Health Equity- Changing Systems Not Victims | Dr. Alvin Powell | TEDxRaleigh

Summary

This powerful reflection discusses the journey of a man who grew up in a large family in Boston, traveling to the racially segregated South in the 1960s. He shares the hardships of discrimination during the Jim Crow era and its lasting impact on healthcare disparities. As a nephrologist, he highlights the ongoing health inequalities faced by people of color and the historical roots of these disparities. The speech emphasizes the need for systemic change, advocating for food and healthcare equity, reparations for historically oppressed communities, and universal healthcare to ensure that everyone, regardless of race or background, has equal access to health.

Takeaways

• 😀 The speaker grew up in Boston, Massachusetts, the youngest of eight children, and their family traveled by car to Alabama in the 1960s, facing both the challenges and the joys of long road trips during segregation.
• 😀 The family’s travel experiences were shaped by the harsh realities of the Jim Crow laws, which enforced racial segregation and discrimination in the South.
• 😀 While the family’s travel method was initially perceived as practical, the speaker later realized it was also a means of protecting the children from the dangers of racial discrimination in the South.
• 😀 Health disparities exist across racial and ethnic lines, with African Americans, Asian Americans, Hispanic Americans, and Native Americans all experiencing higher rates of kidney failure and other health issues compared to white individuals.
• 😀 Disparities in healthcare extend beyond kidney disease, including higher rates of heart disease, cancer, stroke, infant mortality, and shorter life expectancy among people of color.
• 😀 In 1985, the Secretary of Health and Human Services revealed that 59,000 Black lives were lost annually due to health disparities, a number that has now risen to 74,000 lives per year.
• 😀 Health disparities are not caused by biological differences or genetic predispositions, but by social and environmental factors that affect individuals based on where they live, their race, and their socioeconomic status.
• 😀 80% of health outcomes are influenced by social determinants of health, including where people are born, live, work, and age.
• 😀 Historical practices like redlining in the 1930s, which discriminated against communities of color, have left lasting effects, leading to generational poverty and poor health outcomes in affected areas.
• 😀 Solutions to health inequity include incentivizing grocery stores to invest in food deserts, holding nonprofit hospitals accountable to underserved communities, restoring redlined neighborhoods, and expanding access to universal healthcare.

Q & A

What was the reason for the author's family traveling the way they did during their childhood?

The author's family traveled in a 1956 Ford station wagon and took breaks on the road not because they were poor or in a rush, but because their parents were trying to protect them from the racial segregation and discrimination of the Jim Crow laws in the South.

What role did Jim Crow laws play in the family's decision to take these long road trips?

Jim Crow laws enforced racial segregation and discrimination in the South, making it unsafe for African-American families to travel freely, as they couldn't eat in the same restaurants, use the same restrooms, or sleep in the same hotels as white people.

How does the author connect the family's travel experiences to health disparities in America?

The author connects the experience of racial segregation and discrimination during the family's travels to the current health disparities, noting that African-American and other marginalized groups often face limited access to healthcare, which is rooted in systemic inequalities.

What does the CDC define as Health Equity?

The CDC defines Health Equity as a situation where everyone has the opportunity to achieve their full health potential, and no one is disadvantaged due to their social position or circumstances.

What are some of the health disparities mentioned in the transcript?

The transcript highlights health disparities such as higher incidences of kidney failure, hypertension, diabetes, obesity, heart disease, stroke, cancer, infant mortality rates, and lower life expectancy among African Americans, Asian Americans, Hispanic Americans, and Native Americans.

What was the key finding of the 1985 report on black and minority health?

The 1985 report revealed that 59,000 black lives were being lost annually due to health disparities. Over 30 years later, this number increased to over 74,000 lives lost each year.

How does the author explain the cause of health disparities in terms of genetics and biology?

The author refutes the idea that health disparities are due to racial differences or genetic predispositions, emphasizing that all humans share 99.9% of their DNA, and that health disparities are instead caused by social, not biological factors.

What are social determinants of health, and why are they important?

Social determinants of health are factors such as where a person is born, lives, works, and ages, as well as their race and ethnicity. These factors influence 80% of health outcomes, making them crucial in understanding and addressing health disparities.

What historical event contributed to the creation of health inequities in the U.S.?

The federal housing policies of the 1930s, particularly the practice of redlining, contributed to health inequities. Communities of color were deemed risky for mortgage loans, leading to disinvestment and the creation of under-resourced, impoverished communities that are now associated with poor health outcomes.

What solutions does the author propose to address health disparities?

The author proposes several solutions, including incentivizing grocery stores to invest in food deserts, holding non-profit hospitals accountable to communities of need, reinvesting in previously redlined communities, expanding Medicaid and Universal Healthcare, and implementing racial equity training to educate the public about health inequalities.