The Battle for Better Health: A Learning and Sharing Discussion

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Hi, US population identified as such. Any practice that carries the risk of prolonging the longest ending failure to achieve diversity in the workforce.

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Will result in even less availability of black and Hispanic doctors, nurses or other healthcare providers.

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To serve patience of concordant grace. Increasing diverse patient population also demands a diverse health care workforce that can provide more effective and appropriate ways to address in racial and ethnic healthcare disparities.

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We know the racial and ethnic disparities in healthcare result in worse outcomes and not doing anything about it is unacceptable.

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As it goes against our most basic ethical tenant. First do not harm. In conclusion, I believe that this decision carries a great potential to negatively impact equity and justice in the access to the best possible health care standards and outcomes for all sectors of the population.

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But especially for those who are underserved or historically marginalized by discriminatory practices and systemic racism.

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A diversified health workforce is a matter of justice and anything that goes against it. Is then an injustice.

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Thank you.

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Thank you. Thank you for sharing. Dr. Delgado or Cecilia, do you wanna chime in on?

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How this decision impacts health care workforce and are pursued for health equity.

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Certainly. That, Dr. Bill Gotta, please go ahead.

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No, go ahead. I am muted too. No worries.

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Okay. Yeah, I. I was feverishly nodding through most of your comments, Dr.

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Mendoza and I, agree wholeheartedly that, in action.

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Towards improving health equity, one of the means of which we have to take action is to make sure that we've got a diverse representative workforce in healthcare.

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Is, it's in justice and I'll go further to say that it's violence.

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Now, my take away from the Scottish decision is that other action is needed. We're not going to get a judicial, resolve to the matter of inequity in equitable representation in higher education and equitable representation in health care careers and in the workforce.

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So other action is needed. Organizations, public health, community based organizations, health care organizations. And institutions of higher education are going to have to take, new, innovative and stronger approaches to increasing the diversity of those in their ranks.

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And I think that The Scottish decision shines a light on a problem that we have. Just in general that we measure disparities through a lens of isms you know through our race through ethnicity which are social constructs right there are not scientific bounds for what race means, what ethnicity means.

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And furthermore, many people who are grouped in the categories of ethnicity that we're able to check off on census and other documents.

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Don't align with the options that are even listed there. You know, I'd love to talk about that more today as well.

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But we use race, ethnicity, gender as proxies for what's causing disparities and outcomes.

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When what underlies that are systemic. Challenges to, you know, our ability to achieve equity.

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Those systemic challenges are not the cause of race. They're not the cause of ethnicity.

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You know, they are the results of those racist biased unfair systems that are in place. Edward Deming in the work that we do we do a lot of performance and quality improvement and Edward Deming is the father of much of that work.

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Says that every system is perfectly designed to get the results that it does. So we want to change representation in healthcare, we're going to have to change the systems that fuel, that pipeline.

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Hey, thank you.

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And as an agency in a community that is working with and for, students who oftentimes represent the diversity that exist throughout Voulder County in Boulder County, Colorado.

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We are often challenged in how do we create those pipelines in an out of school program? So that I have a DREAM program is an out of school space and we were collaboratively with our school systems and complement the work that's happening during the day.

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And, After SCOTUS made the decision that they made, for us it was really a reckoning of, okay, so how do we increase the resources?

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How do we increase the information that we've been, working so hard to share with our communities around educational opportunities.

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And pipeline, right, is a big term that we often hear often in in a negative setting as well as a positive setting.

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Right? Because we have the school to prison pipeline and then we have the school to prison pipeline and then we take it as well as a positive setting, right?

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Because we have the school to prison pipeline and then we take it a step further and say, what are the pipelines for these medical programs and then we take it a step further and say, what are the pipelines for these medical programs in our communities?

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What are the pipelines for these medical programs in our communities? Because as Dr. Menelaus mentioned, to these medical programs in our communities? Because as Dr.

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Menelausa mentioned, representation in those areas. Because as Dr. Mindlosa mentioned, representation in those areas, when working with and collaborating with communities of color around health disparities is, a factor in the relationships that are built and the success of the community will experience.

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So for us, from an Ed standpoint, I think it's been devastating to see the ripple effects very quickly that SCOTUS decision had on communities of color in particular and ethnic minorities across the country.

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And simultaneously also meeting with institutions of higher ed and partners talking about how we have to be creative, how we have to be innovated as you mentioned Cecilia Round, what can we do in to increase that representation without calling it right a diversity recruitment program.

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And I'm hopeful. I'm hopeful. I'm hopeful that our institutions have Hired, and I'm hopeful.

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I'm hopeful that our institutions of higher ed, will implement these programs and continue to, recruit in, our diverse communities across the country because it does make a difference.

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I have had in a personal level, had to navigate, medical professionals in the medical system with the parents that are aging and having to explain, certain terminology because the doctor is not bilingual or they couldn't find a bilingual staff or understanding also the cultural nuances that my parents who are trying to hold on to their cultural practices and their cultural traditions and food and

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medicine, right? That's often very traditional in my community. And explaining that to a doctor who has not because they don't want to, right, but because they often don't have the time or they don't have the lived experiences of understanding the diverse communities that make up our country.

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And if we get more representation and more cultural understanding, I think those conversations are much easier. To be had, right?

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Not only when that resources being accessed, but also when we're talking about preventative care amongst communities of color, who are after who often don't have access to resources or gyms or many of our communities of color across across the country are in food deserts, right?

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And what does that mean and how do we begin to bridge that gap? And what does that mean and how do we begin to bridge that gap?

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But when you hire from the communities and when you hire individuals who have a cultural responsive lens. Those programs begin to address and close the gaps that exist.

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And I think that's the beauty, right? And as you mentioned, Cecilia, it's really around continuing to be innovative and finding different ways to dismantle these systems that were made for the, beautiful diversity that exist, both socio economically, ethnically and linguistically in this community.

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And basically rebuild them, right? To better. Reflect who we are as a community.

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Thank you.

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And you totally kind of touched on something. That I think is really meaningful. That is, you know, how does inequality and social justice impact health?

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Cause I think some, many times And I know this from working in healthcare, it's like, you know, what is this is the The best, this is a decision that a system did and it impacted all of these people.

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So now we should get this and adopted everywhere. Which oftentimes doesn't necessarily help so I'd love it.

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One of the things I love about this panel is we all have these very different perspectives from education and you work with parents and their families.

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We have public health here and health teams are really focuses on practice. So I'd love to hear your insights on how does an equality and social justice impact health we're all trying to prove these outcomes, but What is it that needs to happen or what is it that we're currently seeing within our communities?

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And this is pre decision from SCOTUS.

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Okay.

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Anyway.

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Good morning.

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Did you want any one of us in particular to jump in?

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I think y'all just go whenever you would like.

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Yeah, I think that one of the things that I've noticed a lot about, initiatives to improve health equity and to, increase, understanding of disparities and outcomes that I've recently become.

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Really cognizant of is that so frequently. Folks who are experts in health and health care will dive in with both feet and great intentions with plans to make everything better, but they don't center a patient voice, a PFAC, a focus group, a single meeting is not sufficient to build an initiative that is designed to change the way that you are fundamentally delivering hair to patients in order to be more responsive and

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to better meet their core needs, right? So we're doing some work in Kansas City with the, Kansas City Health Equity Learning and Action Network.

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The partners in that. Initiative are the Hill forward Foundation, the Casey Health Collaborative and, IHI, and One of the principles, the key principles of the work of the land is centering.

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The patient experience. And that means having patients, community members. As key parts of the team. And not a separate committee but they are there looking at the data they are there defining what the challenges they're they're defining what the drivers of that challenge are and prioritizing action plans.

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And if we're going to figure out why we've got low enrollment in medical training programs.

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We have low even applications to those programs and we have difficulty with matriculating through those programs.

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We've got to ask the students. We've got to ask. By pop folks what what are the barriers?

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What are the challenges? I mean in one such study, It was determined that black students don't tend to graduate from undergraduate, programs at the same levels or rates as other groups of students because they're nearly 3 times as likely to have a full-time job and caregiving duties on top of school.

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So how do we design programs that support those needs and allow people to be successful you know. Family members and contributors while also advancing through their education.

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And the same goes for different initiatives to improve quality and healthcare.

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Awesome. Yeah, Dr.

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Yes, thank you. Yeah, building up a little bit in what Cecilia was mentioning.

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In Boulder County we have a bulletin public health We have been using an equity lens definitely and a very community centered approach.

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And part of that, is working with cultural brokers. From the community. So they help.

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Nice.

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As inform. What are the needs of the community? And then also help us to bring messages to the community as trusted messengers that they are.

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We also are, you know, like 1 one of the important things, that we need to solve is the barrier of language.

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So then also we have interpreters. And this is something that is It's becoming a more serious profession.

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It is a serious profession. Medical interpreting and that medical interpreting conveys also cultural brokering.

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The learning how to manage the flow of communication and also the flow of the cultural. Region. So I think, you know, in a way one thing that we can do at this point is really adopt you know these trusted messengers cultural brokers medical interpreters and so on as our allies like really like being like fundamental parts of the healthcare system, not just some accessory to go to when needed.

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That's one of those things that I think is a reflection of how sometimes the community receives when we approach them like this is very transactional only when you need it.

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Then you reach out to us. And it shouldn't it shouldn't be that way. It should be like all these people.

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That have been breaching gaps for years. Should be part of the healthcare system officially.

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I feel that that's the resources are there. I mean, there's a lot of a lot of them.

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I mean, there's a lot of human resources available. Now they need to be integrated formally.

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And other issues that sometimes They provide services informally. And not being, you know, paid for it.

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Which of course makes everybody tired and we all do it because we want to help the community but still there's a you know the cultural wealth that that leaves in all these individuals.

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Should be also, you know, rewarded somehow, recognize, officially recognize, like really put something on the line.

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To express the willingness. To make that connection with the community. So, yeah, I think that's one way to go about it.

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And you know, meantime, like, what, you know, like, let's see, I was saying, probably right now we're not gonna fix the situation.

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Right now, the changing the room and stuff, maybe it's not gonna happen. I keep thinking about it.

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I'm not a lawyer. But, but I'm like, what is, what is that we can do?

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We can't really reverse this at this moment, but what can we do better with what we have?

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And I think that's one aspect.

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Yeah.

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You know, I think, from my standpoint, I identify as a, And I think, one of the pieces that I have seen evolve within kind of the health.

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Sphere is recognizing the community health practices that exist within our communities that aren't necessarily, I think, defined clearly or understood within Western medicine.

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And I think those practices need to be recognized and acknowledged. And, when those begin to be recognized and acknowledged, then I think there's a bridge that can be created or constructed to further kind of expand, right, some of those practices in those recognitions.

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Well, also introducing our communities to Western medicine that could help them, right, and be proactive because from a community standpoint, what I've seen growing up in this country is that our healthcare system has been traditionally very reactive, right, and very little is done around preventative care and it's like how can we again recognize some of these community cultural, this community cultural wealth within the health kind of sphere.

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Recognize it and then implement some practices that will help our community stay healthy because then in turn, right, our healthcare systems aren't as weighted down with so much demand.

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And we saw it during COVID. We, I mean, that was such a great example of the, our healthcare system being basically, just strained in so many ways, and simultaneously, right, dealing with COVID and then the patients that still needed the care that were sick previous to COVID.

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And so how can we as a community begin to explore very creative and innovative ways. Of maintaining a healthy community regardless of socioeconomics and ethnic background.

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I think that's when we can begin to really create a healthcare system that is equitable and addressing some of the health injustices that exist within our health care system.

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And there are some amazing practices across the globe that we're learning about from communities that don't have these robust healthcare systems but maintain very healthy communities.

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And so I think those are practices that we can begin to instill within our communities here in the States.

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And I think again, that's a way for us to utilize cultural brokers. Well, simultaneously recognizing that there are communities in our youth community right now and I work a lot with the youth community.

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Oh, please.

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So I'm entering this conversation through that. But, I think that we have to begin to recognize the assets and the skills that they bring and begin to plant that seed and provide opportunities for them to see themselves as contributors and potentially leaders within the healthcare system, right?

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I love the cultural broker model. I love using medical interpreters and what can we do to begin to grow that representation within those communities that we've used as Dr.

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Menelaus mentioned for so many years as this additional resource, how we how can we embed them into our staff?

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How can we allocate budget that gives them right the financial stability when they're that they don't have to hop around in a medical facility.

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To medical facility because they're trying to make a living. As medical interpreters but really intentionally builds the systems that see that as a resource.

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Within, our staff structure. So I'll stop there because I can go on and on forever and ever around this topic.

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So thank you.

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Now you're doing your great and a lot of the points that all of you guys have said. Listening to Dr.

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Mendoza about interpreting I also am like he kind of, and I actually from the same.

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We have the same hometown. We were born in the same city. I used to translate from my parents from my mom when we used to go to the doctor and it's scary and half the time I was like God, I hope I didn't kill you trying to figure out like the dosage and why you're taking the dosage and and back then you know, it wasn't a

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requirement to have interpreters. Parents would just take their kids and hope that you know they translated appropriately and when you're doing it at such a young age.

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11 or 12. It's hard to explain to parents. You know, this is what cholesterol is and this is what you have to change in. This is a medication.

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What's the targeting? So I think you all hit various some very important and valid points.

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One of the, oh go ahead. Oh.

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Sorry, Cynthia. I just wanted, I'm gonna put a film and I think you might have posted this on LinkedIn, and I think you might have posted this on LinkedIn, but I think you might have posted this on LinkedIn, but wanted to share a film that has garnered a lot of attention.

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It's called translators. And if you have a moment, please take a look at it.

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It's about maybe 1015 min long, but it touches on that point of how many immigrant communities utilize their children as interpreters because there are not enough medical translators and interpreters within our healthcare system, right?

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And recognizing again that value in that asset and that skill set that our youth are often navigating when their parents aren't familiar with the system.

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It's a beautiful film. For me it was very emotional because I had a similar experience growing up as you did Cynthia and I again I think it's the importance of recognizing that we have that skill set within our community and how do we begin to foster that.

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Sorry for that interruption, but wanted to hear that.

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Oh, no, not at all. Thank you for sharing.

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Yes.

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And my chat is not working very well. So if anybody can get in the chat. Hi, sorry, thanks, Cecilia, not opening on my end for some reason.

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Oh, thank you.

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Cynthia, I can read for you. And I hope I pronounce your name correctly.

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Moses Castellanos. Says for me it was more about the lack of privacy. This especially recording some specific subjects.

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And then we have, I love that. I really like the idea of seeing the interpreter as part of the team because they are, if not the power dynamics, way heavily as transactional versus relational.

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Awesome. Thank you. Thanks for saying that sharing. Figures, this always never works when you're on.

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Thank you. The other thing, cause some of the points that you guys are talking about in terms of the different initiatives that we can take.

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There seems to be more and more more funding for practices for nonprofits for organizations on how to improve equity within our communities.

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And there's always a lot of questions on who is responsible for addressing inequities in health in the broader society.

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And it's a turkey question and I live with a physician and half the time it's like, is it the physician's duty to try to fix this inequities in health.

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So it's a tough question and I'm hoping you have insights on whose responsibility is it.

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My insight is that it's all our responsibility. And, the physician is also a patient.

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I think that we very frequently forget as we're thinking about health care that every single person who's part of the healthcare system is also a patient and a recipient of health care and you know, they're there are so many arguments about.

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Health outcomes are really when they come down to personal accountability. Behavior is definitely a driver of health outcomes.

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But our behavior is it relates to our health is driven by so many factors that are informed societally.

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Behaviorally in terms of our behavioral health and our mental health. And the other Oh, the so many different elements of lived experience that are, circling and cycling around all of us.

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I am.

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Definitely a proponent. That primary care. Needs to be central. In our national discussion about how to improve health for everyone.

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And one of the keys to improving health for everyone is to increase. Of equity by decreasing disparities that are driven by inequities.

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Now does that mean that the primary care provider needs to personally walk a patient to a social service agency and link them to something no.

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But I do think that primary care teams need to be well informed and fully integrated into the fabric of their communities.

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They need to know what public health resources are available. They need to know what social service, social services are available and not.

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By clicking on a computer screen. And finding options, but by knowing like personally understanding what is available, what works, where people feel seen, heard, and cared for.

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And making referrals to those. Those sources. And that is the role that I think primary care and health care in general needs to play in addressing, inequities and improving health equity.

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The other ways that health care needs to play a role in this is being. It's vulnerable and transparent about the role of implicit bias in the way that we treat patients.

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That are different from us. And acknowledging that it plays a role and that there's individual growth that everyone needs to do.

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In order to be a more equitable provider of care and services.

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Thanks.

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And like Dr. Delgado said, I would go on and on. So I'm gonna.

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Yes. So yes, I mean, I agree with Cecilia, you know, we all and we all have to participate on that and one of the reasons is because the more voices the better.

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We all have to raise our voice. Even if it's just, you know, like Being informed, really well informed.

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Of what is the situation, what are the needs, were the solutions and demanding those. And when the message come from different sites.

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Then the possibility of that message being heard increases too. It will be, you know, like kinda like an obvious.

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Thing to say is they well that license on the people who created policies right and enforce them and all that stuff.

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Yes, okay, well, let's say that's the gatekeepers but the gatekeeper also needs to know, you know.

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This to here, I have the push. From the people around to decide. Okay, yes, it really is necessary to open this gate and put the mechanisms in place.

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But if nobody says anything, Or if you know if voices are silenced and others are not advocating for those voices.

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Then kinda like the problem just perpetuates. So I think, you know, just the fact that If our says patients are aware of this is what is happening, this is unfair.

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People, you know, babies, you know, like small babies. Will be much well taken care of.

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If the physician Is Concordant in raise? Hey, I want to have a decision that is in Concordance for my baby.

00:35:45.000 --> 00:35:50.000
That's what I want. And that's my, I really want to get that. Just raise the voice.

00:35:50.000 --> 00:36:06.000
And I'll give up because it's your baby, right? And the other thing like the trust part that you super important if we know that when the concordant race, when there is a concordance between the provider and the patient in terms of race, the trust this better, you know, people trust trust more, then we really need to ask for that.

00:36:06.000 --> 00:36:14.000
I really would like to have a physician that is like me. You know, because, you know, it's good for everybody.

00:36:14.000 --> 00:36:25.000
Save time for everybody and it's good for them because also physician may be having I mean if I see it from the decision point of view.

00:36:25.000 --> 00:36:32.000
When you're trying to help somebody that you're having a really hard time understanding culturally maybe and even linguistically.

00:36:32.000 --> 00:36:40.000
It's kinda like, I don't know if I wanna do this anymore and maybe referring you to somebody else and the per patient ends up going here and there.

00:36:40.000 --> 00:36:42.000
And the reason I want to do this anymore and maybe referring you to somebody else and the per patient ends up going here and there.

00:36:42.000 --> 00:36:56.000
And the opposite within and the patient is the same. The patient is like, well, You know, I don't really trust this dude and I'm just not gonna do what they say and then okay then everybody loses because then we have to go for another resource more expensive for the system, more expensive for us, obviously healthy periods.

00:36:56.000 --> 00:37:01.000
And a lot of things don't happen because of that lack of trust, that lack of trust.

00:37:01.000 --> 00:37:15.000
So yeah, I think I agree with that Cecilia. And really like, you know, Let the people know these are the resources that are out there for you and just push it, you know, inform the people.

00:37:15.000 --> 00:37:22.000
This is therefore you, you said. What is your what is your, what is your, barrier?

00:37:22.000 --> 00:37:33.000
Into accessing these resources. Just let me know and then we'll have to find a solution. And is there at so many levels, but yeah, I agree that everybody has to be in there.

00:37:33.000 --> 00:37:44.000
So this is. This is this question is really great. In regards to how How we hold, I think let me restart.

00:37:44.000 --> 00:37:52.000
I think it's a multifaceted approach. I think we need to hold, our leaders accountable.

00:37:52.000 --> 00:38:14.000
We need to, elect and hire leaders who understand the communities. When we look at health disparities, right, I am often intrigued about all these reports that are published, you know, annually around what are the 10, healthiest communities across the US.

00:38:14.000 --> 00:38:19.000
What are the top 10 unhealthiest communities in the US, right? And when we look at the most unhealthiest communities, right?

00:38:19.000 --> 00:38:36.000
They often tend to be in the South. When we look at the economic. Levels of those communities we know that oftentimes those communities are facing income inequality, the lack of resources.

00:38:36.000 --> 00:38:43.000
Again, they live in food deserts. There aren't options. There's so many, many reasons, right?

00:38:43.000 --> 00:39:00.000
And it's the people in power. So if you are in the audience, if you are position, if you are in a position of power in a position of leadership, I encourage you to step outside and get to know your community, build trust, right?

00:39:00.000 --> 00:39:05.000
And simultaneously it's the community stepping up. And saying, here's what we need from you.

00:39:05.000 --> 00:39:12.000
Here's what we don't have as Dr. Mendelssohn mentioned and Cecilia around here are the resources that we're lacking.

00:39:12.000 --> 00:39:18.000
Here's what we need. Here's how we can collaboratively work together to ensure that these disparities are being addressed and that we're no longer experiencing that, that as the community.

00:39:18.000 --> 00:39:37.000
Our politicians, right, regardless of your. Our politicians, right? Regardless of your, political background, we must hold them accountable both at the local background, we must hold them accountable both at the local level as well as at the local level as well as at the local level, we must hold them accountable both at the local level as well as at the state and federal level because they are the ones.

00:39:37.000 --> 00:39:41.000
We must hold them accountable both at the local level as well as at the state and federal level because they are the ones signing the bills.

00:39:41.000 --> 00:39:50.000
They are the ones placing oftentimes these judges who are approving. Or signing off on some of this, these decisions that impact the community as a whole.

00:39:50.000 --> 00:40:13.000
And so I strongly believe that as Cecilia mentioned, we are all responsible and yet we hold a portion of the responsibility based on where we are in the community if we hold a position of power and we are decision maker you hold a lot more responsibility around what happens to our communities in the success, then the people who are kind of living day to day.

00:40:13.000 --> 00:40:20.000
If you're a person who is a non in a non leadership or non-political position.

00:40:20.000 --> 00:40:33.000
We also have to be informed and again utilize our voice. To a demand change and demand more resource allocation based on the needs in the successes that our communities are experiencing.

00:40:33.000 --> 00:40:41.000
Thank you. Thanks for sharing. One of the things and I wasn't planning on doing this, but I'm gonna put in a plug.

00:40:41.000 --> 00:40:52.000
For one of the roles that I do in in the state of Colorado there are regional health connectors and they are Soon to be funded by the state now.

00:40:52.000 --> 00:41:02.000
We were funded by an initial bill, but we're put in different counties. So I represent Boulder and Bloomfield County.

00:41:02.000 --> 00:41:06.000
So I work, I've often met with Bedla to be able to learn a bit more of what the community is happening.

00:41:06.000 --> 00:41:20.000
So regional health connectors, the intention is to connect community based organizations with different primary care practices because what often happens is A lot of us in the community are working on similar things.

00:41:20.000 --> 00:41:34.000
Or seeing certain trends. Or I experience in different situations when it comes to health care and the role of the regional health connector is to be able to try and see kind of on a more grander level.

00:41:34.000 --> 00:41:50.000
What is happening within the community and where we can start plugging in. So whether it's experiencing with, you know, wait times for a certain community health center.

00:41:50.000 --> 00:41:56.000
For example, if we're saying, you know, our patients can't get into so and so practice, what is the best way to address them?

00:41:56.000 --> 00:42:07.000
You know, if we have kids that need to get well child checks, what's the best way to get well child checks and vaccines and the role of the regional health connectors to be able to connect it.

00:42:07.000 --> 00:42:18.000
So I know with practices, often times you may have patient navigators, they'll have sometimes will have, you know, variation of community health workers or key managers, and it's difficult to be able to go out into the community.

00:42:18.000 --> 00:42:20.000
So the regional health connector is a really good way to have this one person that kind of connects with everybody within your region.

00:42:20.000 --> 00:42:33.000
And has a greater idea of what's happening. Cause communities are so very unique. And what's happening in my Boulder community is so different than what's happening in my Bloomfield community.

00:42:33.000 --> 00:42:36.000
So I get to learn a little bit more from public health departments, from practices and or on different nonprofits, on what's happening.

00:42:36.000 --> 00:42:48.000
And The whole kind of part of the mission and the basis of the regional health connectors to really incorporate everybody.

00:42:48.000 --> 00:42:57.000
It's, you know, going beyond just mean, even like public health but going to the I have the Dream Foundation in Boulder County is what are you experiencing with your kids and their families?

00:42:57.000 --> 00:43:06.000
So for everybody I think Cecilia put it in the chat. But if you're in the state of Colorado, take a look to see who you regional health connector is.

00:43:06.000 --> 00:43:16.000
You can definitely connect with them that way. And if you're not, definitely take a look at the website that might be a potential option, for your communities as well.

00:43:16.000 --> 00:43:23.000
And I am going to go into Q&A here. So if you have any questions, please drop them in the chat.

00:43:23.000 --> 00:43:40.000
We did receive some questions. For those that were registered if you filled in the spot and these are the 3 questions that we received the first question is, what are practical tools for leaders to create inclusive environments?

00:43:40.000 --> 00:43:48.000
So Ladies, this is open to any of you if you think of. If you know of anything, please feel free to chime in.

00:43:48.000 --> 00:43:54.000
Yeah, in terms of practical tools for creating inclusive environments, I think that it depends.

00:43:54.000 --> 00:44:11.000
This is such a hard question because it's not. Gonna be universal. One of the things that I think is, is key to creating a more inclusive environments is to move past.

00:44:11.000 --> 00:44:24.000
The mentality of fit. And to the mentality of belonging. So you're not looking for a culture fit for your existing culture necessarily.

00:44:24.000 --> 00:44:33.000
You're looking for, you know, the skills and the capabilities to make the role happen.

00:44:33.000 --> 00:44:52.000
And you're gonna foster an environment that allows. New perspectives, new personalities. New cultural, tendencies I'll even say to flourish and to be you know welcomed and totally embraced in your environment.

00:44:52.000 --> 00:44:57.000
The sort of antiquated idea of trying to pick your staff. Based on fit for your existing culture is in many ways a misnomer.

00:44:57.000 --> 00:45:03.000
Because each time you add a new member to your team, you're going to go through the process.

00:45:03.000 --> 00:45:15.000
You know, forming Storming Norming and performing again. So your culture is going to adjust and adapt.

00:45:15.000 --> 00:45:28.000
But it's a lot easier for us to say our culture is going to be. The same and we're gonna retain the same culture without acknowledging that every new team member is gonna adjust our culture.

00:45:28.000 --> 00:45:39.000
Another piece of advice that I have in terms of in creating inclusive environments is Something that I mentioned before as leaders.

00:45:39.000 --> 00:45:51.000
I just urge everyone to take some time. To do the work and when I say do the work. I mean, determine where you go implicit biases.

00:45:51.000 --> 00:45:59.000
Take a look at your policies. Take a look at your practices and your procedures. And identify which of those.

00:45:59.000 --> 00:46:11.000
Benefit certain groups of people. To the detriment of others. And you'll if you do that those 2 sort of inventories the personal inventory And institutional inventory, you'll identify those areas.

00:46:11.000 --> 00:46:21.000
That are not inclusive.

00:46:21.000 --> 00:46:26.000
Thank you. Anybody else anything out or should we move to the next question?

00:46:26.000 --> 00:46:34.000
I know that's, that, everything but as you're gonna share in both public health.

00:46:34.000 --> 00:46:40.000
We use a model of, courageous conversations. And so we, it's like, it's something that is going on all the time.

00:46:40.000 --> 00:47:03.000
So we have this meetings and we use all the agreements and the campus and everything and this has been an eye opener for a lot of people who had no You know, not, not, for one thing, not the word, it didn't have the awareness about.

00:47:03.000 --> 00:47:15.000
How hurtful is racism. Our first are the retention of it. And and how to deal with it because it's very uncomfortable right that's why it is courageous conversation.

00:47:15.000 --> 00:47:27.000
So just to learn how to how to entertain. That those concepts and how to. Acknowledge. The privilege and how to become.

00:47:27.000 --> 00:47:35.000
An ally, a better ally. Or even a co-conspirator, you know, but, but then, you know, but there's a lot involved in there.

00:47:35.000 --> 00:47:42.000
A lot of processes of, you know, internal processes and also knowledge from outside and the actions that you can take.

00:47:42.000 --> 00:47:48.000
And I think that's that's that has been very helpful for us as a group. It's a constant thing.

00:47:48.000 --> 00:47:56.000
Is kind of exhausting. So, but. That's one of the tools I can recognize, that can help.

00:47:56.000 --> 00:47:57.000
Thank you.

00:47:57.000 --> 00:48:16.000
And I just wanna add that there are so, so many tools out there, for creating inclusive environments and, I think there's an opportunity to really find one or several frameworks that work for the type of environment that you're working in and that you want to create.

00:48:16.000 --> 00:48:25.000
And I think the best the best tool or slash advice is Cecilia was mentioning earlier is.

00:48:25.000 --> 00:48:47.000
I would really encourage people to give each other grace. We are all at different levels of this journey, whether through lived experiences or through a theoretical lens or a practical ends, I think giving each other grace and meeting people where they're at is for me as a leader, a true commitment to equity.

00:48:47.000 --> 00:49:09.000
And helping people kind of get to where they, sorry about that. To get to where they want to get and again really looking at the flexibility and the versatility around what tools work best for you right now and that might evolve a year from now as your team is progressing.

00:49:09.000 --> 00:49:27.000
And so I think that willingness to say, okay, right now here's the tool that our framework that we're going to use and it might not be the tool that we use 6 months from now or a year from now or 3 years from now because building inclusive communities and equitable communities is an ongoing commitment to recognizing that we're all at different journeys.

00:49:27.000 --> 00:49:32.000
And again, giving each other grace and saying, okay, I'm going to call you in if something.

00:49:32.000 --> 00:49:42.000
If a behavior or something was said and I'm gonna help you kind of work through that and here's some tools that you can take with you.

00:49:42.000 --> 00:49:54.000
And I'm gonna celebrate the milestones that we experience as a team because I think that's part of this.

00:49:54.000 --> 00:50:01.000
Opportunity to create inclusive communities and inclusive environments is by celebrating that we are moving ahead.

00:50:01.000 --> 00:50:02.000
Sometimes it doesn't feel that way. But a niche is better than not moving at all.

00:50:02.000 --> 00:50:19.000
So I just wanted to, share that with you all that it's an ongoing journey and none of us regardless of our lived experiences or our linguistic or ethnic identities.

00:50:19.000 --> 00:50:24.000
Are fully. . I.

00:50:24.000 --> 00:50:31.000
Experts because we all have a lens that is very unique to our lived experiences and our identities

00:50:31.000 --> 00:50:47.000
Thank you. That was the grades. Second question, can you also discuss these issues in relation to oral and behavioral health care services and providers?

00:50:47.000 --> 00:50:48.000
I mean.

00:50:48.000 --> 00:50:57.000
I think it, you see the same trends across. Clinical physical health and behavioral health in oral health.

00:50:57.000 --> 00:51:04.000
And the impacts are, compounding. I mean, it's.

00:51:04.000 --> 00:51:18.000
Very frequently one of the barriers to being able to meet health goals that patients may develop in collaboration with their providers is the need for support for behavioral health needs.

00:51:18.000 --> 00:51:25.000
And at this time, Nationally, we've got a shortage of, behavioral health providers.

00:51:25.000 --> 00:51:33.000
Psychiatrists, without, even introducing the concept of the racially or ethnically important workforce in those areas.

00:51:33.000 --> 00:51:41.000
So, We've gotta build. The behavioral health workforce and the dental health workforce.

00:51:41.000 --> 00:51:54.000
Okay. In the same way that primary care needs more numbers. And I think that we're gonna see the same way that primary care needs more numbers.

00:51:54.000 --> 00:51:55.000
And I think that we're gonna see the same impacts. These these are professions that are also trained in institutions of higher education.

00:51:55.000 --> 00:52:12.000
These are professions that are also trained in institutions of higher education. And I think there's been very concerted efforts to, and I think there's been very concerted efforts to, and I think there's been very concerted efforts to, recruit and retain more, students and therefore professionals populations that they're serving.

00:52:12.000 --> 00:52:22.000
So we've got to replace that. With other methods. Identifying. And this is kind of the, underlying theme here.

00:52:22.000 --> 00:52:28.000
Folks are going to have to become.

00:52:28.000 --> 00:52:51.000
I'll say almost prideful. The strength, the tenacity, the resilience which is a word that can sometimes be very frustrating for me as a black woman to proclaim because it is almost as if you're expected to be battered down, but, stay strong and keep, you know, trudging forward.

00:52:51.000 --> 00:52:58.000
But, by pop folks in our country are going to have to. Claim the strength. That comes from living.

00:52:58.000 --> 00:53:10.000
And persisting within systems that are designed. Not for our benefit. And not for our wellbeing.

00:53:10.000 --> 00:53:16.000
And that's what the Supreme Court said. You're going to have to tell your story.

00:53:16.000 --> 00:53:21.000
You're going to have to relate your value. In a way that doesn't rely on saying that.

00:53:21.000 --> 00:53:35.000
Your race or ethnicity is a signal for those things. And in so many ways that means. Not that we need to burden ourselves down more with an understanding of how hard it is.

00:53:35.000 --> 00:53:45.000
To be an underrepresented person. In spaces where, the majority of those occupying the space are of the majority, right?

00:53:45.000 --> 00:53:56.000
I think that it means we're going to have to more celebrate. Those things that make us culturally, ethnically, different.

00:53:56.000 --> 00:54:07.000
I grew up hearing that. Because we are, African American, black Americans who are descendants from those who were enslaved.

00:54:07.000 --> 00:54:17.000
That our culture was stolen from us. And I think we have to shift that narrative and we have to highlight the culture that we have that's been born out of us.

00:54:17.000 --> 00:54:32.000
And how much of what it means to be a American. US citizen. Is really a culture that is derived from all of us.

00:54:32.000 --> 00:54:43.000
You know, in our contributions despite being overlooked and passed up by general society, mainstream society.

00:54:43.000 --> 00:54:51.000
So I went off on a little bit of a side tangent there, but I think it is a very important point and it's something that Dr.

00:54:51.000 --> 00:55:00.000
Mendoza and Dr. Delgado both touched on in terms of tapping into the richness of our cultural history and making sure cultural histories.

00:55:00.000 --> 00:55:16.000
I'm not saying we have a, you know, singular one on this call. Tapping into our cultural ethnic, you know, histories and bringing those to bear and how we're presented.

00:55:16.000 --> 00:55:32.000
Great. We have one last question on here. How can we engage individuals and communities in daily health practices that can reduce the need for costly emergency intervention.

00:55:32.000 --> 00:55:33.000
Good question.

00:55:33.000 --> 00:55:51.000
Yes. Okay, so I again, I think it comes to being informed. And, and that being said, As a Let's say the ones who have to deliver this care.

00:55:51.000 --> 00:56:01.000
We need to inform people better. We need to be more aware of the culturally relevant ways of saying things, of doing things.

00:56:01.000 --> 00:56:27.000
Of understanding how other cultures take illness or health and what are their practices to to stay healthy or where the practices that may not letting them stay healthy as well but we need to understand those things we need to come to them and then we need to be very clear of our messaging very simple messaging very Check to the head messaging.

00:56:27.000 --> 00:56:45.000
That people really want to to read that really want to keep. And that they can use for their better health and this involves you know not only the literacy taking into account the literacy and and it kind of like has to do with this situation of education of opportunities too.

00:56:45.000 --> 00:56:52.000
But, I think getting a regular literacy but also health literacy and that's that's really to me in us.

00:56:52.000 --> 00:56:55.000
We are we are supposed to be better at engaging people and letting them come in to us and being inviting and welcoming.

00:56:55.000 --> 00:57:05.000
And that's I think what we have to do. We have to start, you know, really.

00:57:05.000 --> 00:57:15.000
Work in those messages and channeling them through trusted. Messengers because that's another problem we learned that we don't have the trust.

00:57:15.000 --> 00:57:17.000
Helter systems, we don't have the trust of community. So, but the trusted messengers too.

00:57:17.000 --> 00:57:27.000
So we need that's why we need to listen to them and we need to deliver the messages that they want, how they like it.

00:57:27.000 --> 00:57:44.000
And that are pertinent through them and stop expecting that because I say you have to get your vaccine because I say so they're gonna do it now that's that's all practice you know like You know, people have better things in their minds than getting vaccinated, like finding, you know, food or housing.

00:57:44.000 --> 00:57:46.000
So those are the things that we need to understand. If I want to give, if I want you to take my vaccine, I need to help.

00:57:46.000 --> 00:57:52.000
You get house and I need to help you get food before I can say take my vaccine because it's almost like offensive to me.

00:57:52.000 --> 00:58:02.000
That's when I think it that way like, this person is. Poking my head.

00:58:02.000 --> 00:58:04.000
I do have to do this and this. No, I really have other needs. So I think that's that.

00:58:04.000 --> 00:58:13.000
Will we need to? To really look at the community and, add up the much. More welcoming.

00:58:13.000 --> 00:58:17.000
Approach.

00:58:17.000 --> 00:58:27.000
Well, thank you. Thank you everybody. The 1 h flew by so fast. I wanted to thank first off our wonderful panelists.

00:58:27.000 --> 00:58:36.000
You guys are all amazing. Thank you for all the hard work that you're doing and thank you for participating in this learning discussion and I'm sure I will be seeing you all very shortly.

00:58:36.000 --> 00:58:41.000
For any of you on the, still on the call, please make sure to connect with us for help teamworks.

00:58:41.000 --> 00:58:43.000
We have a couple of QR codes if you'd like to learn more about what we're doing.

00:58:43.000 --> 00:58:54.000
Our LinkedIn page. This conversation will also be turned into our podcast. So if you would like to share it with some of your colleagues or your friends, please do so.

00:58:54.000 --> 00:58:59.000
Oh, huge thank you. And also you should be getting a survey in the chat. So please make sure to complete that.

00:58:59.000 --> 00:59:12.000
This is how we learn more about what you're interested in and we create topics that are. Meaningful and that we know will make an impact.

00:59:12.000 --> 00:59:17.000
Well, thank you all.

00:59:17.000 --> 00:59:18.000
Thanks, bye.

00:59:18.000 --> 00:59:19.000
Thank you, everyone.

00:59:19.000 --> 00:59:24.000
Hello.