Transcription:
Addressing Equity as a Healthcare Priority Featuring Congressman Danny Davis

Scott intro: Coming to you from Chicago, you're listening to More Than Medicine with Dr. Ng Gazi. Zike. Dr. Zike is the president and c e O of Sinai Chicago. She's a board certified internist and pediatrician who has dedicated her career to addressing issues of health equity and health Justice Sinai Chicago is the largest private safety net health system in the state of Illinois with a service area of over 1.5 million people living in communities of Chicago's West and Southwest sides.

More than medicine is about the fight for health, equity and justice working to not just heal wounds, but truly address the root causes of hurt and distress in our communities and our nation.

Dr Ngozi Ezike (Host): Hello, everyone. I'm Dr. Ngozi Ezike, and thank you so much for tuning into the first episode of More Than Medicine. This podcast is about the fight for health, equity and justice, how we need to work to not just heal wounds, but truly address the root causes of hurt and distress in our communities and our nation. And who better to talk about this on our inaugural podcast than Congressman Danny Davis.

Congressman Danny Davis has been committed to bettering the lives of people suffering in poverty and injustice for decades. Before seeking public office, Congressman Davis had productive careers as an educator, community organizer, health planner, administrator, and civil rights advocate. He has received hundreds of awards and citations for outstanding work in the areas of health, education, human relations, politics, and advocacy, and has been a resident of Chicago's West Side for many years. Thank you so much for joining us, Congressman Davis.

Danny Davis: Well, Dr. Ezike, let me just thank you for, first of all, the role that you have played in healthcare for our state. And I was so delighted quite frankly when you ended up over at Mount Sinai Hospital, because Mount Sinai is in the community where I have lived, worked, been a part of, from the time I hit Chicago in 1961 until now. And so, I kind of call myself a Sinai individual, one of those individuals who have seen the work of this great institution. I've seen the profound moves that the sponsoring community of Sinai making decisions after the community was no longer serving a primarily Jewish population, but deciding that even though the community had changed from being primarily Jewish when the hospital was started to become an African American and Latino as basic residents. The hospital is here taking care of us, and I've always been tremendously appreciative of that.

Dr Ngozi Ezike (Host): Wonderful. So, you are a true, true westsider, and so I'm excited to share this space with you and your community. And you go way, way back with Sinai by just being a long-term resident of the community. So, tell me how you see Sinai as a critical health system on the west side here in Chicago.

Danny Davis: Well, you know, my entrée to health was kind of interesting because I was not a trained health person initially. But I took a job, I was teaching school at Central Park and Ogden, but I always got involved in what was called the community. And so, I involved myself in going to meetings and doing other things, and ultimately ended up working directly with the community. And at that time, the federal government was creating all kind of new programs. The Great Society days were coming. And one of the things, as they would go around the country surveying communities and asking what the problems were, health would loom high on the chart.

And so, the Health Rights legislation was passed, creating national health planning and ultimately creating federally qualified, or what was then called community health centers. And Sinai got involved in starting one of those. There were three started in Chicago. One, Mount Sinai became sort of the sponsoring entity. One, Rush-Presbyterian-St. Luke's became a sponsoring entity. And Northwestern became a sponsoring entity of Near North, Mile Square, and it was called Martin Luther King.

I got involved and worked with the one that Sinai was involved in. Of course, I met Ruth Rothstein and Dr. Stepto and all those wonderful people who were over there. And for me, the rest became history because ultimately Ruth Rothstein, and I always suggest that she and Sister Sheila Lyne, when the two of them were able to combine their experiences, both having been president of private institutions, but both coming into the public health arena. Dr. Sheila as the Commissioner of Health for the City of Chicago, and Ruth as the Director of Health for county, they merged public and private in such a way that they were able to seriously tackle and bring together some of the planning and resources that both the public sector and the private sector had to offer. And the rest has been continuous movement, continuous development.

Of course, as all of this was taking place, one, we saw the passage of a very serious health legislation being Medicare, Medicaid in the mid-1960s, which provided a way to pay for healthcare for seniors and people who would just simply not have any money or any way to pay. And we had a county government that adopted seriously the philosophy that it was the last resort for people in Cook County who did not have the money or the resources to pay for healthcare. So, we have resources. And now, it has become how do we make sure that all of these resources that we have are used most effectively by the population groups who need it the most in order to change health status and improve the health of our communities overall, so that everybody can expect a long life of dignity and the care that they need?

Dr Ngozi Ezike (Host): That is the question, Congressman. So, let's get into that. We have what we called the community health centers, now called the FQs. So, what are the barriers? We have the Medicaid, we have the Medicare. What are the barriers? What's holding us back from actually achieving the equity and the justice that you have been seeking for decades, for your entire career? What's holding us back?

Danny Davis: Well, you know, I'm one of these people who say that we can acknowledge progress and we've made a tremendous amount of progress. But I also say that once we get to the basement, we can't act like we're in the penthouse. And so while we've made a tremendous amount of progress, we have to continue to struggle. And even though we have resources, we don't have as many as we need. Even though people have learned a great deal, we have not learned enough. So, resource development is still a problem. For example, if we talk about culturally competent health providers who are as much like as possible, the patients and individuals that they would want to see, we know that there are not enough, for example, African-American physicians, African-American nurses, African-American therapists, African-American planners.

Cultural competence to me means that you are as comfortable with your provider as you can possibly be. And there are many things that will become factors in that happening. And so, I suggest that we still need an all-out effort to put more African-Americans, more Spanish-speaking physicians and nurses and others into the pipeline, into providing the service. And so, one of our great needs is that. Resources, we don't have all that we need. I believe that we need a national health system where everybody is guaranteed a basic set of healthcare. And then if people want to go beyond that, they have the option of doing so. We call that Medicare fall. Everybody in, nobody out. And so, we've been debating that now for a number of years, and we've made a lot of progress. I mean, the Affordable Care Act was the next big thing that happened after Medicare, Medicaid, but we still have gaps in healthcare delivery that need to be fulfilled and we have environmental changes that must be made.

I mean, in Chicago, people often talk about the differentials in life expectancy. If you live in the downtown area of Chicago or Streeterville, as opposed to living in Englewood on the far south side of the city or the west side of the city, where there might be a 20-year gap in life expectancy. Well, that requires more than just medicine, that requires a lot of other things in addition to medicine.

Dr Ngozi Ezike (Host): Absolutely. And I think you touched on something really big there, because when we think about the gaps in healthcare delivery that you just mentioned, we know how those gaps showed up during the COVID pandemic and how that further worsened that life expectancy gap, and like you said, there are many things besides just the healthcare that affect this. It had included the lack of paid time off so that people could isolate or quarantine, if they were at risk or were infected. So, we really saw through the pandemic how health equity and health justice needs to continue to be at the forefront. So as you lived through that with us and saw those gaps, how did that impact the work that you're continuing to do?

Danny Davis: Sometimes it's difficult to acknowledge that change is a difficult thing to bring about. I mean, I've come to accept the notion that change is far more overt than it is covert. And that while we seek the overtness of it in terms of looking for it, and we'd like to have it today, we'd like to have it tomorrow, that sometimes it takes a bit longer than that. For example, you mentioned paid family medical leave. I just happened to be a part of the committee in the House of Representatives that would have serious jurisdiction over helping to bring that about. And we argue, we debate it, we discuss it. And of course, there are those who would say, "Well, it costs too much. And if we're going to be able to do that, where will the money come from in order to pay it?" And I always say that if we can determine as a nation the quality of life to which we will subscribe, we also can determine how to pay for it.

And since this is Black History Month, one of my most favorite black philosophers and thinkers was Frederick Douglass, who was fond of saying that he knew one thing if he didn't know anything else, and that is in this society. You may not get all that you pay for, but you will pay for all that you get. And I often will take the position that to be healthy and feel good and be optimistic about the future of life, that no price should be too much and that we have to make these investments, I call them, that would promote awareness, that would help provide education to people, and that would help people learn as much as they could learn about taking care of themselves and ultimately understanding that no matter what the physicians and nurses tell you, no matter what the system can provide, that when you get right down to the bottom line, each one of us have a level of responsibility for caring for ourselves, and we must come up with the resources to help teach us those truisms. And as we learn them and practice them, I think they will go a long ways towards creating a healthier health status for all of America.

Dr Ngozi Ezike (Host): Well, that's incredible and we know you've done that and we know of all the dollars that you've pushed to promote health equity and even many places in Chicago have you to thank for a lot of that support. So, you've actively been working in this space to create more access to make sure that people living in areas of Chicago with limited access, that we do something about it. And I love the line, if we can determine the quality of life to which we will subscribe, then we can absolutely determine how we will pay for it. And I trust you and our leaders in DC to do that. So, what are the next steps for you to create more access? What are you working on next?

Danny Davis: Well, you know, I have to be honest about the status of things and the way our system works. I mean, we have a political system that responds to the engagement of the constituency that is people. And we were in such a good position the last two or three years at different times that politically you couldn't ask for much more. That is one political party pretty much had control of the House of Representatives, the United States Senate and the presidency of the United States. And the one thing we were missing at some of this time was the Supreme Court.

Now, if one group of thinkers have control or can dominate all four of those at one time, all the things that they could initiate and implement are just unbelievable. Very seldom do we reach that point. It just does not happen too often. So, my big challenge is to try and keep the resources coming, but also to acknowledge that we still need to keep people engaged, so that they learn. For example, if I skip taking some medication that has been prescribed for me and I don't do it, that's kind of my bad, as people would say. So, that's my bad and I can't blame that on the system. I can't say, "Well, you know, doc so-and-so had called me up and reminded me of whatever."

And so, all of us working as cooperatively and being as empowered as we can be to try and direct things the way we want them to go, and having faith and belief in this system of ours called democracy and believing that if I do my part to make it work the way I think it ought to work and others are doing the same thing, then we will continue to see progress. I mean, we will continue to see the creative ingenuity. We will continue to see the great talent that individuals have.

And I tried to never forget, this is African American History Month, and so I've been thinking a great deal about Dr. Daniel Hale Williams and the work that he was able to do and how we need to create and provide opportunity for a whole bunch of addition of Dr. Charles Drew, of Dr. FA Ellison, and how we got to keep the wheels turning so that the pool of talent gets developed. I think it's here, but we just have to think in terms of figuring out how do we make it happen? How do we make it real? And I guess I've been around long enough to have seen some of these changes that they've helped to make a believer out of me. I believe that we can make it.

Dr Ngozi Ezike (Host): That's wonderful. You do have to have hope. If we don't have faith and belief and we've lost hope, that's a whole different problem. So, I appreciate all that you said, like the government, all of its branches have to do it's part, the health entities have to do their part, community organizations, I think there's a role for religious institutions, but you're saying individual. At the individual level, people have to do their part as well. And so when I think about individuals, I think about the people who will be listening to this inaugural podcast who wanted to tune in because they wanted to hear you talk about health equity. What are these people listening to this podcast, what can they do on that individual level to make health equity a priority? I know you said they got to take their medicine if the doctor says to take their medicine, that's one thing. What else can individuals do to say that, "This is what I'm going to do. This is my part. This is me doing my part to make health equity a priority here"?

Danny Davis: Well, you know, they can venture out and you got to have courage in all of these things. I was just thinking the other day, I was listening to the radio and heard an announcement about Zing Healthcare and I thought of Dr. Eric Whitaker, who kind of conceptualized or dreamed this up or decided to do it. And while it probably seemed way out and farfetched when he was trying to put it together, but it seemed to be coming, it's working.

I try to go to bed at night sometimes. Well, you know, I'm a faith believer and I will say the little prayer that children sometimes are taught to say. "Now I lay me down to sleep, I pray the Lord my soul to keep. If I should die before I wake, I pray the Lord my soul to take." And sometimes I smile to myself while I'm saying it because I do believe that where there is a will, there is a way, and that each person can contribute in some significant way; that there's something. And if it's nothing but trying to adhere to the prayer of St. Francis, "Oh, Lord, make me an instrument of thy peace. Where there is hate, let me sow love. Where there's darkness, you know, let me bring a little light," maybe I can figure out a new way.

We had a bunch of inventors that we took over to the University of Illinois last week at an exposition. And I was so carried away because one gentleman had invented a fork that makes it easier for a person who's had a stroke to feed themselves. He had taken the fork. It had a little thing you slide into your hand and you could barely move your hand and that kind of thing. But the person who's had a stroke could become self-sufficient in terms of just eating or feeding themselves. And I thought this was so cool. I didn't know what to do. I said, "Let me try it and see how it works." And there was another lady who had come up with the way that a mother who was breastfeeding could be publicly engaged and involved and have her child and breastfeed with a high level of dignity in terms of not exposing herself while the child is feeding.

So, all of these little different ways that people can help make things better and make things easier. I challenge people to do that. To go where there is no path and blazer trail or use as much of your creativity. And sometimes I pinch myself in terms of being in an environment where all of these magnificent people are doing the things that they do and the contributing ways in which they live, work, and conduct their lives. And so, I think of how fortunate in many ways that we are living in a nation, in a country where you can try whatever it is that you decide to try. And so, America certainly is not all that it has the potential of being. But as we continue to try and create that perfect union that our forefathers talked about. Unfortunately, they didn't have any ladies there, and that's a development in and of itself. So, we just keep becoming. Keep becoming. And if we can do that, I think we'll do all right.

Dr Ngozi Ezike (Host): That is so inspiring. Congressman, I am so inspired. You have refreshed my hope anew. I am excited to really think about where we can go, how we can keep becoming. You said it at the outset, that change is very difficult to bring about. I spoke about that in a meeting earlier today, that change, whether it's institutional change, behavioral change, it is so hard to bring about. But even with your long career of service, you have seen important changes happen. And while we are not all the way where we need to be, that progress that has been made should continue to catapult us forward to get from the basement to the third floor all the way up to the penthouse.

So, I thank you for inspiring us to know that we are on the right path and that health justice can be a reality even if this system, if we're honest, was not designed to serve everyone. But we can get it to a more perfect reality. And we've had magnificent people like yourself to guide us and show us the way, and we will continue to follow under your leadership and lead on to get to the reality that we hope for. So, I'm so grateful for your words and your leadership and what you continue to do. Just thank you so much, Congressman Danny Davis, for joining me and for your dedicated and long career, your just tireless work in advocating for true equity and in healthcare, in economic opportunity, education, housing, everything, for people in Chicago including and particularly the west side of Chicago. It is my sincere honor and pleasure to have had this time with you. Thank you so much.

Danny Davis: Thank you. And I tell you, I've never had a Wednesday like this Wednesday. So, thank you.

Dr Ngozi Ezike (Host): Thank you so much.

Scott outro: Thank you for listening to More Than Medicine with Dr. In Gazi. Azek. If you haven't already, make sure to subscribe to Sinai Chicago's YouTube channel, as well as follow at Sinai Chicago on Twitter, Facebook, and Instagram for information on upcoming podcasts. Until next time.