Steve Fera, senior vice president of public affairs at Independence Blue Cross, shared sobering statistics about African-American health outcomes in Philadelphia as a backdrop for the discussion. He noted that during the pandemic, African-American life expectancy dropped by three years in Black neighborhoods and they are three times more likely to have conditions that put pregnancies at risk.
Fera cited a 2021 Penn Medicine study which found that opioid overdose deaths increased by more than 50% in Black residents during the pandemic, while the rate for whites dropped by 31%.
“The stats are unacceptable,” Fera said. “We have to change things and that is why this forum … is an important element but it doesn’t happen alone. We do it through partnerships.”
The event comes as Independence joined other major health organizations in announcing Accelerate Health Equity, a multi-year collaboration that brings together organizations across the Philadelphia region to combat systemic racism and barriers in health care.
During the panel discussion, Philadelphia Health Commissioner Dr. Cheryl Bettigole addressed the importance of using data-driven approach to taking in-depth look at factors driving poor health outcomes.
“When we think about common causes of death in Philadelphia, we think about heart disease, cancer (and) gun violence deaths,” she said.
“We understand the proximate behaviors that get people to those things — you know smoking rates, poor nutrition and lack of physical activity (and) involvement in violence.”
“But it becomes very easy for us to say well those are individual behavioral choices but when we look at neighborhoods and we see choices differ by where people live or by the color of their skin then we need to look more deeply,” Bettigole said. “We need to look at where are the structures and systems in our society that are driving people to certain behaviors over others.”
Dr. Ruth M. Abaya, an emergency medicine physician at Children’s Hospital of Philadelphia, spoke on addressing gun violence as a public health issue.
She is also the program manager for the Injury Prevention Program at the Philadelphia Department of Public Health. Abaya said under Bettigole’s leadership they are trying to use a data-driven approach to identify what the core drivers are for violence.
“It’s not just the proximal drivers — having access to a gun for example — but it’s going further upstream to think about what’s happening in communities, what’s been happening in communities for generations, that might be putting us in a position now where we see violence clustering specifically in Black and brown communities in the city of Philadelphia,” Abaya said.
“So what is the data that helps guide us as far as where the problem is originating, what’s driving it and what are some the best interventions that not only reduce violence but promote the general well being of the communities in which violence occurs?”
Dr. Ala Stanford, founder and CEO of the Black Doctors COVID-19 Consortium, said data collection and community work should be done concurrently.
“I think that of the things that I identified being on both sides is that there was a lag between by the time that the data got to the individuals that could create the intervention and the resources and the money to actually execute,” Stanford said.
“I found that how the change is sustainable is that it comes from the top down. The leadership has to decide that there is where we’re going to put our focus and where the resources are.”
“So with the pandemic when you recognize that the positive rates were highest in certain ZIP codes but the testing were lowest in those ZIP codes then that’s where the resources needed to go,” she continued.
When the consortium was hosting a vaccination event at a school that lost a student to gun violence, they realized there was an immediate need for trauma counseling.
“We witnessed that as we saw the children struggle the next day in school, when their classmate had literally been murdered around the corner the day before and they just went to school the next day and didn’t even have an opportunity to process,” Stanford said.
“So my take home is it comes from the top down in that we have acute teams to manage acute issues, rather than be delayed at all by all of the data coming in.”
Stanford and the consortium were honored with the UAC’s Living Legacy Award during the event. The award is inspired by U.S. Rep Dwight Evans and is presented to a visionary leader in the community. The consortium has tested more than 30,000 patients and vaccinated more than 55,000 Philadelphians.
Dr. Sandra E. Brooks, executive vice president, chief community health equity officer, Jefferson Health, spoke about going beyond the constructs of race and ethnicity to address what’s driving health disparities.
“There are a variety of things that we recognize now that we need to go beyond solely race and ethnicity to understand what are the actual drivers,” she said. “Yes we know that racism still exists and we know there are structural barriers but we also need to address what the decades of redlining have done to this city — how segregated this city still is.”
“I think that what the pandemic has forced us to do is to have every entity that is in the position to influence either their local organizational policy or policy outside of their neighborhood to really critically look at those policies to see how those policies are disproportionately disadvantaging one population,” Brooks said.
Ayana Jones is a reporter for the Philadelphia Tribune, where this story first appeared.