Examined Lives: Why healing health starts with racial equity

By Gail Christopher

At the time my three-month old baby died, I could think of nothing but our family’s sorrow. We had lost a dear, beautiful child. What can you do but grieve?

It was only later that I realized that I was a statistic.

In fact, as I looked back, I could recall a number of early deaths in my community. When I was 15, my best friend’s mother was rushed to the hospital before she was due. It was a shock to us all when she died during delivery. This was, we thought, a healthy woman.

Then I remembered my parents’ best friends. The couple had a daughter named Alicia. Alicia also died during childbirth, along with her baby.

What was going on here? Why were these maternal and infant losses so prevalent in families of color?

I made the decision to do something to change these statistics, and began pursuing a career as a holistic doctor.

As I would come to learn, there were gross inequities between whites and African-Americans in birth and maternal health outcomes.

When I graduated from naturopathic medical school in the mid-1970s, I set up a private practice in Chicago. At the same time, I established a company that worked with social service agencies to deliver holistic wellness and well-being services to underserved communities.

Gail Christopher

We focused on getting women to eat healthfully, to get exercise, to manage stress. They did the things that are key in the holistic healing world. And these women began having healthy babies.

It actually became a joke in our community. Women referred to me as “the fertility doctor,” because I saw so many who were expecting, or who couldn’t get pregnant, or who had had babies and lost them. Of course, I wasn’t a fertility doctor. I was making sure that they got the whole health care they needed. Healthy pregnancies followed.

So this was my work: Helping women, children and families become healthier. Helping communities understand and improve disparities in outcomes. Helping reshape the statistics.

And yet I also knew that truly eliminating these differences in outcomes would mean dealing with something much bigger.

To genuinely eradicate health disparities—as a nation—we have to confront the undergirding dynamics that contribute to them. That means addressing African-Americans’ continued exposure to discrimination and lack of opportunity.

That’s hard work: structurally, politically, emotionally.

Challenging the dynamics of discrimination means reaching back through deeply entrenched roots and history. It means reconfiguring the DNA of this country’s belief system.

At a "Save Our School" rally in Cleveland, Ohio, high school junior Gail C. Christopher addresses her classmates as they convene to save their high school from demolition.

For hundreds of years, that belief system has held that it is OK for people to be valued differently based on physical characteristics. We have never as a country dealt with that belief.

Of course, we’ve had a civil war and a civil rights movement—but those dealt with the consequences of that belief rather than the belief itself. We’ve also known that race is a social, rather than biological, construct. But simply pronouncing something false is not dealing with it.

Today, at the W.K. Kellogg Foundation, we’ve put a priority on achieving racial healing and racial equity in this country. This work specifically and openly challenges the historical belief in racial hierarchy.

At the same time, we also work to to equip people with the innate and external resources to mitigate the effects of that historical belief.

It’s a both-and approach.

Dealing with it requires intentional strategies.

Let’s imagine a young boy growing up in a community much like the one where I used to practice. It’s an impoverished neighborhood. He’s enrolled in a failing school system. He’s harassed by police. And he or may not have the benefit of two parents or an extended family.

This child is continually exposed to overwhelming stress responses, something Dr. Jack Shonkoff at Harvard University calls “childhood adversity.” Childhood adversity is a predictive factor in all manner of chronic diseases later in life. And so we see our long racial history playing out across the health of individuals and particular communities from a very young age.

For this boy, and for his children, we have to tackle both the current situation and the historical context.

At the bare minimum, he needs balanced nutrition and social support to cope with the vicissitudes of his body’s adaptation to the stressful environment. People need optimal food for optimal health. The W.K. Kellogg Foundation funds organizations working to improve access to fresh, healthy affordable food for vulnerable children.

Dr. Gail Christopher, with her children Heather and Hassan.

At the same time, we also fund organizations working to acknowledge and dismantle structural racism—the policies and practices that continue to create barriers for children of color.

Which takes us to an evolution of my earlier question: How do we address the early death so prevalent in families of color?

Addressing these health inequities demands that we address inequality more broadly. We must create an environment that supports equity and opportunity while mitigating the effects and consequences of exposure to discrimination.

In other words, I realized that to change the statistics—to change the conditions that resulted in so much premature death in my community growing up—we must bring a racial healing and racial equity lens to our nation’s health discussion.

Until we do, we’re just putting Band-Aids on the hemorrhage.

Click here to read more about the Great Challenge of the impact of poverty on health.

TEDMED Will Hold First-Ever Great Challenges Day at GWU this April

On the afternoon of Friday, November 19th, on the George Washington University campus in Washington, DC, TEDMED will host its first-ever Great Challenges Day, a multi-disciplinary gathering of some 500 TEDMED Delegates including medical professionals, technology experts, policymakers, non-profit leaders, big business leaders and academics.

It’s the culmination of the first cycle of TEDMED’s first Great Challenges Program: A multi-disciplinary, crowd-sourced community effort to understand some of the most complex and persistent problems in health and medicine. Since April 2012, the TEDMED community has explored issues like the obesity crisis, medical errors and medical costs via social media, online at TEDMED.com, and via live online events.

The Science of Storytelling

Using tools from the emerging discipline of medical and scientific storytelling, participants will collaborate to better understand — and to better communicate — the complexities of some of health and medicine’s most complex and pressing challenges.

You must be a TEDMED 2013 Delegate to attend the Great Challenges Day. Click here for details on the Day, and here to apply for an invitation to TEDMED 2013.

Great Challenges: Live event Thursday, Dec. 20th at 2 PM ET to discuss managing chronic diseases better

The TEDMED Great Challenges Program will host another Google Hangout tomorrow at 2 pm ET. Multidisciplinary thought leaders will share their views and respond to viewer questions on the Managing Chronic Diseases Better.

Team members:

Viewers can watch the live video chat on TEDMED.com or on the TEDMED Google+ Page, and weigh on those pages or by following by submitting questions on Twitter @TEDMED, tag #GreatChallenges.

Great Challenges: Sharing ideas on how to cope with the obesity crisis

Can we come to terms with our national obesity crisis? And what can individuals, communities and governments do about it?

Six thought leaders on the topic responded to audience questions yesterday in one of a series of online live conversations. Watch it here:

TEDMED Great Challenges: The Obesity Crisis

Follow @TEDMED #greatchallenges on Twitter, our Facebook page and our Google Plus page for updates on when and how to join the next Great CHallenges live online event.

Great Challenges live online event Thursday: Can we manage our obesity crisis?

 

This week’s Great Challenge conversation: Can we manage our obesity crisis?

Join the Challenge Team at 1 PM EST on Thursday, December 6 to watch a Google+ Hangout, share your thoughts with other viewers, and ask questions of Team members that they’ll answer in real time.

They are:

 

James Zervios – Director of Communications, Obesity Action Coalition

 

John M. Auerbach – Director of the Institute on Urban Health Research and Distinguished Professor of Practice at the Bouve College of Health Sciences at Northeastern University

 

Christine Ferguson – Strategic Initiatives Advisor, STOP Obesity Alliance; Professor, The GWU School of Public Health and Health Services

 

Rebecca Puhl – Director of Research and Weight Stigma Initiatives at the Rudd Center for Food Policy & Obesity at Yale University

 

Maya Rockeymoore PhD – President and CEO, Global Policy Solutions

 

Dan Callahan – Senior Research Scholar and President Emeritus, Hastings Center

 

Scott Kahan, MD, MPH – Director, STOP Obesity Alliance

 

To get started, follow the TEDMED Google+ Page or @TEDMED #greatchallenges on Twitter.

Great Challenges: Experts discuss the Caregiving Crisis

Missed yesterday’s enlightening discussion by TEDMED Great Challenge experts on the caregiving crisis? Watch it here to get caught up on the latest thinking in the field.  Along with the TEDMED community online, the Caregiving Challenge Team talked of assessing the current and future numbers of caregivers, factors contributing to the Challenge, and family, healthcare, business and government interventions that have the potential to help patients and their caregivers.

TEDMED Great Challenges: The Caregiver Crisis

Tune in to the TEDMED Google+ page or on TEDMED.com next Thursday at 2 pm EST for the next in our series of live online events, and follow us for updates @TEDMED #greatchallenges and on TEDMED’s Facebook page.

Join Thursday’s live conversation on the caregiving crisis

This Thursday, TEDMED is hosting the second live Great Challenges TEDMED Google hangout.  This weeks topic:  The caregiver crisis.

Join our caregiving Challenge Team leaders on Thursday at 2 PM ET. They are:

Peter Arno, PhD - Director, Center for Long Term Care Research & Policy, School of Health Science at Practice New York Medical College

Alan Blaustein - Founder, CarePlanners

Barry Jacobs, PsyD - Director of Behavioral Sciences, Crozer-Keystone Family Medicine Residency Program

Cheri Lattimer, RN, BSN - President & CEO, CMI; Executive Director, Case Management Society of America & National Transitions of Care Coalition

Carol Levine - Director, Families and Health Care Project, United Hospital Fund

Suzanne Geffen Mintz - CEO Emeritus and Co-founder, National Family Caregivers Association

Click here to Follow our Google+ page and to post questions in advance — we’ll be choosing a few to answer on-air.

If you weren’t able to make last week’s conversation on the changing role of the patient, you can watch it here.  See you Thursday!

Join the first Great Challenges live event on Nov. 15th

For the past two months, we’ve been holding an online conversation with industry, advocacy, and academic leaders — and the public — about health and medicine’s Great Challenges. Next week, we’re going live with our first Googe + Hangout.

 

Join to watch a moderated talk on The Role of the Patient: What are the opportunities, and the pitfalls, of greater patient engagement? Are patients fully aware of their options, and their rights?  Do doctors know that, and acknowledge it? How can both parties work more effectively with the tools now available, from online health information to electronic medical records?

 

A team of experts will discuss all this and more on Thursday, November 15th, from 2:00 pm to 2:45 pm EST.  They are:

Ted Eytan
Director, The Permanente Federation, LLC at Kaiser Permanente
Theresa Brown
Oncology Nurse and New York Times Columnist
Amy Berman
Senior Program Officer, The John A. Hartford Foundation
Rebecca Burkholder
Vice President of Health Policy, National Consumers League
Alexandra Drane
Founder, Chief Visionary Officer and Chair of the Board, Eliza Corporation

 

To join, visit and Follow our Google + Page.

 

Click here to learn about the The Role of the Patient Challenge and its Team Leaders.

 

Health leaders respond to TEDMED’s Great Challenges

What do some of health and medicine’s leading thinkers have to say about our most pressing challenges?

Over the past month, we’ve hosted online conversations on the Great Challenges of Health and Medicine, which are particularly widespread, obstinate issues that demand varied points of view and creative approaches to address.

Readers have submitted questions and comments on the Challenges to leaders from industry and advocacy groups, and the first groups have responded via video, presentations, and artfully written answers — bringing their own creativity to the table. A sampling:

What are the top ten factors affecting the Caregiving Crisis?  Alan Blaustein, Founder of CarePlanners, responds (with help from a few small friends). And Joe Nadglowski, President of the Obesity Action Coalition, gives an example of a community-wide approach to fighting obesity.

Alexandra Drane, Founder, Chief Visionary Officer and Chair of the Board of Eliza Corporation, pursued a graphic approach while explaining top contributors to the changing Role of the Patient:

Speaking also to that Challenge, Ted Eytan, an MD and a director of Kaiser Permanente, tackled: “What are reasonable and unreasonable expectations of patient responsibility in the delivery of health care?” His answer:

I am not a fan of the idea that patients are reasonable or not reasonable. The health system is designed in service to patients and to society, so that they can be productive people, family, community members, and citizens. Therefore, whatever is in the scope of allowing them to be these people is reasonable.

Sometimes it’s a matter of understanding what’s capable, and as it is said, if two people have the same information, they are likely to come to the same conclusion. We should get at, and eliminate, information asymmetry so that in the end, everything is reasonable because everyone had the same ability to understand the world around them.

 

To see more, visit challenges.tedmed.com.

What makes a doctor-patient partnership flourish?

Both doctors and patients are seeing the value of well-informed patients. See below: As part of a video series filmed by Fenton at TEDMED 2012, Lisa Witter interviews James Merlino, Chief Experience Officer at the Cleveland Clinic, and Dave deBronkart, a patient activist, on why effective treatment starts with a solid doctor-patient partnership.

Perspectives by Fenton and TEDMED: Improving Doctor-Patient Communication

Yet, no one has trained either group on how to go about furthering that goal, and doctors have increasingly less time in which to counsel patients. How can we move forward? Improving Medical Communication is one of TEDMED’s Great Challenges in health and medicine. To learn more and discuss further, visit the Challenges website.