How Could Medical Racism Fuel Soaring Black Youth Suicide Rate? Answers and Solutions

Black children ages 5 to 12 are twice as likely to die by suicide as their white counterparts, and the rate of suicides among Black teens is rising faster than any other racial/ethnic group.

Those statistics are alarming to most people, but they’re not surprising to Yale Child Study Center (YCSC) Chief Resident and Child Psychiatry Fellow Dr. Amanda J. Calhoun.

“Experiences of anti-Black racism affect kids before they are even born,” says Dr. Calhoun.

The stress of anti-Black racism on Black mothers, including experiencing inferior care by health care providers, has been linked to low birthweight babies, putting Black infants at greater risk for developing depression and other mental health disorders.

In addition, racist beliefs start to become ingrained in children as young as four years old, which means that Black children start to experience racism from their peers and teachers as early as preschool.

“It’s not the school-to-prison pipeline. It’s the preschool-to-prison pipeline,” says Calhoun. Black children are more likely to be suspended from or arrested in school than their peers.

When they seek help, Black children are the most likely to be physically restrained in emergency departments. And they are more likely to be diagnosed with disruptive mood disorders than white children with comparable symptomatology.

“You have people who are traumatized, who are being traumatized, by people who are supposed to help them,” says Dr. Tichianaa Armah, Chief Psychiatry Officer and Vice President of Behavioral Health at Community Health Center, Inc.

“Of course, they are going to have poor mental health outcomes,” says Dr. Calhoun.

Dr. Armah and Dr. Calhoun tell “Conversations on Health Care” hosts Mark Masselli and Margaret Flinter that they have seen the effects of this early trauma up close in their work and are exploring what measures can be taken to protect young Black lives.

Dr. Calhoun is leading a Black Youth Mental Health Clinical Case Conference Series at Yale University where experts will weigh in on complex clinical cases involving Black youth presented by YCSC trainees, please learn more here: https://medicine.yale.edu/news-article/black-youth-mental-health-series-yale/

But she is doing things a bit differently. “In a typical case conference, we talk about the problematic behavior of patients,” says Dr. Calhoun. None that she has seen have asked “What if one of the primary causes that has led to the lapses in care of this Black child is the medical racism of the team?” 

Can Health Care Policy Take a Page from Recent Bipartisan Efforts?

In the wake of recent bipartisan policy wins in Washington, can health care policy follow suit?

Dr. Anand Parekh, chief medical advisor at the Bipartisan Policy Center (BPC), spoke with hosts Mark Masselli and Margaret Flinter about how the best solutions emerge from a solid understanding of the issues and the eventual give-and-take of political opponents.

For example, The Milbank Memorial Fund’s 2024 Scorecard Report of The Health of U.S. Primary Care declared that the state of “primary care is in crisis.” The report made clear the systemic lack of support for primary care is harming people’s health and weakening the U.S. health system.

Dr. Parekh agrees the issue is dire. “As a primary care physician…this is the most important health care issue in America,” he says. “A strong primary care system needs to be the foundation of our health care system. So much of what is ailing us is because we haven’t put in the resources into our primary care system infrastructure.”

How can a bipartisan approach help?

Dr. Parekh points to the recent effort by the BPC to relaunch the Congressional House Primary Care Caucus, which had been dormant for years. They began by identifying bipartisan co-chairs to lead the caucus (two Democrats and two Republicans) who will be educating members about the importance of primary care before they begin to discuss policy solutions.

Dr. Parekh’s interview this week on “Conversations on Health Care” highlights how ensuring that both parties are working together from the beginning on an issue lays the foundation for mutual understanding and agreement down the line.

An Environmental Psychiatrist Explains Climate Anxiety As We Celebrate Earth Day

As we mark Earth Day, we have just experienced the hottest March on record. But climate change’s impact isn’t stopping with the weather; it’s also affecting our mental health, says Dr. Gary Belkin, director of the Billion Minds Project at Columbia University’s Mailman School of Public Health.

Climate anxiety, which refers to having distressing feelings related to climate change impacts, is increasingly prevalent in communities where the impact is the most severe.

And the problem is only getting worse.

Dr. Belkin says it is important to ask, “What happens when there is mass hopelessness?” From individuals to politicians to society as a whole, feelings of hopelessness can hamper people’s ability to problem solve and result in people giving up and retreating from the issue.

A solution? Start small in communities, Dr. Belkin says.

He’s putting this idea into practice through his work as chair of COP², an organization that curates coalitions of experts, advocates, care providers, decision-makers and funders to support projects that are co-created with local communities living on the front lines of the climate crisis.

“What I think is really exciting,” he tells hosts Mark Masselli and Margaret Flinter, “is that the climate pressures have generated some powerful forms of local organizing and intersecting actions.”

Why NIH’s Dr. Collins Accompanies Opera’s Renee Fleming in Highlighting Music & Mind’s Power

What happens when music therapists and neuroscientists team up? Patients win, says Dr. Francis Collins. From adults with Parkinson’s disease to children with autism, music has the power to help people walk, talk, ease pain and so much more.

Dr. Collins recently stepped down from his role as the longest-serving director of National Institutes of Health. As he faces a personal battle against prostate cancer, he’s exploring the promising impact that music and art therapy could hold for patients with health challenges.

Dr. Collins is hoping to develop a deeper understanding of music’s influence on brain circuitry. The goal? To help patients ease the symptoms of conditions like chronic pain, post-traumatic stress disorder and dementia.

His interview with hosts Mark Masselli and Margaret Flinter is a follow-up to a conversation with opera singer Renée Fleming about her new book “Music and Mind: Harnessing the Arts for Health and Wellness,” for which Dr. Collins wrote the foreword.

Opera Superstar Renée Fleming & Experts Reveal How Music Can Make Us Healthier in New Book

She’s received worldwide praise for singing at the Super Bowl, during a presidential inauguration and regularly for The Metropolitan Opera, but Renée Fleming is stretching her voice in new ways. She’s the editor of “Music and Mind,” a curated collection of essays from leading scientists, artists, creative arts therapists, educators and health care providers about the powerful impacts of music and the arts on health and the human experience.

Renée shares how she discovered her own music and mind connection early in her career when she had back pain and how a dinner with three Supreme Court justices led her to become an unexpected advocate for neuroscience.

Renée, a five-time Grammy award winner, also explains to hosts Mark Masselli and Margaret Flinter what happened when she saw the results of a functional MRI experiment she took and what it means for all of us.

This special edition of “Conversations on Health Care” will continue on April 18 with guest Dr. Francis Collins, the former National Institutes of Health director, who’s written the foreword to Renée’s book.

Reporters' Roundtable: Why Health Care Will Impact the Election—But To Whose Advantage?

It’s about seven months to election day and our regular panel of health care journalists sees a lot of divisions in the electorate. Joyce Frieden, who’s in charge of MedPage Today's coverage of Washington and health policy, says the debate over abortion is driving voter interest. Yet Ben Leonard, a health care reporter at POLITICO, notes that Republican voters place issues such as immigration ahead of health care.

Meanwhile, Nathaniel Weixel, a health policy reporter for The Hill, says the health care sector should consider itself a winner for avoiding the chopping block during the recent federal budget showdown. This trio of journalists joins hosts Mark Masselli and Margaret Flinter to share their insights about their news stories including Washington’s take on artificial intelligence in health care and efforts to get federal dollars for the new obesity drugs.

Expanded Coverage of Weight Loss Drugs? Diabetes Advocates Say Yes

Medicare just announced that it will pay for weight loss drugs if patients using them also have heart disease and need to reduce the risk of future heart attacks and strokes. Medicare has already been covering the costs of the GLP-1 class of drugs to treat diabetes problems. However, Medicare Part D plans are still restricted by law from covering obesity medications used for chronic weight management alone.

It’s a decision the American Diabetes Association would like to see overturned. “It really is important that we try to get upstream of diseases…we know that obesity is a disease and it’s a bigger driver to the increasing number of people developing diabetes…it’s important that people have access to treatments that are effective. Medicare isn’t covering that [obesity] treatment and that’s something we’ve been advocating for,” says Dr. Robert Gabbay, chief scientific and medical officer for the American Diabetes Association

Dr. Gabbay also tells hosts Mark Masselli and Margaret Flinter that anybody with diabetes on insulin should have access to a continuous glucose monitor and the ADA is proud that it helped secured Medicare coverage for such monitors.

Young Deaths from Colorectal Cancer Skyrocket as New Research Emerges

The recent death of former college football player Craig Roh from colon cancer at age 33 has brought attention to the “alarming” increase of colorectal cancer in young people. The American Cancer Society reports colon cancer is now the most common cause of cancer deaths in men under 50 and second for women under 50.

Dr. Alan Venook at the University of California-San Francisco is one of the nation’s leading colorectal cancer researchers. March is Colorectal Cancer Awareness Month and Dr. Venook explains to “Conversations on Health Care” hosts Mark Masselli and Margaret Flinter how to stem the rise in cases among young people.

Dr. Venook also talks about his research that found there’s no compromise in colorectal cancer patient survival or the risk of recurrent cancer over time with less radiation—a finding that goes against conventional wisdom.

Super Sperm Donors - America’s Underground Surrogacy Movement: Author Explains Her Journey

The family planning revolution has a new chapter and journalist Valerie Bauman is both documenting it and participating in it. She and others pursuing alternatives say they’re frustrated with fertility clinics because of the cost, what they call the discriminatory nature of the system and the lack of insurance coverage. Bauman explains how she met her sperm donor and why others like her say it makes sense for them.

Hosts Mark Masselli and Margaret Flinter interview Bauman about her upcoming book “Inconceivable: Super Sperm Donors, Off-the-Grid Insemination, and Unconventional Family Planning.”

IVF Fallout: Top Biden Health Official Sees Dangers Beyond Reproductive Rights

Originally broadcast on March 4, 2024

Even as Alabama scrambles to enact a law protecting in vitro fertilization in the state, the Biden-Harris Administration sees additional challenges that legislation may not be able to quickly fix. Carole Johnson leads the Health Resources and Services Administration, the part of the U.S. Health and Human Services Department tasked with strengthening the health workforce and connecting skilled professionals to rural, urban and tribal underserved communities.

Johnson explains that some health care providers were already reluctant to work in states with restrictive reproductive legislation and the Alabama situation presents a new challenge.

In rejecting Alabama’s Supreme Court decision she says, “It should not be the case that young women in this generation have less rights than I did growing up and we need to change that. We will continue to lean in as an administration supporting women.”

Nurses Ask: Where is the respect?

Americans say nursing is the most respected profession, but nurses say their challenges tell a different story. They’re sounding the alarm on staffing shortages, violence in the workplace and racism (63% of nurses say they have personally experienced an act of racism in the workplace).

The American Nurses Association is also fighting an American Medical Association policy recommending advanced practice registered nurses be licensed and regulated by both state medical and nursing boards.

Our guest to tackle these issues is the president of the American Nurses Association, Jennifer Mensik Kennedy, Ph.D., MBA, MBA, RN, NEA-BC, FAAN. Join hosts Mark Masselli and Margaret Flinter for this important conversation.

Better Primary Care: What Will It Take to Get the U.S. to Wake Up to the Need?

U.S. spending on primary care fell again, to a mere 4.6% of total health care dollars spent. Primary Care Collaborative is the only national multi-stakeholder organization focused on whole-person primary care.

Primary Care Collaborative President & CEO Ann Greiner joins hosts Mark Masselli and Margaret Flinter to discuss better compensation and reimbursement for primary care clinicians and efforts to increase training, expanding access to community health centers, and opportunities for primary care to help as the country faces a mental health crisis.

What will it take to get the United States to wake up to the need for better primary care? Tune into this week’s conversation to learn more.

Damning Research Reveals Extent of Pediatrics Care Gap: Children of Color Receive Worse Treatment

Across the board, children of color in America receive less treatment and fewer life-saving interventions than white children, according to a research review published in Lancet Child and Adolescent Health. The data find that strongest disparities between whites and children of color involved pain management; kids of color are less likely than their white peers to get painkillers for a broken arm or leg, for appendicitis or for migraines.

Dr. Nia Heard-Garris, pediatrician and researcher at the Feinberg School of Medicine at Northwestern University, helped lead the project. She explains that the research also shows white children are sometimes overtreated, which is also not good for their health. Join hosts Mark Masselli and Margaret Flinter as they examine the findings and look for policy solutions.

Mental Health’s AI Revolution: What It Means for Patients & Providers

How is the long-held image of a psychiatrist with a couch in an office being replaced by artificial intelligence? And what are the promises and perils of using technology to help treat depression and anxiety? Dr. Jodi Halpern is a psychiatrist, noted author and co-founder of the University of California’s Berkeley Group for Ethics and Regulation of Innovative Technologies.

Research shows that 26% of adult Americans have a diagnosable mental health situation each year, and private industry is rushing to provide AI and bots to help patients navigate these issues. However, Dr. Halpern explains the ethical problems that are arising from the marketing of these services. Join us for this insightful “Conversations on Health Care” with hosts Mark Masselli and Margaret Flinter.

A Roadmap to Improve Health Outcomes By Investing In Green and Healthy Homes

There are many ways to address the social determinants of health but do we need to pay more attention to the one right in front of us? The Green and Healthy Homes Initiative thinks so, and it’s focused on addressing health inequities by making homes healthier, safer and more energy efficient.

Helping Community Health Workers Succeed: Ideas From an Innovative Program

Experts praise community health workers as the keys to building a more equitable and fair health care system in America. Is there a way to unlock more success for hiring and retaining them?

Dr. Shreya Kangovi thinks so; she developed the IMPaCT Care program, which is saving money and quickly growing. “Conversations on Health Care” hosts Mark Masselli and Margaret Flinter talked to her about how it’s a standardized, scalable program that transforms the effectiveness of the community health workforce by reimagining each step.

She Helped Design Pres. Biden’s AI Bill of Rights—How Does It Protect Patients?

Less than three months ago, Alondra Nelson, Ph.D., proudly watched as President Biden unveiled the administration’s blueprint for an artificial intelligence bill of rights, which is focused on ensuring safe, secure and trustworthy technology. Nelson had a big role in developing the strategy as she served as deputy assistant to the president and acting director of the White House Office of Science and Technology Policy. Since then, major health care companies have agreed to work toward solutions that advance health equity, expand access to care, make care affordable and other commitments.

But there’s anxiety about clinical algorithms showing racial bias and privacy worries. Nelson joins hosts Mark Masselli and Margaret Flinter to explain how the health care sector, including its employees, can benefit if AI is thoughtfully deployed.

(Alondra Nelson Photo/Dan Komoda)

Are You Up to Date on Health Care Policy & Innovation as 2024 Kicks Off? We Can Help.

A new year brings hope for breakthroughs for our most complex health care issues. The leading thinkers have been sharing their perspectives with us. We’ve captured the highlights from our recent interviews covering vaccinations, abortion, mental health and all the top stories. Plus, we have important updates for 2024. Click below to join hosts Mark Masselli and Margaret Flinter for “Conversations on Health Care.”

Long COVID: 2023’s Enduring Medical Mystery

The diagnosis and treatment of Long COVID made many advancements in the past 12 months and “Conversations on Health Care” covered all of them. We’ve collected the most important insights from leading researchers and clinicians as this medical mystery continues. Join hosts Mark Masselli and Margaret Flinter as they highlight the perspectives of guests ranging from NIH researchers and patients, to the leader of the Mayo Clinic’s COVID Activity Rehabilitation Program.

Any Hope to Avoid Govt. Shutdown in ’24? Health Care Reporters Assess the Chances

The advice from one of Washington’s health care policy reporters is to rest up and enjoy the holidays because 2024 is going to be a very intense time. The top items on the agenda include a federal fight over the budget (including health care) that could lead to a government shutdown at the beginning of the year, a presidential campaign that will place health issues at the forefront, continuing concerns about AI and health, and a Supreme Court decision expected by June on medication abortion.

Hosts Mark Masselli and Margaret Flinter get the health care policy prognosis for 2024 from: Joyce Frieden, who oversees MedPage Today's coverage of Washington and health policy; Caitlin Owens, a senior policy reporter for Axios; and Nathaniel Weixel. a health policy reporter for The Hill.