 All right, we're going to start with some library news and some library information before we turn it over to our brilliant panelists. So we are celebrating our more than a month, which is our version of Black History Month. We kick ours off at Martin Luther King Day and run it through all of February. And on a whole nationwide, the theme for Black History Month is Black Health and Wellness. And you can see our beautiful art there by Tiffany Conway really embodies the beautiful meditation, the ancestral portrait in the background. It's just gorgeous. So we're so excited. Tiffany will be joining us for two events, May 8th, I'm sorry, February 8th and February 10th. One for an artist's spotlight, so a retrospective of her work. And then February 10th, a draw with Tiffany. All fun for the family. Art is meditative and healthy and relaxing. And we want to welcome you to the unceded land of the ancestral homeland of the Ramya Tushaloni people who are the original inhabitants of the San Francisco Peninsula. We recognize that we benefit from living and working on their traditional homeland. As uninvited guests, we affirm their sovereign rights as first people and wish to pay our respects to the ancestors, elders, and relatives of the Ramya Tush community. That link that I stuck in the chat box has a great reading list and website resources of Bay Area, Aloni information and reading lists and places you could donate to. As I mentioned, this is our more than a month celebration working on health and wellness. We are celebrating our on the same page, which is our bi-monthly read, a long standing bi-monthly read where we encourage all of San Francisco to read the same book. And we're celebrating the work of Jessamyn Stanley. So you can pick this book up at any of your branch locations. And she will be in conversation with the amazing Tamika Kaston-Miller February 22nd. Starting today in our African American Center, we have activist Dennis Billups. He can be seen in Netflix, Crip Camps. He's a completely amazing human being. And he'll be leading a meditation every Wednesday in our African American Center. Third floor of the main library. Every Thursday, we're hosting our Thursday at noon film series. And we'll be showing the series High on the Hog, How African American Cuisine Transformed America. And I am going to breeze through these, but I do want you to know we have a lot of great programs lined up for more than a month. Friday, we have the vegan hood chefs. I know it's going to be good. Their Instagram makes me hungry daily. And then February 11th, we have our second yoga demo and small business spotlight with Andrea Stern from Satori Yoga. And then the one and only amazing Ramakan will be rescheduled from January to be in February 20th in the African American Center. Come two hours, nice meditative crochet jam. All right, do know we have a lot of events and you can find that at sfpl.org slash more than a month. All right, and I want to turn it over today to Brittany Doyle, who is really the mastermind behind today's panel. And Brittany Doyle is the founder of Wise Health SF, which provides services within housing sites, homeless shelters, community centers, churches, and wherever there is a need for community health impacts. Brittany, thank you so much for bringing these amazing panels together. And I'm going to turn it over to you. Thank you. Thank you so much. Thank you, everyone for joining us today. We have amazing panel and information in store for you. Today's panel of community health leaders, we'll talk about lessons learned from 2021, the work that they're currently doing, where we are in the community in regards to health, and how we can work together to move forward. Participants today will walk away with goals towards healthy living and community organizations that are participating today. We're hoping that you'll receive some nuggets on how to engage better with the Black community, how you can serve as better partners and stakeholders, where you can put those health dollars. And mostly, and more importantly, we're hoping that the information today will help guide program planning. But before we move forward, I want to call Dr. Monique LaSara to the table so that she can get us grounded, so we can acknowledge our ancestors in this space and just get us grounded so that we can all be on the same page. Thank you, Brittany. Can you hear me okay? Yes. Wonderful. Again, thank you to the San Francisco Public Library, to Brittany Doyle, to the amazing panelists. I have the pleasure in life to actually work with all of these amazing people in different ways. So we are truly blessed today to have this conversation. I wanted to start off, this is, I want you all to check, go right now to SF Reparations and Instagram. This is their live feed. This is a brand new piece of work that was inspired by the Ramatush Shaloni and the land acknowledgement that was done with the Human Rights Commission last year. This is from our amazing San Francisco African American Reparations Advisory Committee. We have, I believe, the chair or co-chair today at Tamea Collins is actually with us. So I'm going to go ahead and read these, this acknowledgement for our African American ancestors. But first, I wanted to just invite you all to take a breath, you know, find your feet on the floor or maybe you're sitting in a chair or standing, just rounding yourself, straightening your back, lengthening your spine, taking a big deep breath in through your nose and out through your mouth. Let's do two more together, breathing in and out, breathing in, hold, hold, hold, hold, hold, hold, and then breathe out with sound, giving yourself rounded. Let's shake a little bit. Talking about race sometimes in mixed groups can feel challenging or may feel challenging in general for folks. So just kind of shaking it off, you know, being present with yourselves and others. I want to take a moment to do libations first. So libations, if you do not know, is an African American tradition that has been brought over from the Africa diaspora. So I have right now my little trusty SF Black Infant Health Cup and some clean fresh water. And what I'm going to do is just offer gratitude and acknowledgement of our ancestors. Usually this would be into the earth or something green, which I'll put it into later. And as I do this, I just want to ask you to say Ashay. And so as I give mode of play, as I give offerings to the ancestors to this land, then you say Ashay. You can say it violently or you can unmute yourself and say it together. But first I would like to just give homage to the ancestors of this land in the case of where I am. It's from a Tushaloni land. So thank you so much to this land and the steward and the ancestors of this land. And we say Ashay. And I want to give homage and honor to all of our ancestors, particularly those that were lost in the middle passage in Africa as they were coming and being enslaved, people's coming to the Americas. I want to say Ashay. All of those whose names that we do not know, but we know that we stand on their shoulders that we carry their genetics in our bodies, in our ways of moving, in our ways of speaking, in our ways of seeing the world. I want to say Ashay. And to my shiro always, I want to say Ashay to Harriet Tubman. Say Ashay. And this is a moment now for you to talk about all your shiro. So all your shiro and heroes and beiro. I want to say Ashay. Ashay. Ashay. Ashay. Ashay. Mode play to the ancestors. Mode play to all of our families. Mode play to all of those who came before us. Mode play to the ancestors of all of us. So I want to say thank you. Mode play is thank you and give thanks in Yoruba. And as I read this, I take a moment to just listen to the words. We honor the gifts, resilience, and sacrifices of our Black ancestors, particularly those who toiled the land and built the institutions that established this city's wealth and freedom, despite never being compensated nor fully realizing their own sovereignty. We acknowledge this exploitation of not only labor, but of our humanity. And through this process are working to repair some of the harms done by public and private actors. Because of their work, we are here and will invest in the descendants of their legacy. Ashay. Back to Brittany. Thank you so much. Yes, thank you so much. And as we all know, health is wealth. So reparations will come in many forms in our community. Go ahead and share my screen. You hear those sirens, that good old city living. In just a few housekeeping, as you know, this event is 100% virtual. It was going to be in person, but we had to move it online because of the pandemic. In the emails, you probably read that you will be receiving farmers market vouchers for participating today. We will be following up with you via email to let you know the best way for you to get those vouchers. Since we were meeting in person, we were able to give them to you in person, but now that it's online, we have to be strategic on how we get those to you. So we'll follow up an email. This will not be an unmuted mic opportunity. So we ask that for anyone that has any questions to please put them in the chat and we will answer those questions throughout the panel. And whatever questions that we're not able to get answered, I will again follow up in an email with the answers to those questions. All right. So just to let you know, just to let you know a little bit about Wise Health, we are a public health consulting company that develops innovative engagement programs and strategies to engage underserved hard to reach or socially isolated communities. And we focus on isolated seniors, low income housing sites, critically ill caregivers. We have a vast array of communities that we're able to reach. Over the years, we have worked in collaboration with medical and nursing school programs to develop platforms for medical for medical students to gain community experience and for community members to receive free access to medical care. We train community members to carry out their own community health programs. We take pride in coming up with innovative programs to increase access to health technology, education and food. And we also do a lot of speaking engagements at conferences and just anywhere that people just need to get an understanding around health. Our model is pretty simple. In order to advance health equity, we have to increase access to free medical care, increase access to healthy food, health education, community resources, physical activity and social connectedness. And you know, it's really about how you put all of these things together to effectively engage the community. Just to give you a snapshot of the work that I do and how it impacts to move forward health equity. We collaborate with medical and nursing schools. And we like I said before, we provide a platform for students. This is very important. I consider this like a seed planter, because you work with medical and nursing students in their first year. You stay engaged with them as they're going through school. And when they become doctors, they're able to walk the halls with confidence knowing that they have, you know, a relationship with the African American community, you know, they know your grandmother, they know your parent by their first names, they've actually been to their house if they've worked with the wise health. And so this is a really good way to just make an impact on an institutional level. We also create signature training programs for incoming health professional students to help set a culture within universities to educate students and get them prepared for how to effectively operate within African American communities. We develop signature engagement programs to increase engagement efforts like what we're doing with the BHI, the Healthy Streets program, which we'll be talking about a little bit later. I also work with clinical researchers to help them develop community advisory boards that can help them guide clinical research. And I think this is also really important because if community members participate in these community advisory boards, you know, it allows community research, clinical research to be more effective in black communities, it diversifies participation in clinical research. And again, these medicines, any sort of innovation, anything that comes out, it will meet the needs of what we need in the black community. On a community level, impact that I do looks like developing capacity building trainings that I do for organizations to help increase their capacity on how to work in communities regarding increasing access to HIV education. I develop programs using a community-based participatory design, ensuring that whatever programs I create or that organizations that I work with create meets the needs of the community and not, you know, we put forth what we think is needed, but it actually meets the needs. Also do health education workshops, brainstorming talks, and Q&As. So as we talk about moving forward and what that looks like over the past two years, as we see with how the pandemic has impacted the black community, we see that our pre-existing disparities have been heightened and overlooked because there's been a main focus on COVID. With the focus being on COVID, a lot of our disparities have not been addressed, our chronic disease, you know, we're talking about HIV, our health disease, our mental health, our behavior health. And so I thought it was really important that we come together and have this conversation on what does it look like to move forward? How can we move our black communities forward? We saw that we had a lack of access to resources, especially around technology and quality health services and care. And we saw that community violence is on the rise, especially across the entire Bay Area. Addiction and drug use is on the rise, with fentanyl killing two people per day. I might be wrong with that number, but I believe that it's like two people per day. Dr. Moe will have to correct me on that. The rise of mental health and depression in our community, isolation among our seniors, COVID has, you know, had a huge impact in our community, where our members are still not, members in our community are still not vaccinated, boosted, or they're not incorporating testing on a regular basis. HIV and STD is still very prevalent and is increasing in our senior communities. And then medical mistrust above all else, medical mistrust is regulating how our community is moving forward because it's preventing the community from receiving the type of quality care that we deserve. And so we have a panel here today that is going to help guide us, you know, on how we can move forward, to help guide this conversation on how we can move forward. We have Dr. Monique Lissar here, Dr. Ayanna Bennett, Dr. Malcolm John, Tanisha Hollins, and Dr. Renee Navarro. As each person comes up, they're going to tell you a little bit more about themselves. They're going to talk about the work that they're doing in the community right now, and we're going to focus now on the lessons learned from 2021. So the first person I would like to call up is Dr. Ayanna Bennett from the San Francisco Department of Public Health. Hi, Brittany. Good morning. So I wanted to do this to be able to get this information out to all of you because this is essentially my work and the thing I care most about. So the role that I have at the Department of Health is I'm the Chief Health Equity Officer, and the many projects that we run, one of the most important to me is the Black African American Health Initiative, which is in its, I think, sixth year, and has had some impact on how we treat Black health. We are trying now to really learn the lessons of COVID, which I want to talk about, but those lessons are not, they're not news. They really aren't. They're things that are known, that many of us in our community have known, that people in the medical community have known, but when the paper says it's unearthed something, what they mean is they were stepping over it for a long time, and now it got too big to step over, which is different. So I want to be sure that we are not just talking about what's happening in the moment. We need to be talking about what's been happening for the last 100 years, or at least the last 30 or 40, something like that. We need to be in decades, not months or years. So when we talk about what's happening right now, I really was struck by one picture early in the COVID pandemic for the first seven months or so. Well, the second month to about seven months from there, I was the incident commander for the health response for the city, so I got a lot of stuff thrown my way. And one of the most important decisions we made was to really think about this geographically. That was how it was moving. That was how people were talking about their lives. And so that's how we moved in looking at it. And I just want to show one picture and then I'll come back so we're not staring at PowerPoint. So my theme for COVID is really same as it ever was. It really is not a change. It's worsening. We have lost a lot of people who should still be here, but we are already losing people who should have been here. So this is our redlining map. So for those of you who maybe this isn't really something that was important within your family, segregation happened all over the country everywhere. For some reason, there's some kind of junior high school history version of segregation and racism that makes it all seem like it was something that happened in Alabama. I have shockingly run into people who that is the conception that they got as a child. That is not even remotely true. Everywhere was segregated. Every major city, most small cities. So this is what San Francisco segregation looked like. If you lived, this is how the government graded San Francisco. If you had any black people or really any immigrants in your neighborhood, you got a lower score. So all of the red areas that have the low score and you cannot get a mortgage in those areas that is backed by the government in 1938, all of those had black people in them. So if you see that distribution, there were particular areas. Some of them, it was immigrant populations, but for the most part, it was that those are the places where black people settled. Harlem of the West and the Fillmore, the shipyards over in Bayview. If you were yellow, maybe you had a little incursion, not of black people, but perhaps some poor people in some immigrants. If you were green or blue, you had a good chance of getting a good mortgage and those neighborhoods were white and middle class. If you look at that map, San Francisco does not look that different from that now. You can layer over that map, and we have done that over the years. I've been talking about this forever. You can layer our school quality scores on that map, and it looks like nines over on one side and twos on the other, and it looks just like that and some six and sevens in the middle. You can layer home prices, you can layer unemployment, you can layer almost any factor that you measure a community by, and it lays out the exact same way. So when COVID came around and we did this map, we got it down to the census track, like tiny little block-sized things, but if you look at this map early in COVID, it already looked like this, where the darker colors are where there are more cases and the lighter colors are where there are fewer cases. And if you work at a job, you had to leave home to do every day, which most black and brown people in the city did, or you worked at a job where you went home and you practically worked from home already anyway, your chances of getting COVID were very different, and because those jobs and access to them are racially mediated, your risk of COVID was racially mediated. So there's a lot to do about people's pre-existing health, which has to do with the resources in their neighborhoods. There's a lot there, but really risk and resources are laid out in a geographic way all across this country because of decisions that were made sometime in the beginning of the 20th century. And we have not done anything to correct it, and every time something bad happens, it's going to distribute in this way. So if it's a hurricane, it almost does not matter what it is, this is how it's going to distribute, and we should not be shocked by that. We should expect that where we're going to need to go is the same neighborhoods over and over again. So my main lesson that I want to bring to this is it is geographic. What we need to be talking about is the places where people live, the neighborhoods that we have, the communities. We talk a lot about individuals and please eat, ride, and do these things, and those are very important. Everybody needs to have some agency, some control, some real power over their own life, but the things that are actually determining your health are things that you are experiencing collectively with everyone who shares your skin color, your neighborhood, your address, and those are the ways that we need to change. So the things that Brittany is doing, that Monique is doing, that Tanisha is doing, to improve the area that you live in, to improve how your community responds to health, those things are actually probably going to have a bigger impact on you, especially the generations as we go forward than anything your doctor or I am doing. So we need to really be looking at things in that way, looking at our communities, and I'm going to show you one more picture, because I have a little hero too. The way Kamara Jones was the head of the Public Health Association for the United States and is I think the master at explaining health equity to people who don't even understand racism yet, and she describes it as the gardener's tale. And her point is it's not the seed, it's the same life planted in two different places. And if you suck all the vitality out of the soil, you cannot expect that you will get the same kind of thriving that you would get if you had taken care of the soil. And that is what we have done. We have taken all the vitality out of some communities, grocery stores, parks, jobs, schools, all of those things were removed or never put into some communities. And then we're looking at the people as they grow and going, gosh, why can't you guys get it? Why you guys smoke so much? Why can't you eat better? You have planted my seed in soil, you have consistently maintained to be bad. And that is how we get where we are. So stop looking at people. If you're only, Kamara Jones says if you're, if you look at a problem and your only explanation is the people, then you have not looked right. And so that is how I want us to look at COVID and what we do after COVID. Thank you, Brittany. Thank you so much. That's the perfect way to get this started, to get the conversation started, is to really show the history, which is very important. And the next person I would like to call up is Dr. Malcolm John from UCSF. Good morning, Brittany. Thank you for inviting me. And good morning, everyone, and happy Black History Month. It's a real honor and privilege to be here. You know, I think some of you may know me, but my name again is Malcolm John, I'm an infectious disease physician at UCSF University of California, San Francisco. Been here since 1997 and was the director of the HIV clinic at Pernassus for 18 years. And in that setting really worked with community to establish our men of color program with Black Center for AIDS before it became Rafiki with Perry Lange for those of you who remember and others. And through that really got into health equity work in UCSF and more in the community. And currently I'm the inaugural director for health equity for UCSF health, trying to help the health institution do a better job around access and patient experience and patient health outcomes when they come to us. But as we all know, most of the work is as Ayanna pointed out, what happens in our community and the reality that racism impacts all the social determinants of health, our environments, our education, our finances, what we breathe, our access to health, our ability to achieve our fullest potential is real. And so I'm really excited to be a part of this conversation of how we can take care of ourselves. And with that, I'll ask if they can put up the slides for me. So again, I want to say welcome. And today I want to talk a little bit about some of the lessons I've learned from COVID-19. And Brittany is also asking me to talk a little bit about some of the lessons related to HIV and sexually transmitted diseases, STDs, or otherwise known as STI, sexually transmitted infections. The next slide. So the first thing that I have listed here is there's a lot to celebrate despite the fact we for more than 400 years have been constantly oppressed as Ayanna so well described for us. And that is the community truly has come together to take care of ourselves. That's one lesson that I learned. It feels like a renaissance, again, in many ways of folks working across silos. BHI, the director of the Black Health Initiative, I think I forgot to mention that, of course, which some of you know, was established about a year and a half ago to really help UCSF do better with the Black community around COVID and related health disparities and through such partnerships with the San Francisco African American Faith-based Coalition, we've been able to go out there and share education and vaccinations. And BHI itself has established with the leadership of Brittany a Healthy Streets Initiative, really getting out there to bring Black health providers and staff and learners to the Black community and really just kind of listen and engage and be part of the community in ways that we haven't been for a while. And so I think that that's exciting and affords an opportunity for us to build on that momentum on the wonderful work of groups like Mega Black, SF, and Rafiki and others to really think about a Black health agenda moving forward. And so I think that's really exciting. I do think that the second point is real and Brittany touched on it, which is I encounter a lot of myths and distrust in going out in our community. And that's just a reality for many good reasons. I was particularly struck by some of those helped by the youth. We were at Booker T Washington for several of their youth sessions and we did a session in one of the youth juvenile court systems. And you know, it's interesting folks really have this firm belief on different things, but importantly, around what they see on social media. And if it's on social media, it's real. And I can recall this one gentleman who insisted that, you know, you got magnetized after you got COVID vaccination. And I said, well, I'm not really sure that that's, that is actually not the case. And I said, well, you know, people have been vaccinated. Can you go up to them and see if they're magnetized, et cetera? And he said, well, it doesn't matter. I saw it on social media. And so it's a real challenge sometimes. But it highlights that people have trusted venues and trusted messengers. And one of the key things that I think health systems have missed is, or rather have have experienced is a loss of trust. Or perhaps the trust wasn't there, but it really is kind of well deserved, right? The health system hasn't always treated us well as a community. And we'll talk a little bit more later about how that is changing. But I think there's a lot of people on campus, including Dr. Navarro and Alejandro Rincón and others on campus who spend a lot of our lives swimming upstream, doing the hard work. And really because of the momentum that's been happening with the unfortunate events, with the murder of George Floyd and others, with the unfortunate events of COVID. But even before that, the work of students at UCSF were really demanded more. And before that, when Dr. Navarro and others were solitary soldiers, really holding on to the torch. So hopefully that will change. I didn't want to get to the next point. Well, just one last thing about myths I would say is that one of the key predictors is that of your peer group. So for people who were in peer groups who actually didn't believe in vaccinations, didn't believe in other health issues, you'll find that only about 20% of people would actually do the work. And I think it's important for us to think about that for a moment, that when you actually have peers who actually support a certain thing, you may see a twofold increase or two times increase in the likelihood of something happening. And I think that that's really important. These myths translate to persisted throughout the pandemic and affected people's hesitancy. I think back in 2020 when the pandemic first started, the California Health Initiative Interview Survey rather did an assessment of the likelihood to be vaccinated. I think African American and Black patients, people, individuals, they said about 48% were likely to get vaccinated. And here in San Francisco, as you know, our rate is roughly around 73%. So a lot of the good work that has been done here has led to a higher acceptance over time. Part of that is transparency and trusting each other. But nonetheless, all that hard work comes fatigue. And people are tired, and that's something I've been hearing a lot more. I mean, even I'm tired of COVID, right? But people are wary of, want to go back to normal living, partying, being with family and friends, to not having to wear a mask. Again, in our community, wearing masks has been seen as more stigmatizing and associated with less likelihood of wearing the mask. But again, here in San Francisco, with a lot of education and good work from our peers, people have really done a lot to keep the death rate down. But as Ayanna said, a lot of people still have died about 8,000 or under 8,000. Black residents of San Francisco have died of COVID, and that's 8,000 too many. I do think it's important to recognize that people are definitely hurting, particularly our youth. There's clear evidence that older, particularly older youth in schools are more likely to do remote learning and more likely to have depression and anxiety as a consequence. And that translates as well to their parents and many of the adults. This is not enough. Anything new, as Ayanna mentioned, disparities in all chronic diseases, including mental health existed before COVID. And unfortunately, they'll continue unless we take action. But I did want to acknowledge that. And my daughter is in college and has experienced her among her peers, people who have harmed themselves or even taken their own lives. I don't think that's news to many of us, but it is, again, one life too many. But I think there's much that needs to be done. I think we'll be dealing with that. And I want to acknowledge the great work of folks like Manik Lassar and others, Dr. Lassar and others, who are making sure that we take care of our whole being. And that's essential. Next slide. One of the key points to recall for me that's already been said is that there is just more disparities all around. It is the conjoining of social injustices, racial inequities and health disparities that existed beforehand, as Ayanna said. It's on all health conditions. We're seeing increased all-cause mortality or deaths, regardless of COVID. It's almost like a 23 percent increase in the Black population. And among, I think, significantly lower, I think it's about 12 percent increase in the general white population. So that's a huge difference that is reflected. And I could give you numbers for cardiovascular disease, but take my word for it. It's all there. Importantly, a lot of people have opted to defer care. And again, that's not unique to our community. But I think it's important. And I just want to pause here, actually. I meant to say this at the start. If any of this is triggering, I'm not really trying to present too much data. Please do take care of yourself. It's okay to turn off the screen, to walk away, have some water stretch, wait till I'm over, or just take a breather. So apologize for not having said that earlier. But I think that's really important because we are not numbers, we are not statistics. These things are real and we all experience it. So again, please do take care of yourself if you need to. But I did want to say that there's a lot of deferred care. And in particular, a lot of folks are missing their medications, missing their colonoscopies. And unfortunately, for many of our diabetics, missing their foot care and amputations have actually increased inpatient. So again, I want to circle back to that when we have future discussions. But that is something that's compounding more disparity upon disparity. This next point, there is stigma in the community still around COVID-19. And I think that that is something that we have to be clear. I think it's clear in our conversations and experience that people who have had COVID don't tell that they've had COVID. People who have gotten vaccinated may not say that they've been vaccinated. And it really is interesting and important for us to reflect on that because it impacts the health of our community. And it impacts Black lives. And I think when we go out in SBHI partnering with several of our partners, it's interesting to see or unfortunately to see that COVID testing is usually elsewhere or other in location. And this is something that I want to come back to when we get more to the open panel discussions. As was noted, COVID vaccine testing and vaccination rates are still not where we want it to be. Black San Franciscans have the lowest rate along with White San Francisco in the 73% range, whereas our Latin American, Latinx compadres are about 86% vaccination, Asian Pacific Islanders around 85%. So there's stuff we can do there. Next slide, and I'll wrap up pretty quickly here. Basically, among HIV, STD, we have similar lessons that are learned. In my clinic, we've seen deferral of care just like anywhere else. Yet, and importantly, we've seen a significant rise in sexually transmitted diseases with like a 15% and 25% increase in chlamydia and gonorrhea across the city, which is interesting because everyone's sheltering in place. But I don't know, but you go figure. But I think part of it is that we're doing less testing in addition to people really feeling the need to connect. And we want to continue to have that dialogue so people can do that safely and not increase their HIV risk, which we'll see in the next slide, that we did lose some ground in getting the word out about HIV prep, which is pre-exposure prophylaxis. But those of you who don't know, that is the taking of a drug once a day. And I can actually take it once injection, once every two months. And that really reduces the rate of your risk of getting HIV by 99%. And that's significant. Yet when you look at the recommendation that at least 50% of people who are eligible for HIV prep for short, there's nationally about 25% uptake. It's 66% among whites, white individuals who are eligible and only 9% on black African American individuals. It's about 16% for our Latin American colleagues. So that is in my field, really disheartening and work that we need to continue to do on the good news. We did do some linkage to testing with the public health department at our BHI pop-ups. And that was really well received. A lot of good giveaways, including hoodies, made a difference, I'm sure. But really, people just were open to the conversation. And again, as we, I think people are really motivated, again, thinking back to the positive, that renaissance moment that people are starting to think more along community and being open to engagement in the community where they feel most comfortable. So I'm really excited about that. However, I'm done. This is the last two slides, the last two points. We're really, people are open to testing, but I want to say HIV rates are increased in our community. Infection rates have gone up from 17 to 21%. And then I'll end on the next slide, which is just these four bullet points of really just everyone just do it, just go out and do it. Take care of yourselves, engage for yourselves. I did it for this little boy who was a first generation in college and became a physician, dedicated to serving his community. And I'm here talking to you today. Next slide. Do it for your family and loved ones. I did it for my daughter, who was the next generation, like many of you. Next slide. I think that's a duplicate. Next slide. This is for all of us to engage and take care of ourselves in our community, in the city, but also next slide as a black physician doing it for the community at UCSF in our health system. We have to do better. We must do better and we are being driven to do better by our students. Next slide. And I just want to thank you all. One more slide to thank you all and to stay strong and take care of each other. Thank you, Dr. Malcolm John for that wonderful presentation. That was great. You gave us a lot of great nuggets to choose from. And I definitely want to give a shout out to the Have a Good Sex campaign from the San Francisco Department of Public Health. They are doing a great job working within communities to get people familiar with taking confidential HIV tests at home and incorporating HIV testing into your life if you are sexually active. So shout out to them in the cold trainer. So next we have, coming up next we have Tanish Hollins. Good morning. Thank you, Brittany. Good morning, family. Thank you so much for having me. For those who don't know me, my name is Tanish Hollins. I'm the executive director of Californians for Safety and Justice. I'm also a co-founder of San Francisco Black Wall Street. I'm a San Francisco native from Bayview Hunters Point. I think I am the only panelist who is not a public health official or has a public health background. But I have been working on and organizing and advocating around violence prevention, specifically dealing with violence in our community and trauma in our community as a public health issue for over 20 years. And in my nine to five work, working on public policy and making sure that we are changing laws and priorities to create opportunities for healing, especially as it relates to our black community. So I'm going to share a little bit about the work that we have been doing collectively here in San Francisco to address these issues and then where we need to go moving forward. A couple other things that might be helpful for y'all to know about me and my experience. I started organizing over 25 years ago because I believed that all of the responses to the black community for what we were experiencing, especially here in San Francisco came with penalties that created more harm for us. And we have learned, we didn't need, we didn't need those examples to learn how all of those responses just added to the disparities that we see, whether it was trafficking people into the criminal justice system or other systems, adding to the trauma, the systemic trauma. And I love what Dr. Moe has uplifted over the years that anti black racism is a public health crisis. And we see where it picks in where it shows up and all of these different issues. So not only am I not a public health professional, but I'm also not a tech professional. So I'll do my best to share this screen and this presentation very briefly and then share some things about lessons learned from 2021 and then where we hope to go in 2022. So bear with me. Okay, y'all see that. Now let me do slideshow. Okay. All right, we're getting somewhere, again somewhere. So how all this fits into the puzzle of this conversation that we're having. And I wish I had all the pretty pictures that all the other presentations do, but you know, I work in policy, so it's lots of words. Anyway, the state level, the work that we have been doing at state level, especially last year, really addressing anti black racism in the victims rights movement. I'm gonna tell you a little bit about what we mean by that. In a nutshell, black people don't get to be victims. We're not seen as victims. We're often seen as causing our own victimization in the community. So when harm happens, many times we don't get the same response and we don't get the access to the resources, whether that's victims compensation or you know, other resources and we can talk more about that, but you've heard a little bit from Dr. Bennett and Dr. John about the over and from Brittany about the overall crisis that our community has been in when these issues are not new. They've been for a very long time, but we have, we can't ignore how when our victimization, our trauma is ignored, how that increases the disparities and also how it contributes to all the things that we see happening, right? This is, it doesn't help our public safety, it doesn't help our people heal. And so addressing that has been really important. So we've been working to remove barriers, you know, for people from our community, really making sure that people understand that black folks have been harmed. They've been harmed by systems. They experience harm in their community that we have cultural norms that prevent us from being able to participate in systems. Other communities may get, you know, a cultural pass because it's their cultural norm that maybe they don't report crimes or they don't talk to police. Well, that's dangerous for us in our community. And we've had plenty of examples to point to, but we are not often given that empathy and we're also facing a lot of barriers to getting help. So a lot of our work last year was focused on removing those barriers, calling out the discrimination and making sure that people from our communities are seen as victims and survivors and they get access to help. One thing that we were able to do is launch something called the We Are Survivors campaign. I will drop a link to the documentary that we filmed. We filmed part of it here in San Francisco. So a lot of our on the ground community warriors who are also survivors, people that have been impacted by crime and violence or been in the system and the criminal justice system who are now on the front lines in the community helping our communities. They were the same people that were passing out PPE and food and water during COVID, but they're also the same people that are responding and taking guns out of people's hands and intervening to keep our community safe. So we did a documentary called We Are Survivors to uplift what it means to be a Black victim or survivor and reclaim that identity because it's important, but also how we're surviving our resilience and the importance of bringing resources back directly to our communities because we keep each other safe and we've been doing it. Our organization has also been working to protect policies that have moved hundreds of millions of dollars from jail and prison spending straight back to our communities throughout the state of California and we are able to focus on programs specifically that benefit Black children, families, individuals, folks who are coming out of incarceration, but centered on prevention, intervention, and healing opportunities and really uplifting how important that is. A lot of people don't make the connection between the two, especially when you get into the political realm. But the whole purpose and my purpose in doing this work is to move resources and create opportunity for those resources to come directly back to our community and people on the ground so that we can heal. We have options for healing. We have options to create safety for our people and get them the help that they need. We also worked on some big pieces of legislation. SB 299 is one that would expand victims' compensation to survivors of police violence and their surviving family victims of police violence and their surviving family members. We know that disproportionately impacts Black people and what does it mean when we're not recognized as victims, especially when it's law enforcement or state that commits the crime against us or takes a life. So this is very important and very central to the lives of Black folks and so all of our stories and experiences are reflected in this policy and advocacy work that we've been doing. And then SB 731, which would sunset past convictions for millions of Californians who are living with past convictions, who can't get access to housing, employment, meet their basic needs. And again, the majority of those folks are disproportionately Black. So our policy work directly connects to the health and well-being of our communities and creating options and opportunities for people to heal. Switching gears, community level, here at SF Black Wall Street, our mission has been to protect Black cultural space, protect our right to come together. We saw during the pandemic and you heard this from our medical professionals, it wasn't safe to do so. But we had to acknowledge the crisis that we were in emotionally and how it impacted our mental health as well. So SF Black Wall Street was very intentional about protecting Black cultural space, giving us opportunities to come together safely, outdoors, whether it was to host events where we were able to break bread and see each other or give access to market so that a lot of our Black households and folks who were out of work or in transition due to the pandemic were able to create new businesses and trade and create opportunities to build money with each other, make money with each other. So that's all important and it's all important part of our health. And we were able to support our Black community's response to COVID-19. So we had the pleasure of sitting with Dr. Monique Lissard, Dr. Malcolm John, Brittany, other folks, Ms. Veronica Shepherd, many folks who may be on the call today, and to coordinate together how our community was responding to COVID-19 and the resources that we need. So we've been able to do a lot of things just in 2021. Unfortunately, the things that we did didn't stop many of us from being directly impacted. I can tell you in the end of the year, I lost a brother to self-inflicted gunshot wound and 77 days later lost the aunt who raised me to COVID-19. And so I'm naming that because many of us have been directly impacted by the issues that we're working on and trying to protect and support our community through. So that is part of what we need to make sure that we are addressing moving forward in 2022. This is a real issue that the people who are on the front lines are also dealing with every single day. We have to continue to put the boots on the ground, community providers, and folks who are managing our public health systems in the same room because these are public health issues. Violence, access to healing, pushing out and creating more options, not just the traditional options and removing barriers so that people can actually get access to those helps sooner than later and make it flexible. You know, when we, our community deserves to have agency to say how we want to use these resources. Yes, traditional counseling and types of therapy, those things are important. Yes, dealing with your physical and mental health, but it's time for us to also expand our conversation around what healing options can and should look like and how to make it practical for people. It's a one-size-fits-none approach right now. We got to make sure it's a one-size-fits-all. And then the last two things, make sure that Black voices are centered in conversations around policy, whether it's your policy and procedures and how you serve community or in our legislative policy and where resources go, making sure we remove those barriers and then give us protective space. And, you know, that's physical, emotional, tangible space because we don't have enough of that to be able to process, to connect, and to heal. So I'm going to stop sharing here. I'm also going to stop talking because I think that's enough. But I appreciate all of y'all for making space for me on the panel. I look forward to hearing from the rest of you. Thank you. Yes, thank you, Tanish. I always love to hear Tanish talk. She is, she's very, very powerful in the way that she moves throughout our community. I think one of the favorite, one of my favorite things that you can't really talk about, favorite things when you talk about the pandemic, but I really did enjoy seeing how grassroots community organizers came up and took control of their own communities during the pandemic. Organizations like San Francisco Black Wall Street uprooted in 2020 for all the reasons that she just said, but it was needed at the time. It was important. You know, our community was hurting. We needed healing and we had nowhere to go. You could go to any other neighborhood around the city. You could see they had clean streets. They had the little, you know, spaces where they could sit outside and eat and convene in a district 10. Well, specifically in Bayview, we didn't have that. And so we had to create our own space by all means necessary. And the community, a lot of people in the community did not like it, but you know, it's we were here first. So it is what it is. All right, moving forward, we have Dr. Renee Navarro from UCSF. Hey, Britt, maybe it's me. Oh, I'm so sorry. Dr. Monique Lissar from Refiki Wellness. I truly apologize. No worries. Thank you so much. I am going to also get into my sharing situation. And as a lady to me shall instead, I am not a techie. So bear with me for a moment while I find what I need to find. And let me first, before I do that, let me just invite you all. Take your hands, left hand, right hand, whichever one you are. I just want you to tap your heart. Tap your heart. So much of what has been said has been at least for me. And I know the data work with it every day 24 seven is overwhelming. And one of the things about trauma is it impacts our ability to pick up and keep moving. And sometimes when we're so overwhelmed, it's hard to have hope. It's hard to reset. So one of the things that I always invite you to do is to tap your heart, imagining a rose blooming in it, breathing into that rose in your heart. Because if we don't have hope, and we don't have ourselves, we can't anchor in this moment of, you know, all the different amazing things the panel said, having agency, having healing space, being able to actually get our stress down enough, actually breathe and think. One of the things that is so impactful about stress is that it impacts our ability to remain calm, to make good and positive decisions for ourselves, whether it's what we eat, what we do, how we're driving, if we're flipping off the car next to us, all of those things have an impact. So I want to just first invite us, you know, it really is true that oxygen math self part is really true. We have to breathe. We have to take care of ourselves as I'm working to breathe and figure out, oops, that's not going to be right, how to get, Brittany, maybe you can help me just throw out my PowerPoint for me and I'll just start talking, because otherwise, I may not get there if that's okay. And I can't hear you muted. But let me let me do this. We're going to see some data in a minute. But it's really, it's not about the data, because the data, unfortunately, even as I connected with the San Francisco Department of Public Health, and I asked for data. One of the things that they have recognized is that they don't have enough data on African Americans in mental health, we know, through our work that we are overrepresented in prison, jail site, overrepresented in crisis response, but we are not represented well enough in the ongoing care. So let me back up as Brittany, do you have my wonderful, thank you. Perfect. Thank you so much. Let me back up and say I'm Monique, Dr. Moe. My stress got ahold of me as I was listening to Tamisha and to everyone else. Because I'm nervous, I want to do a good job for everyone and I want to represent well. But I also want to say, you know, we have to keep it real about all this data and how it impacts us. And it's impactful. And we have to let it in in order to change it. We can tell you stats all day long, but if I haven't changed your feeling, if you haven't connected with what is happening in your body and your mind and your spirit, then we aren't going to be getting anywhere in this change. And that is one thing that I've always recognized. We've got to be able to connect to each other. So I first want to just tell you, this is all general data. This is not even San Francisco data. As I said, we don't have that data. And we are asking for the data. So I am executive director at Rafiki Coalition for Health and Wellness. I'm also the chair of the implementation working group with Mental Health SF and the co-chair of SF Block, San Francisco Black Lead Organization Coalition. And as you look at this data, what you can really basically see is that African Americans are not getting access to care and in the ways that we need it. And if we can go down to the next slide, please, Britt, what I want you to look at here is addictions and overdoses. So one of the things that we have seen in the news, and I'm just going to pop into it really quickly, as we saw Regina King's son committed suicide last week, a beautiful person, beautiful life, amazing, phenomenal, bad mom, who loved him dearly and also couldn't save his life, and Alexander Jenner. We saw former Miss USA, Chesley Christ committed suicide last weekend. Former Miss USA had everything going for her incredible, beautiful, brilliant woman committed suicide. We had Michael K Williams, our amazing, amazing, brilliant actor who died from an overdose this past year. So these are these are celebrity deaths, but these are our African American heroes and sheroes. And these are the people that we look up to. And also we have had lives that have both mirrored our regular population, but have also been privileged. And so if we're looking at African Americans, as we always do as the canary in the coal mine, we as Dr. Malcolm John said, we are already in this case, what was the stat 23% higher death rate for African Americans over across all different types of illnesses. And if we look at this particularly black African Americans are exponentially more likely to die of an overdose. And let me tell you something, these are preventable deaths. We can have Narcan, we can have naloxone, we can prevent these deaths. These are completely preventable deaths. But black and African American folks are making up a quarter of all the deaths, and we only represent three to 5% of the population. So we must, must, must have Department of Public Health in the city take this more seriously. I want to go to the next slide. This is some of the legislation that Brittany asked me to share with you. As I said, I'm chair of the San Francisco implementation working group. And this is mental health staff. So we are working on this desperately, I probably designate about 20 hours of my month every month to this work that's not paid. This is volunteer work from my heart, because we need to really shift the system, the system in San Francisco is broken and we need to impact the system. So we all know that right now we can't access, I have only, I have, I think three therapists, three and a half therapists. And I have, we're serving over 50 people in therapy, but we have 25 people on the waiting list. I can't get enough therapists because of funding in order to serve the need. Our community has finally decided that they're not, they're so overwhelmed that we don't, we're not even worried about the stigma anymore. We're like, I need a therapist, please get me into therapy. And we can't, there's no therapist. So we're failing right now. Mental Health SF is designed to work on that. California 20th State Senate bill 221, which has is right now being amended requires health insurance across the state reduced wait times for mental health care to no more than 10 business days. Right now, I've had people on my waiting list for, you know, and I'm not an insurer, but we are a nonprofit for over three months. So this is, this is not, this is not okay. The community is suffering as you heard from the suicide rates, overdose rates, and these are preventable. These are preventable. And so SB 855 from Wiener strengthen mental health parity laws requiring private health insurance to cover medically necessary treatment for all mental health and substance use disorders. This is coming into effect this month, or actually last month, January 2022, we are supposed to have parity yet myself through my own health insurance can't get a therapist. I can only go to group. So we've got to do something different. I want to go down to the next slide and have you look at this. While I invite you back to tap on your heart again. And take a breath again. Because really what I want to invite you to do is learn the lessons that we worked on. And Brad, if you can just give me a quick time check as well, that would be great. I don't want to go over the time. You can have one more minute. Okay, one more minute. Okay. So one of the things that I want to invite us to do is to number one, what we learned throughout this pandemic is to work together. As you heard, I want to give major props to Mary, to supervisor, Shaman Walton, to director, Dr. Davis, to Kim Rose, Dr. Navarro, and all of the people at UCSF that also helped get us going with this pandemic. But I really want to say is that we cannot move forward unless we have parity. And so this anti-blackness piece is really about black people can't solve anti-black racism. That is a problem that has to be solved by other groups. What we can focus on is to celebrate and to have joy and to take care of ourselves and to focus internally on what we need to do to take care of ourselves. Because if we focus externally and we need to provide more healing spaces for ourselves, it's got to be Pujachakalia that we do self-determination and we take care of ourselves. We aren't the cause of anti-blackness. And so with that being said, we have to be able to operationalize that work that Tameesh talked about, that work that said anti-blackness is a public health concern. We have to be able to say, what does that look like? How do we solve for structural racism? As Dr. Bennett showed us, this is decades of this, decades if not, and you know, prior to that century of this. So we can't solve this overnight. It is not a sprint. It is a marathon. We have to work together. We have to have strategy. We have to have allies. We have to be able to work together. But we also have to recognize that if we don't work and take care of ourselves, we won't be around. And this is the biggest thing that I want to say to the Department of Public Health and to all the other providers is that if we, and funders, is that often the first responders are the community that we serve, and we're struggling. We're struggling. And it's been two years and we're going into a third year and we need to be able to do something different. And that really means that the city has to be able to take care of its first responders. And so we've done a long way towards doing that and in our work together, but we've got to do better. So that wasn't quite the presentation I thought I was giving, but I really want you all to know that we've got to take care of our hearts. We've got to connect through our relationships. And as Dr. Cornell West says, our love in public looks like justice. I'm going to pass it back to you, Brett. Yes. Thank you so much for that. Thank you. All right. So now we have Dr. Renee Navarro. She's our last panelist. And after she's done speaking, then we will go into the questions, understand that we, I mean, this is all amazing information. We may not be able to get through all the questions today, but we'll definitely try to get through some of the questions. And like I said, whatever we don't get to, we'll follow up an email. All right, Dr. Take it away. Thank you very much, Brittany. Thank you to the library as well. And to my co-panelists, it's just a privilege to be here with all of you today to share with you how UCSF, what our commitment is and how we're going to be working better, doing better with the City and County of San Francisco, our surrounding communities, and internally to UCSF as well. We recognize we have a long way to go. So as she said, I'm the vice chancellor for diversity and outreach at UCSF. I'm the first and still the only black woman to be a vice chancellor in our 150-year history. So as I said, we have a lot of work to do. I've been in this role for 11 years now. And I'm also a professor of anti-sensiology and perioperative care and worked for 20-plus years at ZSFGH, running the ORs. And I had the privilege of serving as their chief of staff. So what I'd like to share with you is just a bit about how the impact of racism on the healthcare as an institution. And we talk a lot about why people don't trust us. And I have to say we need to turn that question around and say, well, are we trustworthy as institutions? And when we look at the legacy of slavery, white supremacy, and the way that in fact it has impacted the healthcare system, you know, you could argue that in fact we're not necessarily trustworthy. All the way back from the Tuskegee experiments in the 1932 up until 1972, Henrietta Lacks, there's just numerous examples in which inappropriate and ethical experimentation took place against black communities, black bodies were used in the early treatment and care of women with gynecological diseases. We know that our institutions were separate and they were unequal. And it wasn't until 1965 when the Medicare Act was put into place, one of the provisions were that the hospitals had to actually become integrated as institutions so that they could receive Medicare funding. Lack of access, we've talked about how there's still a lack of access for our communities. And even when our communities access our institutions, there's lack of diversity in the providers. And the providers we do have don't have an understanding of cultural humility and don't understand how their own biases show up in the ways in which they care for patients. When we look contemporarily at how the bias plays out, in 2016 studies, all of these reflect pain treatment. 40% of medical students believe that there's biological differences in blacks and whites and that black patients have thicker skin and therefore are less likely to experience pain. In cardiac care, given a scenario where you see a vignette and make a recommendation, cardiologists, when they saw a picture that was a black man or a black woman, they were least less likely to offer complex care and intervention for those individuals, which was not consistent even with their own guidelines. And in cancer treatment, studies have shown that oncologists, especially if they have a greater degree of unconscious bias, implicit bias, they spend less time with black patients. They're less empathetic. They don't do reassuring kinds of interactions with patients in the ways in which they communicate. So I would argue that, you know, we really have a long way to go to become trustworthy. And that's where we're trying to move forward. Well, Dr. Bennett talked about one of my favorite people in this fight. And that's Dr. Kamara Jones, past president of the American Public Health Association and actually the current UCSF presidential chair. So I have the privilege of meeting with her on a regular basis as she guides and informs the work that we're doing around anti-racism at UCSF. And we've taken the definition of racism to be one that is reflective of our needs to actually dismantle the structures that we have in place, the structures that exist in the red lining that Dr. Bennett shared, but it exists as a result of that in education, including higher education, including professional education across medicine, dentistry, pharmacy, nursing, our graduate school. It is ubiquitous. And so we take this definition of the systems that are structuring opportunities and then assigning values on the social interpretation of how one looks, which unfairly disadvantages some individuals and communities, unfairly advantages other individuals and communities. And this is a piece that predominantly, you know, in a predominantly white institution, people have a hard time understanding the unfair advantages that they've received. But the challenge is it really saps the strength of our whole society through the waste of human resources. And we therefore have to really start to disaggregate all of those systems and challenge each of those systems. We also need to work on interpersonal racism. We certainly still see too many examples of micro and macro aggression, aggressions happening between people in interpersonal ways. So we're working on that as well. So we launched in 2020, an anti-racism initiative. And the anti-racism initiative came about after the murder of George Floyd, after the campus, you know, called out the administration to do more, to do better, to really focus on black lives, to look at the anti-blackness that has happening across different identities at UCSF. And so our anti-racism initiative is really predicated on valuing black lives and eliminating systemic racism. I consider us to be in the first decade of this work. You know, we talk about the long history, the legacy, like I said, the perniciousness of racism. It's going to take us a commitment over decades in order to actually see what we need as far as equity and the absence of the obstacles to full inclusion. We have an obligation to make sure that our environments are safe. You know, we've had issues of racial profiling defined. We've had issues of it being an unwelcoming climate for our visitors, for our patients in some instances. We recognize that we're an institution of higher learning and that if we are going to be responsible for educating the next generation of leaders, as well as our position as an institution is one that actually leads the nation because we're producing great leaders, but we're also sharing knowledge that impacts academic health systems, academic program, graduate programs across the country. So we need to be producing physicians, nurses, nurses, pharmacists who understand anti-racism, understand their role and their obligation in ending racism as it exists across the health sciences. We need to make sure that we actually with intention change the ways in which we make decisions. Who's a part of that process? How are the decisions being made? What is the level of transparency? And then how are we holding ourselves accountable that there are not unintended consequences to individuals or communities? So this is really a part of that destructuring our current systems. We need to achieve demographic diversity. You know at UCSF now we have 122 black faculty, which is twice what we have when I started, more than twice when I started in 2010, but it's only 3% of the faculty across UC that are black. We have 1700 black staff, 8% of our staff are black, but the staff total number is 21,000, opportunities abound and for our learners, 357 black learners, which represents 6% of all of our learners. So actually across the board we have opportunities to increase the diversity of our institution. Patient care equity, Dr. John is really leading the efforts in our patient health equity councils and we're grateful for his leadership and stewardship of that work. We need to work better in the community of San Francisco. We're the second largest employer in the city. We have an eight billion dollar budget. How are we in a positive way impacting the Bay Area communities with opportunities for jobs and how we spend our money? And then we need to look at the kinds of research that we're doing to make sure that we are one doing anti-racism research specifically. How do you dismantle racism in an academic health system? But then the clinical research we are doing needs to be done in a way that is inclusive and driven by community partners with us and that we have equity in identifying and growing the kinds of individuals who are actually engaged in those research initiatives as well. So one of the things I wanted to just highlight is how we're thinking about our place as an anchor institution in the city and county of San Francisco and we are really trying to advance what our commitment is to the Bay Area. The pledge of this is to leverage our business operations to advance economic security and opportunity in under resource communities to ultimately advance health equity. So workforce opportunities is about health equity. Jobs that have benefits and good working conditions and a climate and a culture that's supportive will benefit health equity. We have, I said, an eight billion dollar annual budget. We buy a billion dollars worth of products and services. How much of that is spent on Black Wall Street with our Black communities, with our minority-owned businesses. We need to expand that and then we need to take some of our actual resources and invest those resources back in the creative. We've started with a five million dollar small, five million dollar investment into some of the community resources but we need to build on that. This is just the start. Some of the things we've accomplished kind of in the first year of doing this work is really around police and security, teaching our police to do more de-escalation training. Security are not there as many police officers. They're really there for customer service, wayfinding, etc., having more accountability and, you know, inviting the community to help be a part of our police accountability boards. We need to have a role obviously in COVID equity. You've heard Dr. John at others talk about how we worked, how he and others have worked to try to improve UCSF's participation in some of these community equity events but also internally as we found that there was a disparity in our own employees about who was getting vaccinated, etc., so we have internal, external strategies and also extending into the East Bay as well. As part of educating people and being able to have these discussions and engaging people, we've required now a mandatory training for everybody so that we have a foundational knowledge base upon which to build. We also now have mandatory utilization of equity advisors who are really working to assure best practices around the ways in which we search for faculty and the ways in which we search for staff leaders. We've increased the dollars spent in minority and women-owned communities, small, small, and we have a lot of space and work to do there. Dr. Listerra talked about mental health and, you know, our Black residents actually came to us and said, you know, we're suffering here. We're at the front line. We are seeing disproportionately people of color coming in and this COVID, you know, and COVID and then all the racial injustice. We need something that's special and for us and so we've supported getting counselors specifically for them in ways in which they can come together and really help to support one another and to promote their own healing, recognizing that I think it was interesting just to get our institution to understand the impact of racial trauma creates post-traumatic, you know, episodes and so often we're in these situations where people want our Black students and faculty and staff to tell their story. Well, no, they don't need to relive their trauma for your benefit, like it's traumatic in doing that. So we're a learning organization around this, but we're happy to continue to support Black Healing Days, happy to support the Black Health Initiative, this work that Brittany is doing so brilliantly along with Dr. John and the Latinx Center of Excellence as well. And then we're an educational institution who really wants to start to look at how is race used in medicine? We held a symposium to sort of deconstruct the fact that, you know, why do we look at kidney function based on race and where does that come from? Pulmonary function tests based on race, where does that come from? So we're challenging some of this and really trying to lead the nation to think differently. And then we do annually our health disparities research symposium to highlight the work that's being done that's often undervalued and underlooked at UCSF as we look for solution based work. But disproportionately there are more African-American and by other people of color doing this kind of research and we want to elevate them and their roles and their contributions. And we also support and advance our Black Women's Health and Livelihood Initiative, happy to do that. So when we talk about next steps and what it is that, you know, we're trying to accomplish at UCSF is that we actually want to be more trustworthy. You know, we can't just say trust us, you know, we're this institution on the hill. We actually need to demonstrate how we're trustworthy. How are we engaging honestly, authentically with the community? How are we being responsive to the needs of the community? Right? I was going to say early on when after the desegregation of hospitals in the 1960s, our chancellor came out, Phil Lee, he had done that work at the Health and Human Resources and then became the UCSF Chancellor. And UCSF in 1968 was known as the Plantation on the Hill. And it was the advocacy and the work of the Black staff who formed the Black Caucus and went on strike that really started to lead the history of advocacy at UCSF to make change. And Malcolm showed a plaque, which is a memorable piece of art that is over our elevators that talks about it tells a story actually of the Black Caucus and how they tried to lead us to be better and they continue to be a strong group and partner with me at UCSF. But what we asked for the community to do is to hold us accountable. Demand Black and culturally humble providers. Why can't I find a Black primary care male doctor? You know, who's our learners are the Black folks having opportunities to be a part of our class? Who's leading the organization? Is it diverse? What kinds of opportunities are there for careers at UCSF? Real careers with good benefits and opportunities to advance? And then how are you doing clinical research that is what we need in our communities, right? Not what you need based on your gut funding, but come and identify what our needs are and then help to propel that along. And we also ask you can invite us out, invite our faculty, our staff, and our learners to engage with you and your community groups. This is the Office of Diversity and Outreach. We have arguably the most diverse when I look at my colleagues in the cabinet. We're just now looking at the diversity of who our leaders select to be their first line folks. And we blow obviously everybody else away at UCSF, but we don't want to be the only one and we're looking at how people can be accountable as leaders for the decisions they make and who they hire. But from all of us at the Office of Diversity and Outreach, thank you. And I thank you for this opportunity. If you want to communicate with us directly, you can email us at diversityoutreach.ucsf.edu or check out our website. You can join our listserv. We have a lot of engagement. We're in the San Francisco Unified School District. We're at the Boys and Girls Club. We're running a lot of afterschool programs so you can get engaged in any number of ways. And we're now partnering for new opportunities for jobs, et cetera, at UCSF. So thank you for this opportunity. And I look forward to the discussion. Yes, that was amazing. Dr. Navarro, thank you so much for coming and speaking on behalf of UCSF and just recognizing the history and just acknowledging and giving us a plan of how to move forward. And you all saw firsthand like what community accountability should look like and how we are to hold UCSF accountable. Just hearing what everybody has been saying, just a lot of great information. We now see where the neighborhoods are that need more engagement and need more programming and care. We know that the programs that we put out should incorporate some sort of trauma-informed information. We have to understand that violence is a public health issue. And so when we're creating interventions and programs, we have to be intentional about what we do and incorporate to address community violence in what we do. There's a need for more therapists and more mental health providers, especially African-American providers. We want to incorporate more healing, self-love, self-esteem building in what we do and knowing that as community members that we are worthy of quality care and that we have to demand it and that we are worthy of safe, healthy spaces for African-Americans and that this is something that we have to demand for ourselves. When we're developing programs, we also have to include these frontline workers that are working in the community in regards to violence that are standing in the line and standing in the trenches with violence because not too many people can do that. You have to be a special kind of people to walk that road with community violence. And so anyone that's working in that type of realm should always be included in program planning and program design. Diversifying healthcare, supporting and collaborating with pipeline programs. Dr. Navarro spoke about the workforce pipeline program that they're doing. I can't think of the name, but I know it's with Michael Jones. I'm so sorry if he's on this call. I'm so sorry I cannot. Dr. Navarro. The Excel, the Excel program. Not the Excel, the other one. He's gonna get me. I'm so sorry. But we want to collaborate with programs like this to, you know, the Excel program is a good program, but we also want to become phlebotomists. You know, we want to become doctors. We want to become clinical researchers. You know, we want to be the face. You know, all of this is to change what the face of community healthcare looks like and how we engage our communities moving forward. So I know we're at time. It's like 1130 and we haven't even got to the questions yet. And so this is what I'm going to ask my panelists. We're going to ask one question and, you know, the member, people that participated today, I really wanted you all to walk away with one goal from each panelist. One goal that's going to help us collectively move forward, you know, as the individual or even as a community. And so as we close out, you know, the main question is, you know, what does moving forward look like to you? And so I want to ask all the panelists this question, you know, what does the, what does it, what does it look like moving our black communities forward towards healthier living? And then as you talk about it, and if you close out, if you could just give that goal, I'm going to write the goals down. And then as we, as I keep talking about this follow-up email, I'm going to be sending everyone, but I'm going to send these goals in a follow-up email. And I know for 2022, the goals that we come up with today are, that's going to be my content. That's going to be my mission for the year. I'm going to make it my business to ensure that in everything that I do that I incorporate these goals that I'm intentional with what it is that I do. And I just hope that everyone on this line will be intentional in the work that they do too, as well. So we will go ahead and I'm just going to, if you want to just call out, if whoever wants to start talking, I just ask that you answer the question, what does moving forward look like to you and the goals with what you want to leave the community? I'll start, we'll go back to the same word. Moving forward to me looks a lot like what happened during the last two years of this pandemic. And that was community coming together, speaking with one voice, lots of groups, but one voice many times asking for concrete resources that they needed. So that kind of collective effort really is, I think, the only way we can have equity, like there isn't anybody who can deliver to you what you need without you. So there is no way to do that. And anybody who thinks they are really isn't doing it. So having that collective voice, I think, is really going to be the thing that makes all of these changes equitable and not just somebody's best effort. So my goal would be twofold. One, I would love for anybody who feels moved to or has time, which I think is many, many people more than they think, add your voice to the collective when it comes up to have an event like this and you can put your little thoughts into the chat or any time that there is some way for you to add your needs to the call for resources, do it so that we can really be representing the whole community. Every leader that ever talks for the community really would love to be representing everybody's needs, but they can't do that unless people tell them like nobody's going door to door all over the hill. So add your voice, even if it's once in the next year you participated, find something that will let you add your voice. And then the other is we really do have to do again what we did during COVID which is take care of each other in an immediate way. People looked after their neighbors, we got services right in front of people's churches, so making sure that you and your neighbor get what you need, not just some collective, but just right now what you need is going to be really important because a lot of people didn't take care of their high blood pressure and not just because they chose to defer. It was dang hard to get your services during some parts of COVID, really hard. It's hard now. 30% of the staff is homesick. It's hard now, so it is not even with your best effort unless you did something heroic, there's a decent chance you didn't get what you needed. You need to get it now. Don't wait any longer as soon as it's possible, do it and make sure that you're neighboring your grandma and whoever else get what they need to because we're going to have to help each other. People need more than their usual. That's it for me. So I'll go next Ayanna touched on all the major points there. I think for me it's also about envisioning a healthy community where we all have our sort of fair and just opportunity to reach our real fullest potential. That includes physical, mental, spiritual, emotional, educational, and financial. I think it brings me to really bridge across those social determinants. It brings me to the point that I did want to mention earlier, which is a community working forward needs to do the things Ayanna says. That also includes not othering healthcare as separate from our political needs and economic needs, which are critically and essential and foundational to health. But we need to keep it all connected and avoid the appropriate avoidance that we develop for the reasons Dr. Navarra mentioned. Healthcare has led us down in so many different ways. I think as a community many of us have adopted or adapted through avoiding healthcare, health systems, and de facto their health. This has also led some of the health issues. I don't want to say that because it's important that, as Ayanna mentioned, we're often accused of being the source of our own problems. This is an appropriate adoption. It is protective. That gets us to a certain point. Now we're looking forward to move beyond that point. I think that the adoption has led to some behaviors like health stigma, whether it's COVID, HIV, mental health, colonoscopy. A lot of men, I don't want that thing up my butt, or the C word, cancer. In my own family, how many people I find out later, they had cancer. With COVID, how many people aren't sharing or testifying about what they're experiencing? I think that to me is an essential part of moving forward to add to what Ayanna said. My recommendations would be for community health organizations to help be a trusted resource, health resource for the community. Be that trusted partner or linkage to be a resource or a venue where voices can be shared, as Ayanna said. To volunteer, to partner with academic centers, public organizations, DPH, to continue what has been accomplished during COVID, these collaboratives and collectives, and for us to be innovative in moving forward. I would say as an aside, but not really an aside, an important point is to also promote and engage in trauma-informed care. I think, and really instructing our community on trauma-informed care and seeking that in their providers. And then on the individual front, I will just say one, find your trusted health messenger. It can be a health organization like UCSF, it can be a community-based organization, it can be a community health advocate, but that is really critical. And as I said before, share or testify if and when it feels comfortable, even if it's in a small way. Thank you. Shout out to Uzuri who shared and testified in the chat. I've heard her before. It makes a huge difference. And silence, that's when we don't get the care, the support, the love, the direction to where the best resources, suffering alone is not the way to go. So please share. And lastly, join BHI's mailing list if you need additional information or you don't know where to turn to. Brittany is a well of resources as am I and others, but I think Brittany is the star at BHI. And so we really want, if you have any questions on how to work with UC, check us out and we'll point you in the right direction. So I'll stop. Thank you. I think I'm next. There's so much that I could piggyback on, but I'll keep mine brief. I think for us as Black folks, folks who are living in Black bodies, your self-awareness is key. So take care of yourself. And that is going to be critical for us to continue caring for our communities and to make real a lot of the things that we're talking about right now. If we're not well, our communities are not well. And we have to think about wellness more than the way that it's being defined right now. I think the other thing is addressing trauma. We talk about being trauma-informed, but we are experiencing constant and perpetual trauma in all aspects of our lives. So let's be realistic about that. Let's be compassionate with ourselves and with each other and let's remind these systems and other things that we have to interface with that they also inflict traumatic experiences on us and use our voices and be involved in shifting that so that we can actually heal and get what we need. And then I think the last thing is just stay a part of the conversation. Nothing changes if we're not central to the conversation. So as hard as it may be, as fatigued as we might be, it's still important, it's critical that we be here and that we stay working together on putting things in place that we need for our community. No one else is coming to save us. Nobody else can design what we need for us. No one else is going to give us equity. We have to make that happen. We have to push to make that happen. Man, I'm saying thank you to me. Just a word for healing centered versus trauma-informed. Let's start to shift into something on the healing. No, this isn't for you Malcolm. This is for all of us. We've been trained trauma, trauma, trauma, trauma, trauma, but we're all freaking traumatized, right? So where's the healing center? So where's our joy? Where's our opportunity to laugh and smile and be happy and have fun together? I'm always so serious and I look at my Black Wall Street sisters especially and they have fun. I'm always looking at it like, wow, I'm so jealous. I want to have fun too, but I'm so tired. And so I've got to figure out for me and for all of us, we have to figure out how to put more balance in our lives so that we cannot be so tired to have fun. There should never be too tired to have fun. That's a shame, too tired to live our life. And so I want to just say a senior person in San Francisco City and County government said to us, which is why we created San Francisco Black Lead Organization Coalition to begin with. So I want to shout out my sister Joy Jackson, Morgan, Majid Crawford, Gigi Brown and say two things. They said to us, we didn't worry about Black people because you didn't make us. And so this is why we're also freaking exhausted is because we have to show up, make people listen and know and care. And that is exhausting. So for other allies, you've got to stop exhausting us. Pay attention to your parts. Get up. It's Black History Month. You celebrate us. I'm asking a Black person to come for free to celebrate to tell you about us. Like, how are you going to support us? Like, where's our, you know, where's my $25 and my Grubhub account? Where's my massage? Where's my, you know, whatever, right? How are you all taking care of all of us? Because we have been, we have left it on the field. We leave it at 150% every day, 365 days of the year that Black tax is serious. So I would just want to say we have to, we have to have more fun. We have to make them listen to us. So how are we going to make them listen to us? That means everybody has to show up. That means Black folks have to show up and that means that we have to do our self-care. So I want to invite you to 28 days of the Black Wellness Movement. And as my good friend and colleague said, Glenn Brown says Black is plural. So that means everybody is invited. So in a Black community, everybody is there. So we want to invite everybody to join the Black Wellness Movement, take care of yourselves, write in your journal, you know, do your breathing, you know, go out and be healed in nature, you know, whatever you can do, take, you know, a walk. But these are things that we're so exhausted that we have to be able to actually deeply rest. And the only way we can deeply rest is that if others stand up and we stop being the only ones, you know, I can't even imagine what these folks, Dr. Navarro, Dr. Bennett, Dr. Malcolm John, Tanisha Hollins have gone through and in the white stream systems that they are in because I have paid those taxes and I'm now in a Black agency. And yes, we deal with all these folks every day in the white stream world, but we're a Black agency. We get to come to work with other Black folks and know every day what we've gone through. And we don't have to explain it. But for all y'all in the systems, you know, I can only imagine. So I just want to say thank you, thank you, thank you to you all for fighting that fight. And I will continue to do my part to join you. But today, we're going to celebrate and enjoy Black History Month and have some good times. And I want to just say thank you to you all. I mean, so much has been said. I'll say just a few things. First, Dr. Lazar, thank you. Thank you for your words, your wisdom, for your leadership at UCSF, you're helping us to be a better institution. We're committed to trying to become a trustworthy institution. And that is what we are moving forward to do. But this work obviously requires a collective impact. We need to all be working together to, I mean, the forces are so strong that without our collective impact, we're not going to have the kinds of sustained changes that are going to be necessary really to get us where we need to be. Get your care. When you get your care, demand, you know, demand that they take care of you. Where are the providers who understand you? Like, let your needs be known so that we can do better as healthcare systems. And then finally, I would say just have grace with yourself, recognizing what the last couple of years have been like on top of everything else that you carry, this constant burden of being Black in America. You know, you have grace with yourself and have grace with those that are around you. Because a lot of times we talk about self-care, but when we're most needy, we don't recognize that we need care. So we got to care for each other. And I agree we have to have joy and we have to celebrate our resilience. My tagline is despite. Despite everything else that I've gone, I'm still here. I'm still standing and I have joy. So with that, thank you. Thank you, Brittany, for this opportunity and to all my panelists, this has been fantastic. Thank you. Yes, thank you so much. You all were absolutely amazing. I learned a lot. I know our community learned a lot. And I'm hoping that this is something that we can do every year to kick off Black History Month just to talk about the lessons learned from the year before and giving our community and individuals goals for each year so that we can collectively work together to move forward. I just thank you all again for taking the time out and for working with me and making slides and, you know, just really putting thought and intention for our community. And I'm just really, really excited with, you know, what's to come for 2022? You know, we are leveling up our communities in 2022. I saw what we could do just in our own right for our community, for ourselves, what we were able to, you know, create out of the out of the dirt for ourselves, you know, over the last two years. And so I am just, you know, greatly inspired by everyone on this panel, many people that are participated today. And I'm just looking forward to the collaborations. I'm looking forward to the growth, the strength, the love, the prosperity that we're going to receive this year. And I'm just very, very grateful. If you all look in the chats, you'll see everybody's like social media links, you know, websites, emails, please tap into all of us, tap into us, you know, email us, reach out to us, come volunteer with us, ask us questions, you know, fund us, all the wonderful things, all the wonderful things. And, you know, just thank you again for joining us. And we wish you all a wonderful day. Thank you so much. Thank you all so much. That was amazing panel and so much information. And all of the folks came out. So it was a great panel, great attendance. And I know it was a lot of information. So definitely pick up that link. I will send a follow up email so we can all have these resources. Thank you all. You're all brilliant and shared such amazing, amazing resources. Friends, library community, we love you. Have a good day and come see us again. Thanks, Anissa. Thanks, Brittany. Thanks to you all. Thanks, y'all. Thanks, y'all. Beautiful people. Bye, everybody.