Honoring Rev Dr Martin Luther King Jr - A Community Conversation with Bronson Healthcare

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welcome to the reverend dr martin luther king  community conversation with bronson healthcare   i'm beth washington vice president of community  health equity and inclusion dr king once said   of all the forms of inequality injustice  and health is the most shocking and inhumane   2020 brought us the shocking covid 19 pandemic   and inside that pandemic our black  brown and indigenous communities   faced the injustices that dr king spoke of they  were disproportionately impacted by this virus   so today's conversations we're going  to talk about those health disparities   we'll talk about community health and we'll  address and talk about the covid19 vaccine joining us to facilitate the conversation will  be beatrice orns our organization development and   learning analyst and we'll start the conversation  with myself and our president and ceo bill manns thanks beth bronson has a large footprint  in the lower part of southwest michigan   with the four hospitals and three counties a  number of practices the needs of the community   are vast and many as a major health care system  how does bronson know what the community needs   it's just the short answer is we have to  kindly ask people what they need and then   we have to believe them when they tell  us that and since 2010 the united states   requires non-profit hospitals to conduct what's  called a community health needs assessment   where we summarize the health needs and the issues  that are facing the communities that we serve   one of the things we've learned about health  since we've been doing these community health   needs assessments is that as a country we know 80  percent of a person's health outcomes are actually   influenced by the societal factors by economic  factors so for instance your access to housing   your access to good food your access to jobs  living wages good education the the exposure   you have to violence or racism or sexism or other  types of trauma all of those things we know impact   the ultimate outcomes of your health so in 2019  when we started conducting our this most recent   needs assessment we knew we needed to talk about  that we needed to understand how people thought   about those determinants of health and so that  would be huge right asking people what they need   and then all these needs across three counties so  what we didn't realize was really important was to   determine who has the greatest needs is there data  out there secondary data that we could identify   where the greatest pockets of needs already  were by zip code and then go there and ask   people what they need to be healthy and  they told us some pretty amazing things   after interviewing about 800 or so folks in  in those three communities both stakeholders   and focus groups they told us things like this  people need just inequitable laws and policies   people need and recognize that systemic and  institutional racism negatively impacts health   mental health and trauma need more support  especially in our black and brown communities   people need living wages  healthy foods safe neighborhoods   people also identified quality of health  care when they're talking about quality   of health care and education they were  talking about providers and educators   who are culturally competent who listen to what  people say and believe them about their needs   so lots more data in those three reports but  useful to know what do people want what do they   need to be healthy and then we have to believe  them and and take action on that so i believe   the report the assessment that you're that you're  identifying is called the community health needs   assessment okay and we we abbreviate it called  the chna okay so from the community health needs   assessment sounds like you got a lot of data  sounds like you got a lot of impactful quotes   that were helpful for you to determine and to kind  of identify some things that that the community   wanted you to know so from that data from those  quotes i'm sure there was also some strong emotion   that you may have experienced as you dissected the  report as you balance your role as vice president   of community health equity and inclusion and as a  person a woman of color in the kalamazoo community   what responses from that community health needs  assessment were difficult for you to see and why   yeah beatrice um there's one i'm going  to read and it was indicative of all   three counties that came up in a in various  formats in calhoun in kalamazoo and van buren   and in it this is the quote access to health  care means i'm not excluded from the care i need   because of who i am and so i  have a personal story with that   i was 24 and engaged in first time pregnancy and  really excited about that and for the first time   i decided to break sort of for my family's  traditions or rules and seek care at bronson   because there were midwives i think that might  be dating me a little bit because midwives were   around the first time so so i'm in the waiting  room i was there by myself that day because i   no one in my family i felt guilty if i asked  them to come with me to the simple appointment   when they needed their their work hours right  they needed to be at work and so i was there   alone excited maybe a little nervous a woman  comes to the desk and or a door and calls my name   i walk back she takes me she says hello  says my name walks me back to this little   sort of cubby room that's kind of dark with a tv  in it and a vcr so i know i dated myself there she   put the tape in the vcr and the whole thing was  about teenage pregnancy i was like wait what you   you had my chart uh you you made some assumptions  i think about me and so although i had great   outcomes had both my children at bronson it's  those little kinds of things that cause you pause   and sort of weaken your trust um so lots of those  kinds of things came through in our in our report   so some that you definitely resonated with and  then sounds like some that you definitely could   empathize and have compassion for as well um so  i had the opportunity to look at the four reports   there was a results from each of our hospitals and  the results that i saw were just as diverse as the   communities that we serve so how does bronson take  that information make it make sense drill down and   help use it to focus the efforts on what's  needed in in in the black communities or   in the communities that were included in  the assessment a very important question   we can't do everything nor should bronson try  to do everything right like our expertise is   around health care and and health care is beyond  just the doctor's office so where does it make   sense for us to have intersection between our  expertise and what the community told our needs   and really looking how can we use our internal  information so do we have internal capacity   do we have the resources do we have  um the strategic plan that matches up   to it do we have um the people to to work on  something does the need that we're looking at   go across all three regions is it something  that even though we're going to attune to the   differences of each one of those counties and in  areas does it still something we can systemize   that's an important thing for us to consider  we also have to think about our partnerships   in the community where do we already have  partnerships and so it's getting that   alignment of all of those things covid helped  us this year actually it helped us really   focus in because because of the demand on our  system in our resources and we also know that it   showed us the disparities that we already said  were in the saw in the chna that covid made them   real time and so it was easy for us to take  a look at the chna at the environment and say   where can our greatest impact be where can we  intervene early and know that that's going to   have long outcomes and so we looked at trust and  access to healthcare we know that we can do that   work right we can we can actually get involved  right away around how we interact and work with   folks and and then with covid we know we could  eliminate some disparities can we start doing   that and so we have two priorities first is to  eliminate perinatal eliminate racial and ethnic   disparities in the perinatal experience and then  to eliminate racial and ethnic disparities within   our workforce to support families and so if  we can build that trust and eliminate those   disparities we know that we're going to be able  to have a sustainable impact on our communities   so that sounds like a internal project that is  bleeding itself out into our communities bill   how much of that have you had involvement with  and is there a way that you're able to shape   the direction of that as you are coming into  our community oh absolutely so as a new ceo   it was exciting to actually review the chna and  more exciting to review the implementation plan   i've seen a number of community health needs  assessments in my career but the quality of   this one demonstrated that bronson really  listened to the communities that we serve   the board has held management and the ceo  accountable to actually making some improvements   on that and so as i've come in and interfaced with  beth the community the board to say we hear you   and we're going to hold ourselves accountable  to actually making a difference and so for me   that's been really exciting we've started  to see some positive results for example in   our response to the covid pandemic the  distinction between equality and equity   is something that we spend a lot of time talking  about here at bronson and i think to beth's point   really meeting the community where they are  and not taking a paternalistic approach to   their health and saying well you really need this  when they're telling us that we need they need   something totally different so i think to be the  president and ceo and be in a position to listen   and to help shape our response is uh both humbling  and exciting i think historically um health care   systems have always had like a savior a savior  mentality so you have the leaders the people the   physicians um take on the responsibility  of telling a community what they need   how do we transition or start to transition  from telling the black community what they need   to a more allied approach to where we partner  together to assess that need and then to focus   on it so two things um one accepting and realizing  that the african-american community in particular   is very uh deserving of mistrusting the health  system just kind of based on the history um   so let's acknowledge and accept that and then  two let's listen and so we spend a lot of time   talking about the importance of listening people  often say i know my body better than anyone else   and so pushing against kind of that paternalistic  hierarchical approach to health care and taking   more of a listening we're in this together  approach to healthcare and really listening   to our patients and i think that'll make a  huge difference in the healthcare outcomes   in this community definitely a culture  change definitely a culture definitely   something that will have an awesome impact on the  way people perceive bronson as an organization and   also on the way that we care for the community  um another great way to build trust right   so it's about trust and building  trust but with all that being said   the pandemic as beth has spoken about and as  as you also have noted um it has surfaced lots   of disparities and when you think about trust and  disparities the covid vaccine has to come up right   so as it relates to that how do you shed light on  something that has historically and justifiably   been a mistrust in a community and then  also encourage and start to build that trust   specifically around that vaccine because that's  what we're pressing and working toward now but   including those efforts to filter into other areas  absolutely so one we're going to have to listen to   what is the reticence of some to take the vaccine  acknowledge the past history and some of us are   actually going to have to model the way and lead  the way and get the vaccine ourselves this case of   the vaccine is particularly interesting when you  look at the number of scientists and physicians   who are excited to get the vaccine themselves  and so this is a circumstance in which i think as   we see many of those individuals as we see  leaders actually getting the vaccine i'm   hopeful that the african-american community will  follow us and say okay we can trust this vaccine   i was talking to a pastor recently who said he  was preaching to his congregation that you pray   and pray and pray for something and then you  get it and say well no that's not how i want it   and so in this case we actually have a vaccine  that's safe it's effective and i can't think of   any reason not to get it so i'm grateful i was  able to have my vaccine actually get my second   vaccine in a couple weeks so again trying to  model that behavior in the community trying to um   be transparent and share information accurate and  truthful information so one last question for you   if you don't mind um if you had one wish when  it comes to bronson meeting the well-being needs   of the black community what would that be  so if you will indulge me i'd say two okay   um so the first is um bronson is the largest  employer in the region and i had a professor   in graduate school who used to say if you want to  improve someone's health give him or her a job and   so as the largest employer i think it's incumbent  upon us to drive bias out of the hiring process   when you think about dr king and his dream to  judge people based not on the color of their skin   but the content of their character i'd like to  see us judge new hires based on their skill set   and how well they'll fit within  bronson and not the color of their skin   and so there is an unconscious bias that exists in  organizations and health systems in government you   name it and to say what can we do to drive out  that unconscious bias and hire the best people   not based on their skin not based on their sexual  orientation or gender identity but because they're   the best person for that job so that's my my  first dream for for bronson i think the second   and we've talked a little bit about access is  ensuring access for everybody um and so you think   about the african-american community in particular  many of us don't go to the doctor don't want to   go to the doctor et cetera right and so let's  raise the the level of education and awareness   and then let's make it easy for people to get into  their physician's office so if we can improve the   access for our communities and if we can hire  people based on their skills and not on their   ethnicity color their skin sexual orientation or  gender identity i think we'll be doing a great job   sounds like a great start to some wonderful things  beth do you mind me throwing you a ringer sure if you had a megaphone that could only reach the  ears of the black community what would you share   about the work that bronson is doing to respond  to those health disparities that you were able   to identify in that chna or the community health  needs assessment yeah great question disparities   are differences and to be able to see the  differences sometimes takes a change in mindset   and bill's already talked about this a little  bit right i mean how many times have you heard   people say oh i don't see color oh i don't see  you as black or colored or you know as a latina   or whatever it is right we hear that but if you  don't see that difference you're not acknowledging   my lived experience and how that may be  impacting how i interact with systems and so   that's uncomfortable for people they don't want to  to see those differences we're often taught not to   and so we have been doing work here at bronson  to look at how we how intercultural we think we   actually are and where we actually are so that gap  and in that gap is that implicit bias that bill   talked about so once people begin seeing they have  that gap and begin learning about unconscious and   implicit biases that they may have and learning  to see differences as a positive versus a negative   that's it's not quick work um but that's the  kind of mindset culture shift that can lead to   overall systemic change not only in our  institution but in the systems that we interact   and then therefore the communities in which we're  engaged i love that you bring that up because i am   had the experience of being a part of that work  that that you and your department has been doing   to reduce those differences to reduce and  to educate on that implicit bias and and the   things that surface for us that we may not know  exists and so the internal growth that bronson   is experiencing based on those things based  on identifying those biases that you may have   based on acknowledging um that we are different  and we have differences and that's okay because   we can use those to grow i think um i love that  you bring that up because i think the community   it's a great and great so uh a great source of  information for the community to receive um and so   it's been an honor to speak with you beth and and  to speak with you bill to talk about some of these   awesome things that are happening in our  community and to be transparent and accountable   for some of the work that is going on at bronze  and that people in our community may not know   about because the work is actually you know  happening internal inside of the system that   will have great effects for people outside  of the system in the communities we serve so   i appreciate your time and your insights  for today in our next segment we will   be focusing on the covid vaccine and we'll  have the opportunity to talk with two of our   forward-facing physicians who are responsible  for sharing information on that thank you at bronson we understand that a level of mistrust  exists in the black community related to the covid   19 vaccine to answer some of the common questions  and fears heard in the black community i'd like to   welcome dr richard van enk director of infection  prevention and epidemiology and dr martinson arnan   vice president and clinical officer for bronson  medical group thank you both for joining us today   dr van enk i'll start with you as one of  the most trusted and familiar faces our   community sees representing bronson when there's  a discussion around the cova vaccine what would   you tell the person who believes the vaccine was  rushed into production and might not be safe yes   vaccines take time to develop the technologies  that we use to make vaccines take time but this   vaccine actually wasn't rust as much as you might  think um i can explain how the vaccine came to be   and and that might might help us understand it the  technology for the vaccine that we have is not new   it's new in humans but it's been  used in in in the laboratory for   many years it was discovered many many  years ago and so it's not an untested   technology the application to this this disease  is new but the technology is not new and it's   been known to work for a long time the other  issue is that it's it's only been a year   since the virus was discovered and we already have  a vaccine that seems fast that's true but that's   because the different steps of the vaccine were  done at the same time sometimes and overlapping   rather than one by one and sequentially  so they were able to compress   the the time sequence of vaccine development  and that allowed the vaccine to come to market   sooner than than the typical vaccine so the  question is whether it's safe or not and and i   think that the the technology of this vaccine is  very different than any other vaccine we've made   then it's extremely safe one of the advantages  of this technology is that it removes a lot of   the contaminants and the problems associated  with other vaccines and so you have a pure   vaccine now instead of a vaccine that that has  additional issues and side effects so this is   probably the the safest and cleanest vaccine  that we've ever made in the world wow thank you   dr arnan as a physician who's researched  the safety and efficacy of this vaccine   and honoring the validated fears and concerns  of the black community as it relates to vaccines   is getting covid 19 really that  bad and is the vaccine riskier   beatrice thank you so much for this question i  think this question touches on a very important   issue and the issue of trust i think that  uh events that have happened in america   recently speaks to the fact that some of our  institutions get shaken and we get shaken to our   call and we ask ourselves can we trust what we are  hearing on tv or from the so-called experts and so   i come to your audience today not as an agent of  the government or an agent of the state i come   as a physician a practicing physician who cares  very deeply about this community and my neighbors   and as a son of a reverend or preacher and  hence i hold my integrity very dear to my heart   and so i can i can speak clearly and truthfully  to the fact that i believe that this vaccine gives   us an opportunity to be able to put this pandemic  behind us touching on the issue of which is worse   getting the disease or the vaccine i would  say that although most people who might get   infected by covid might survive it there are some  who do not survive it and it is difficult for you   to determine which group you might be in and being  in the unlucky group that might not survive it has   an impact not just on you but all your loved ones  and perhaps some of the people that you might care   for that you take care of who rely on you and so  that's a high risk to take in addition to that   we have found that there is uh an aspect of  covid that a lot of people have been talking   about you may have heard about it by the name  of long covid that means people might have covid   and they'll continue to have symptoms for a  long time often symptoms that are affecting   how their brain functions like their memory  tiredness forgetfulness and all of these issues   and so when i think about all the devastation that  this disease has rot on people both in terms of   the community and as individuals and i see that  the science around how this vaccine was developed   and its effectiveness which has been shown to be  extremely high i can say confidently as someone   who has received the vaccine that i think that  we all do ourselves a huge favor by getting this   vaccine so that we give ourselves an opportunity  to avoid all the devastation that this disease can   cause on you personally and also to your loved  ones thank you dr arnan one more thing does the   vaccine actually contain the coronavirus and if  if you receive the vaccine will you get covid 19   that's a good question and i think that that's  one of the exciting new technology about how   this vaccine was made that is worth touching  on it is called an mrna vaccine and i'm just   going to explain how this is different for the  longest time the way we have created vaccines   is either we take the virus that is causing the  problem we weaken it pretty much beat it black and   blue and then we give it to you so it can't hurt  you but at least your immune system recognizes   this beating up weakened virus and develops  an immunity to it or sometimes you might   take a subunit a part of it and  again introduce it to the body   in this particular scenario they used very unique  technology that was developed as far back as 1990   it's when they started publishing papers  about this and basically got a genetic code   of one narrow segment of the virus which  is pretty much a pointy spike that is on   the head of that virus and took that message  it's almost like giving a person a book to read   and so you give that message to your own cells and  say read this line and your body reads it and says   ah this is the picture of the spike on the head  of that virus and that information is sufficient   to make your own body create an immune  response to fight the virus so that if   the real virus should come your body is already  ready because it saw a picture of what that virus   could be and so there is no viral component that  is used in the development of this vaccine wow   thank you for the response i think that answers  a lot of questions as it relates to contracting   the virus from the vaccine dr van enk there are a  lot of wait and see or you go first people in our   community what are the dangers in that approach  and what would you say to change that mindset   yeah i i think it's understandable that  people might think this is a brand new   vaccine it's never been given to humans anymore uh  yet and so maybe i don't want to be the first one   i would like somebody else to take it first and  then i'll find out what this vaccine does to see   if it has any harm that's a reasonable approach  but now we're beyond that the vaccine's been   given in kalamazoo for four weeks now it's been  given you know in in other parts of the country   for a long time we have millions and millions  of people who have taken this vaccine now   and so now we know what the vaccine does  and it's it's very safe and so we have   that experience we have that observation we know  what people how people respond and they do just   fine and so i would say now is a good time to make  your decision to get the vaccine because you have   all the information you need to make your decision  you know that it's safe and you know that it works   so let's make a decision and let's decide  to take this vaccine when it's available   a follow-up question to that is after getting the  vaccine how long will people need to continue to   wear masks practice social distancing washing  their hands continue to do those things and the   all the ex the bonus question to that is i guess  when will we get back to normal yes get back to   normal that's right everybody wants to get back  to normal that's that's absolutely true it's a a   difficult question to answer because some of the  some of the answer depends on us and some depends   on the virus some of you might be aware that  that there's a new strain of virus that arose   in england and it's here in the united states  now and it's spreading very fast so that gives   the virus an advantage um the vaccine will work  against that strain but that means that the virus   will probably be here a little bit longer the more  people get the vaccine and the sooner they get it   the sooner the virus will go away so to some  extent how long the pandemic lasts depends   on us it's our decisions our personal choices  that we make that will make the vaccine go away   or allow it to hang around and so far we've done  a lot of things that allow it to hang around   we haven't socially distanced we've gone to  parties we've gone to family gatherings some   people won't wear masks so all those things allow  the virus to hang around in our communities and we   don't want that so the sooner we we do the things  to make the virus go away the sooner the virus   will not be able to to find another susceptible  person and then it will leave so in a sense   the way we operate as a community as an  individual we're our own saviors when it comes to   accepting the vaccination and doing the proper  things around it exactly one last question and   this is a toss-up for either of you or  for both of you an opportunity to respond   there is a clear push to encourage people in  the black community to receive the covid 19   vaccine what effects of this virus have you seen  in the black community that compels you to keep   that intentional focus i think one of the  most unfortunate things that we learned   as this virus was visited upon us was the  disproportionate mortality rate among african   americans compared to other racial groups  in the united states and this was something   that was seen in michigan seen in new york  seen all across the united states of america   it is not because uh african americans have  weak genes it's because there are systems   in place that have put some people in this nation  at a disadvantage and so a virus such as this   just exposes the disparities in care that have  always existed however because that reality exists   that's why people such as myself dr van enk are  so vigilant and persistent in making sure that   all communities including african uh american  communities have an opportunity to get this   vaccine so that you might get a leg up against a  disease that might uh disproportionately target   you in terms of its impact on our communities  and so that is the uh the driver if you will   that makes us feel that we want communities  that have been so devastated by this virus   because of other structural issues that are in  america to have an opportunity to get this vaccine   so you can have a leg up over the vaccine yeah  yeah this week is the first week in january   we are planning vaccination programs for our  communities right now the next week we'll be   putting the plans together to deliver that vaccine  to our people in our communities and i can tell   you we are very very aware of the disparity  between between different communities and   we're very will be very vigilant and aggressive  about making sure that communities of color   have great opportunities to get the vaccine in  terms of of access getting into those communities   making sure that those people are are talked to so  that they understand their concerns are addressed   they understand what the issues are we make it  very easy to them because frankly they've been   excluded for many years and often are  and so we need to address those issues   and the county and the hospitals are working very  hard to achieve those goals as we wrap this up do   you have any final things that you want to  add to the conversation that we've had today i can start i think basically um again i would  touch back on the issue of trust that even though   uh trust in our systems at some point might be  shaken we have to also trust in what america   represents it's really the land of freedom it's  the land of opportunity and it's a land where   uh amazing things have been accomplished as  america led the way to the moon and also helped   for us to really stand up this vaccine we continue  to set the pace for the world and i think that   it's incumbent upon us as citizens of america or  people who live here to take advantage of these   opportunities and one of these opportunities is  we have access to a vaccine there are people in   the world who are begging to have a chance  to have a shot and so i think if you have an   opportunity you should take advantage of it it  is your for lack of a better word a god-given   right as someone who lives in america and your  taxes are paid for it so take advantage of it yes   yes we hate covid we hate it so much it's it's  been a terrible thing for us for our communities   so many people we've lost because of covid we want  it to go away so now we have a tool to make it go   away so it's our responsibility to use that tool  so that we can never have to deal with covid again   and we can get our lives back to normal again  it's been such an honor to speak with the both   of you to have this conversation about the you  know the covid vaccine and the effects and the   importance of this specifically for the black  community again i just thank you so much for   your time and questions i know it's important for  bronson to have these acknowledgments in these   conversations to and to improve on the trust  that we have and can build in our communities   and that starts with leaders with scientists and  with physicians like you so thank you very much   for your time today and i really appreciate  your conversation thank you be interesting you

2021-01-26

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