Featuring John Kim, Executive Director of Advancement Project California: Why are people of color disproportionately affected by chronic illnesses like diabetes and asthma? Is it the individual’s fault, or is it their environment? Would better health insurance help? Listen as John Kim and Code WACK! host Brenda Gazzar explore strategies to build trust and save lives. Plus, why universal health insurance is only part of the answer.
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Combating inequality – the role of public health, education & community
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Welcome to Code WACK!, your podcast on America’s broken healthcare system and how Medicare for All could help. I’m your host Brenda Gazzar. Today, we’ll continue our discussion on coronavirus, race and racism.
John Kim is Executive Director of Advancement Project California, a multi-racial, multi-generational racial justice organization with expertise in research, advocacy, and policy. This is our second episode with Kim on this issue.
Welcome to Code WACK!, John.
Q: In our last episode, you said that your research confirmed that racism is the deadliest underlying condition. But what about chronic conditions like diabetes and asthma that disproportionately affect people of color? What is the root cause of these conditions?
Kim: When you look into these neighborhoods, the neighborhoods that are having high spikes of COVID-19 confirmed cases are the same neighborhoods that have lit up all of our research and maps over a couple of decades, that have showed that these are the places that have the least access to healthy foods, the least access to public infrastructure, healthy parks, the least infrastructure in terms of just their overall health and wellbeing.
There are more per capita liquor stores in these areas than in others and fewer per capita supermarkets with healthy fresh foods in these areas as well.
And so, I sort of want to take anyone who really espouses this individualized narrative and plop them into some of these neighborhoods and say, you try to stay healthy in these conditions. You got no car, you got less money, and see what’s available to you and let’s just see how healthy you are and how judgy you can be on some of the residents of this community after you’ve had to deal with some of these things.
And so, I think we have to understand the environmental context in which these co-morbidities are happening. … We actually started this research with that in mind. We actually started it to say as quote-unquote recovery happens that in the end, we need to be fighting for a permanent surge in public health infrastructure in these communities so that this doesn’t happen again so that we can start to erase some of those underlying conditions, so we can start to erase some of those co-morbidities and so on and so forth but as we started to track the data and we started to see the spike and disparities really grow, it really propelled us to say ‘actually we can’t lift up this data only to speak to the long haul fight. We need to actually push his data out immediately because we need to have an immediate response to these racial disparities.’
Q: I see. What are some of the recommendations you have for addressing these inequalities during this pandemic?
Kim: When you are dealing with this massive lack of public infrastructure in these communities and a massive lack of trust and cohesion between community and government in these places then you have to have a more targeted and a sort of more nuanced, multi-pronged approach. And so what may have just been in some wealthier neighborhoods just a medical response, right, how do we tent out some testing sites, how do we make sure that there’s some capacity around PPE, and what have you, in these conditions, in these neighborhoods, you have to have the medical surge, but you also have to have an air game and a ground game. You have to have a three-pronged approach and what we mean by that is that there’s a woeful lack of infrastructure — full-stack hospitals, linkages to treatment and unfortunately many of these neighborhoods are last in line for testing and PPE kits and so how do we surge that in a targeted way.
Let’s look at where there are co-morbidities, where there are spiking cases and pinpoint and surge resources on the medical side into those neighborhoods but we also have to have a public education campaign that is culturally appropriate, that we choose as many people as possible and in vehicles and modes where actually these community members and residents trust. It may be in language. It may be on the radio and it may be from some ethnic media sources and so we have to have the air game … We have to have a ground game that includes community organizations, gang interventionists, faith-based leaders folks that are trusted, that are embedded, that can also get the message out that we need to take this seriously, that we are unfortunately seeing a new siege on low-income communities of color and we need to link them to the medical side so it has to be all three of those.
Q: I see. What do you think about having universal healthcare, like Medicare for All? Would that address some of these systemic inequalities?
Kim: I think it would but I also would caution us that there will never be an instance where one size fits all. Having access through full coverage on insurance is one thing but if there’s not the brick and mortar infrastructure in these neighborhoods, if there’s not massive investments in South L.A., in the east side, in particular parts of the valley, actually in these communities, then just having better insurance is not going to immediately translate into better health. We’re going to have to couple any move to Medicare for All with a massive public infrastructure investment and that needs to have equity as its driving force.
Q: Thank you so much, John!
Find more Code WACK! episodes on ProgressiveVoices.com and on the PV app. You can also listen at HEAL dash C-A dot org. This podcast is powered by HEAL California, which uplifts the voices of those fighting for healthcare reform around the country. I’m Brenda Gazzar.
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