Selected Podcast
Black History – African American Physicians in the Pursuit of Health and Racial Equity
“Hally® Healthcast is the wellness podcast from Hally® health – your partner in helping you live your healthiest life. February is Black History Month, so today we’re discussing an incredibly important topic for our communities and our country as a whole – the pursuit of health and racial equity for Black Americans. Here with us is Dr. Kevin R. Teal, staff neurosurgeon at Carle Neuroscience Institute in Urbana, Illinois. Welcome, and thanks for being with us today.”
Featuring:
Kevin Teal, MD
Kevin Teal, MD is the Staff Neurosurgeon at Carle Foundation Hospital. Transcription:
Caitlin Whyte: Welcome to Hally Healthcast, the wellness podcast from Hally Health, your partner in helping you live your healthiest life. Every episode on our podcast addresses a new topic important to your health and wellbeing, bringing in expert doctors, therapists, and specialists who offer advice and answer your most pressing questions.
February is Black History Month. So today, we're discussing an incredibly important topic for our communities and our country as a whole, the pursuit of health and racial equity for black Americans. Here with us is Dr. Kevin Teal,
a staff neurosurgeon at
Caitlin Whyte: Carle Neuroscience Institute in Urbana, Illinois. Welcome and thanks for being with us today.
So Dr. Teal, we know that issues of race, racial injustice, and racial inequities have been in the news a lot the past few years. Before we even delve into the healthcare aspect, can you tell us a bit about why so many people are focusing on these important topics now and why this focus is needed in our communities and all across America?
Kevin Teal, MD: Well, I think it's a great question. And I think we're living in an interesting time where there just been a syngergy of actions and events and awareness that have really pushed us to a new place as a country. And I think we're experiencing that in every discipline. And so I think as we look at these issues through the telescope of time, I think we just see that it's kind of deja vu all over again. And I think we're having to learn different lessons now in a newer context. But I think we see that there's been a thread that has been unfortunately consistent and we can trace that to some inequities and injustices and patterns that have been very debilitating for various communities.
And I think we as a country start looking at how do we take care of each other, how do we navigate crises. I think we're having to ask some fundamental question of why do we have some of the inequities that we have, how does that play out in people's resilience and reserve. And so I think this is a really a pressing issue now. I just think there's so many different things going on across the countries, I think across nations, that I think we're being called to look at how do we build systems that help people. And I think when the systems are stressed, we really see the weaknesses and we see the fault line. And I think from a sanity standpoint, we're trying to figure out how to make things more resilient and build things up so that people can navigate better through things like COVID and through things like hurricanes and financial crises.
And so I think in the healthcare arena, all these things back up to our doorstep when people come in and they haven't been taking good care of themselves or they've found themselves falling deeper into addiction or finding themselves, you know, in emotional stress and turmoil. So I think it's just been a perfect storm, so to speak, of economic, of social, of political. And then I think all of that comes back to the medical because we treat everybody from politicians to paupers.
Caitlin Whyte: Yeah. No, that's a perfect word for it, a perfect storm like you said. And moving on to the healthcare aspects specifically, can you tell us a bit about the disparities and inequities that exist within this field? It's slowly starting to make the news, but I think many people are stillunaware. You know, many white people are still unaware of the ways that healthcare can be greatly affected by race.
Kevin Teal, MD: Well, again, I think when we look at the issues of, you know, just wellness, health and wellness, I think those are concepts that we throw out and think that everybody has access to the same health and wellness vehicles and processes. And so I think when we look at something like the infant mortality rate, you know, in our country, I mean, we're not doing the best despite our financial resources. And so I think there's many reasons for that. I think there are reasons that have been baking for a while.
And so when we start trying to address these issues, we find something like, you know, black female mortality rate around pregnancy, which is just disturbing and cuts across socioeconomic lines and educational lines. So when we start unpacking these problems, then we have to look at the history, look at some of the cultural practices that have come in and also look at some of the social and psychological stressors that are there.
And as we as clinicians, try to unpack, well, how do we start earlier with these moms? How do we start earlier so we can get them in the system and get them better? And those are difficult questions and it really backs up to educational questions and social access questions. So all those issues kind of work to give us this tapestry that we have to work through. I mean, there's studies that have been done and you look at any major city, but there are certain ZIP codes that are predominantly African-American or predominantly Hispanic, and the life expectancy is different from a ZIP code that is five miles over, which is predominantly Anglo. And, you know, you're seeing decades difference between people's life expectancy. And that goes to the lifestyle and the life experiences of people.
And so if we have access to healthcare and can get our prostate checked and our breast exam and our COVID vaccines and our booster shot and all these things, we're going to do better. And as we're heading into this pandemic, we're seeing-- you know, what's going on in South Africa is very telling. I think I saw a stat where it said 66% of Europe was vaccinated versus 6.6% of South Africa. And so again, you're looking at 94, 93% of your population is not vaccinated compared to 44%. So you're going to have a different experience in a pandemic, right?
And so some of that's access, some of that's quality. Again, if you're not getting your breast exam about once every five years, you're playing Russian roulette with whether you're going to have something develop over those five years. But people have to make hard choices about, do they eat? Do they stay afloat? Or do they buy a $1,500 health plan on the net or something, you know, through all these venues?
So this is really, I think an issue and it backs up to the economic question. I think when we look at wealth in our country, I think the percentages are that African-Americans have like 2% of the nation's wealth compared to our Anglo counterparts who have, you know, 80% and that's just really a resource issue. So it boils down to a resource question. If you have the resources, you tend to put more at work for you in advocating for yourself, dental health, you know, mental health, physical health, exercise, fruits, and vegetables, all those things that we know are going to be healthy for you. So all these things, you know, impact access to resources. And I think that's really a big part of the problem. And when you let that play out over a couple of centuries, then you start getting, you know, more patterns of cardiovascular disease, more problems of kidney disease, more problems of hypertension and diabetes. And how do you, you know, start bending that arc to healthier eating and healthier exercise patterns. So it's going to take time.
Caitlin Whyte: Yeah, of course, it's going to take time and you know, we're talking about such a large issue here. But with these disparities and inequities existing in our communities, what can doctors and other healthcare professionals try to do to start addressing these issues?
Kevin Teal, MD: Well, I think there's a lot and I think medicine has tried to work toward giving people some cultural awareness and sensitivity. And so I think studies have been done in the African-American community. I'm sure they've been done in the Hispanic and Asian communities. People tend to resonate more with doctors that look like them, and they tend to listen to the advice that they're given through a different lens, ideally.
And so there was a study done in California where they looked at barbershops as a way to talk about taking your blood pressure medicine for African-American men. And they paired them up with African-American physicians and they saw a significant decrease in the blood pressure of the men who had come through a community portal, had found a physician that looked like them and could speak their language and help them reality test where they live and really help them get on top of the problem and give them accountability and access.
And so I think looking at that is part of it. And I think for situations where there aren't African-American or Hispanic or Latinx physicians in the community, I think having our Anglo counterparts understand some of the cultural issues that their patients of color are going to be facing, how they encounter, you know, coming into the waiting room and there's armed security there or police there, how that sets them up for a different experience in the clinic, right? And so, working through that, kind of making that process something that's not intimidating or threatening, but something that is helpful to keep the clinic flow going, you know, those kinds of things.
So I think being aware of those things and really just listening to your patients who share with you an encounter that they had in your clinic or in your hospital that was not culturally sensitive, that didn't make them feel valued, that made them feel less than getting the best treatment and kind of unpacking that experience. And I think that's part of what I see the healthcare system and healthcare workers having to do, because from the environmental services people all the way up to the CEO of the hospital, we have to have a culture that understands that not everybody has access to the same things and not everybody has had the same life experiences.
And so trying to work through that and not endorsing things that are dysfunctional per se, but unpacking things and helping people understand that though that may have worked for your grandmother, that's not going to work for you with your high blood pressure. And so that's not going to work for you with your diabetes. You know, you're not going to be able to eat all the pecan pies and pound cakes and, you know, do that day in and day out. So looking at people's experience and diet and helping them understand that they're going to have to make different life choices. And they're going to have to be maybe the sentinel person who goes back to their community and say, "We need to start cooking differently. We need to start eating differently. We need to start being more active," if they can, right? If they're in a neighborhood that's got a green space and they can do that.
Caitlin Whyte: Now, I've heard a lot of inspiring stories about the role specifically of black doctors and healthcare workers. Can you tell our listeners how these care providers are taking action across the country?
Kevin Teal, MD: I think one thing that black doctors and physicians of color are having to look at, and I think institutions and organization looking at it, there was an article that came out that was looking at the number of physicians of color that were in the community. And it found that when they looked at the African-American males, they had seen actually that the numbers had stayed the same or gone down a little bit since 1978. And so there was like a 5% representation of African-American males in medicine. And with the numbers trending down and not going up, at least in 2014, when it was looked at, that kind of set off an alarm bell that we need to look at, how are we going to bring more diversity into medicine? How are we going to get a pathway for students who are interested in medicine or science or technology to come through the educational processes and portals that are available to them and try to incentivize them, hopefully to come down a path where they can be present in their community in a medical way?
And so I think you've got universities that are working toward early access programs, showing students research, showing them career paths. And whether that's physicians or nurses or dieticians or speech therapist or physical therapist, really getting more diversity across the waterfront so that patients, whatever portal they come through, are finding some more cultural sensitivity and the healthcare environment is becoming more culturally sensitive.
And so that I think has been a big outgrowth of some of the recent turmoil, because I think we're looking at every institution and wondering are we representative of the community that we're serving. And so I think as being engaged in the medical field, I think it helps all African-American physicians and other physicians of color to take a stewardship role and look across and see who can we help develop so that we have more people coming down this pathway and we don't see it dry up, knowing that the system needs more diversity. So I think that's one thing that black physicians and Hispanic physicians and Asian physicians are partnering with our Anglo counterparts to bring more diversity to the landscape of medicine so that patients are getting a better experience and our organizations are becoming better representatives of what's coming in through our ER doors and through our clinic doors.
Caitlin Whyte: Wow. I'd love to get into that history a bit because while these are newer issues in the culture and the news, they're not new issues in the grand scheme of things, right? People have been fighting these issues for a while. So can you tell us a little bit about that history? For example, about the formation of the National Medical Association and the Black Physicians of Carle?
Kevin Teal, MD: Right. Well, like you say, a friend of mine gave me a book a couple of years ago, and it was talking about healing the racial divide in American medicine. And I had never heard of this book. I had never heard of the racial divide, and it's basically called The Racial Divide in American Medicine. And it was edited by Richard D. deShazo, MD. And it's written from a group of doctors who were actually in Mississippi. And it's a very interesting snapshot of the history of American medicine. And they talk about the National Medical Association, which was founded in 1895 as the National Negro Physicians, Surgeons, Dentists, and Pharmacists, and it was founded in Atlanta.
And it was founded as a result of the black physicians and professionals not being able to get into the American Medical Association. And so there were some members of what was called a Medical Society of District of columbia who had been denied delegate status to the AMA. And many of them were actually black faculty members at Howard University College of Medicine. So they renamed the organization the National Medical Association. And this rejection of black physicians by the AMA in the 1870s, unfortunately was supported by former confederate doctors and surgeons who were AMA members. There was a famous general JM Keller, MD, who was on the AMA ethics committee. And he was a confederate general who didn't want the black physicians in the AMA. And so this was a problem because you had to be in the AMA to be able to get credentialed at the hospitals. And so the NMA founded itself really as a parallel organization providing educational efforts. They had a biracial house of delegates and board of trustees, hopeful that they could one day be integrated with the larger medical community.
And so they continued to try to get back aligned with the AMA, but the state medical associations had local restrictions that persisted until the 1970s that said that black physicians could not be members. And so this really set up a parallel system because there were black and white physicians that had to set up separate hospitals. So there were black physicians who actually built hospitals in Mississippi and other states, Oklahama, Chicago to allow their community to have access to a hospital. And so this continued until really Medicare because Medicare came out and said, "We couldn't have separate hospitals." So this Title VI in 1965 and it pushed the hospitals to end segregation. So ultimately, they were able to prevail and get integrated.
And so the AMA and the NMA still exists now, obviously, and the National Medical Association continues to advocate for issues that are important for African-Americans and provide medical literature that addresses some of those concerns. And so this I think is a legacy that a lot of us didn't know about. And so, you know, to their credit, I mean, during Freedom Summer in Mississippi in 1964, NMA members, along with members of something that was called the Medical Committee for Human Rights from New York, took care of the volunteers who were in Mississippi that summer. And if you remember, there were three workers who were killed in Mississippi during that summer. And so this was risky for the physicians.
And so there was a lot of high risk for African-American physicians who were working in the south and trying to be advocates for their community. And so interestingly, the dean of the University of Mississippi would actually join the local NMA chapter in 1965 because he was working with black physicians to integrate their hospitals so they could keep their Medicare status. And so he became one of the few white members of the National Medical Association in Mississippi of all places.
And so it took until 2008 at a national NMA meeting in Atlanta for the AMA to issue an apology for his role in racial discrimination in medicine. And they acknowledged the wrong they had done to African-American positions, their families and patients with the attendant healthcare disparities.
And so that's the history. And I think, again, we think these problems just started, but they didn't. And again, if you can think back to 1950 and 1960s, 1970s, if a patient was going through a hospital that wasn't and didn't have all the bells and whistles, didn't have all the equipment and they were struggling to even to go to the basic level, we can see how that set up a pattern of inequity and poor health that was going to persist. And unfortunately in places like Mississippi, we still see very low health quality and very low health outcomes. And I think we look at that legacy and I think we squandered an opportunity to help our whole country get better and invest in communities I think at an early level that really would have helped I think set a different trajectory for us.
And so the Black Physicians of Carle was birthed out of these charged events, the death of Ahmaud Arbery, Breonna Taylor, George Floyd. It really was a crescendo that I think awakened a lot of people of color and particularly African-Americans. And so the Black Physicians of Carle, which is a chapter of the NMA was started in June of 2020. And our role is really to be a source of community, education and advocacy. And so we want to build community for the African-American physicians, some of the unique stressors that go along with that. And then we want to provide education to the community as a whole. And then be an advocate for us moving ahead, so we can address some of the pressing problems that are facing us.
Caitlin Whyte: It's wild to how that's just another part of history we didn't learn in public school, right?
Kevin Teal, MD: Right. We missed that class.
Caitlin Whyte: We missed that one. Yeah. So Dr. Teal, most of our listeners most likely aren't doctors or healthcare workers. So focusing first on our Anglo allies, what can they do to help make healthcare more equitable for black Americans and other people?
Kevin Teal, MD: Well, one thing that I really advocate for people is for them to become educated because I mean, one thing has been my own personal journey in the last three years is really reading books like The Racial Divide in American Medicine by Richard deShazo, books by Beverly Daniel Tatum. She's written a book called Why Are All the Black Kids Sitting Together in the Cafeteria? which looks at racial, ethnic, and cultural identity development. Reading a book recently called The Warmth of Other Suns by Isabel Wilkerson, which chronicles the story of Jim Crow and how African-Americans had to migrate out of that or a lot of them did to escape and get to a life where they could live. And then another book, The Half Has Never Been Told by Edward Baptist, which he's a Dartmouth professor and it took him 12 years to write this book, just meticulous unpacking of slavery and what that was like and what that was about. Because I think if we don't have an understanding of it, I think we sometimes come alongside people and say, "Well, now, dust yourself off, pick yourself up by your bootstraps. Let's run on." And I think we don't realize that there are some things that need to be addressed and then there's some things that need to be kind of unlearned and things that need to be implemented so we can all feel and grow to our fullest potential. And so I recommend getting some information and knowledge. I think those are resources that will be helpful to people, because I think you really can't have the conversation if you're not grounding the conversation in reality.
And I think there's been a pretty strong miseducation process. And I think, I mean, I was included in that. I grew up in Texas. I didn't get a good sense of all the nuances that were going on to kind of drive that system of disparity. And I didn't understand that. And so I think sometimes we're quick to blame the victim if we don't understand what people have gone through. And again, there are things that we want people to change and adopt, but I think it's a process of understanding where people have been, what stressors they're facing and then figuring out how we can help them navigate to a better place. But I think if we do that with the sensitivity and awareness, I think we don't put answers on the table that offend people or don't acknowledge what they've been trying to do already.
Caitlin Whyte: Well, and then on the flip side of that question, what would you say, not to put the labor back on the black community, but what can black communities do to stay healthy and well even in the face of these disparities?
Kevin Teal, MD: Well, I think the challenging thing is that when we look at something like the African-American female mortality around pregnancy, that doesn't respect socioeconomic class. There've been a couple of high profile female physicians who've died after giving birth within the last year. And so this wasn't a 1968 problem, this was a 2021 problem. And so I think that understanding that something is going to be higher risk in a certain situation, I think is helpful. So we don't put people off and not pay attention to their symptoms, that we don't minimize when they say they can't breathe well, or they're noticing they're got swelling in their foot.
I think sometimes we're quick to, you know, not delve into a symptom that may be leading us to a bigger problem in a population that we know could be higher risk during the season, you know, African-American females during pregnancy. So I think African-Americans have to, again, adopt lifestyles that are going to be helpful to them, eating fruits and vegetables, eating things that aren't always fried and using moderation with things so we have a balanced diet. We also have to learn to take time off. We have to learn to step away.
There's a great book called Five Gears, which talks about first gear, which is self maintenance gear. And so being able to take time off, to relax, take vacations, recharge. And then, you know, our second gear, the gear where we take care of our family and our friends. So we have relationships. We have homes. Our third gear is a social gear where we are interacting with people and building a broader culture of contacts and networks. Our fourth gear is multitasking where we're able to do the things, taking our kids to the games, going to work, you know, networking through our emails. And then our fifth gears project gear, where we've got to get something done in a timely fashion.
And so I think we have to learn to navigate those spaces successfully. And also do it in a way that's helping. And I think as we grow, African-American physicians and professionals, we grow into a different social status. I think hopefully we can continue to contribute to organizations that are helping educational prospects for African-American students, investing in scholarships in medical school, investing in African-American universities, investment in charitable and, you know, social giving. And I think also getting educated. I think sadly the miseducation process has gone pretty deep for African-Americans also. So reading books like Stamped From the Beginning by Ibram kendi, again reading Beverly Daniel Tatum's book, understanding where we've been and then charting a new path of where we want to go.
I think we're living in a time where the history is being written and unpacked in a way that's making it really accessible. And so I think it's an exciting time to get our families educated, to get ourselves educated, to be part of a community that's more aware, that's more sensitive and then that's more proactive and less reactive.
Colin Kaepernick has a great series on Netflix called Colin in Black & White. And he really unpacks a lot of impactful conversations that we need to have. If we're going to be a multicultural society, what does that look like? How do we make each other feel welcome? How do we value each other? And I think these are timeless conversations, but I think in a pandemic, they become more pressing. And so I think life is going to send enough crises and stresses our way to where we're going to have to, I think as Martin Luther king said, we've got to learn to live together or perish together as fools.
Caitlin Whyte: Well, Dr. Teal, like we mentioned, it's a very large nuanced topic to fit and do a half hour conversation. But with my final question, in today's world, we've often are captivated by headlines of the day and it's hard not to live in the worry of emotions in the moment and pandemic news every 10 minutes. I know I'm on Twitter way too much. But looking towards the future because, you know, achieving health equity isn't going to happen tonight or tomorrow, despite being in a pandemic, what would you say the future direction for making America's healthcare more equitable for everyone is? What are some big steps or future actions that you think will be or need to be taken in the years to come?
Kevin Teal, MD: Well, I think that what we're finding is we've got to make healthcare accessible to people right where they are. And so, again, coming from states where we didn't expand our Medicaid to allow people to have access to basic services, right? So I think we've got to look as a country as how do we invest in our people? And I think we can invest in so many different things, but I think we really squandered a lot of opportunities to invest in people and help people develop so that we as a country can be the best we can be and stay competitive, right? Not in a way where we're cutting off the needs of other countries, but where we're competing well with other countries and helping them get better. So I think that's going to be our future and how we do that I think is going to cut across party lines, is going to cut across socioeconomic lines. But I think we're understanding that that's how we all rise together. So I think that's going to be part of our future direction.
And I think having difficult conversations with each other, I think that's something we practice in medicine all the time. How do you tell somebody they have cancer? How do you tell somebody, you know, their family member has a life-threatening brain injury delicately? Delicately, but directly because the conversation needs to be had. And I think we're at a place as a country, we're going to have to mature enough to have hard conversations. We're going to have to acknowledge past failures because that's how we're going to get better. And I think if we can see it and acknowledge it, we can correct it. But if we deny it and don't see it, then it's impossible for us to correct it.
So I think medicine's data-driven. We need good data to make good decisions. And I think we, as a country are going to have to accept the historical data unvarnished and say we can do better than that. I think anything else is going to be putting our head in the sand and hoping for something better, which traditionally doesn't work out.
Caitlin Whyte: Well, such great information, doctor. And you've simply been a wonderful, knowledgeable and inspiring guest. Thank you so much for joining us today and for all you do every day at Carle and beyond to help so many people throughout our communities.
And that concludes today's Hally HealthCast. Tune in next time as we tackle yet another important topic for your health and wellbeing. And remember Hally Health is your partner in helping you live your healthiest life. Visit hally.com for resources, information, tips, and much more. Let us help keep you and your family healthy and well.
Thanks for listening. We hope you tune in again.
Caitlin Whyte: Welcome to Hally Healthcast, the wellness podcast from Hally Health, your partner in helping you live your healthiest life. Every episode on our podcast addresses a new topic important to your health and wellbeing, bringing in expert doctors, therapists, and specialists who offer advice and answer your most pressing questions.
February is Black History Month. So today, we're discussing an incredibly important topic for our communities and our country as a whole, the pursuit of health and racial equity for black Americans. Here with us is Dr. Kevin Teal,
a staff neurosurgeon at
Caitlin Whyte: Carle Neuroscience Institute in Urbana, Illinois. Welcome and thanks for being with us today.
So Dr. Teal, we know that issues of race, racial injustice, and racial inequities have been in the news a lot the past few years. Before we even delve into the healthcare aspect, can you tell us a bit about why so many people are focusing on these important topics now and why this focus is needed in our communities and all across America?
Kevin Teal, MD: Well, I think it's a great question. And I think we're living in an interesting time where there just been a syngergy of actions and events and awareness that have really pushed us to a new place as a country. And I think we're experiencing that in every discipline. And so I think as we look at these issues through the telescope of time, I think we just see that it's kind of deja vu all over again. And I think we're having to learn different lessons now in a newer context. But I think we see that there's been a thread that has been unfortunately consistent and we can trace that to some inequities and injustices and patterns that have been very debilitating for various communities.
And I think we as a country start looking at how do we take care of each other, how do we navigate crises. I think we're having to ask some fundamental question of why do we have some of the inequities that we have, how does that play out in people's resilience and reserve. And so I think this is a really a pressing issue now. I just think there's so many different things going on across the countries, I think across nations, that I think we're being called to look at how do we build systems that help people. And I think when the systems are stressed, we really see the weaknesses and we see the fault line. And I think from a sanity standpoint, we're trying to figure out how to make things more resilient and build things up so that people can navigate better through things like COVID and through things like hurricanes and financial crises.
And so I think in the healthcare arena, all these things back up to our doorstep when people come in and they haven't been taking good care of themselves or they've found themselves falling deeper into addiction or finding themselves, you know, in emotional stress and turmoil. So I think it's just been a perfect storm, so to speak, of economic, of social, of political. And then I think all of that comes back to the medical because we treat everybody from politicians to paupers.
Caitlin Whyte: Yeah. No, that's a perfect word for it, a perfect storm like you said. And moving on to the healthcare aspects specifically, can you tell us a bit about the disparities and inequities that exist within this field? It's slowly starting to make the news, but I think many people are still
Kevin Teal, MD: Well, again, I think when we look at the issues of, you know, just wellness, health and wellness, I think those are concepts that we throw out and think that everybody has access to the same health and wellness vehicles and processes. And so I think when we look at something like the infant mortality rate, you know, in our country, I mean, we're not doing the best despite our financial resources. And so I think there's many reasons for that. I think there are reasons that have been baking for a while.
And so when we start trying to address these issues, we find something like, you know, black female mortality rate around pregnancy, which is just disturbing and cuts across socioeconomic lines and educational lines. So when we start unpacking these problems, then we have to look at the history, look at some of the cultural practices that have come in and also look at some of the social and psychological stressors that are there.
And as we as clinicians, try to unpack, well, how do we start earlier with these moms? How do we start earlier so we can get them in the system and get them better? And those are difficult questions and it really backs up to educational questions and social access questions. So all those issues kind of work to give us this tapestry that we have to work through. I mean, there's studies that have been done and you look at any major city, but there are certain ZIP codes that are predominantly African-American or predominantly Hispanic, and the life expectancy is different from a ZIP code that is five miles over, which is predominantly Anglo. And, you know, you're seeing decades difference between people's life expectancy. And that goes to the lifestyle and the life experiences of people.
And so if we have access to healthcare and can get our prostate checked and our breast exam and our COVID vaccines and our booster shot and all these things, we're going to do better. And as we're heading into this pandemic, we're seeing-- you know, what's going on in South Africa is very telling. I think I saw a stat where it said 66% of Europe was vaccinated versus 6.6% of South Africa. And so again, you're looking at 94, 93% of your population is not vaccinated compared to 44%. So you're going to have a different experience in a pandemic, right?
And so some of that's access, some of that's quality. Again, if you're not getting your breast exam about once every five years, you're playing Russian roulette with whether you're going to have something develop over those five years. But people have to make hard choices about, do they eat? Do they stay afloat? Or do they buy a $1,500 health plan on the net or something, you know, through all these venues?
So this is really, I think an issue and it backs up to the economic question. I think when we look at wealth in our country, I think the percentages are that African-Americans have like 2% of the nation's wealth compared to our Anglo counterparts who have, you know, 80% and that's just really a resource issue. So it boils down to a resource question. If you have the resources, you tend to put more at work for you in advocating for yourself, dental health, you know, mental health, physical health, exercise, fruits, and vegetables, all those things that we know are going to be healthy for you. So all these things, you know, impact access to resources. And I think that's really a big part of the problem. And when you let that play out over a couple of centuries, then you start getting, you know, more patterns of cardiovascular disease, more problems of kidney disease, more problems of hypertension and diabetes. And how do you, you know, start bending that arc to healthier eating and healthier exercise patterns. So it's going to take time.
Caitlin Whyte: Yeah, of course, it's going to take time and you know, we're talking about such a large issue here. But with these disparities and inequities existing in our communities, what can doctors and other healthcare professionals try to do to start addressing these issues?
Kevin Teal, MD: Well, I think there's a lot and I think medicine has tried to work toward giving people some cultural awareness and sensitivity. And so I think studies have been done in the African-American community. I'm sure they've been done in the Hispanic and Asian communities. People tend to resonate more with doctors that look like them, and they tend to listen to the advice that they're given through a different lens, ideally.
And so there was a study done in California where they looked at barbershops as a way to talk about taking your blood pressure medicine for African-American men. And they paired them up with African-American physicians and they saw a significant decrease in the blood pressure of the men who had come through a community portal, had found a physician that looked like them and could speak their language and help them reality test where they live and really help them get on top of the problem and give them accountability and access.
And so I think looking at that is part of it. And I think for situations where there aren't African-American or Hispanic or Latinx physicians in the community, I think having our Anglo counterparts understand some of the cultural issues that their patients of color are going to be facing, how they encounter, you know, coming into the waiting room and there's armed security there or police there, how that sets them up for a different experience in the clinic, right? And so, working through that, kind of making that process something that's not intimidating or threatening, but something that is helpful to keep the clinic flow going, you know, those kinds of things.
So I think being aware of those things and really just listening to your patients who share with you an encounter that they had in your clinic or in your hospital that was not culturally sensitive, that didn't make them feel valued, that made them feel less than getting the best treatment and kind of unpacking that experience. And I think that's part of what I see the healthcare system and healthcare workers having to do, because from the environmental services people all the way up to the CEO of the hospital, we have to have a culture that understands that not everybody has access to the same things and not everybody has had the same life experiences.
And so trying to work through that and not endorsing things that are dysfunctional per se, but unpacking things and helping people understand that though that may have worked for your grandmother, that's not going to work for you with your high blood pressure. And so that's not going to work for you with your diabetes. You know, you're not going to be able to eat all the pecan pies and pound cakes and, you know, do that day in and day out. So looking at people's experience and diet and helping them understand that they're going to have to make different life choices. And they're going to have to be maybe the sentinel person who goes back to their community and say, "We need to start cooking differently. We need to start eating differently. We need to start being more active," if they can, right? If they're in a neighborhood that's got a green space and they can do that.
Caitlin Whyte: Now, I've heard a lot of inspiring stories about the role specifically of black doctors and healthcare workers. Can you tell our listeners how these care providers are taking action across the country?
Kevin Teal, MD: I think one thing that black doctors and physicians of color are having to look at, and I think institutions and organization looking at it, there was an article that came out that was looking at the number of physicians of color that were in the community. And it found that when they looked at the African-American males, they had seen actually that the numbers had stayed the same or gone down a little bit since 1978. And so there was like a 5% representation of African-American males in medicine. And with the numbers trending down and not going up, at least in 2014, when it was looked at, that kind of set off an alarm bell that we need to look at, how are we going to bring more diversity into medicine? How are we going to get a pathway for students who are interested in medicine or science or technology to come through the educational processes and portals that are available to them and try to incentivize them, hopefully to come down a path where they can be present in their community in a medical way?
And so I think you've got universities that are working toward early access programs, showing students research, showing them career paths. And whether that's physicians or nurses or dieticians or speech therapist or physical therapist, really getting more diversity across the waterfront so that patients, whatever portal they come through, are finding some more cultural sensitivity and the healthcare environment is becoming more culturally sensitive.
And so that I think has been a big outgrowth of some of the recent turmoil, because I think we're looking at every institution and wondering are we representative of the community that we're serving. And so I think as being engaged in the medical field, I think it helps all African-American physicians and other physicians of color to take a stewardship role and look across and see who can we help develop so that we have more people coming down this pathway and we don't see it dry up, knowing that the system needs more diversity. So I think that's one thing that black physicians and Hispanic physicians and Asian physicians are partnering with our Anglo counterparts to bring more diversity to the landscape of medicine so that patients are getting a better experience and our organizations are becoming better representatives of what's coming in through our ER doors and through our clinic doors.
Caitlin Whyte: Wow. I'd love to get into that history a bit because while these are newer issues in the culture and the news, they're not new issues in the grand scheme of things, right? People have been fighting these issues for a while. So can you tell us a little bit about that history? For example, about the formation of the National Medical Association and the Black Physicians of Carle?
Kevin Teal, MD: Right. Well, like you say, a friend of mine gave me a book a couple of years ago, and it was talking about healing the racial divide in American medicine. And I had never heard of this book. I had never heard of the racial divide, and it's basically called The Racial Divide in American Medicine. And it was edited by Richard D. deShazo, MD. And it's written from a group of doctors who were actually in Mississippi. And it's a very interesting snapshot of the history of American medicine. And they talk about the National Medical Association, which was founded in 1895 as the National Negro Physicians, Surgeons, Dentists, and Pharmacists, and it was founded in Atlanta.
And it was founded as a result of the black physicians and professionals not being able to get into the American Medical Association. And so there were some members of what was called a Medical Society of District of columbia who had been denied delegate status to the AMA. And many of them were actually black faculty members at Howard University College of Medicine. So they renamed the organization the National Medical Association. And this rejection of black physicians by the AMA in the 1870s, unfortunately was supported by former confederate doctors and surgeons who were AMA members. There was a famous general JM Keller, MD, who was on the AMA ethics committee. And he was a confederate general who didn't want the black physicians in the AMA. And so this was a problem because you had to be in the AMA to be able to get credentialed at the hospitals. And so the NMA founded itself really as a parallel organization providing educational efforts. They had a biracial house of delegates and board of trustees, hopeful that they could one day be integrated with the larger medical community.
And so they continued to try to get back aligned with the AMA, but the state medical associations had local restrictions that persisted until the 1970s that said that black physicians could not be members. And so this really set up a parallel system because there were black and white physicians that had to set up separate hospitals. So there were black physicians who actually built hospitals in Mississippi and other states, Oklahama, Chicago to allow their community to have access to a hospital. And so this continued until really Medicare because Medicare came out and said, "We couldn't have separate hospitals." So this Title VI in 1965 and it pushed the hospitals to end segregation. So ultimately, they were able to prevail and get integrated.
And so the AMA and the NMA still exists now, obviously, and the National Medical Association continues to advocate for issues that are important for African-Americans and provide medical literature that addresses some of those concerns. And so this I think is a legacy that a lot of us didn't know about. And so, you know, to their credit, I mean, during Freedom Summer in Mississippi in 1964, NMA members, along with members of something that was called the Medical Committee for Human Rights from New York, took care of the volunteers who were in Mississippi that summer. And if you remember, there were three workers who were killed in Mississippi during that summer. And so this was risky for the physicians.
And so there was a lot of high risk for African-American physicians who were working in the south and trying to be advocates for their community. And so interestingly, the dean of the University of Mississippi would actually join the local NMA chapter in 1965 because he was working with black physicians to integrate their hospitals so they could keep their Medicare status. And so he became one of the few white members of the National Medical Association in Mississippi of all places.
And so it took until 2008 at a national NMA meeting in Atlanta for the AMA to issue an apology for his role in racial discrimination in medicine. And they acknowledged the wrong they had done to African-American positions, their families and patients with the attendant healthcare disparities.
And so that's the history. And I think, again, we think these problems just started, but they didn't. And again, if you can think back to 1950 and 1960s, 1970s, if a patient was going through a hospital that wasn't and didn't have all the bells and whistles, didn't have all the equipment and they were struggling to even to go to the basic level, we can see how that set up a pattern of inequity and poor health that was going to persist. And unfortunately in places like Mississippi, we still see very low health quality and very low health outcomes. And I think we look at that legacy and I think we squandered an opportunity to help our whole country get better and invest in communities I think at an early level that really would have helped I think set a different trajectory for us.
And so the Black Physicians of Carle was birthed out of these charged events, the death of Ahmaud Arbery, Breonna Taylor, George Floyd. It really was a crescendo that I think awakened a lot of people of color and particularly African-Americans. And so the Black Physicians of Carle, which is a chapter of the NMA was started in June of 2020. And our role is really to be a source of community, education and advocacy. And so we want to build community for the African-American physicians, some of the unique stressors that go along with that. And then we want to provide education to the community as a whole. And then be an advocate for us moving ahead, so we can address some of the pressing problems that are facing us.
Caitlin Whyte: It's wild to how that's just another part of history we didn't learn in public school, right?
Kevin Teal, MD: Right. We missed that class.
Caitlin Whyte: We missed that one. Yeah. So Dr. Teal, most of our listeners most likely aren't doctors or healthcare workers. So focusing first on our Anglo allies, what can they do to help make healthcare more equitable for black Americans and other people?
Kevin Teal, MD: Well, one thing that I really advocate for people is for them to become educated because I mean, one thing has been my own personal journey in the last three years is really reading books like The Racial Divide in American Medicine by Richard deShazo, books by Beverly Daniel Tatum. She's written a book called Why Are All the Black Kids Sitting Together in the Cafeteria? which looks at racial, ethnic, and cultural identity development. Reading a book recently called The Warmth of Other Suns by Isabel Wilkerson, which chronicles the story of Jim Crow and how African-Americans had to migrate out of that or a lot of them did to escape and get to a life where they could live. And then another book, The Half Has Never Been Told by Edward Baptist, which he's a Dartmouth professor and it took him 12 years to write this book, just meticulous unpacking of slavery and what that was like and what that was about. Because I think if we don't have an understanding of it, I think we sometimes come alongside people and say, "Well, now, dust yourself off, pick yourself up by your bootstraps. Let's run on." And I think we don't realize that there are some things that need to be addressed and then there's some things that need to be kind of unlearned and things that need to be implemented so we can all feel and grow to our fullest potential. And so I recommend getting some information and knowledge. I think those are resources that will be helpful to people, because I think you really can't have the conversation if you're not grounding the conversation in reality.
And I think there's been a pretty strong miseducation process. And I think, I mean, I was included in that. I grew up in Texas. I didn't get a good sense of all the nuances that were going on to kind of drive that system of disparity. And I didn't understand that. And so I think sometimes we're quick to blame the victim if we don't understand what people have gone through. And again, there are things that we want people to change and adopt, but I think it's a process of understanding where people have been, what stressors they're facing and then figuring out how we can help them navigate to a better place. But I think if we do that with the sensitivity and awareness, I think we don't put answers on the table that offend people or don't acknowledge what they've been trying to do already.
Caitlin Whyte: Well, and then on the flip side of that question, what would you say, not to put the labor back on the black community, but what can black communities do to stay healthy and well even in the face of these disparities?
Kevin Teal, MD: Well, I think the challenging thing is that when we look at something like the African-American female mortality around pregnancy, that doesn't respect socioeconomic class. There've been a couple of high profile female physicians who've died after giving birth within the last year. And so this wasn't a 1968 problem, this was a 2021 problem. And so I think that understanding that something is going to be higher risk in a certain situation, I think is helpful. So we don't put people off and not pay attention to their symptoms, that we don't minimize when they say they can't breathe well, or they're noticing they're got swelling in their foot.
I think sometimes we're quick to, you know, not delve into a symptom that may be leading us to a bigger problem in a population that we know could be higher risk during the season, you know, African-American females during pregnancy. So I think African-Americans have to, again, adopt lifestyles that are going to be helpful to them, eating fruits and vegetables, eating things that aren't always fried and using moderation with things so we have a balanced diet. We also have to learn to take time off. We have to learn to step away.
There's a great book called Five Gears, which talks about first gear, which is self maintenance gear. And so being able to take time off, to relax, take vacations, recharge. And then, you know, our second gear, the gear where we take care of our family and our friends. So we have relationships. We have homes. Our third gear is a social gear where we are interacting with people and building a broader culture of contacts and networks. Our fourth gear is multitasking where we're able to do the things, taking our kids to the games, going to work, you know, networking through our emails. And then our fifth gears project gear, where we've got to get something done in a timely fashion.
And so I think we have to learn to navigate those spaces successfully. And also do it in a way that's helping. And I think as we grow, African-American physicians and professionals, we grow into a different social status. I think hopefully we can continue to contribute to organizations that are helping educational prospects for African-American students, investing in scholarships in medical school, investing in African-American universities, investment in charitable and, you know, social giving. And I think also getting educated. I think sadly the miseducation process has gone pretty deep for African-Americans also. So reading books like Stamped From the Beginning by Ibram kendi, again reading Beverly Daniel Tatum's book, understanding where we've been and then charting a new path of where we want to go.
I think we're living in a time where the history is being written and unpacked in a way that's making it really accessible. And so I think it's an exciting time to get our families educated, to get ourselves educated, to be part of a community that's more aware, that's more sensitive and then that's more proactive and less reactive.
Colin Kaepernick has a great series on Netflix called Colin in Black & White. And he really unpacks a lot of impactful conversations that we need to have. If we're going to be a multicultural society, what does that look like? How do we make each other feel welcome? How do we value each other? And I think these are timeless conversations, but I think in a pandemic, they become more pressing. And so I think life is going to send enough crises and stresses our way to where we're going to have to, I think as Martin Luther king said, we've got to learn to live together or perish together as fools.
Caitlin Whyte: Well, Dr. Teal, like we mentioned, it's a very large nuanced topic to fit and do a half hour conversation. But with my final question, in today's world, we've often are captivated by headlines of the day and it's hard not to live in the worry of emotions in the moment and pandemic news every 10 minutes. I know I'm on Twitter way too much. But looking towards the future because, you know, achieving health equity isn't going to happen tonight or tomorrow, despite being in a pandemic, what would you say the future direction for making America's healthcare more equitable for everyone is? What are some big steps or future actions that you think will be or need to be taken in the years to come?
Kevin Teal, MD: Well, I think that what we're finding is we've got to make healthcare accessible to people right where they are. And so, again, coming from states where we didn't expand our Medicaid to allow people to have access to basic services, right? So I think we've got to look as a country as how do we invest in our people? And I think we can invest in so many different things, but I think we really squandered a lot of opportunities to invest in people and help people develop so that we as a country can be the best we can be and stay competitive, right? Not in a way where we're cutting off the needs of other countries, but where we're competing well with other countries and helping them get better. So I think that's going to be our future and how we do that I think is going to cut across party lines, is going to cut across socioeconomic lines. But I think we're understanding that that's how we all rise together. So I think that's going to be part of our future direction.
And I think having difficult conversations with each other, I think that's something we practice in medicine all the time. How do you tell somebody they have cancer? How do you tell somebody, you know, their family member has a life-threatening brain injury delicately? Delicately, but directly because the conversation needs to be had. And I think we're at a place as a country, we're going to have to mature enough to have hard conversations. We're going to have to acknowledge past failures because that's how we're going to get better. And I think if we can see it and acknowledge it, we can correct it. But if we deny it and don't see it, then it's impossible for us to correct it.
So I think medicine's data-driven. We need good data to make good decisions. And I think we, as a country are going to have to accept the historical data unvarnished and say we can do better than that. I think anything else is going to be putting our head in the sand and hoping for something better, which traditionally doesn't work out.
Caitlin Whyte: Well, such great information, doctor. And you've simply been a wonderful, knowledgeable and inspiring guest. Thank you so much for joining us today and for all you do every day at Carle and beyond to help so many people throughout our communities.
And that concludes today's Hally HealthCast. Tune in next time as we tackle yet another important topic for your health and wellbeing. And remember Hally Health is your partner in helping you live your healthiest life. Visit hally.com for resources, information, tips, and much more. Let us help keep you and your family healthy and well.
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