In this episode, Risha discusses systemic racism in healthcare with Laura Bellis, Executive Director of the Take Control Initiative; a health equity program focused on contraceptive access in Tulsa, OK.
All of this and more in this episode of Risha Talks.
[MUSIC PLAYING] When it comes to healthcare, we have got to do better. For any disease that you can think of, Black folks and people of color are affected worse than any other group. There are zip codes in Tulsa where the life expectancy rate is less than other parts of Tulsa. And we saw the effects of COVID-19 on those same groups throughout the world.
There’s a lot we can do. And our next guest is going to shed some light on how we begin to deal with systemic racism in healthcare. Thank you so much for doing this. Would you, please, introduce yourself to our viewers.
Yeah, hi. I’m Laura Bellis. I’m the executive director of the Take Control Initiative, which is a health equity program focused on contraceptive access in Tulsa.
So, Laura, you know that we’ve been doing a series on systemic racism. We want to help Tulsans understand, really, what that means throughout the different industries. So can you tell me a little bit more about what you do at the Take Control Initiative first.
Yeah, absolutely. So because we’re the second highest state in the nation for folks that are uninsured, a lot of people don’t have equitable access to birth control. And at the Take Control Initiative, we focus on bridging community and health centers spaces, so that people are able to equitably access that resource, and then also just continue accessing care, and really build trust between those spaces.
So we know health disparities have existed, especially for marginalized communities since the beginning of time. Are we seeing any changes in that? Is it getting better?
Well, now that we have voted to expand Medicaid, I’m optimistic. That said, the disparities definitely continue and take different shapes and forms. And we continue to see significant disparities in health outcomes, especially– and this is something folks are working to combat heavily right now, especially when it comes to maternal mortality rates.
Got you. So let’s get into the systemic racism part of it. How have you seen that manifest in women’s healthcare?
Yeah, I think, one of the best examples of racism being alive and real in healthcare is in women’s health, especially in maternal mortality, in which black women are three times as likely as white women to die from pregnancy or childbirth related causes. And what’s really notable here, and Dr. Neel Shah from Harvard points this out, is that defies socioeconomic status. Someone could be very wealthy, have a high level of degree attainment when it comes to their education, and still experience either death related to that pregnancy or childbirth, or morbidity, right, like a close call.
Do you think that’s just due to systemic racism that’s been going on forever? Because if you look at black folks in general, we have the highest rate of everything, blood pressure, cancer, heart disease, I mean, you name it. It’s been an issue. And so I always think, why is it that we are dealing with this on every level for everything? Do you have any thoughts about that?
Yeah, absolutely. So some of it is just even what it takes for someone to get to care if they’ve been marginalized by so many factors, whether it’s access to nutritious foods or access to a space to be able to exercise and be outside in a healthy way. And then you get into, who has access to an insurance to be able to afford healthcare? Who has transportation to get to a health center if there’s not one in their neighborhood? Who can get child care for someone to watch their kids when they go to a doctor’s appointment? Who has access to paid time off through their work?
And all these things stack up. And there’s so much of that chronic stress in an environment if you don’t have access to all of those resources and things. If you’re living under fear of things, like police brutality, which has been shown when there has been an episode of police violence, they’ve actually found that that can impact black women’s pregnancies. That chronic stress adds up and causes more health issues, and then you have challenges just getting to the door of the health center. And all of that coalesces to create an environment in which you see these extreme health disparities in communities of color, and then that’s just getting to the door of a health center. Of course, you also then have the experience. You might have access and care.
Right. And we know in Tulsa that we have zip codes where life expectancy is at least 10 years shorter, in certain parts of our city. So we have so much work to do. But how do we begin to overcome these challenges? Because a lot of people are saying, hey, it has nothing to do with me. It doesn’t bother me. People go about their lives, and they don’t have to care about this. So how can we make it something that they care about? And how do we start to overcome these challenges?
The health of our community impacts all of us, whether we experience it firsthand or if we actually just experience that our economic outcomes. It’s expensive to have to provide tons of services and care for chronic conditions that were preventable, right? And if we don’t all invest as a community in that health, it does impact us. Our tax dollars– wait, I hate to take the economic argument. We should just care and be compassionate, because we care about other humans, but if this is where it gets to folks, right?
Our tax dollars that could go toward education, and public parks, and things that help all of us experience life and enjoy it, we end up having to put those things to supporting folks with chronic conditions and to– sometimes then folks being in distressed circumstances and ending up in our justice system. All of that interacts.
And things that we can do here, of course, one, really support as we’re expanding Medicaid. People getting enrolled and insured, that’s huge. And then the next piece is, we need– part of it’s really transportation solutions. How can we ensure people can access care? And then– and this is something everyone can latch onto. If you’re in a position of power, especially as an employer, ensuring that people have paid time off and sick leave, so that they feel that they’re able to really take that time and access care. And then, of course, parental leave, so that people have the time as they’ve just had a new baby to heal and spend time for both parents. And those are policies that can happen on a local level.
Definitely. So, if any, do you have advice for positions that are working with black women and women of color to help avoid some of these disparities?
Yeah, so one of the biggest things that folks, while they’re practicing healthcare, do have the power over is their own actions. What’s tough for our centers is they– especially our community level ones, they are serving people constantly everyday, and our healthcare system that’s profit driven kind of makes them potentially rush, right? And that makes it hard to provide patient centered services that are culturally competent and really intentional, especially when they’re serving marginalized communities, and especially serving black women. Especially, since women’s pain and, especially, black women’s pain, doesn’t always get acknowledged in healthcare settings.
And physicians can, one, of course, be part of trainings. But then to be part of informing policies in their practice and in their health setting, that help people break out of their default settings. And take those paused moments to really ensure that they’re being truly patient centered, that they’re checking their biases, right? Not just going through the training, but then actively engaging in policies, and working with their clinic workflow to slow things down, and pause, and reflect, and ensure that they’re being intentional as they provide services.
I love that. There is so much work to do in every industry. Is there something that the regular person can do? Just to help spread the word, and just make people more cognizant of what’s going on in our healthcare system.
Yeah, I mean, for one thing is, of course, we just need to actually have these conversations. And naturally, those conversations aren’t enough. We have to acknowledge that there are disparities. And we have to really have that conversation acknowledge that it’s not because some people make worse choices than others, right? It gets really easy for folks to go, oh, well, they’re less healthy because they didn’t make healthy choices. We have to dispel that kind of narrative, and talk more about how it has to do with access to resources.
And what we can do as a community is advocate for things that help alleviate those pain access points, better transportation, again, helping people get enrolled in healthcare and health insurance. And then in the healthcare setting, what you can do is just an everyday person if you’re not a doctor is learn your patient rights. And we can all help each other self-advocate.
You have rights as a patient to ask questions. Just say, hey, to the doctor. If you’re not comfortable with something, I’m not comfortable with that, to help elevate your voice and be heard. It’s a tough power dynamic, and folks don’t always know what their rights are as patients. And as just everyday folks, we can help learn our rights, and then inform others when it comes to accessing services.
So one last question for you. I’m really big on personal responsibility as well, like when you start talking about unconscious bias and diversity in systemic racism. I know, of course, that there is a system put in place. But I also think that there are things that we have to do. What are your thoughts on that? Like we as individuals have to take some personal responsibility for whether it’s our health or whatever it is that we’re doing in our lives, how much of that is on us? And how much of that is really on the systems in place?
Yeah, I think there’s part of me wants to put so much on the systems. Especially for communities of color, there’s a lot of distrust in healthcare for a good reason. For instance, the father of modern gynecology, he experimented on enslaved women. And so from our healthcare systems, there needs to be a lot of intentional reach to build trust. There’s that people feel safe in accessing care. But on the individual, what can be done is, a lot of times folks wait to access care when it’s an emergency, and they end up at the ER or an urgent care. People have to be proactive about their healthcare, and go before something’s wrong, not after.
And I know, right now, it’s a pandemic. So folks may be extra hesitant to proactively go get care if they don’t think anything’s wrong. But there are telehealth resources and services that you can engage with over the phone, over like a Zoom call. So there are options, and people can take that into their own hands and go, you know what? I want to go proactively see how I’m doing, so that I can stay healthy and catch something before it gets worse.
Thank you so much for all of your insight. I really appreciate you spending time with this and educating the folks here in Tulsa. I’m so– I’m proud of the work that you’re doing, so keep it up.
Thank you. I’m so thankful to get to spend time with you and all the phenomenal work you’re doing as well.
Thank you. There are a lot of things that we still need to do in the healthcare industry. So the most important thing that you can do is take personal responsibility for your health. Educate yourself. Do the research. If they’re not going to take care of us, we have to take care of ourselves. This is Risha Grant with 2 Works for You.