Many people who go into medicine come from well-off families and don’t know what it’s like to live in poverty. So when they graduate and become physicians, they can struggle to understand why their therapeutic interventions aren’t improving the lives of their patients.

This, according to Dr. Pedro José Greer Jr., is because med schools have not done a great job helping their students understand the social determinants of health — the many nonmedical factors that influence health outcomes.

“It's not for the student physician to be able to resolve the social determinants, it's for them to really understand what they are,” Greer said. “Without understanding all these other things, we're not going to make [the] right therapeutic calls.

“The health outcomes in this country are embarrassingly bad,” he added. “So we have to be driven to improve those disparities.”

Greer is an American physician of Cuban descent and founding dean of the Roseman University of Health Sciences College of Medicine. He spoke with Health Disparities podcast host Claudia Zamora about how to improve medical education, why diversity matters, and why it’s critical that med schools train doctors to show compassion and empathy for their patients.

The conversation was recorded in person at the 2023 Movement Is Life annual Health Equity Summit.

Movement is important for a person’s health and well-being. The good news is: many activities that promote movement come with enormous benefits that extend beyond physical health. 

Today’s discussion features the founders of two organizations that aim to promote physical activity — and build community while doing it. 

Walk with a Doc began in 2005 after Dr. David Sabgir, a cardiologist in Columbus, Ohio, invited his patients to go for a walk with him in a local park. The program has since spread to more than 500 locations.

Semilla Cultural, founded by Isha M. Renta López, is a non-profit organization in the Washington, D.C., area that promotes the development and cultivation of a community that embraces Puerto Rican culture and arts, including by teaching and performing the Puerto Rican musical genre of Bomba.

Sabgir and López spoke with Health Disparities podcast hosts Dr. Hadiya Green and Christin Zollicoffer. This conversation was recorded in person at the 2023 Movement Is Life annual Health Equity Summit.

Dr. David Ansell’s book “The Death Gap: How Inequality Kills” was first published in 2017. In a foreword for the book updated in 2020, Chicago Mayor Lori Lightfoot wrote that “Three years before the COVID-19 crisis, Dr. David Ansell published The Death Gap, brilliantly synthesizing what he experienced in decades of practicing medicine in two utterly different medical worlds that were mere blocks apart. What makes this book so compelling is that rather than focusing exclusively on data and statistics, Dr. Ansell makes these gruesome numbers real. He tells the story of the disparities through the real-life experiences of patients with whom he had deep, committed relationships.” 

In today's discussion Dr. Ansell reflects on the collision between the ongoing epidemic of social and structural determinants of health, and the pandemic of COVID-19. He also shares recommendations for ways that healthcare providers can bring together quality, safety and equity in medicine. 

David A. Ansell, MD, MPH, is Senior Vice President for Community Health Equity for Rush University Medical Center and Associate Provost for Community Affairs for Rush University System for Health, Chicago. 

Dr. Carla Harwell is Medical Director, University Hospitals Otis Moss Jr. Health Center; Associate Professor of Medicine, CWRU School of Medicine, Division of Internal Medicine; and Vice Chair for the Board of Directors at Movement is Life. 

(c) Movement is Life 2023

Can equitable real estate development organization Parity help solve Baltimore's empty housing problem and build Black wealth? Founder Bree Jones and her backers are making it happen. According to a profile in Baltimore Magazine, Bree Jones counts herself among a generation of young Black Americans who are being spurred to activism by high-profile killings of unarmed Black people. These are people who demand accountability on issues involving race, violence, and equality in the U.S.

For Bree Jones, a central solution is revitalizing neighborhoods – without gentrification. Her organization, Parity, a non-profit equitable real estate development company, is working in Baltimore to do just that. Visit https://www.parityhomes.com/ for more information. 

In this episode of The Health Disparities Podcast, Bree Jones tells the story of Parity, and discusses why building Black wealth and impacting social determinants is so important to health, and why so many high profile investors are getting behind the initiative. 

With host Dr. Michelle Leak, Mayo Clinic in Jacksonville, Florida,  and member of the board of directors for Movement is Life. 

The Health Disparities Podcast is a program of Movement is Life. This episode was recorded live and in person at Movement is Life’s annual health equity summit. The theme this year was “Bridging the Health Equity Gap in Vulnerable Communities.”

(c) Movement is Life 2023

Our guests are health equity practitioners Christin Zollicoffer and Dr. Bonnie Simpson Mason, who discuss programs and initiatives that are making headway in dismantling structural racism with episode host Claudia Zamora. Together they explore a number of different examples and critical success factors that contribute to success, and mention some common mistakes that organizations may make when establishing initiatives. This is the fourth and final episode in our mini-series focused on systemic bias and systemic racism, and we end with constructive forward steps and an optimistic outlook. 

Christin Zollicoffer is Chief Belonging and Equity Officer at Lifespan Health System. Dr. Bonnie Simpson Mason is the inaugural Medical Director of Diversity, Equity, and Inclusion at the American College of Surgeons. Claudia Zamora is a consultant who serves on the Board of Directors for the National Hispanic Medical Association and the Board of Directors for Movement is Life.

0:01 Excepts | 2:30 Introductions |5:30 Dr. Simpson Mason shares solution examples | 6:30 Different levels of experiencing oppression | 7:20 Increasing access via Nth Dimensions pathway programs | 9:30 Equity Matters ACGME | 10:45 Medical specialty societies education & communication | 11:45 Christin Zollicoffer shares solution examples | 12:15 Four levels of racism: internalized, interpersonal, institutional, structural | 12:15 Baking in DEI for patients & employees | 15:00 Employee resource groups role | 15:30 Workforce education and skills building | 16:30 Integration of equity practices | 20:15 Community based program Operation Change | 24:00 Importance of trauma informed lens | 29:00 Equity as the 6th domain of care (IOM) | 31:30 Addressing data collection to support equity | 34:00 Claudia Zamora shares examples including NHMA programs | 37:30 Critical success factors for programs e.g. change management & working with the “moveable middle” | 40:10 Definition of equity | 42:15 Common mistakes e.g. tokenism & placing DEI under HR | 46:00 Speaking the language of health equity | 49:00 Are things changing?   

© Movement is Life 2023

For the third installment of our mini-series exploring systemic bias and racism in healthcare, our panel of experts discuss various examples which illustrate how systemic racism is embedded in systems of healthcare and social determinants of health. These include measurements such as eGFR, BMI, and metabolic panels, scoring for post-operative risk; lack of diversity in dermatology textbooks; and how subjective information that is potentially deleterious to patients may be captured in EMR systems such as EPIC. 

Episode host Christin Zollicoffer (she/her pronouns) serves as Chief Belonging and Equity Officer with Lifespan Health System, an academic medical center affiliated with Brown University and Warren Alpert Medical School.

Dr. Carla Harwell is a nationally recognized leader in health care disparities education and medical issues affecting minorities. She is Medical Director, University Hospitals Otis Moss Jr. Health Center, and Associate Professor of Medicine, CWRU School of Medicine, Division of Internal Medicine. 

Dr. Daniel Wiznia is Assistant Professor of Orthopaedics and Rehabilitation, Yale University School of Medicine. He is the co-director of Yale's master’s program in Personalized Medicine & Applied Engineering.  

© Movement is Life 2023

For the second episode in our mini-series exploring systemic racism in healthcare, our panel explores different definitions of bias, stereotyping, systemic racism, and structural racism, and how these behaviors intersect with social determinants of health. Perspectives from both patient and professional viewpoints are addressed. The panel also discuss solutions such as bias training, cultural competency, language competency, self-reflection and mentoring.

Dr. Melvyn Harrington is an orthopedic surgeon and Vice Chair for Community Engagement & Health Equity at Baylor College of Medicine in Houston. Dr. Elena Rios serves as President & CEO of the National Hispanic Medical Association, (NHMA), representing 50,000 Hispanic physicians in the United States.  Episode host Dr. Charla Johnson is the Director of Clinical Information Systems & Nursing Informatics, Franciscan Missionaries of Our Lady Health System, in Baton Rouge.

0:20 Introductions | 1:55 How patients experience & express bias | 4:45 Harmful stereotyping | 6:40 Bias in medical record | 8:20 Bias as gatekeeper to college admissions & healthcare careers | 10:05 Systemic factors for healthcare workforce | 11:30 Bias steering students away from premed | 12:30 Importance of bias training | 14:40 Resistance towards bias training | 17:10 Differences between structural racism & systemic racism | 21:10 Role of social determinants of health (SDOH) | 24:05 Bias towards people with obesity | 26:10 Bias leading to inconsistencies and inequities | 27:50 Importance of self-reflection | 28:50 Bias causing patients to disengage | 29:30 Importance of cultural and language competency | 30:15 Role of age bias | 30:45 Bias toward minority healthcare professionals | 34:25 Do professionals & patients understand structural and systemic racism? | 37:10 How NHMA works to educate professionals & patients about bias | 41:00 Closing remarks.

© Movement is Life 2023

This is the first of a 4 episode mini-series of The Health Disparities Podcast exploring bias & systemic racism in medicine. The series aims to bring to the surface discussions, definitions, & perspectives about the problem of bias, examples of bias, structural & systemic racism, & examples of programs and policies that are tackling bias & racism.

"Unconscious Bias, Yes it is Real" is a useful short guide to understanding unconscious bias, its consequences in healthcare, & some ways to mitigate unconscious bias. It discusses most types of bias impacting the quality of healthcare, including race, ethnicity, gender, gender identity, sexuality, religion, mental health, & weight bias. The "Unconscious Bias, Yes it is Real" booklet is available as a digital download on our website. Movement is Life invites listeners to use the booklet in association with this audio resource as the basis for workshops and discussion groups aimed at improving cultural sensitivity & understanding.

1:35 Introduction – We are all biased | 3:25 What is bias? | 5:30 Types of bias | 8:02 Unconscious or implicit biases | 9:55 Unconscious bias in healthcare | 13:40 Unconscious bias involving weight | 16:12 Unconscious bias involving mental health | 18:20 Unconscious bias involving race & ethnicity | 23:10 Unconscious bias involving gender & gender identity | 28:35 Unconscious bias involving sexual orientation | 30:35 Limitations in research | 32:18 How patients respond to bias | 36:30 Measuring unconscious bias using IAT | 41:50 Counteracting bias in healthcare | 44:30 The LEARN model | 46:00 Glossary | 50:30 Closing comments

Unconscious Bias, Yes it Real - Digital Booklet: http://startmovingstartliving.com/wp-content/uploads/2019/07/Unconscious_Bias_Content_03_print.pdf

About Movement is Life https://www.movementislifesummit.org/website/56162/about-movement-is-life/

Narration by Dr. Michelle Leak & Rolf Taylor.

Adapted for audio from the booklet & produced by Rolf Taylor. 

(c) Movement is Life 2023

The Movement is Life Annual Summit is fast approaching, and thanks to philanthropic support from the Zimmer Biomet Foundation, there is no cost to register. Over two days (Nov 30 - Dec 01) a mix of plenary sessions and workshops will feature a stellar lineup of health equity thought leaders at the Renaissance Hotel Downtown, Washington, DC. Online registration: https://www.movementislifesummit.org/website/56162/program/ or Google Movement is Life Summit. 

In our 150th episode of the Health Disparities Podcast, Dr. Michelle Leak hosts a discussion about Summit highlights, exploring the theme of  "Bridging the Health Equity Gap in Vulnerable Communities." Joining Dr. Leak are Movement is Life Chair, Dr. Mary O'Connor, and Vice-Chair Dr. Carla Harwell. Attendees can hear a sneak preview of the program and also consider which two of the four workshops they will want to attend. 

We hope to see you at the Summit, but if you can't make it there is a plan B, as many of the Summit speakers will be joining us on the The Health Disparities Podcast after the event. 

(c) Movement is Life 2023. 

*please note this schedule is not final and is subject to change*

Very few physicians can name Dr. LaSalle Leffall and Dr. Clive Callender as pivotal mentors in their career, and also cite their experiences growing up with sickle cell as another important teacher. In a wide ranging discussion with fellow surgeon and Howard University alum Dr. Randall Morgan, Dr. Frederick explores some of the most important aspects of mentorship. He also discusses developing young leaders in science, the ongoing evolution of Howard University, and the challenges of building a diverse healthcare workforce that is better able to meet the needs of a diverse population. Dr. Frederick also talks about why his frequent visits to Trinidad to teach science are so important to him, and how he will enjoy his upcoming sabbatical. Recorded at the recent National Medical Association annual meeting in New Orleans. 

Dr. Wayne Alix Ian Frederick is a Trinidadian-American scholar, surgeon, and university administrator. He is currently serving as president of Howard University in Washington D.C. since July 21, 2014. He also serves as the distinguished Charles R. Drew Professor of Surgery.

Dr. Randall Morgan is an orthopedic surgeon based in Sarasota Florida, and the Executive Director of the W. Montague Cobb Institute. He also serves on the steering group of Movement is Life.