Terry Streetman (Host): Hello, listeners. Thank you for tuning into the Well Within Reach podcast, brought to you by Riverside Healthcare. I'm your host, Terry Streetman. And joining me today is Dr. Stonewall McCuiston, Chief Medical Officer, who's here to talk about health disparities in the Black community and how we can rebuild trust in healthcare. Thanks for joining us, Dr. McCuiston.

Dr. Stonewall McCuiston: Thank you for having me.

Host: So, we'll start off, I know you've been on the podcast before, but can you give our listeners a quick reminder of your role and your background?

Dr. Stonewall McCuiston: I have been practicing here in town for approximately 37 years as an internist and as a pediatrician. I've had different roles here at the hospital, some of the community boards. And I am presently now the vice president and chief medical officer here at Riverside Medical Center.

Host: Well, all right, that's a big job, and thank you for joining us, taking the time out of your day. So, let's jump right into it then. What are some of the health disparities that we see in the Black community that you want to highlight?

Dr. Stonewall McCuiston: Well, we want to highlight that there are higher rates of heart disease, higher rates of stroke, higher rates of cancer, higher rates of asthma, higher rates of influenza, higher rates of pneumonia, higher rates of diabetes, higher rates of AIDS and HIV, higher rates of STDs in the Black community. And one thing that you do need to know, we have higher rates of infant and maternal mortality.

Host: That is a long list and an important topic and I'm glad that you're here today to talk about it. And the other part of our topic today then is also medical mistrust. Can you talk about what that is and how it contributes to these disparities?

Dr. Stonewall McCuiston: That had started a long time ago with the medical mistrust that started back in the 1800 when they had enslaved Black women and they were doing experimental processes and surgeries on them. That was started by the father of obstetrics and gynecology. He did a lot of experiments on women without their consents, without anesthesia. Everybody is aware of the Tuskegee Project where men were given syphilis and went untreated. And the latest wanted to come to light was Henrietta Lacks, where John Hopkins took her cells without her permission and used them for research.

And most recently, the COVID pandemic where Blacks, we were the last one that gets the vaccines. We weren't treated as fairly. When we looked at it, we had higher admission rate, higher ICU rates. So, just that mistrust is out there.

Host: Yeah, that's a long history of it, and I think that's important to address. And so when it comes to Riverside, why are these particular topics important in the communities that we serve here in the local area and beyond?

Dr. Stonewall McCuiston: Well, it starts at the top. It is important to the board, important to the senior leadership, and all the way down to the medical staff. We're trying to do things to bring back that distrust.

Host: Okay. What are some of the other contributors then beyond medical mistrust when we talk about these health disparities?

Dr. Stonewall McCuiston: Well, you always have to look at social determinants of health. Riverside is big on looking at that. When you come to the clinic, you're looking at education, food, environment, economic, social. If you don't have a job, you can't have housing, you have trouble with food, you have shelter problems. It affects you. It affects the kids. Kids have these adverse childhood events. Not only it affects their mental wellbeing, but when you look at the study, they go on and have other healthcare problems associated with that. So, that needs to be addressed globally. I do think the CDC has made it a major initiative and Riverside have made an initiative at all of their clinics.

Host: I've definitely seen and heard that, you know, with appointments where they ask questions about do you have housing? Do you feel safe at home? Do you need resources? So, that's a great thing for Riverside to be doing. Before we continue, we'll take a quick pause to discuss the importance of primary care.

At Riverside, our primary care providers are right here in your community, offering personalized care for you and your family close to home and connected to the specialists and services you may need. Having a primary care provider means having someone who knows you, listens to you, and helps you stay well through every stage of life.

From annual checkups and preventive screenings to managing everyday concerns when they pop up, because remarkable care should never be out of reach. Remarkable care right where you live. To find a primary care provider who's right for you and your family, visit myrhc.net/acceptingnew.

Okay. We'll jump right back into it then. We've talked a little bit about this with social determinants of health and some of the other things. What is Riverside doing to address health disparities and medical mistrust?

Dr. Stonewall McCuiston: Well, it is talked about in the medical group and with the medical staff at the hospital. If you are aware, Riverside does have a food pantry. And I think we are the only hospital in the state of Illinois that has a food pantry that we can refer patients to and employees to.

Host: Wow, that's really good to have in the community. I know that's been a big issue that people face. And that's wild to know that we're the only one. That's impressive. So, one of the other things I know that you're involved with is the NAACP. How does that work influence how you think about these issues?

Dr. Stonewall McCuiston: Well, with the NAACP, we had several town hall meetings with them where we had different physicians from the medical staff and the community come where we sat and took questions. They could either do questions live, some people were online and listened to. So, we sat there for a couple hours, explained different processes, how you get into the system, what symptoms you may be having. We were able to let people know what we do here at the hospital and what to expect when they get here.

Host: I think that makes sense and goes a long way toward like helping people feel more comfortable going to the doctor, because they have that face they can connect it to And that openness

Dr. Stonewall McCuiston: And that's right. They need a face. They want to know who are they going to be seeing.

Host: Yeah. Well, I'm glad that we get out there in the community and do that. So, what are some things that people can do in their own lives to reduce their risk of chronic health issues?

Dr. Stonewall McCuiston: First thing you have to do, you need to be an active participant in your care. You need to get a primary care doctor. You need to go and have all the healthcare screenings that are recommended. You need to get the immunizations that are recommended, get the appropriate lab work. You need to be able to speak to your provider about your needs. You need to be able to ask questions and get those questions answered, and you need to feel comfortable in that environment.

Host: Well, and I'll give another plug then. If folks don't have a primary care provider currently, you can visit myrhc.net/acceptingnew and find a primary care provider who's accepting new patients. So, speaking of those providers, how can providers and healthcare systems restore trust in healthcare?

Dr. Stonewall McCuiston: They have to realize that it is for real and not bury their heads. I think doctors here in Illinois, you have to do a course on implicit bias. So, that's one thing that we'll help on. Riverside will provide some education. You just have to recognize that you may have some implicit bias and you have to realize that and have it come to a front. You have to realize that everybody is different, but everybody needs to be treated the same.

Host: Yeah. And that's one thing I do appreciate as an employee here at Riverside, not in the clinical side, but the resources we have for training and some of the things we do to highlight those during Black History Month on this specific topic. I think that's really important, as you said. We're getting toward the end here, and I have a question that I always like to ask. What is the biggest takeaway that listeners should have from this episode?

Dr. Stonewall McCuiston: You need to be an active participant in care. You need to get a provider that you trust that will understand your needs, somebody you can be honest with, where you can have those difficult discussions.

One other thing that I did hit is we need to be looking at advanced care planning. We all are going to die one day. And we don't want to leave it on our children or our spouses about making that decision. That's something we often fail to do that we need to address out there.

Host: So yeah, and at Riverside, we have the primary care provider and some other resources here that can help you take care of that advanced care planning. So, make sure to ask your provider about that. So, we're coming to the end here. Thank you so much for joining us, Dr. McCuiston.

Dr. Stonewall McCuiston: Thank you for having me.

Host: If our listeners would like to learn more about Riverside's commitment to diversity, equity, and inclusion, you can visit myrhc.net/deicommitment.

Thank you for tuning into the Well Within Reach podcast with Dr. Stonewall McCuiston and your host, Terry Streetman. Be sure to like and subscribe to Well Within Reach on Apple, Spotify, or wherever you get your podcasts. To learn more about the services at Riverside Healthcare, visit riversidehealthcare.org.