In light of COVID-19, now is a time when we must look for new ways to fight against the environment that put so many people at risk.
Coronavirus is really sort of the microscope that really shows us, you know, how inequality and even systemic racism has really impacted our healthcare system. I mean, you need only look at the death rates of African Americans from COVID to really see that people of color, especially low-income people of color with other chronic conditions that typically plague those populations like cardiovascular disease, obesity, diabetes, are all the folks at greatest risk of contracting COVID and dying from it.
In fact, in Louisiana, Michigan, Illinois, many other states, we’re seeing African Americans die from coronavirus at a rate of two to four times what they are represented in the population. So, you know, I posted recently on LinkedIn that coronavirus is racist as hell, and its lethal comorbidity is poverty. When you have these two things together, it’s an excessively lethal combination especially for people of color.
In our interview with John, he also mentioned the desire to see a universal basic income become a reality. I had a book sitting on the shelf about the topic of universal basic income, and I just finished reading it after our conversation.
Universal Basic Income
The book is Give People Money by Annie Lowrey. It’s a fantastic explanation of what universal basic income is and how it is already playing out in a variety of tests being done around the world. Though the author is clearly in favor of the idea, I appreciate her being willing to point out the potential downfalls of this new policy.
Just as importantly, the author takes the time to show how inequality around the world and in the United States impacts wealth and physical well-being. Lowrey’s focus is to demonstrate all of the reasons why we may need to rethink the concept of the safety net. Her ability to weave in important aspects of history to explain how some cultures are more privileged than others is critical to getting the true picture across.
I’m sure there are other books that delve more deeply into the causes and impact of racism and classism throughout our history. That said, this information resonated within me especially because of the conversation we had had with Gorman.
I live in Louisiana. We’ve seen higher rates of African Americans dying due to COVID-19. The entire concept of social determinants of health is coming into stark relief when I see how a terrible disease is hitting our community.
Moving Past the Label of “Them”
As I was thinking through this, I also did some cleaning through my bookshelves. I came across a book called More or Less by Jeff Shinabarger.
Check out the subtitle. It’s Choosing a Lifestyle of Excessive Generosity.
Looking back to the book, one of the parts of the story that really impacted me is how directly the author came into contact with a new homeless neighbor. This neighbor was a fixture in their area, and the author had conversations with his neighbor and hired him for various tasks around the house. The experience of interacting so directly and at such length with this new neighbor change the author’s perspective on what it means to give and to be aware of those around him.
I bring this up because I believe that seeing a group of people in a different situation becomes much more real when it’s an individual we’re talking about. Instead of a group of “them” we are talking about a real human being. It’s not “the poor;” it’s “my neighbor.”
There is hope. People are doing what they can to change how we react to and even do our best to prevent health crises.
This is obviously much different than bringing about some sort of sweeping new policy for the entire country, but it at least shows positive movement while policy may be mired in gridlock.
The Safety Net and the Use of Telehealth
The safety net is a term that describes a loose network of different types of healthcare facilities around the country, federally-qualified health centers, other category called free clinics, as well as often immediate health service, migrant farm workers clinics, and healthcare for the homeless sites.
Within the context of safety net practices, Dr. Anderson and his team have been working on a telehealth solution to meet a very specific need.
They’re providing asynchronous telehealth, often called eConsults, where primary care providers can “submit consult questions, content from their electronic health record, and send them to be reviewed by a specialist.” The specialist can then provide guidance on how the primary care provider can help the patient.
This provides a huge help in creating more access for patients and specialists, particularly for rural locations and inner-city clinics. As Dr. Anderson describes it, “When I need a specialist to give me advice, information, make suggestions about a particular medicine, or advise me on a lab test, but I don’t need them to see or lay hands on the patient.”
The better use of communication tools allows practices to keep their patients from having to go to multiple facilities and keeps costs down. Both of these factors are incredibly important during a time of higher health risk.
Investing in the Community
John Gorman’s Nightingale Partners are actually working on a project just down the road from New Orleans.
We are working on a big one right now in Baton Rouge that we’re getting very excited about where LSU has basically donated its old Memorial Stadium to us and a team of developers that we’re working with led by Roy Austin, that we are going to build Memorial Stadium into a ginormous healthcare campus for underserved populations in West Baton Rouge.
And it’s gonna have a core set of services that we know lower-income communities are in desperate need of like a walk-in clinic and access to primary care. We’re gonna have a community pharmacy there. We’re going to have an adult and child daycare center that’ll be multigenerational. We’re going to have a hub there for community health workers and community pharmacists to train and do their residency through LSU’s College of Pharmacy. And we’re basically going to begin a campaign with Roy and his team to convert these types of public spaces or work public spaces into healthcare hubs that better address the needs of medically underserved populations as we see in western Baton Rouge.
Obviously, getting the chance to interact with a large school like Louisiana State University is a huge undertaking that requires a ton of coordination. That said, it’s not just the universities that are making things work.
I’ll harken back to the BUILD Health Challenge that Dan Dunlop mentioned on our show as another example of people bringing big ideas to meeting healthcare needs in exciting new ways and in a variety of contexts.
There are several stories of hope, despite everything that’s happening in the world.
Fighting against negative social determinants of health is not entirely dependent on the government. We can make an impact through new business ventures, new coordination with educational institutes, or even through health systems and non-profits coming together.
Featured Photo by Jose Martin Ramirez C