Transcription:

Scott Webb: In honor of Black Maternal Health Week 2022, I'm joined today by Dr. Cheryl Johnson. She's a board-certified OB-GYN, and she's here today to discuss health inequities for black and brown populations and how initiatives like Black Maternal Health Week strive to empower vulnerable and underserved members of the Summa community.

This is Healthy Vitals, a podcast from Summa Health. I'm Scott Webb. Dr. Johnson, it's So great to have your time. This is going to be an interesting topic, one that I'm glad that Summa is doing. And as we get into the conversation here today, I want you to talk about empowerment within the black community for health and especially maternal health.

Empowerment within the black community surrounding health and maternal health

Dr. Cheryl Johnson: I think that it's essential that we empower black and brown communities surrounding their healthcare in America. And so ways in which we can do that and that we find it important at the Department of Obstetrics and Gynecology at Summa Health is to make sure that we're educating mothers regarding their healthcare and their children. Also, making sure that we're getting them involved in the community and that they're aware of their rights.

Scott Webb: Yeah, that sounds good. And I know that education is just so key. And so many of the topics that we've covered with Summa had really just been about outreach and education. And maybe you can just kind of speak to that a little bit, like the difficulties, the challenges in getting these messages out there.

Dr. Cheryl Johnson on navigating difficulties and challenges 

Dr. Cheryl Johnson: So I think the first thing is that we need to focus on ways that we could mitigate the health disparities that black and brown women face. And so one of those tangible ways that we can do that as healthcare providers is through education. I think that is important that we support healthcare professionals that women feel most comfortable with. And in speaking with the community, those individuals named by black and brown women are doulas and certified nurse midwives. And so a lot of times, when they get their education from those individuals, it's received in a better manner than the way they received education historically.

But I think that also what's important is when we're educating communities, is that we're educating them on points that matter to them. So it's important to survey the community in regards to what education they're looking for, and what their questions might be and then what the barriers are, so that we're making sure that we're addressing things that will motivate patients to have a more positive outcome.

Scott Webb: Yeah. That's really interesting that some folks may respond better to maybe a slightly more casual approach, less maybe strictly speaking medical approach. And I want to make sure I'm hearing you right, it's sort of getting that advice and that education from a doula perhaps, not from an MD or an OB-GYN or somebody like that. That's really interesting.

Dr. Cheryl Johnson: Yeah. And then also to take it further, as we challenge ourselves as MDs to step out of our comfort zone and have more of those casual conversations where it's not so formalized and not so medical. And so I think that's a growth edge for us as medical doctors, because it's something we can do, it's just not something that we're used to doing.

Scott Webb: Yeah, I see what you mean. And one thing I've learned from speaking with so many healthcare professionals is there's a strong willingness. Maybe not on the part of every MD, of every nurse, but in most cases, most doctors want to be better at their jobs. They want to understand patient needs, expectations, all of that, sort of meeting them where they are, which is not how traditionally medicine has been done, right?

Dr. Cheryl Johnson: Right.

Scott Webb: Absolutely. So let's talk about health equities, or maybe a better way to put it is health inequities. And maybe you can speak to that a little bit. Like when we say, you know, that there's a lacking either in health equity or that there is a tremendous amount of health inequity, what does that mean exactly? Who are the most vulnerable patients?

What is health inequity? Who is the most vulnerable?

Dr. Cheryl Johnson: So I would say the most vulnerable patients are black and brown mothers who are pregnant. And when we look at the statistics, those are the individuals that have the highest disparity in regards to maternal health and infant mortality. So what that means is that when we compare black and brown mothers to their white counterparts, the morbidity and mortality is higher for them when we take into account all other factors.

Scott Webb: The theme here has been education and outreach, I'm assuming that includes things like having conversations and educating about SIDS and things like that.

Dr. Cheryl Johnson: We are educating our moms about safe sleep practices. And we look at barriers when we try to drill down on root causes why certain populations might engage in unsafe practices and ways that we can help mitigate that. But I also would be a myth if I didn't say when I speak to education that it's all on the onus of the black and brown individuals. I think that when we look at what we're doing in healthcare, it's a lot around education and around providers being aware of where their blind spots are, where there's bias that they might have and things that they can do in the moment to mitigate those thoughts and feelings as they're caring for individuals.

Scott Webb: Yeah, I see what you mean. And one of the things that came up during COVID has been on the part of, you know, as you say, black and brown communities, especially African-Americans and there's sort of inherent and understandable, I don't know if it's mistrust is the right word, but definitely, you know, some resistance to vaccines, to hospitals and doctors and things. Is it your sense that really is all a part of this conversation about health equity and experiences and things like that?

COVID-19's effect on the black community 

Dr. Cheryl Johnson: Absolutely. I think that one thing that COVID brought up for us is that the trauma we've experienced as African Americans in this country is still present, even though things happened a long time ago. So we still carry with us feelings regarding the Tuskegee experiment or if you read Harriet Washington's book, Medical Apartheid. Many of the things that happen to black and brown bodies in this country, and those are things that we still carry and that still play out in healthcare. And so the way that it plays out in healthcare in this day and age is a reluctancy to trust, especially when we're talking about inserting foreign devices or medication into our bodies, especially in an injection form.

So I think that those are things that we need to work through. I think that sometimes they requires more than just education. It requires trust, and I think that's where seeing yourself in your provider who comes in, having providers that look like the patients that they're providing care to is important. In working in a health system, I think it's important that there's representation of providers that look like the population, even if that's not necessarily the provider that the patient's seeing. So knowing that the health system thinks it's important that there's diversity in the workplace I think goes a long way in building trust.

When we implement those measures and also with repeat messaging from doulas or certified nurse midwives or those individuals in which patients feel comfortable, that we will begin to move the needle in regards to engaging in vaccination or better safe sleep practices or a lot of the things where we're challenged currently as we support moms and women's health.

Scott Webb: I think you're so right. And we could probably have an entirely separate conversation, Dr. Johnson, about encouraging more black and brown folks to become doctors and helping to facilitate that and encourage that, and finance that and all of that, because, you know, as you're saying, people tend to respond better and well when providers look like them or when they walk into an office and they feel like, "Oh, there's people who look like me here. I'm welcome as well," right?

Dr. Cheryl Johnson: Right. Absolutely.

Scott Webb: Yeah. That's awesome. So when have you talked about the importance of Black Maternal Health Week and what goes on.

What is Black Maternal Health Week? Why is it important?

Dr. Cheryl Johnson: Absolutely. So Black Maternal Health Week is being celebrated this year, April 11th through the 17th. And so what it is a time that we set aside to raise awareness in the community regarding the health disparities that we previously touched on. And to take it a step further, having courageous conversations around how we can advance health equity within our community. Whether that's looking at policy, whether that's looking at things that we can do within the community or things that we can do within our health system to help move that needle forward.

Things that I would say that we're doing at Summa Health in the Department of Obstetrics and Gynecology is that we're courageously owning the fact that healthcare disparities are not because of some flaw within the people, which is a way that was approached in the past. We're recognizing that the social determinants of health and building programming to support our moms is the way to go. Additionally, we're having courageous conversations with those that touch the patient. So for example, myself and then Dr. Edward Ferris, who is our department chair, are co-facilitating an advancing health equity series, which is geared towards our residents. So since our residents are on the first line, I think that it was really important with the social unrest that we we've been going through over the past two years that we develop some programming and a safe, sacred space where we can digest our feelings regarding what's going on, so that we can make sure that we're taking the best care of all of the patients that come to labor and delivery.

Scott Webb: I think that's a perfect way to end. This has been really informative and educational today. We've kind of been on a common thread here as we've gone through the conversation about outreach and education and really understanding patients and where they are and trying to meet them there. So really appreciate this. Thanks so much and you stay well

Dr. Cheryl Johnson: You do the same. Thank you.

Scott Webb: For more information on Summa Health's Maternity and Women's Health Services, please visit summahealth.org/maternity. If you found this podcast to be helpful and informative, please share it on your social channels and be sure to check out the entire podcast library for additional topics. This is Healthy Vitals, a podcast from Summa Health. I'm Scott Webb. Stay well, and we'll talk again next time.