 Shalynne was, you know, she was 22 and she was in school full-time to become an RN. She had been recovering from a torn ACL in her leg. She had had an MRI done before she left, knowing that she was transitioning jobs. She drove 20-plus hours to get over on that leg injury. It wasn't severe at that point. But when she arrived, she kept on saying, look at my leg, Mom, all the time. Look, it's a different color and it's swollen. And when I left, I got a phone call from her. She was playing around and then she had fallen on that same leg. For her to be in as much pain as she was in, that was like, okay, yeah, we need to go to the hospital. They were asking her for her insurance. Shalynne had mistakenly replied, no, when they asked her if she had it. I'll never forget the tone of her voice when she called me. She's like, Mommy, I'm begging them for something for this pain. It hurts so bad and I'm begging them for some testing to see what's wrong. I asked them for an MRI and they told me I need to go get insurance and see a specialist because they're not a doctor's office. They failed to notice that there was a blood clot. I think it was a week or two weeks later, she had to fly back to Kansas City. And, you know, when you get into a plane, the cabin pressure can cause a blood clot to dislodge. And it went into her lungs and caused a massive pulmonary embolism. She had a clot so massive that it was from her ankle up to her groin. When the time came, I got up into bed with her. I was there with her when she took her first breath and I was gonna be with her when she took her last. And as she died, I whispered to her, I love you so much and I promise you, you will not have died in vain. I had made attempts to contact the hospital. No one was really interested in speaking. And pretty much it was we gave the best service for Shalyn. We did everything that we're supposed to do. One of the things that really struck out to me as I was searching for reasons why Shalyn died, I ran across studies after studies of the discrepancies and outcomes for black and brown women versus white women. As a medical community, there needs to be a lot more attention to these discrepancies, that she had all of these things that made her higher risk for a blood clot were not taken into an account. She was black, she had sickle cell trait, she had PCOS, she was on birth control, she was overweight, and she had a red swollen leg. She had all these symptoms, she didn't check for a blood clot, and instead of them doing the necessary test required, they did what was called a wallet biopsy. And they essentially sent my daughter to her death. How would you feel if it was you? That's the guiding principle you should be thinking about. How do you change going forward? We all know that companies have mitigated risk and risk assessment. We need to stop thinking of it that way, and especially healthcare facilities. These are people's lives. I would say treat your patients like they're your family, treat it as if you were in that situation to where you would lose your sister, your daughter, or your mother. Don't discriminate towards people. If they're saying they need help, help them like you're supposed to, if you go into the medical field, you should have that passion to help save people, live up to that passion and save everyone no matter what, and treat them as if they were your family. How would you want your family or your loved one to be treated? So not only is it the moral thing to do, but from a business standpoint, I think you're absolutely nuts if you're not reaching out to patients and trying to better what's happening in your facility and stopping the needless deaths. Not stopping it down by a percent, but to none, to none. The sad thing is that when I got Shalyn's phone after she died, I was looking through what she had been doing, and because she had been so embarrassed and so demoralized, instead of going to a hospital immediately, as she had been told, she needed to get insurance, because she was looking up signs of a heart attack hours before she called an ambulance. As we just saw from Shalyn's story, not only did she not receive immediate attention due to the color of her skin, disparity in care happened because the hospital wasn't sure how it would be paid by insurance. Let's talk more about disparities in healthcare. Growing up in rural, segregated Alabama, was a very common back build. So what I saw there and what I still see all these years later is at the time I did not know was disparity. And that disparity I would describe as this indifference. And W.E.B. DeBose described it as a peculiar indifference. And that indifference continues to persist. It is pervasive and it is stubborn. The result of this indifference are significant, less than optimal and poor outcomes for black, indigenous, and other people of color in the United States and in fact around the world. And this is quantifiable. It comes back to us through qualitative measures such as surveys and opinion surveys and the patient experience that we see in healthcare today. So when we think about these disparities then these differences for specific populations, primarily these marginalized populations, we see this in surgical procedures, surgical outcomes, decisions being made about medical treatment and medical interventions. We see it expressed in the harm that's caused both in outpatient and specifically inpatient setting as it relates to hospital-acquired infections and other hospital-acquired conditions such as falls with injury and pressure ulcer. We also see the same disparities in long-term care facilities and there are other marginalized and vulnerable populations where disparity is also present. This is in disabled populations, people who are in the rural areas that are poor, people who have some other kind of cognitive disability, people who are obese. We see it in the LGBTQ plus population as well. One of the issues that we really need to take on if we're ever going to achieve health equity and eliminate disparities is take an honest, courageous look at structural and institutional bias and racism that has been part and parcel of healthcare delivery and clinical decision-making far too long. We see it back to the early 1600s when Black people first came to the U.S. as slaves from Africa and it continues to this day. So then as we begin to have these frank and honest conversations about what are the structures, what are the policies in place that continue to support a system that is currently designed to create disparities and create the pain and anguish that many of our patients see, particularly in the Black indigenous and people of color populations and, again, other marginalized populations. So then as a care provider, what I would say is I have to find ways to be a better service to all patients, not just the ones that are insured, not just the ones that are white or high income or et cetera. So in order to do that, what I would advocate for is that patients should be charged with their healthcare, that they in fact become part of an abolitionist movement if I may call it that, so that we begin to address disparities and abolish disparities and abolish inequities begin to undo deep-seated institutional and structural biases that have existed for too long. In order to do that, we have to engage with the patients and say you have to be more active in your healthcare and enter into those partnerships to co-produce that, if I may call it equity in healthcare. A big part of this for patients is we and I'm a patient learn to communicate, to take charge of our health and our healthcare. Communicate, ask questions, seek more knowledge about your healthcare. Begin to break down these paternalistic barriers that have existed for too long in healthcare settings and almost the passive acceptance by marginalized communities and populations as it relates to their healthcare. So in order to do that then, we have to form relationships. People that we care for need to work on building a trusted relationship with clinical providers, clinical decision makers and truly reach new levels of activation that we haven't seen to date. I'm very hopeful that we're having these conversations. I'm very hopeful that we can begin to at least make more progress in issues around health disparity and healthcare disparity and then start to achieve health equity that we so desperately need in healthcare, not just here in the U.S., but globally. African-American mistrust of healthcare is real. It's a real thing. But the larger society has to understand is it's well-rooted. There were so many things going on, not just the Tuskegee experiment. There were forced non-consensual sterilizations. My own grandmother, my mom's mother, was an unknowing participant in a radiation experiment that took place at a hospital in Cincinnati from 1960 to 1972. My grandmother died when my mother was 15. It was devastating to their family. And these kinds of stories are pervasive across the country with black people. And so there is a history there, not just the Tuskegee experiment, but other things that took place in healthcare that make African-Americans not trust the system. And then when you go into a hospital today and you have some of the experiences that I had, nurses asking how can your parents afford to be here or people bringing garbage to my dad, and then when we talk to the nurse manager, they say, well, we don't give any blacks here. When you have that kind of flippant behavior, when you have that kind of offensiveness, it's easy to understand why blacks don't trust healthcare. So we've got to repair that trust. We've got to build a bridge and be better. We've got to start looking at healthcare and the way we treat patients of color. In a pandemic, unfortunately, minorities suffer disproportionately. Recent statistics show that blacks had 2.6 more times the risk of dying after contracted COVID-19. In New York City as well, black people make up 22% of the population but accounted for 28% of COVID-19 deaths. And similar trends can be seen among Hispanic and Latino populations at national and state levels. A pandemic unveils our different realities. Everybody should take COVID-19 seriously. And by these, I do not mean living in fear. But we should be properly informed about common symptoms and recognize that some people have a high risk of progressing to a condition where hospitalization might be needed, especially people above the age of 60 and those who suffer diabetes, cardiovascular disease and cancer. Unfortunately, again, these chronic conditions are far more common in certain minorities. It is a responsibility to help spread the message of prevention in all our communities. As physicians, we strive to save and improve lives but we can also do so by avoiding errors, by creating a safe and transparent environment in the hospital. This is a big change of paradigm. I believe that preventing errors is a condition that can cause more than 250,000 deaths per year in the United States and this condition should be studied rigorously and above all, we should act together with full transparency. I am proud to represent this movement that has the potential to improve our lives immensely. Unite for Safe Care represents to me hope, health and happiness. If you're a personal color and you're a patient in the hospital there are a couple of things I feel like you should really hold this central. You need to hold with both generosity and clarity that racial bias in the healthcare system is a thing. When I say generosity and clarity what I mean by that is generosity toward the human beings behind the system that are struggling. When I say clarity I mean even though you hold the humanity of the people and you treat them like human beings first I'm talking about doctors, nurses, etc. Just be clear that racial bias is a thing and you're going to need to advocate for yourself. So advocate for yourself. Do it early and do it often and don't make any assumptions. When it comes to disparities in the healthcare system right now especially due to COVID I have a personal stake in this because I'm pregnant right now but black maternal health is really on my mind. I've just read so many stories about black mamas who are not getting access to the kind of testing that they need because there's so many barriers that so many people have anyway about going to the doctor but in the era of a pandemic when you're getting constant messages from the hospital to do as many appointments via video as you can you don't have someone touching your belly to figure out how big your uterus is maybe you're not going in for frequent blood tests maybe doctors are missing things and many of the women the black women who have died in childbirth in this era of COVID was because they missed these vital tests so one recommendation that I would have around this is I would love to see hospitals doing more outdoor care especially in this era of COVID if we know that being indoors I didn't go to the hospital as much as I needed to this pregnancy because I didn't want to be inside I didn't want to be stuck inside of a hospital room with an N95 mask just shaking and praying that I didn't get infected but there are certain tests that can be done outside what would it look like for a phlebotomist station to be set up outdoors that is something that feels very important to me for patients of color I would say need to make sure that they're going to credible sources to be informed in regards to COVID-19 and with that I would also ask people to be responsible in using social media social media is a great platform but you have to know when to use it in social media Facebook, Instagram, Twitter should not be your end all and be all for your source of information especially as it pertains to the medical points of this pandemic I think if you're trying to find credible information you want to rely on credible sources that are based in the science and medical facts and you can find good resources from the CDC website you can find good information at Chicago.gov there's a subsection on that website that specifically talks about COVID-19 as well as the Illinois Department of Health website so those are good sources that you can rely on for credible information also this is a small more medically related fact people of color tend to be more vitamin D deficient so we all think about vitamin D as it relates to our bones but vitamin D also has an immune protective effect and a lot of people of color particularly African Americans tend to be vitamin D deficient so because we've seen in treating patients with coronavirus that vitamin D has a positive effect I would urge people to be more knowledgeable about their own vitamin D status and if you're deficient or low that you want to make sure that you're keeping up your vitamin D through your diet and possibly with supplementation as a Native American woman I have a very special message um health issues in our reservations in our communities are we don't have much due to poverty due to lack of facilities on the reservations it's very sad what's going on with the COVID per capita the rates of death and infection are higher than the population in general in the United States and I have special words that you please understand what is going on we're talking about people who do not have running water gas or electricity 40% of the reservations lack those basic rights we are trying to fight for those things but people do not pay attention to this very often so again this is very important for Native people I'm addressing you personally please learn you have rights and please use those rights and speak up hello everyone my name is Stix rapper slash activist and I'm coming to you live from Think Watts headquarters right here in Watts California when it comes to bringing new messages to the world I'm all about it and today I want to talk about the patient safety movement the United for Safe Care campaign it's all about bringing awareness for medical errors and did you know that medical errors are the third leading cause of death today in America and did you also know that the black and brown community have rates of infection and medical errors higher than any other background in culture the disparity between the two cultures is insurmountable creator, grandfather grandmother I offer this prayer a very short prayer I want to go to here I'm asking for blessings for all people who are ill at this time who are suffering in some way creator ask this in a good way I ask for our spirits and our ancestors to surround us and give us good energy and to be healthy and to have good food clean water and all the things that we need for life that are simple nothing more food and good health creator I ask for all caretakers that they realize these are human beings to always treat them with kindness especially during this pandemic I see many frontline workers they put in hours and hours of work and they're the last person to hold that person who is passing their hand their family is not allowed to be with them it's such a hard time so creator these are my special prayers and I ask this for in a good way I ask for your blessings