Prakash Chandran: Health disparities are preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by disadvantaged populations. As a minority group, black Americans today must struggle with a wide range of health disparities, including higher rates of diabetes, hypertension, heart disease, obesity, asthma, cancer and preterm birth. Additionally, in terms of access to higher education in healthcare, black Medical School, applicants represented only 8.4% of the US Medical School applicant pool compared to 46.8% of white applicants in 2019.

So what are the contributing factors that cause these disparities in the first place, and how can health and education outcomes be improved for black Americans? We're gonna talk about it today with Dr. James Lundy, chair of Emergency Medicine at Bergen Newbridge Medical Center and Reverend Gregory Jackson, Pastor Emeritus of Mount Olive Baptist Church. This is Wellness Waves, a Bergen New Bridge Medical Center podcast. My name is Prakash Chandran. So, Dr. Lundy and Reverend Jackson, really great to have you here today. I really appreciate your time. Dr. Lundy, I wanted to start with you. I talked about a lot at that introduction. We're up at the top. I'd love to understand a little bit more about the disparities that Black Americans face in terms of overall health and wellness.

Dr. James Lundy: Okay. Thanks for having me here and, given the privilege of talking to one of my dear subjects being an African American male and in the healthcare field for 28 years now, I've, seen this upfront. Okay. Now, some of the disparities I've seen is multi multifactorial. Okay. The talking points of the breaking down is some of the socioeconomic status we see in, this country and certain patients. Inadequate access to healthcare. Okay. Environmental threats, individual and behavioral factors and educational in inequalities, that have, contribute to. This healthcare disparities in our country here. I mean we need, days to talk about this to get there.

 And I'm trying to get talking points in to, just to sum things up, like that. But these are the, some of the, but the socioeconomic status is probably one of the biggest ones. And the second is access to healthcare. Okay. Access to healthcare, I think is something that, is being worked on by the government and the change in healthcare. And these healthcare systems are getting more and more smaller, urgent cares, smaller, quick care places to have access. Now the problem. The African Americans who are mostly in this country, in the metro areas like that, it's actually the numbers. And the numbers of patients compared to the fraction number of ratio to facilities, that can actually contribute to the overcrowdingness.

 I've worked in, I trained in inner city in Detroit. And I then also worked in Newark, New Jersey, where, we have an emergency department, either 12 to 14 hour waits, you know, like that, where we go out to the suburbs, whereas less minorities where there's less than a half an hour wait. So this, I'm not just access to care of facilities, but also access to care of standing facilities. It's even difficult.

Prakash Chandran: Yeah. You mentioned a number of different things there and some of those factors. I'm curious around what the actual contributing factors that have led to this disparity, and you're starting to touch on it, but Reverend Jackson, I'd love your opinion on this as well.

Reverend Gregory Jackson: Well, thank you. Certainly I agree with what the doctors mentioned. But one also is I think, access revolves around economics as well, insurance company and whether or not people can afford it. The Affordable Healthcare Act, I think was a wonderful gift to the underserved and unserved people of our nation. Sometimes politics get in the way in terms of certain states of offering these kind of very much needed programs for people, but also those people who might have the insurance. Sometimes it's a matter of the location where the hospital is. If you can't get there, it doesn't matter what kind of insurance you got, and.

And sometimes it's not a matter of being rural, you cannot have access because of lack of public transportation or the affordability of public transportation, even in an urban environment. Beyond that, I think that's some psychological, maybe even some kind of spiritual kind of thinking that some church folk may have that all you need is Jesus. Just let the pastor pray over me over my more than 50 years of ministry. I've seen those kind of situations that people believe in holistic medicine or some other kind of spirituality kind of medicine. And I think that it's important for those of us who are in the faith community to try to debunk those kind of thinkings and talk about a combination of both the spirituality as well as the medical.

Prakash Chandran: Yeah, Reverend Jackson, you know, it reminds me of what my parents used to tell me. God helps those who help themselves. the human body obviously needs attention and, praying is obviously one part of that puzzle. There are so many different factors here. Some of the things that you mentioned are baked into the culture and it seems like such a big problem to address. Dr. Lundy. I'd love to get your opinion on how these disparities can even start to be addressed?

Dr. James Lundy: Yes. One thing I mentioned it was, it's a multifactoral situation here, and it's gonna be, have to hit it at a lot of different angles. A lot of different levels. Okay. But one thing I feel is important is the trust factor the African American community has had in healthcare field over the years. Okay. Maybe we saw that with Covid.

Reverend Gregory Jackson: Yeah.

Dr. James Lundy: We saw that all the way back to Tuskegee experiment with syphilis and dealing with that syphilys. Okay. But one thing we're doing is having providers, healthcare workers, providers that actually mimic and look like us. One thing, I'm involved in a project. it's the first, medical school being, started at a HBCU campus, which is a historical black university in Baltimore and Morgan State, which is starting a first class of 2024 , who's going to. Have ability to provide more, providers of color and especially African American colors, there's a couple other projects going on.

But actually, like we mentioned before in your early statistics about there is a almost 50 year low for African American males in medicine. The percentage or as of 2019 are as low as two point, I think it's 2.7%. and overall African, African-Americans it's 7.1% and, but we make up 13% of this country. So try to get more providers who actually look like this, and that would actually bridge some of that trust factor that I'm talking about.

Reverend Gregory Jackson: Yeah, I think that's a great point too. And I think that, sometimes it is timing. For instance, it's almost impossible to get a doctor's appointment. You do not wanna miss a doctor's appointment today. If, you have an appointment, it's almost like, listen, you have to break everything else is happening in your world to keep that a doctor's appointment. Because if you don't keep it, it may be a month later before you can get that doctor's appointment. Never mind getting to the emergency room. If you have a regular doctor, you can't get to that person. And somewhere, I think I read that hell is discovering God too late. And the same thing is true about trying to get a doctor's appointment. You get one, but you already are almost dead by the time you get it. So it's a matter of access.

Dr. James Lundy: Right.

Reverend Gregory Jackson: And particularly in males too. So, historically I know black males, we don't necessarily like to go to the doctor. We have this kind of tough mentality. And finally, after your girlfriend or your significant other or your wife convict you to go to the doctor, it is already maybe too late because we've discovered that the earlier you get detective, for instance, I'm a prostate cancer survivor, the earlier you get a diagnosed and you get the treatments, the more likely you are to survive. That's one of the problems we have.

Prakash Chandran: Yeah. You touched on a couple things there that I wanna unpack a little bit, but I think a common theme that I am hearing and, Reverend, I saw you nodding your head. Was just around trust. Trust within the medical provider system. So, I wanted to just hear from you a little bit about that representation within that medical community and how it makes the black community feel to go to someone that looks and understands their culture versus another healthcare provider that may not talk about why that's so important.

Reverend Gregory Jackson: Well, from what I hear is sometimes, when you have a doctor that you go to on a regular basis, obviously that increases the trust level. When you go to some of these emergent care kind of places, these, facilities, it seems to be a matter of trying to get you in and get you out and you become a statistics and then some of the, implicit biases that doctors and others have about black people in terms of their medical conditions, what they don't need, what kind of diag, what kind of, prescription in terms of x-ray exams and that kind of stuff. It's not done, very often in low income and underserved. and, and then, the word gets out in the community that the last place you want to go and when you get sick is X, Y, Z place.

Prakash Chandran: Yeah. I mean, Dr. Lundy, let's talk about the representation of the black community in the healthcare setting as doctors, PAs, or APNs. Can you talk a little bit more about what that looks like and why there's not more representation there?

Dr. James Lundy: Well. Again, that's another multifactorial situation. The representation for the physicians and ancillary staff for which are our mid-level providers, which are APNs, and physician assistants, is actually the inability to get into schools and programs. There is a gateway to those programs, but actually we have to get in. Now, there's a lot of reasons why we having to get into, you know, cause these are our licensed programs you have to go through to become licensed, to be a provider in a healthcare field. Now, the problem is if you take, statistics have shown that, the amount of African-American kids coming out of high school and even in college, their interest in medicine is very low for one thing.

So the thing is, we can't start, we cannot start at the college level and say, Hey, you wanna be a doctor? You wanna be a nurse, you wanna be a LPN? We have to catch them earlier. Okay. So bridge programs, which are done by the community, done some hospital systems done by some universities where you started to get these kids in sixth, seventh grade. You said, Hey, let me show, let me bring you to the hospital. let me show you around. let's you come and talk to some doctors and nurses and LPNs and, just get, feel more familiar, get more comfortable with the field of medicine. This is something that, they definitely gonna be needed in the future and we need to get them more involved.

But Bridge Programs is getting them something started because once they get in college, it's almost too late because they've made up their mind, about the choices they've made for, most universities. I mean, statistically saying that most universities start out with large pre-med, Classes in the biology year, but sometimes the nutrition rate is so low, it's almost only 1%, maybe one to 2% actually graduated in that field. I'm talking about African American, HBCU colleges like that. so by the time we get into college, it's almost. Okay. So that's one thing we have to, consider is, catching these young men and women earlier, maybe in a middle, high school level.

Prakash Chandran: So Reverend Jackson, I'd love your take here. Obviously getting to them earlier, encouraging them that they can do it, and also just basically inspiring them earlier. How do you see that happening in the community?

Reverend Gregory Jackson: I see it happening in the faith community, but I also see it not just in the faith community. I think that in the barbershops, to encourage kids, young men and young women that it is possible. And because I think, in the sciences, that's a very difficult thing sometimes kids don't feel like they can do it. I'm just thinking about my own life. In high school when I had to take biology, that was not exactly the greatest course in the world for me, and remembering the parts of the body and all that kind of stuff. But it is possible and I think that with doctors like Dr. Lundy participating from time to time, or if he's a person of faith in his own faith community or visiting faith communities or whatever, in terms of the African American community, it will be helpful. Even though in this virtual space, attendance is down, but it might be even more of a to reach more people virtually, like we were talking right now than we might be able to reach if we were in the building.

Prakash Chandran: you were speaking earlier about showing up, right. Showing up for the appointment. And one of those disparities was basically just geographic. So maybe now that things are digital and you have that quicker access to a doctor via Zoom, for example that hopefully that will improve outcomes. Is Dr. Lundy, what are your thoughts on that?

Dr. James Lundy: Yes. it is easier access and the more access, the more beneficial we'll be with patients. But it's still not actually, like seeing the doctor or provider face to face. Okay. I mean, I'm a provider. I'm, I've been doing this for 27, 28 years now. And the telehealth thing is, I can't put a stethoscope on someone's chest. Okay. I can't touch their hand. I can't touch their hand and see if they're fee brow. I can't, see if they're fi diaphoretic, seeing if their feet are swelling, even though they can tell me that. But it's diff it's a difference now, but any little extra access can be it's not all negative.

It's a positive thing. So the more access, as I mentioned before, the, I think the more success we have. But we have some older patients and debilitated patients who cannot make it to doctors' offices, by having telehealth and if they have, that goes back to socioeconomic. But do they have the equipment to have the access to the telehealth of that? Do they have the laptops to their iPads? Do they have the phones and stuff like that? These are things that, like I say, it's multifactorial that we really need to, hone in on.

Prakash Chandran: So understanding the nature of it. Like I want to talk about how this gets better, how do we improve the outcomes for Black Americans, and how do we start to bridge the gap on some of these disparities? Reverend Jackson, I'd love to start with your thoughts.

Reverend Gregory Jackson: Partnership with hospitals. I mean, I think that during Covid, Newbridge was wonderful in terms of helping to, open the doors of access to African American persons. And so on this end, I was reaching out to pastors and congregation, and then through greater Bergen community, actually we were setting up access through transportation and that kind of stuff. I think partnership works, conversation, communication with one another. Also I can think of my own life. When I first discovered that I had prostate cancer and I was sitting down in a deacon board meeting and I was telling him, I gotta have this surgery. Most all of those guys in the room were older than me.

And they started talking about when they had prostate cancer. This was like 25, 50 years ago, how terrible it was, and scaring me to death. But what I found out it wasn't like that at all. The whole world had changed since they had prostate cancer. They were already 75, 80 years old. Here I was about, 50 years old. So, I think, conversation and talking about how medicine has changed is important to maybe open the doors and encouraging other people to go to get checked out or what have you.

Prakash Chandran: Yeah, Reverend Jackson, you're talking about the importance of partnership and this conversation is a representation of that. We have a reverend and a doctor, basically two members, important members of the community coming together and talking. Dr. Lundy, I'd love your thoughts there. And I'd also maybe like to talk about beyond just partnership, any programs or support systems that might be available to help bridge this gap?

Dr. James Lundy: What I'm gonna touch on what Reverend Jackson mentioned about like, our hospital, Bergen New Bridge, medical Center. And we have a great PR program. We have good community service program that comes out to the community and reaches out of community. So being visible into this community, having the community accessible to us. It's actually like that. It's, one of the things that our hospital has done, and hopefully we're pioneers to other hospitals and other systems that are out here. And then there's some great other hospitals that are doing great things too, like that.

Prakash Chandran: I think you started to speak to this. I think there's a theme of visibility, right? Like how do you bring and surface up this, issue in a more apparent way by partnering with each other, by bringing members of the community together, members of the spiritual community, members of the medical community to really basically try to holistically solve this issue, which feels so big. So, just as we start to wrap up, I always just want to ask like one question. There's gonna be a lot of people listening to this. They might be future leaders of the black community. They might be members of the black community or just otherwise. I want to ask one thing that you wanna leave or something that you want them to take away from this conversation. And Reverend Jackson we will start with you.

Reverend Gregory Jackson: Let's do the same thing with cancer and with high blood pressure and with diabetes and many other diseases, that's killing people and certainly killing black people as we did with Covid. Make sure that we partner and when New Bridge, I don't know, they have this, I call it a rolling hospital, this big bus man, whatever it is that they bring right to the parking lot of the church. My job is to pastor, is to talk about, get people sign up, have enough leeway so that we can make sure that they're not wasting their time when they bring their van or the bus to the church community. and my job would be to encourage pastors, not just at my own church, to encourage pastors that we can have it in Mawa or we can have it in Ridgewood.

And then the whole idea, that certain communities, there's not low income and unserved people, underserved people. In Bergen County, we tend to think, oh well, we're just the black community. Hackensack and Tinik and Inglewood. No, there are low income people all over this county and we need to figure out how to spread it out in Garfield and Ridgewood and Mawa and other places as well to reach out to those underserved people.

Prakash Chandran: Yeah, an amazing message to end on Dr. Lundy. We'll let you have the last word. Anything that you wanna leave our audience with today?

Dr. James Lundy: Yes. And I agree with everything Reverend Jackson just mentioned. I agree. But also, it's a two-way street. I think everyone has to take accountable for their own health. You can rely just on doctors or hospital systems. you have to do the research. If you get a diagnosis, if you get a question with the internet these days, it's a lot of information out there, you can go to hospital websites, Newbridge Medical Center's website's a great site. You have CDC and a lot of hospitals and web MD they do the research on yourself.

A healthcare provider, mentions a, condition or possibility. You look it up. If they've mentioned a certain diet, you look it up, see if it fits you. Part of it, you have to do some of the work yourself, doctors can only, you know, with the healthcare systems there. Unfortunately healthcare today is a healthcare business. It's not healthcare like. when me and Reverend grew up with, either family doctor knew everyone in the family, this is a business these days, you know, you have to ask the doctors for help. If you have questions, to call the doctor's offices, just be proactive is the worst question, like I said. And we're out here to help and, we encourage, To live a healthy lifestyle and, that's it.

Reverend Gregory Jackson: The other thing if I may just add, that I think is a real problem. Just what we're doing right now is not feasible and possible for so many people in low income and underserved community. They don't have access to technology or to computers, and some of the seniors may have the access, but they don't know how to use it. So it's the same thing. Doesn't matter whether you have it or not, but. If you don't know how to use it, it's a real problem. So a part of this modern technological world that we live in is lack of computer and networks kind of systems.

Prakash Chandran: Well, we, covered a lot today. I think we could probably talk for the next decade about this. I know that there are a lot of issues here, but I think the takeaways, this visibility partnership from the community and also some accountability, just making sure that. We all put in the work that we need or people put in the work that they need for themselves to do the research and to take care of themselves. So Dr. Lundy and Reverend Jackson, I really appreciate your time. Thank you so much.

Dr. James Lundy: Thank you.

Reverend Gregory Jackson: Thank you .

Prakash Chandran: That was Dr. James Lundy, chair of Emergency Medicine at Bergen New Bridge Medical Center, and Reverend Gregory Jackson, pastor Emeritus of Mount Olive Baptist Church. For more information, you can head to new bridge health.org, and if you found this conversation helpful, please share it on your social channels. Thanks again for tuning into this episode of Wellness Waves. My name is Prakash Chandran. Thank you so much and be well.