu nation, basically in, in and around Durban. And in the course of providing healthcare to this community, he became very impressed with the role of culture and how cultural resources.
[00:10:21] Can protect, people when you have, strong social report systems, you have an intact, culture. and then you can weather all kinds of storms, under those conditions. So here they were this group of, south African physicians of trying to provide care to this community of African people.
[00:10:38] As South African apartheid was coming down with both feet on the natives of South Africa, and they could see how this system of political and economic oppression was destroying the culture of the people and making them vulnerable to health issues that historically they had not been vulnerable to.
[00:10:58] So that impressed him, that social and cultural and economic and political, conditions are profoundly. Important in terms of influencing the health of populations and creating vulnerability. It was that vision, that understanding of the role of social conditions, as a, factor in the health of populations that he brought with him to the department of epidemiology at UNC Chapel Hill.
[00:11:23] And that was the story he began to tell me. and he didn’t say it in so many words, but I think one of the reasons why they were especially interested in me was that I grew up in the south. I grew up under American apartheid. So, he knew as he was speaking to me, he knew the circumstances under which I grew up. And at one point he said, I think that someone with
[00:11:45] your background, this is a paraphrase. It’s been many years now. someone with your background could make a real contribution to the work that we were trying to do. Because they had a big project, underway in Georgia, looking at cardiovascular disease, the epidemic of cardiovascular disease in the black population in this county in Georgia.
[00:11:45] And they thought that as the trained social scientist, as a psychologist, I might be able to help them bring, a unique perspective to bear on the work that they were doing. And then at another point, he said, epidemiology is the place where science and social justice come together.
[00:12:14] And boy, I set up on the edge of my chair when he said that, because now he was really speaking to me here I am the project of the early 1960s. Civil rights movement had been searching for a way to bring together my interest in social justice and civil rights and science. And here it was, it fell into my lap.
[00:12:32] Thomas LaVeist: [00:12:00] Yeah.
[00:12:33] Sherman James: I thought to myself. Holy cow. This might be it. This might be the thing that I’ve been looking for. So I was completely different person. The second day of my interview there I was, my ears were wide open. I wanted to learn as much as possible about this thing called epidemiology. And then it was a matter of, thinking through my options.
[00:12:49] So I’ll stopped there, but that was how, , my journey from Hartsville through college, through the air force, through graduate school, led me to the department of epidemiology at UNC Chapel Hill, which is where we had my career.
[00:13:01] Thomas LaVeist: Now, this county in Georgia, this is Evans county. And so from someone who didn’t know what epidemiology was to the president of the S E R that’s some journey.
[00:12:36] Sherman James: it’s been a remarkable journey. Yes.
[00:13:11] Thomas LaVeist: So, if, how would you answer the question? what drives you or what, certainly when you were developing these concepts, like John Henryism, what was the driving force behind that?
[00:12:47] Sherman James: I wanted to do something, that was meaningful, not just meaningful to me, but meaningful, in my own conceptualization of things, meaningful to black people, meaningful to my people. that has always been the driving force, in my life, I wanted to do something to help my people.
[00:13:36] Sherman James: And I wanted to draw upon, what I considered to be my strength. I’ve always been a very curious person. I’ve always been interested in a lot of things. I’m not an activist in the, in the traditional way, you think about that, going out marching.
[00:13:48] I did my fair share in college, but I’m not that kind of leader. I consider myself, a serious academic always was, really a very serious academic interested in, ideas and interested in the application and the implementation of ideas and the service of improving social conditions, and particularly for black people.
[00:14:05] So for me, public health represented an institutional venue where I could do that. was pretty clear to me, as a graduate student in psychology, that I wouldn’t be able to work on this core commitment that I had, to really work on applied issues, on practical issues, on issues that had political and social significance.
[00:14:24] I didn’t feel like that was where I could be me. And so public health turned out was a place where I could be me where I could pursue my intellectual interest. I could pursue a variety of ideas and I could be close to the front line. I could try to generate some knowledge, that could make a difference. and that was really what I wanted to do and dedicated, 43 years, trying to do that in terms of teaching research and. Various kinds of service. So I asked you to, for, an article from the early point in your career and something from later in your career, and I asked this of everyone that we interview, and I’m always curious about the articles that people select.
[00:14:58] Thomas LaVeist: You selected an article that you published in the American journal of public health, 1978. It was an essay. It was an introduction to a special issue of the journal. and the title of the essay was blood pressure and skin color. tell me about that essay why did you select this one to talk about?
[00:15:15] Sherman James: So, it was an invited editorial, which I coauthored with, Senior Conly, Al very famous, epidemiologist physician epidemiologist, who. Who passed? I think in 2007, the editorial was a commentary on an article that was published in the journal. It wasn’t a special issue of the American journal of public health, but it was an article that was, conducted by some researchers at the University of Michigan.
[00:15:42] It turns out, on the role of skin color, dark skin color as a risk factor for high blood pressure in black folks, black men and black women in Detroit, and they also had a sample of whites and they looked at skin color and, variations of skin color among whites and relationship to blood pressure and variations in skin color and blacks, and, the relationship to blood pressure.
[00:16:03] And they found. As a few other, studies had found that the darker, the skin color, the higher, the blood pressure and the, this particular association was stronger, for black men than for black women, it was present in black women, but not quite as strong as it was for black men. And they advanced, an explanation that was a combination of well genetic factors in some poorly understood, psychosocial circumstances.
[00:16:30] Now this is 1978 and, the data that they collected had been collected in,the late 1960s. And university of Michigan group had published a series of articles beginning in the early 1970s probably through the early 1980s on their research in Detroit. And so this one, as I mentioned, focused on skin color, and blood pressure, and they sort of advanced an argument that positive that maybe there was something about melanin concentration that was part of the terocin, melanin biochemical pathway. And they made kind of some superficial comments about racial discrimination and kind of thing.
[00:17:06] Maybe being the real explanation for the darker skin color blood pressure fine, but they didn’t go into much detail. Ola, senior colleague was asked to actually write the editorial, but Al said, I want to invite Sherman, to join me. So the two of us. Together wrote this editorial Al really focusing more on the biological, dimension of it.
[00:17:26] And then I focused on the psychological, the social cultural, the historical significance of skin color, as a risk factor for black folks for African Americans, both in the largest society, but also in terms of social status differentiation within the African American population. noting that, African Americans who were racially mixed even before emancipation, had access to certain privileges that, darker skin enslaved people did not have, access to.
[00:17:55] And certainly with emancipation following emancipation, African Americans of fair skin, a lighter skin color were much better positioned. To take advantage of the quasi freedom that newly freed African Americans had. They were more likely to be literate. They were more likely to have skills.
[00:18:12] and if by will, they probably had more cultural capital just by being closer to the, to the stabling families. So, they were better positioned to, to really take advantage of the narrow and short lived opening that black Americans, had, at going into reconstruction period, and then after the fall of reconstruction.
[00:18:29] Sherman James: So I wanted to tell that story, I wanted to bring that historical perspective to bear, on the researcher’s findings about why dark skin color might, put African Americans those so exposed to those with that particular characteristic at a high risk, because of the discrimination.
[00:18:46] that they were faced with the denial of access to these critical social and material resources and that the struggle to overcome those disadvantages could have, a in deleterious impact on their cardiovascular health, as indicated by a higher risk of high blood pressure, that there will be physiological consequences of having to, work so hard to acquire, material and social resources that would enable you to, to get ahead in life if not to survive itself.
[00:19:18] Sherman James: So this chronic struggle with difficult circumstances in the midst of all kinds of uncertainty, could have a deleterious impact and that darker skin, African Americans would be more subjected to these kinds of pressures and obstacles. than those who were fair skin. so it gave me a chance then to, because I had a pretty strong liberal arts education, it enabled me to kind of really draw on history, draw on psychology, draw on culture, and bringing that perspective to bear, on this, particular paper, which otherwise, would’ve just fueled the then dominant point of view that the problem with high blood pressure and African Americans is pretty much about genes.
[00:19:54] Yeah. those African genes are just, kicking in and wreaking havoc with the cardiovascular system of black folks. And I was thinking, let’s look at it historically, understand where this comes from and why darker skin, African Americans, are so much more disadvantage arguably than any other group in the United States with a possibly exception of native Americans. But. That potential exception, darkest skin, African Americans are just faced with so many more obstacles, so many more barriers, so much more stigma. And I wanted to interrogate those findings from that point of view.
[00:20:26] Thomas LaVeist: your interest in the humanities certainly came through in that essay. It’s I think it’s a beautifully written essay and I’d like to recommend anyone who’s interested in just seeing some excellent scholarship to take a look at that essay. As I think it covers a lot of ground, especially considering when it was published. I think the ideas in this article have become pretty commonplace now but back then, it was not at all commonplace to talk about, how slavery, and how, Jim Crow and how the entire history of this country, as it relates to race, ultimately, coexist s within the body of human beings, today.
[00:21:01] but at that time, this was quite a radical idea. I get this question a lot from people, writing about these topics back at that point, back in the eighties, you were doing this in the seventies. Tell me what that was like. And what kind of reaction did you get from colleagues and from others?
[00:21:16] Chapel Hill was a very interesting place at that time. and, I guess the short answer, Tom is, a lot of compliments. , that’s a short answer. , I had a lot of support from the senior faculty.
[00:21:26] Sherman James: I was the first black professor to be hired in that school of public health, on the tenure track. And the first black American to become a full professor, in the school of public health at chapel hill. As I look back on it, I don’t recall getting any, at least to my face, push back on that, but the essay, the editorial was coauthored by one of the most prestigious, epidemiologists in the country.
[00:21:45] Thomas LaVeist: Yeah.
[00:21:46] Sherman James: So the fact that he was a co-signer, to the, to these ideas, I think, provided me a bit of protection that I might not have otherwise had.
[00:21:53] Thomas LaVeist: Yeah. I think that’s an interesting thing, that he basically used his privilege to, to help bolster your voice in bringing that out. I think that’s really, really meaningful and really impactful about how people can be allies and help support this work.
[00:22:07] Thank you for that, Dr. Sherman, James, thank you so much for this great conversation as always. We hope you found this engaging and we look forward to having you tune in to our next episode.
[00:00:33] Thomas LaVeist: Welcome, everyone thanks for joining us so, some of you have talked about the pandemic and obviously the pandemic has, un earth much maybe too many of us maybe it didn’t unearth much of anything, but for a lot of people it has unearthed things that we have been talking about for many years, and as a result, health equity is much more prominent and getting much more attention, because of the realities of where we are, how do we make the best use of this moment?
How do we ensure that we take this opportunity where there is a focus on health equity among people? Unlike those of us in this conversation, who’ve been doing this, basically our entire adult lives, people who have not been focused are now paying attention, now that we’ve got their attention, what do we want to say?
[00:01:11] Sinsi Hernández-Cancio: I think this connects very much with the point about what is our theory of change, right? cause this is not about moral outrage. This is not that doesn’t move people. it’s about their self-interest and when it comes to individuals, and it’s also very much about, creating, the money narrative and so people really finally saw what it means when, the people that provide their services aren’t available. What it means when, people in your community, people who go to school with your kids, don’t have access to care, don’t have access to vaccines. Where there’s no infrastructure, needed to be able to address these challenges, what it means to not be able to go to the hospital. Not because you can’t afford it, but because there’s no space, right? So, I think we have an opportunity to connect, where people are feeling a bit raw. About what’s actually needed for the common good for the economy to move forward. I think that there’s limitations to that because as long as we are only talking about It’s your own enlightened self-interest, we’re still gonna miss a lot of people and at the end of the day, you can all really political decisions. And I think that, my brother, from another mother or Daniel Dawes’ work on the political determinants of health or something that it’s really important for us to think about that. There’s an opportunity now for people who are a bit outraged to think about, okay, how do I make that more than just. Pearl clutching and being upset, and channel that into something more productive.
[00:02:30] Al Richmond: just wanted to just pick up. with Cara’s has point about, intersectionality. And I was saying that my background and training is in social work, and I would actually envision systems where people are working across, disciplines and if there’s anything that, in tying it back to your, recent question is to get people to work together across these disciplines and I think it means we’re have to retrain ourselves such that we’re not looking At things in the past a great session I went to was by Kimberle Crenshaw when she talked about the intersectionality of disciplines. And I said it critical race theory, and it really brought home the point that every discipline has contributed to inequities in this country. And as long as we see that in kind of siloed approaches, then we’ll just think of it just like that. This is an issue of, for social work or medicine or public health. And I’m hoping that going forward, that we’ll see less of that, where we’ll see people as whole, whole beings made up of different parts of them. As a result of that, we will begin to develop policies and practices that really acknowledge, them is just being just that and that what their needs are, our collective needs are to be seen. In a way that respects and honors who we are in our totality.
[00:03:47] Thomas LaVeist: Yeah. The way I like to talk about that is that there are any really important problem is too complex for any one discipline. I think that the Covid response in the previous administration demonstrated that with their, operation warp speed, which is an outrageously unfortunate name for an effort to create a vaccine, focusing on the speed rather than the care it’s being taken to create a quality vaccine.
But the focus there was on creating the vaccine and of course, vaccines will do nothing for a pandemic. It’s the vaccination that matters. And you need much more than virologists to get vaccines. You need virologists to get a vaccine, but you need much more to get a vaccination. And so, the focus on the virology and ignoring the communication science, the sociology, the anthropology, the psychology, all of which has turned out to be, perhaps even more important, is why we didn’t really get the progress that we were hoping to get with the creation of the new vaccine. So, you’re right. The important problems are too important for anyone discipline.
[00:04:49] Cara James: I think you bring up a really important point that is going to be with us. Going forward is narrative information, misinformation and distrust. Those are here to stay, for the foreseeable future. And we need to be taking those into account. And I think what health equity needs in terms of this moment and making sure we need more time, because people are thinking about this as a 30, 60, 90 day, or, here we are two years later, haven’t we solved the equity issues and we’re done with it.
We can move on. That is not the case because these things are things that took decades and centuries to happen, and they’re not going to be teared down overnight. This is a window of opportunity that we have, and we need to prop that window open so that we can actually get some of the work that’s needed done.
And I think narrative change and how we talk about, the inequities, the causes of those is important because And I’m not going to get into the right or wrong of this. We’ve rammed health equity down and racial equity down people’s throats for the last couple of years, which means that people who are sitting on the sides, angry feeling like it’s costing me to do this. We have to bring more people into the conversation and kind of use that community-based participatory model of meeting people where they are so they can enter that equity continuum and move forward. because we are really polarized as a country. Everything is political. But we need to have that narrative change that we own the narrative, because that’s another thing that there are a lot of people who are coming into this space, creating narrative, and getting credit, or, props for narratives and things that they may not be as, expert in and we need to own that narrative and prop that window open so that we can continue the work that needs to be done, because this is going to take us a generation decade.
[00:06:31] Sharrelle Barber: I actually really appreciate that idea of time. And in fact, what I was thinking about, in response to, these inequities have been, created over centuries. I think time is important, but it’s also, what does it mean to build collective power in this moment as well? we don’t move systems and structures or even policies without creating and leveraging power. And so, what does it mean in this moment when literally we are in an existential crisis of humanity?
Climate crisis health crises, all of these things. And so we, tip toe around, the tulips or if we don’t, really think boldly and audaciously in this moment, what other moment will we have when so much of the veil has been lifted? And so, in this moment, I think, it’s important that we think about power and I would say, we think about politics, but not in the normal partisan, Republican Democrat left. Right? But the distribution of resources is fundamentally wrapped up in, issues of power and issues of who gets to control the things that, should be, of common good.
And I think as much as this moment calls for some of the technical kinds of questions around, what we do and what solutions, what is our imagination for this moment? Like literally what we’ve experienced and are still experience requires really kind of a bold and a radical imagination about what would be.
And if we lean into that imagination in this moment, what could we create collectively together? And so, I think there’s a power in this. Open moment. I feel like we need to push the door open because my ancestors, our ancestors didn’t, die, give blood, sweat, and tears for us to come to a moment like this, where we have so many resources.
And we just, we failed to be bold in how we, act in this moment, the last thing I’ll say I was on another call earlier today. And a space of being aspirational, what does it mean to be a good ancestor? Because what we’re doing today is actually it may change some of the things, but it is actually more about future generations. So what is it in this moment in 2022, when we’ve endured a pandemic? What we’ve seen so many instances of state sanctioned violence when climate change is, really threatening our future, what does it mean to be good ancestors to generations. down the road? And I think that’s where we have to be in this moment if we’re going to really push the door open.
[00:08:52] Thomas LaVeist: So, you talked about power and, so I’m making an assumption based on what you said. At least my thinking of it is that by power, you’re talking about, who controls resources, right? Who gets to determine who gets, what is that? What you’re referring to
[00:09:04] Sharrelle Barber: That is one aspect of power, right? that’s asking who controls, who gets to make decisions, et cetera. But there’s also this collective power that we’ve seen throughout history of movements really, of the folks who decide that in a moment in history that we’re not going to accept the status quo. And so, the power that I think we can leverage in this moment is the collective power of movements. Some of the work that we’re doing within the context of the Ubuntu Center. Leaning into what movements teach us about how change actually happens, actual transformational change, right? We know that the civil rights movement led to, fundamental changes that shifted how this country operates.
We know that there have been movements around the globe have done the same thing. have we gotten everything? Absolutely not. But we are coming into about a decade of movement building through the movement for black lives and other movements that has. Us to think about these systematically, these structures, these fundamental causes of health in different ways and I think we need to sit with what we’ve been taught and what we’ve learned over this past even decade. So think about how do we leverage that to move us forward. because the things we need to change are just that. Big. There’s just that large. And, and so I think that we have to be thinking about, how do we build power? What does that look like? and how do we lean into the insights of social movements to do that work?
[00:10:21] Thomas LaVeist: I think that’s an excellent segue, to talking about the collaborative that we’re trying to form. So, we’re forming this collaborative. The idea was. a health equity, as someone pointed out previously in compensation, health equity, we’ve beat people over the head with it.
And it’s a thing that people at least if nothing else, they know what to thing. I may not agree, but it even exists, but they know there’s this thing out there called health equity. And we’re putting a lot of resources Into it and people from many different sectors, I’ve been doing stuff. and, almost like craps and see, but they doing stuff, So you’ve got people in the private sector, doing stuff, people in the public sector, community organizations, communities, universities, researchers, all of that. And everyone’s off doing their own thing and being driven by their own set of incentives. I guess that’s motivating the action. How do we create more synergy across these sectors? How do we get people to come together and work in a more coordinated fashion? Presumably that coordination would lead to more progress. Any thoughts about that?
[00:11:17] Cara James: I think a couple of things. So one, and this is something that we’ve spent some time at, Grant Makers in Health to use a radar analogy, a lot of dots coming up on the radar that we’re trying to connect in terms of exactly what you’re just saying. I think one of the things is a little bit of an ask that I would say for those who may be entering the space a little bit newer is to just stop and ask yourself who’s in this space, even in your local area. who’s been doing this and try and reach out. I talked a little bit about this and couple of years ago, entering the space with cultural humility.
and understanding what’s already been there, what the landscape looks like. I think the other piece that we need is a common roadmap. and so, what is the roadmap to move us forward in this space? Are there are three to five things that we could all work on that would help to move progress and working at different levels to help us move forward. So I think what that roadmap looks like. That can get us going there. so that we’re all swimming in the same direction, if you will. and then lastly, I think that we do need to think big and think about the structural changes that we need to be making and pushing on those at, what we need to have from a policy standpoint to bake this in stainable as we move forward. And the last thing I would say is we need to have a lot more conversation, attention and focus on the pathways that we are, not focused on to create. The future workforce and communities that we need. People have hired however many diversity officers; equity officers want to diversify their boards.
There just aren’t enough, bodies across all of the populations. If we aren’t focusing on increasing college graduation rates for communities of color and thinking about how we’re developing our healthcare education, government law, business, science, tech, whatever workforce, so that it looks like our communities and that is not work that’s going to be happening overnight again, but we need to have a lot more conversation about pathways and how we’re creating more pathways for people to get through. They’re living their fullest potential, which obviously has economic income, outcomes and reduces disparities.
[00:13:30] Sinsi Hernández-Cancio: Yeah, I want to double down on what Cara saying about the need for a roadmap because we’re past the time when we need, people to stop thinking about these equities, like the weather, like something that just happens. Although we also know that the weather then just happened, that we actually influenced the weather, but these are decisions, Decisions that have been made. And part of the roadmap, I think, needs to be giving people, not just people who think that themselves equity experts, but everyone kind of tools to help disrupt the standard operating procedure and asking the right questions, like who is not at this table, and we at the partnership recently put together a tool that actually looks at both in terms of research development and policy development, implementation at different stages. What are questions to ask to stop for a minute, pause and say, “Am I asking the right question here, or am I asking the wrong question?”
And so much of it has to do with surfacing issues and especially with going to the people who are the actual experts, who are the people with the lived experience. and so having a roadmap that is not so much about, this is what you do in healthcare, this is what you do in. Education, but these are the right questions to ask, to interrogate the structures underneath and to design changes to the structures. Those are the kinds of things that, I think will be really useful and you don’t have to become a DEI expert to be able to use it. Because that’s the other thing, as Cara said, there are just not enough of us to go around right now. so those are kind of my initial thoughts on how we could work together in one direction.
[00:14:57] Thomas LaVeist: It seems to me that the gatekeepers of who gets to be a part of these different sectors and disciplines is critical here. and typically, that’s university that’s who trains people to be lawyers or physicians or public health researchers or nurses and so forth and so on. what’s the role of universities? And how do we change universities to produce people that are thinking more along the lines of what we’re talking about in this conversation?
[00:15:20] Al Richmond: I think academic institutions have to start early. this whole idea of pipelines, I’m a bit, little kind of annoyed with that term in some ways, because, I remember years ago growing up, black and North Carolina. And there was this one day when we would have this critical mass of African American leaders and to feel all these positions and I’ve still been waiting on that day to happen. And it just hasn’t. And it’s unfortunate and not think so. The role of academic institutions for me, community campus partnerships for health is really to forge real partnerships with the community around educating young people, starting even at K through 12 work. That’s what I’m looking for. Academic institutions to do to me if you wait until.
The freshman year, it’s almost too late. Quite frankly. I think it has to be very much upstream. It requires, kind of tearing down the walls and working in communities like Tulane really immersing itself in New Orleans and every academic institutions. And I want to bring attention to even the role of historical black colleges and universities, the important role that they must have in other minority serving institutions to start early.
So I’ve been sitting here thinking about this nationalized approach, and I think that. There has to be an academic approach to some of these issues, but it really requires them to think, A lot about how they intersect with their own local communities and supporting the education and the development of the bright, smart minds around them every day, the children of the people that work in the basement, the children of the people that are nurses assistants at healthcare systems, all of that, if they could think about that and approach it from that perspective? I think that would actually, actually served a garner, a lot of good will in the community and address some of the more systemic issues that we see. In fact, the communities where we have some of the largest universities in the world in the U S are some of the poorest most resource limited, communities and that really should not be.
[00:17:21] Sharrelle Barber: I can completely agree with Al, academic universities are part of the community. they pull the workforce from the community and it’s not just the professors, but the people who are working in the dining halls and all of those places, and it behooves them. as well as others.
And I think it is again, changing our mindset. And I can’t remember it as if it was you or, Al talked about our immediate kind of gratification and thinking about ourselves and what’s best for us, but we need a less centered approach and a more. Holistic approach to this because it does serve all of us getting earlier into community, developing those relationships, helping kids to see that there is a pathway for them to go to whatever it is that they want to do to fulfill their dreams, and providing some of those resources and those needs. I think that we talk about, income inequality in this country. And I heard today something about, we’re going to do this for those where 600% over the federal poverty level. Most people other than those on this call, maybe have no idea what the federal poverty level is. And we need to talk about it in language that resonates with people to say that if you are an individual who’s living on $13,000 or $14,000, you’re not considered poor in this country, but you’re not going to college given the cost of college today. Any, community college or whatever the training may be afterwards. So thinking about how we do that, the same way that we’re putting in together, the focus in hospitals with their, community and health assessment, community needs assessments, and pushing them into community. All of our big institutions, health systems hospital. Academic universities and colleges are part of the community and need to be thinking about how they’re working with community to support it because it benefits everybody.
[00:19:05] Thomas LaVeist: Okay. Now on that note, I see we’re running low on time, and I wanted to, thank you for this fascinating conversation. We touched on many topics and many issues that are precisely the reason that we’ve created this learning collaborative. And hopefully as we continue to have these conversations where we able to put some meat on the bones and get down to the brass tax of how we actually enact some of these policies.
So, thank you for sharing your thoughts and wisdom on these topics. And we hope that you found this time productive and that you join us as we continue our collaborative learning through a calendar of activities.
Please become a part of the process. Visit our website for information on P for H, G and upcoming events. How to become a member and follow us on social media. We’d love to hear how you think about health equity.
Thank you for joining us, looking forward to continuing the conversation
[00:00:33] Thomas LaVeist: Welcome everyone. Thank you for joining us We have a panel of speakers from across a spectrum of sectors shaping health equity. The panel will feature Sinsi Hernández-Cancio, Cara James and Al Richmond who will offer their perspectives on how they think about and address health equity. Sharelle Barber is Director of The Ubuntu Center for Racism, Global Movements and Population Health Equity at Drexel University. Sinsi Hernández-Cancio, Vice President for Health Justice at the National Partnership for Women and Families
[00:00:52] Cara James is president and CEO at Grantmakers in Health, and Al Richmond is Executive Director at the Community-Campus Partnerships for Health. Welcome all to this conversation. I’d like to make this a free-flowing discussion. So please feel free to chime in with your comments and insights. research, and advocacy to promote equity.
[00:01:12] For most of its history has focused on proving what people already know through their lived experience, that their discrimination that services aren’t available or affordable, communities are being polluted or schools don’t have resources just to name a few. Where do you think research in the past has failed?
[00:01:28] Cara James: First of all, thank you, Tom and Tulane for hosting this conversation, I’m excited to be joined by such illustrious panelists for this conversation. And I think, one, there’s been a lot of work on health equity and health inequities, over decades and lots of people have been responsible for this work, including yourself.
[00:01:46] I don’t want to say that the work has failed so much as I think one of the places that we have maybe relied a little too much on is the moral suasion argument. That if we show these inequities that we would get the change that we need. And I think that is clearly not happened. So I think there may be the premise of what it takes to our theory of change is one of the things that we may need to focus on and I would say that where we need to do more work is, again, thinking about a paper that you have. 2009, looking at that economic cost, tying this to the money, to the things and the outcomes that people with the money care about, and how we make that business case for health equity or some of the places where I think we need to focus more of our attention and look less maybe for that moral suasion argument.
[00:02:32] Sinsi Hernández-Cancio: I would a hundred percent agree with, care the assessment. It’s very, when I don’t agree with Cara, just to be honest. thank you so much. Dr. LaVeist for inviting me to this panel, and to be in community with, so many excellent, leaders in this field. I think the other place that, I don’t want to say it’s a failure, but I think it’s, surely an area of growth is, that we have gone from. Thinking about inequities and disparities, from black, white to black, white, and other. And I think that a lot of the work that people are really leaning into now more is dis-aggregating it out, right? and getting rid of that horrible other category, because in addition to it being dehumanizing, it’s simply not helpful, from an analytical perspective.
I think that one of the biggest challenges, from the model of healthcare, having to be, a wealth generating activity, as opposed to the health generating activity, is the fact that we just don’t have solid data, that will not only allow us to target resources and interventions in ways, that are most needed, but also.
[00:03:42] Sinsi Hernández-Cancio: That promote the kind of accountability that we really need to hold. the political and economic systems accountable, one, we have to measure what we treasure, and we don’t measure right. Another way of thinking about this as you don’t count unless you’re counted and that’s something that I think we all need to lean into more, and we have an opportunity now with the way that COVID has elevated, how particular communities are doing, to build on that momentum, hopefully, so that we can get to better data systems that are more transparent and equitable.
[00:04:14] Thomas LaVeist: Yeah, thank you for that. And since he please just call me Thomas, Al you looked like you wanted to weigh in.
Al Richmond: Yeah, I think there’s some consensus among all of us around some of shortcomings of research. And actually, I would just weigh in by saying, I think there’s been an over-reliance on research quite frankly. And, what comes to mind is, this whole idea, that knowledge production in and of itself actually validates. inequities when it’s really, to me, the lived experiences, people have been saying this for years. How much more research do we really need? and how many more dollars do we need to spend in the area of research at the federal local level to really, bring home the case that there are inequities, they are real, and they are systemic in nature.
And some of my concerns as a project out of Chicago, I’m going to paraphrase a title as a, why am I always being researched where, African Americans in particular, Chicago are saying, why are you always researching me? what good does this research do? we know that there are problems I think it’s the shortcoming of over-reliance on research. Sharelle what do you think we’ve talked a lot about these issues. I would love to know what you’re thinking there.
[00:05:20] Sharrelle Barber: Yeah, no, I think that’s a actually right on, and I think that it’s also been on a lot of research on the problems and not on the solutions.
So we have focused, and it was necessary, right. To, document the inequities. But I think that one. Almost over relied on looking at the pain and that appreciating the power of communities that have been harmed by these systems and structures of oppression. and also, not recognize the ways in which communities who have been most harmed have come up with solutions, pretty powerful ones in the face of this great harm. And the pandemic is a prime example of that. You saw at the very onset of the pandemic when local state and national government failed communities. It was communities who came to the aid, to help with food and here in Philadelphia, we had the black doctors COVID consortium who was testing and, providing vaccinations, and off of little funding, but they saw a need they developed a solution. They executed that solution, and it is a story of how you can look at the inequities, but then act not just sit on the data, sit on the quote, unquote knowledge production. So, I do agree out that this idea of, communities are tired of being researched. They’re ready to get to the solutions. And I think in fact, those who have been most harmed by these systems and structures. Our prime to be some of those solution generators
[00:06:47] Al Richmond: I was just going to say, I think that, as I listen to Sharelle, it’s like there’s almost a paternalistic, attitude around research, right? It’s like we know best, and we’re going to tell you what’s best and our research is going to document it. And we’re going to tell you the way forward. And so, for me, I just been thinking about how much more research do we need around. I remember some of these projects that have gotten funded around, increasing physical activity among African American women without even looking at what are some of the challenges and barriers that women may face every day.
They may not be exercising simply because they’re working from 8:00 AM to 11:00 PM at night. and so, what are they going to exercise? yeah, again, it’s this paternalistic attitude around research and it’s not real until the research says that it’s real.
[00:07:28] Cara James: And what I want to tease out a little of a dichotomy that I think we’re talking about, there’s the, how we do the research and there’s the actual research. One of the things, so for eight years, I sat at the director of the office of minority health at the centers for Medicare and Medicaid services, the research is critical because we can’t make policy on antidote. And even though we know there are problems and I would say health equity research in particular has a higher bar for action in part because people use that as a way to not do things. So we need the evidence and as much as it’s, in a frustrating, in terms of documenting, we still need that national health care disparities report to show that 20 years later, 95% of the disparities have largely remained unchanged because without that evidence, we can’t move forward.
But I think what Sharelle and Al you guys are talking about really is the, how we do the research, what we’re focusing on and what’s needed to move it because the evidence alone doesn’t make for action. But I think there’s still that kind of conversation of there are some who still are not believing that there are disparities or believe that they are the result of, whatever over there, and that’s not what we need, but to your point, as well as thinking about this from an asset driven perspective, rather than a deficit model is really important, but we need the research focusing on the solution so we can see how to expand those, to move forward.
[00:08:52] Sinsi Hernández-Cancio: Yeah. And I want to add to that because. It’s not a question I believe we need the research, on solutions like people have said, we need to hold, those, that fund research in general, especially health systems research and medical research, straight up, more accountable for actually, focusing on equity right in my opinion, there should be no program out of the federal government or out of any university that is allowed to report without desegregated data, right? Because we don’t care just about the average outcomes, the distribution of outcomes matters. And as long as we don’t hone in on that, we’re not going to make progress. But the other thing is. I think that it’s true that for many things that are completely inappropriate, we’re tired of being researched, but there’s also things that we are not researching.
Like I as a Puerto Rican woman who almost died giving birth, am really frustrated the last time, maternal health outcomes, where research in any particular way, knowing that these inequities exist, what’s 15 years ago. lumping us in with the rest of the Latinas doesn’t work because. Our experiences of the community, which we know exist when you look at Boston or when you look at New York city or, some specific areas get completely diluted out when you lump us into everyone else.
And let’s not even talk about the huge differences in the API communities and the fact that small sample size is constantly gets in the way when we try to look at indigenous communities. So, I’m a believer of research. I do believe that research is not the only thing though. You need to have as an advocate, because more than anything, I’m not a researcher.
[00:10:23] I’m an advocate. We need to have the one, two punch of the facts and the story. The egghead stuff, the wonky stuff, and the heartstrings, what it means to real people stuff. And that’s how we win. and the last thing I’ll say, because I’m getting a little bit animated here because the things animate me, is that we already know that, there’s been a lot of work in the last several years, trying to get more diverse, people in research, right in medical research, which has been a challenge for very good reasons. we don’t have, we like to talk about evidence-based medicine, but you know what medicine, first of all is 50% art and not science. And that’s what the national academy of medicine says. I’m not making that up. and number two, it was generated on whose body then whose experiences not on mine. and we take it on faith that whatever works for a white man is going to work the same way for everyone else. sometimes that’s true. Sometimes it’s not, but we don’t know. We are mostly guessing, and we need to do better than that. We need to be transparent about that.
[00:12:23] Thomas LaVeist: Let me push you a little bit on that. So doesn’t that create a mixed message. On the one hand, we’re saying there’s enough research. We don’t need more research as a group in Chicago saying they don’t want to be resourced anymore. On the other hand, you’re pointing out that much of what we do in the health sciences is the result of research done on white males that were extrapolate to everyone else.
[00:11:42] Sinsi Hernández-Cancio: So my answer is that it depends again on how the research is constructed and who, and what you’re researching. I don’t think we need to research anymore as much on identifying problems because we know they are other than what Cara was saying, where we need to continue to document to build the evidence because I’m a lawyer by training. So, I do think about evidence, to building the evidence base, for continued action.
Not that a problem exists, but the why of the problem is what we really need. we need people to understand that it’s not because we make crappy choices. I’m sorry. I should not speak with that kind of language that, we make bad choices, but it’s about what is out there? What are the choices to be made and research like what happens with weathering and the links that you were telling me, yours, and all of that is really compelling. but at the same time, even though we know, for example, the asthma albuterol does not work very well for black and Puerto Rican people. I want to know where the research is developing drugs that are going to be better for black and Puerto Rican people.
Because we have disparities in death rates. And there’s no good reason other than that, we haven’t done a good job in creating solutions and for people in this country to be dying of asthma. So that’s a lot more nuanced than don’t research me or I’m tired of the research. It’s who, what, and for what purpose? And are we looking for problems? Are we just that we know already exist, and wasting money and resources that way? Or are we looking for solutions? and what solutions actually work with whom?
[00:12:59] Thomas LaVeist So, Sharelle, would you like to respond to that.
[00:13:03] Sharrelle Barber: one of the things that I actually really appreciated your point about the, how these inequities came to be, because I do think there’s a lack of work that has really, fully engaged the complexity of these issues. say, you all talked about this idea that, health is produced because of these intersecting inequities, these intersecting systems of oppression.
And we have not done. I think the extensive work to think about how this, historically this plays out. How these, structures and institutions connect to one another and reproduce and create the inequities that we do. See. That’s actually something that I don’t think we’ve done enough of fact, if we can understand how we got here, it may produce evidence that it’s helpful for thinking about how we undo these things.
So we’ve built this system, this nation, this world that we currently live in that has produced the, staggering inequities on so many different health outcomes. And so how do we rebuild it? We don’t know how to rebuild it unless you understand how we got here.
And I think this pandemic has been an inflection point that really showed that interconnectedness, for example, we could have done all the testing, et cetera, early on in a pandemic. But if you didn’t think about workers, if you didn’t think about essential workers, if you didn’t think about what that meant for transportation, especially when folks were staying home.
If we didn’t think about, all of these policies, they were disparate policies, but that were coming into focus. During a public health crisis, and so to focus only on one aspect of the problem actually did not solve or didn’t, mitigate inequities. And so that’s where I think a really a good, nice, sweet spot is, to understand the complexity and really deal seriously with the complexity of these issues.
[00:14:39] Thomas LaVeist: So Cara, I want to follow up with something you said earlier that I thought was really interesting. You alluded to the work that, I had done some years ago on the economic burden of health inequities. I should say it, this is a little plug that we are coming out with a new and updated report this year. So we’ll have new numbers later this year yeah, I’ll send you a percentage of my zero that I get for that study. but you made a comment. You said that we need a new theory of change. And I thought that really resonated with me because it was early 1960s when the surgeon general, indicated that smoking was a carcinogen.
And now here we are nearly 60 years later and people are still smoking. So one thing that has been abundantly clear is that simply informing people. of things is not going to lead to change. And you said that we need a new theory of change. Say more about that? what do you think would be the components of this new theory of change if just informing people’s is not enough.
[00:15:30] Cara James: Yeah, I think it’s a great question. So, I think that the theory of change that I think we have had for many years in health equity, is that again, if we showed the inequities. People would work to address them. I think that is false. we are in a space now where more people clearly are committed to addressing these issues, but we do have a lot of folks who are not and are really just what I would say biding their time before we move on to the next bright, shiny object and go back to the way things were.
So, I think that part of what we need in this theory of change. Thinking about, and I like to say that we, for all of the things that Sharrelle just said, we need to be looking at the intersection of all of these issues for too long, we have thought about these in silos. Healthcare is in this silo. Education is in this silo, income. As in that silo, they clearly have been linked all along. We all knew, but I will say some others have recently woken up to that and that we need to have more of that intersectionality in our approach. And the way that we’re going to address the disparities, no one sector, academia, business education, healthcare is going to fix these.
So we all have to work together and strengthen the partnerships, many of which are already happening in community. But have these partnerships happen at a higher level, which means when we think about. What moves people? I think about a project that was looking at readmissions and a collaboration between the health system and the community development corporation up in Pennsylvania.
And they showed that they reduced hospital readmissions, ed visits for those. Who had frequent visits, but that wasn’t the outcome that the community development corporation needed to be able to show success. So how do we get more bilingual and multilingual to talk to business, to talk to education, to show outcomes in the ways that help them, continue investments or strengthened investments to move forward given this intersection. I think the other piece, and I’m going to the intersectionality. We do have data gaps. we do not have great data for a lot of those root causes that we think about. We don’t have great data on a culturation. We don’t have great data linking immigration and other pieces.
[00:17:42] And we have, as Sharrelle mentioned, we need to make some of those linkages clear between how do you get from. and the example, I will use Medicaid policy and payment to inequities and access and quality and disparities that we see because, it’s very clear. Medicaid pays a doctor less than Medicare who pays doctors less than commercial for the same thing. I think we all can agree. That is an inequity, a structural inequity that is in our system. And because of the other intersections that we have with income, disproportionately affects people of color. so how do we get better data and linkages to make that conversation more relevant and present to people are some of the things that I think we need.
And I think again, Sinsi says, she shouldn’t say crap, I’m going to use the reference, biggie. It’s all about the Benjamins baby. You’ve got to get to the money because that’s what people are focusing on and caring about for those who are holding the purse strings for the big programs.
And we need to be thinking about how we build equity into our policy programs for sustainability. So, we don’t need a special initiative or a special grant or some charismatic leader at the top. Who’s driving it.
[00:00:00] Thomas LaVeist: Welcome everyone. Thank you for joining us my name is Thomas LaVeist. I’m Dean and Weather head presidential chair in Health Equity at the Tulane University School of Public Health and Tropical Medicine we acknowledge that the land on which New Orleans is cited as Balbancha, a Choctaw word, meaning a place of other languages.
[00:00:17] And we honor generations past and present of the several tribes who live in this region. Today we are presenting many voices, one goal. Next steps, advancing health equity, the inaugural webinar of Partners for Advancing Health Equity led by the Tulane Institute for Innovations and Health Equity at the Tulane School of Public Health and Tropical Medicine and supported by a grant from the Robert Wood Johnson Foundation.
[00:00:40] P4HE is a national learning collaborative of scholars, funders, government, community members, and private sector representatives working together to understand the latest issues related to obtaining health. P4HE seeks to foster synergy across sectors and align efforts to create priorities for research, to address obstacles, to health equity today’s event marks the start of a series of participant driven initiatives with the goal of bringing health, equity stakeholders of all sectors to the table to build an actionable and sustainable solutions.
[00:01:14] So what’s different about this approach. We want to break down silos and bring into conversation. People from academia, philanthropy, government, the private sector, and community leaders to build a national dialogue to advance the way that we conduct research to bring about health equity.
[00:01:31] Our program today includes a section designed to further explain our approach to achieving health equity led by our associate director. Andrew Anderson.
[00:01:57] We love for you to gauge in this conversation. So please share your thoughts on Twitter by using our hashtag partners for health equity, that’s partners, the number 4. The letter is H and E. Now please welcome Andrew Anderson associate director of Partners for Advancing Health Equity, and assistant professor in the Tulane University School of Public Health and Tropical Medicine.
[00:02:18] Andrew Anderson: Thank you everyone. so, we want to first start by painting a picture of where we are and where we hope to go the call to address health inequities.
[00:02:34] Isn’t new. This learning collaborative is joining a long tradition of people who aren’t satisfied with the status quo. We know health inequities are morally wrong because they represent injustice. They also exist in stark contradiction to our ethical principles. The failure to live up to these principles has been brought to life through activism and documented through lived experiences and scholarship. For many decades, health equity research has been chronically underfunded and has rarely received the attention it deserves, but we’re currently living through a time where the attention to health inequity has arguably never been greater.
[00:03:08] And the solutions lay in targeted investment, policies, and programs that go well beyond public health and health care. We as people who are dedicated to this work have come together to advance these solutions. And we know that it will require approaches that recognize the interconnectedness of social issues.
[00:03:25] The pandemic has once again, surfaced the need for access to basic resources for people to live with dignity and thrive in response to the pandemic emergency measures were provided. But when the emergency relief ends millions of people, including millions of children may lose these needed resources.
[00:03:44] Funding for policing is increasing in cities across the U S yet homelessness and food insecurity is on the rise. Wealth inequality is increasing as our depths of despair. We know necessities like access to food and housing and safe places to live directly impact health. But there are many other factors, including non-health policies and programs that can indirectly impact health.
[00:04:06] And some of those are currently under. Over the past decade, the Supreme court through several decision has weakened the voting rights act, which is responsible for ensuring the right to vote, especially for black Americans. And we should spend some time really fitting with this reality because it’s so fundamental to the success of health, equity work and democracy.
[00:04:24] Generally, gerrymandering is rampant and unchecked. Now the Supreme court will debate the need for affirmative action and many think this practice will end. Reproductive rights are on the chopping block. Our system of immigration and asylum unfairly privileges, some groups over others. These issues may seem distant to some but are in fact tied to many of the solutions that we need for addressing health inequities.
[00:04:46] And it’s more than just politics. We too often ignore our shared humanity and faith with people throughout the world. We’ve seen corporations and many of which have questionable business models and practices stepping in laudably, but inadequately to fill large gaps in our public safety net.
[00:05:02] Yet we see these same companies engaging in exploitative work practices, domestically and abroad all the while overshadowing these issues. It’s an imminent climate catastrophe. That will undoubtedly displace the same communities that are already victims of the long history of unremedied injustice.
[00:05:19] For instance, the Isle de Jean Charles community, just outside of New Orleans, where we are presenting to you from today, which is primarily a native American community who escaped the 1830s Indian Removal Act. And the trail of tears is now facing resettlement because of the impacts of climate change for over a century, the native Americans on the island fished hunted trapped and farmed among the banana and pecan trees.
[00:05:41] That was once abundant on the island. But since 1955, more than 90% of the Island’s original landmass has washed away. And now they’re the first to receive federal tax dollars to relocate many don’t want to leave. And given the history, some have expressed distrust in the government. These circumstances are co-determinants of existing inequities that shape the social environment.
[00:06:02] Fortunately, it’s not a mystery, how we got to where we are or why we have the power to make real change possible. We have mountains of empirical evidence documenting health disparities over decades. We also have critical theories that reveal and challenge power structures that perpetuate these inequities. But we have a long way to go.
[00:06:19] Our system of laws and policies from the past and today shape the existing distribution of power and resources and create systems and social norms that lead to these differences of outcomes because these root causes of rarely been addressed. We’ve seen relatively little change over time. So, we need a new approach that actually serves communities and leading the charge for their own liberation.
[00:06:40] We believe this learning collaborative Partners for Advancing Health Equity will foster the co-creation and spread of knowledge by bringing together people and organizations with a shared commitment to achieving health. We will continue to bring attention to health disparities, but we aim for this learning collaborative to sharpen our research tools, harmonize our voices and challenge the status quo to shine light on practices and outcomes that we think are indefensible, irrational, and inconsistent with the moral principles we believe in this learning collaborative will be led and shaped by its members.
[00:07:13] And we aim to disrupt traditional research approaches to make it more effective and useful for communities seeking change. Research is slow. We recognize people don’t have time to wait and are frustrated with the rate of progress, but we need to come together to create new knowledge and consensus for advocacy, policymaking, and ultimately social change.
[00:07:32] For instance, how do we make grant funding more accessible, transparent, and aligned with the needs of communities and society? How do the incentives at institutions hinder or facilitate health equity research? How do we meaningfully support communities and leading this work? The answers to these questions will require that we have honest conversations about what it’s going to take to achieve health equity.
[00:07:54] And to that end. I leave you with this quote from Dr. Martin Luther King. Our goal is to create a beloved community, and this will require a qualitative change in our soul, as well as a quantitative change in our lives.
This episode is part of our Pathways to Health Equity Series. This is part one of a two-part episode featuring Sherman James, PhD. his research focuses on the social determinants of US racial, ethnic, and socioeconomic disparities in health and healthcare. He is the originator of the John Henryism hypothesis, which posits that repeated high effort, coping and chronic stress, and economic stressors rooted in systematic racism contributes to the early onset of hypertension and related cardiometabolic diseases in African Americans.
For more on his career and work go to his website.
This episode is part of our Pathways to Health Equity Series. This is part two of a two-part episode featuring Sherman James, PhD.; his research focuses on the social determinants of US racial, ethnic, and socioeconomic disparities in health and healthcare. He is the originator of the John Henryism hypothesis, which posit that repeated high effort, coping and chronic stress, and economic stressors rooted in systematic racism contributes to the early onset of hypertension and related cardiometabolic diseases in African Americans.
For more on his career and work, go to his website.
This episode is part of our Pathways to Health Equity Series. This episode features Dr. Paula Braveman, is professor of family and community medicine and founding director of the center for health equity. At the University of California in San Francisco for more than 25 years, she studied and published extensively on health equity and the social determinants of health. Her research has focused on defining, measuring, and documenting socioeconomic, racial, and ethnic disparities, particularly in maternal and infant health.
If you want to learn more about Dr Paula Braveman check out her website.
From our inaugural webinar held on March 8, 2002, we hear from national cross-sector thought-leaders as we discuss next steps in health equity practice and policy across research, community, and funders. Hosted by Thomas LaVeist, Dean, Tulane University School of Public Health and Tropical Medicine, Weatherhead Presidential Chair in Health Equity. Panelists in this episode:
- Sharrelle Barber, Director, The Ubuntu Center on Racism, Global Movements, and Population Health Equity at the Dornsife School of Public Health
- Sinsi Hernández-Cancio, Vice President for Health Justice, National Partnership for Women and Families
- Cara James, President and CEO, Grantmakers In Health
- Al Richmond, Executive Director, Community-Campus Partnerships for Health
From our inaugural webinar held March 8, 2002, we introduce Partners for Advancing Health Equity, a research learning collaborative designed to spark discussion, share learning, foster collaboration, and facilitate resource exchange for the promotion of action-oriented health equity research, practice, and policies. It also includes the current state of health inequities, and why we must identify next steps necessary to improve the lives of those impacted by social injustices.
From our inaugural webinar held March 8, 2002, we hear from national cross-sector thought-leaders as we discuss next steps in health equity practice and policy across research, community, and funders. Hosted by Thomas LaVeist, Dean, Tulane University School of Public Health and Tropical Medicine, Weatherhead Presidential Chair in Health Equity. Panelists in this episode:
- Sharrelle Barber, Director, The Ubuntu Center on Racism, Global Movements, and Population Health Equity at the Dornsife School of Public Health
- Sinsi Hernández-Cancio, Vice President for Health Justice, National Partnership for Women and Families
- Cara James, President and CEO, Grantmakers In Health
- Al Richmond, Executive Director, Community-Campus Partnerships for Health