Friday, October 31, 2014

Dr. David Williams (Photo: Karen Elliott Greisdorf)In the US, socioeconomic status determines health outcomes, and socioeconomic status is determined by race, according to Dr. David Williams, Professor of Public Health and African American Studies at Harvard University. “Economic policy is health policy,” said Williams, a global expert on the social determinants of health. He was speaking at a Community Trustbuilding Forum on October 7, convened by Hope in the Cities and hosted by the Richmond-Times Dispatch.

The US consumes half the world’s medical resources but ranked 11th in life expectancy in 1980 and 33rd by 2006. All immigrants have better health than all US born Americans, but the longer they stay in the US the unhealthier they become. “America’s way of life is dangerous to your health,” says Williams. Why is this?

Williams noted that exposure to adversity has an impact on health. His data showed the impact of segregated schools, segregated neighborhoods and other influences on health. Racial disparities cost the US economy $310 billion in health care costs every year. In addition, lower worker productivity and premature death costs over $1 trillion.

Williams also highlighted the impact of unconscious bias. Studies show that across the board minorities receive fewer procedures than whites. One study of hospitals across the country showed that minority patients with broken femurs were 50 percent less likely to be offered pain medication than white patients.

(Photo: Karen Elliott Greisdorf)

Community resource facilitators representing Richmond organizations involved in health care or building healthy communities, elicited responses from breakout groups. Questions included: How can we reduce unconscious bias and institutionalize the change over time? What would it take to fundamentally address the issue? What is the scale of intervention that is necessary?

In Williams’ view, intervention on the level of the Marshall Plan is needed. Williams encouraged participants to “see people as individuals and not members of a group,” and “to tell the story in ways that connects with values we all hold and that encourages empathy…We are driven by emotion.”

Dr. Danny Avula, deputy director of the Richmond City Health District, conducted an interview with Williams, who noted that it is in our best interest to ensure that every child, regardless of race has the opportunity, the skills and the education to be productive. By 2002 we will be a majority minority nation. The majority of people receiving Social Security will be white. But one out of two workers supporting the system will be black or Hispanic. “We need to come together and decide that we would like to build a future together. It’s not about us and them, but by working together…we can improve opportunities for all.”

(Photo: Karen Elliott Greisdorf)

Closing the forum, Tim Joyce of the YMCA of Greater Richmond, one of the lead partner organizations, challenged the participants with two questions: “Whom do you need to meet in the next 30 days to share what you have experienced? What one thing will you do with what you have heard?”

Rob Corcoran, national director of Initiatives of Change, noted that this forum was a pilot project of the National Center for Community Trustbuilding, a further evolution of the work of Hope in the Cities, and that more forums would take place next year.

Collaborating with Hope in the Cities and the YMCA were the Richmond Peace Education Center, Richmond Academy of Medicine, Bon Secours Richmond Health System, and Virginia Commonwealth University.

Download Dr. Williams' presentation

Listen to a podcast of Dr. Williams interviewed by Dr. Danny Avula