The Health Disparities Podcast

Mentoring healthcare leaders: Howard University President Dr. Wayne Frederick moved to DC at 16, mentorship has provided both professional & spiritual guidance. With fellow alum, Dr. Randall Morgan.

Very few physicians can name Dr. LaSalle Leffall and Dr. Clive Callender as pivotal mentors in their career, and also cite their experiences growing up with sickle cell as another important teacher. In a wide ranging discussion with fellow surgeon and Howard University alum Dr. Randall Morgan, Dr. Frederick explores some of the most important aspects of mentorship. He also discusses developing young leaders in science, the ongoing evolution of Howard University, and the challenges of building a diverse healthcare workforce that is better able to meet the needs of a diverse population. Dr. Frederick also talks about why his frequent visits to Trinidad to teach science are so important to him, and how he will enjoy his upcoming sabbatical. Recorded at the recent National Medical Association annual meeting in New Orleans. 
Dr. Wayne Alix Ian Frederick is a Trinidadian-American scholar, surgeon, and university administrator. He is currently serving as president of Howard University in Washington D.C. since July 21, 2014. He also serves as the distinguished Charles R. Drew Professor of Surgery.
Dr. Randall Morgan is an orthopedic surgeon based in Sarasota Florida, and the Executive Director of the W. Montague Cobb Institute. He also serves on the steering group of Movement is Life. 

Affirmative Reaction: Mission-centered advancement is now central to education & workforce diversity as ruling reshapes DEI. With Michaele Turnage Young, Senior Counsel, LDF, & Dr. Tamara Huff. E148

Michaele Turnage Young, Senior Counsel at Legal Defense and Educational Fund (LDF), joins orthopedic surgeon Tamara Huff, MD, MBA, to discuss the recent SCOTUS ruling on the Fourteenth  Amendment which has impacted affirmative action.
According to the Legal Defense Fund, "the Supreme Court has bowed to pressure from anti-civil rights activists, finding that Harvard and the University of North Carolina’s affirmative action programs violate the Equal Protection Clause of the Fourteenth Amendment. This radical decision comes at a time when efforts to advance opportunity in education have been under attack across the country, and the need for such programs remains acute."
Although the ruling is widely considered as a barrier to DEI efforts, Michaele Turnage Young shares an optimistic analysis of the ruling with Dr Huff. She outlines the many areas of DEI activity that the ruling does not affect, and discusses strategies which admissions officers can adopt. Central to this approach is supporting the mission of the many institutions aiming to address health disparities in underserved communities, where lived experience is a key qualification. 
For further information on LDF please visit: www.naacpldf.org & www.defenddiversity.org
© Movement is Life Inc., 2023
Excerpts: 
“It’s really important to understand what this ruling does and does not cover.”
“It seems to be a coordinated effort to cause a chilling effect, to lead people to retreat from efforts to further equal opportunity. These efforts have not been successful thus far.”
“Black students were 13% of US high school graduates, but only 6 % of students enrolled in large selective public colleges, while white students were 50% of US high school graduates and 56% of students enrolled in large selective public colleges.” (2020-2021 academic year).
“If you are charged with looking for talent, you want to do so in an objective way that serves your mission, and it might be that the mission of your school has something to do with serving communities that have long gone underserved.”  
Producer: Rolf Taylor
 

Framing a new post-affirmative action world. Insights from Dr. Ruth Simmons, Harvard University & Rice University, and Dr. Tamara Huff, orthopedic surgeon. E147

When the supreme court struck down race-conscious admissions this year, they ended policies of affirmative action that have helped to diversify college campuses since 1978. The ruling is considered detrimental to efforts to cultivate a representative healthcare workforce. At this year’s annual National Medical Association scientific assembly in New Orleans, Dr. Ruth Simmons was the keynote speaker at a symposium organized by the Cobb Institute, in association with Movement is Life (1). In this episode she explores the implications of the SCOTUS ruling with Dr. Tammy Huff, a board director for Movement is Life and an orthopedic surgeon.
In 1995, Dr. Simmons became the first African American woman to head a major college or university upon being named president of Smith College. Here, she established the first engineering program at a woman’s college. In 2001 she was selected president of Brown University, making her the first African American woman to head an Ivy League institution. She was later appointed President of Prairie View A&M University, the second-oldest public institution of higher education in the state of Texas. Most recently she joined Rice University, in her home state of Texas, as a President’s Distinguished Fellow, and is an advisor on HBCU engagement to Harvard University.
(1) “From Hopwood to Harvard: Anti-Affirmative Action in Higher Education Admissions Amidst Systemic Racism and Historical Racial Inequities in Health.”
© 2023 Movement is Life, Inc.
Host:           Dr. Tamara Huff, Vigeo Orthopedics 
Production:          Rolf Taylor, Project Advocacy
Executive Producer:     Dr. Randall Morgan, Cobb Institute 
Excerpts:
“Merit has often been defined in the past in a political context. We cannot give so much credit to assertions of merit that are fundamentally rooted in something that is corrupt.”
“I want us to begin to talk about human worth in different terms, and not these, I would say, lazy ways of classifying people.”
“Seeing yourself as worthy of healthcare, seeing yourself as worthy of education, seeing your family and your children as worthy of something better – is powerful.”

Healthcare Ready is a disaster preparedness organization working to make communities more resilient to emergency situations, with a health equity focus. With Executive Director Tom Cotter, MPH. E146

From COVID to Katrina to soaring temperatures, when disasters strike it is our most vulnerable communities that are on the emergency frontline, and it’s our underserved populations who experience the most disproportionate impact – and widening health disparities.
The mission of Healthcare Ready  is to help build resilient community health infrastructure that is prepared for, can respond to, and able to recover from disasters and disease outbreaks. One of their specific goals is to ensure historically underserved communities and medically fragile populations can access medications and medical care during a pandemic or natural disaster.
In this episode, Healthcare Ready’s Executive Director Tom Cotter shares some of the ways that the organization goes about helping to prepare communities for disasters, and how these approaches target the drivers for better health equity. With host Rolf Taylor.
© Movement is Life 2023

Why do religious people achieve better nutrition & physical activity goals, & have better cardiovascular outcomes? Clarence Jones, Dr. LaPrincess Brewer & Dr. Mary O’Connor unravel a new study. E145

Research findings from Mayo Clinic & published in the Journal of the American Heart Association at the end of 2022 found that “participating in religious activities, from church services to private prayer, as well as holding deep spiritual beliefs, are linked to better cardiovascular health among Black Americans.” According to Dr Brewer of the Mayo Clinic, multiple socially determined challenges which were magnified by COVID-19 are preventing African Americans from living their best lives by following a healthy lifestyle to prevent heart disease.
The recent study focused on better understanding some of the psychosocial influences on health behavior change among African Americans, and in particular following those activities as defined by The American Heart Association’s “Life’s Essential 8TM.” These include eating well, being active, quitting tobacco, healthy sleep, weight management, controlling cholesterol, managing blood sugar, & managing blood pressure. 
The study found that increased church attendance and spirituality was associated with higher levels of physical activity and less smoking, suggesting that having social support and an optimistic outlook may also encourage individuals to practice healthy behaviors.
Today’s discussion features Robert “Clarence” Jones, M. Ed., CPH, CHW, CPE, Executive Director at the Hue-MAN Partnership and a Community Engagement Strategist, along with Mayo Clinic cardiologist and study lead author Dr. LaPrincess Brewer, MD, MPH, whose primary research focus is in developing strategies to reduce and ultimately eliminate cardiovascular disease health disparities in racial and ethnic minority populations and in underserved communities. Dr. Brewer is also an Assistant Professor of Medicine at Mayo Clinic.
This episode is hosted by Dr. Mary O’Connor, Chair of Movement is Life and Co-Founder of Vori Health.
Copyright Movement is Life 2023

Five barriers & pathways to DEI, discussed in the context of healthcare delivery. With Professor Laura Morgan Roberts, Dr. Randall Morgan & Dr. Mary O’Connor. Episode 144.

In a recent white paper, “Normalize DEI in Your Organization,” professors at the University of Virginia Darden School of Business discuss common barriers to real progress in DEI, and offer evidence-based steps that can help transform DEI efforts from siloed side-projects to core systems embraced throughout an organization’s culture and practices.
For this episode of the podcast, one of the authors, a UVA Professor, explores the findings of the white paper with two surgeons, one of whom is her father. Together they discuss the importance of inter-generational change, "positive weirdness" and some unique aspects of DEI in healthcare.
The white paper references the following framework:
Five barriers and pathways to DEI    1) The Identity Regulation Barrier, 2) The Authority Barrier, 3) The Things Are Working Well for Me Barrier, 4) The Inertia Barrier, 5) The Motivation Barrier.
Five pathways to DEI    1) Build a More Inclusive Hiring Process, 2) Design for Intelligent Inclusion, 3) Enable Mindful Conversations, 4) Empower Mentorship and Sponsorship, 5) Leverage Identity. 
Featuring Professor Laura Morgan Roberts, Associate Professor of Business Administration, Darden Business School, & CEO and Founder, The Alignment Quest Enterprise, LLC; Randall C. Morgan, Jr., M.D., M.B.A., Clinical Associate Professor of Orthopedic Surgery at Florida State School of Medicine, President & CEO, Cobb Institute; and episode host Mary O'Connor, MD, Co-Founder and Chief Medical Officer, Vori Health, & Chair, Movement is Life. 
“Normalize DEI in Your Organization” (link to article & White Paper): https://news.darden.virginia.edu/2022/09/02/new-white-paper-normalize-dei/ "Positive Organizing in a Global Society" https://www.amazon.com/Positive-Organizing-Global-Society-Roberts/dp/1848725760   Excerpts 
“Practice expressing your positive weirdness. It gives others permission to bring out their weird. Differences are assets and resources for organizations, not problems to be solved.”
“Diversity, equity and inclusion (DEI) efforts in the corporate world remain a vortex of passion, malaise, hope and cynicism, despite overwhelming evidence that diverse and inclusive workplaces simply perform better.”  
“DEI does not often generate the short-term benefits that people would like to see. It requires a long-term, sustained, and often inter-generational investment for us to see those returns.”  
“A perpetual learning environment should be a goal of any organization that really wants to make an advance with regard to diversity, equity and inclusion.”
“We need diversity in thought, and diversity in culture and background, because people bring their life experiences into that filtering process. That all matters if we are going to make good decisions, especially in healthcare, with how we take care of people.”
© Copyright 2023 Movement is Life Inc.
Host: Mary O'Connor, MD
Research & Production: Rolf Taylor 

As the number of patients getting value-based healthcare doubles, many more high-risk patients are excluded. EMMT is a potential bipartisan solution. Episode 143.

Value-based care has emerged as an alternative and potential replacement for traditional fee-for-service reimbursement, centering quality and outcomes rather than quantity. That is the theory.
In practice, value-based care has been shown to exacerbate some disparities in the healthcare system by making it harder for those patients with complex conditions, or being impacted by social determinants of health, to access care. Put simply, if some categories of patient are more financially risky than others to treat, providers may find ways to exclude them – unless checks and balances are put in place to help manage risks associated with SDOH and comorbid conditions.
Health policy expert Matt Reiter hosts a discussion featuring Bill Finerfrock from Capitol Associates, and Tom Dorney from The Root Cause Coaltion. Together they discuss the very real danger of widening health disparities resulting from the expansion of value-based care, and the legislative solution proposed by the John Lewis EMMT Act (Equality in Medicare and Medicaid Treatment) which has been reintroduced in 2023 by Rep. Teri Sewell and Sen. Cory Booker.
All organizations advocating for health equity are encouraged to help advance the legislation by writing letters of support (template below) to Matt Reiter reiterm@capitolassociates.com who will coordinate their forwarding to Representative Sewell and Senator Booker.  
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LETTER OF SUPPORT TEMPLATE 
Dear Representative Sewell & Senator Booker, 
I am writing in support of S.1296/H.R.3069, the John Lewis Equality in Medicare and Medicaid Treatment (EMMT) Act of 2023.
The EMMT Act would require the Center for Medicare and Medicaid Innovation (CMMI) to include experts in health disparities and social determinants of health as part of the evaluation and review process for new payment models. If enacted, this bill would also require fairness of these new payment methods for women, high-risk patients, patients from racial or ethnic minorities, or patients from rural communities. Lastly, it directs CMMI to develop and test a payment model that is tailored to addressing social determinants of health.
While quality and cost are important considerations, equal consideration should be given to the impact a proposed model may have on access to care for women, minorities and beneficiaries residing in rural areas. CMMI is under no statutory obligation to account for social determinants of health when considering new payment models. Indeed, the only factors CMMI must consider when determining whether to approve a new payment model are quality and cost.
Because Medicare is the single largest health care payer in the country, and many commercial insurance plans will adopt policies based on Medicare, Congress must ensure that the models approved by CMMI incentivize reductions in minority and rural health disparities and not create barriers to care. We appreciate all that this CMS Administration has done to advance health equity. Passing the EMMT Act will ensure that all new models account for social determinants of health and how the models impact minority and rural populations.
Your leadership on eliminating health disparities for women, minorities and beneficiaries residing in rural areas is deeply appreciated.
I applaud your leadership on this important bill. The EMMT Act will go a long way towards improving access to quality healthcare for Medicare and Medicaid beneficiaries.
On behalf or our organization: 
Sincerely,
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Health Disparities Podcast Episode 143 (c) Movement is Life 2023

When a hospital becomes the patient: The challenge of receiving an “F” Grade during the pandemic, and the pathway to recovery involving Just Culture. Episode 142.

One of the recurring themes linked to healthcare in the United States is that where the need is greatest, there you are likely to find the fewest resources needed for resilience to challenges. This is particularly true during a disaster, be it pandemic, hurricane or economic downturn. A year into the COVID pandemic, the St. Bernard safety-net hospital in the South Side of Chicago received an “F” grade on its safety report. Already under disproportionate strain, the management team needed to implement a turnaround.
Deploying the Just Culture model and collaborative change principles, the team fostered adoption of improved practices and documentation, resulting in a “B” rating in 2022, and at the time of publishing this episode in May, 2023, St. Bernard Hospital has now scored an “A” Grade.
For this episode of the podcast, three members of the team that led those changes share their experiences with our host and Movement is Life Chair, Dr. Mary O’Connor. Featuring Orthopedic surgeon Dr. Daria Terrell MD, Medical Director of Clinical Programming and Health Outcomes, and President of Medical Staff; Orthopedic surgeon Dr. Vietta L. Johnson, MD; and Michael Richardson, RN, Chief Clinical, Quality & Patient Safety Officer.
© Movement is Life 2023

Nurse Practitioners with full practice authority can reduce disparities in access to care. With AANP President, Dr. April Kapu.

Dr. April Kapu, DNP, APRN, ACNP-BC, FAANP, FCCM, FAAN, is president of the American Association of Nurse Practitioners® (AANP). She has 30 years of experience in health care and 18 years as an acute care nurse practitioner (NP). Dr. Kapu has committed her career to advancing NP-delivered care and increasing access to NP care across all settings. Currently, she is Associate Dean for Clinical and Community Partnerships, Vanderbilt University School of Nursing, with oversight for several nurse-led community practices.
In todays episode, which is hosted by NP and rural health expert Mary Behrens, FNP, FAANP, we hear about Dr. Kapu's  experiences of meeting NPs across the country during her year of presidency. NP Behrens and Dr. Kapu also discuss some of the reasons why being an NP is now widely considered to be one of the most rewarding careers in healthcare, and explore the importance of building diversity in the profession. This year marks the 102nd birthday of NP founder and advanced practice expert, Dr. Loretta Ford. Dr. Kapu discusses her accomplishments, her commitment to health equity, and the continued mission to make sure healthcare is accessible to everyone, everywhere. 
Copyright: Movement is Life, Inc, 2023 

The importance of place. How a non-profit called Purpose Built Communities helps community leaders create healthy “cradle to college pipelines” in neighborhoods. With Carol Naughton & Dr. Tamara Huff.

Carol Redmond Naughton, JD, shares with us some aspects of the proven Purpose Built Communities model, working with local leaders to help them plan, implement, and sustain holistic neighborhood revitalization initiatives that create healthy neighborhoods which include broad, deep, and permanent pathways to prosperity for low-income families. During the discussion she describes the essential role of “community quarterbacks,” and calls upon listeners to look with open eyes and think about the systems that have kept people trapped in poverty, particularly Black and Brown people, and to not blame the victims.
Carol believes that we need to recognize that the systems have been broken for so long that they have “broken the place,” but the people remain unbroken.  So, when we think about building communities of purpose for children with unlimited human potential, we can find ways to create great places with a “cradle to college pipeline,” and we can change the systems to make it easier to create other great places.
With host Dr. Tamara Huff, MD, MBA, Founder and CEO of Vigeo Orthopedics, in Columbus, Georgia, and member of Movement is Life Board of Directors. 
© Movement is Life 2023. Visit www.movementislifecaucus.com for transcripts of this and other episodes.
Excerpts
The secret sauce is creating a community quarterback organization. You have got to have an organization that isn’t in the service delivery business, but is thinking about how after the residents have created their vision for the community, how do they implement it? Thinking about how to work with public, private and non-profit partners to actually do the housing, to build the education pipeline, and create those health and wellness amenities.
I love Columbia Parc and I am so proud of what the district partners have been able to do since hurricane Katrina. These were three business leaders that really did not know anything about community development at the time, but our mutual connections suggested they to go to see East Lake in Atlanta and learn how it could be the model for the rebuild of New Orleans. We spent two days together and they came home committed to trying to do what nobody had been able to do in New Orleans before.
Our network members really encouraged us to elevate economic vitality within our model. Poverty is expensive, if you don’t live within walking distance of a grocery store you will be paying higher prices at the convenience store, if you don’t have a car you will be paying a driver or paying with time on a two hour bus journey.
My call to action is to look with open eyes, and think about the systems that have kept people trapped in poverty, particularly Black and Brown people, and to not blame the victims. Recognize that the systems have been broken so long that they have broken the place, but the people are not broken, and if we come at it thinking about how we are building communities for children of God with unlimited human potential we can create great places and we can change the systems to make it easier to create other great places.