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?” 

Black Women Taking Steps to Health: Funder & Nonprofit Explain How

Join us for a unique conversation with an innovative nonprofit leader and the grantmaker who’s helping support her efforts. Morgan Dixon is the co-founder and CEO of GirlTREK, which she calls a “life-saving sisterhood.” Their campaign seeks to heal intergenerational trauma, fight systemic racism, and transform Black lives by organizing women walking teams. While participants walk, they also mobilize community members to support advocacy efforts and lead a Civil Rights-inspired health movement.

Sharing Best Practices: Lessons from Community Health Centers Coast to Coast

This week we’ve brought together some of the brightest minds who run many of the best and most innovative community health centers across the country. From Long Island to San Francisco, community health centers served over 31 million patients last year. How are they keeping pace with their success while always working to improve the quality of the care?

The guests are part of the Community Health Best Practices network and serve as CEOs of their nonprofits:

--Gloria Amador from Salud Integral en la Montaña in Puerto Rico;

--Eddie Chan with North East Medical Services in San Francisco;

--Nieves Gomez with Columbia Basin Health Association in Connell, Washington;

--Ann Kauffman Nolon with Sun River Health in New York City, Long Island and the Hudson Valley; and

--Greg Wilmot with East Boston Neighborhood Health Center.

“Conversations on Health Care” co-hosts Mark Masselli and Margaret Flinter explore how they navigated the COVID pandemic, deal with employee engagement and tackle funding challenges.

Meet America's Hidden Health Heroes

You know about the Army and Navy, but have you heard about the USPHS Commissioned Corps?

It is one of the nation’s uniformed services — a branch committed to the service of health. Its over 6,000 officers advance the nation’s public health, serving in agencies across the government, as physicians, nurses, dentists, veterinarians, scientists, engineers and other professionals.

President of the Public Health Service Commissioned Officers Foundation Gene Migliaccio spoke to “Conversations on Health Care” hosts Mark Masselli and Margaret Flinter about the role the Corps played in combatting the pandemic.

The fight against COVID-19 was the largest deployment in the 223-year history of the United States Public Health Service Commissioned Corps. At the beginning of the pandemic, “I think what we did right was the mobilization,” Migliaccio said.

“When Covid hit, we didn’t have testing centers. It started slowly, and then all of the sudden there were hundreds of them. It took a tremendous amount of effort and some of the best and brightest minds within the Department of Health and Human Services” to accomplish that, he said.

The Public Health Service Commissioned Officers Foundation is part of a new documentary titled “Invisible Corps,” narrated by the actress Ali McGraw. The piece is trying to raise awareness about the Corps and also how public health has become politicized.

Nurses & Moms Partnering for Health Success: How Babies Benefit

What if we say there’s a way to have healthier pregnancies, improve children’s health and create better economic outcomes? And it all begins with a knock on the door? That’s the way Nurse-Family Partnership works. It’s an evidence-based, community health program with 45 years of research showing significant improvements in the health and lives of first-time moms and their children affected by social and economic inequality.

The initiative succeeds by having specially educated nurses regularly visit first-time moms, starting early in the pregnancy and continuing until the child’s second birthday. Research consistently proves that the partnership between a nurse and the mom is a winning combination that makes a measurable, long-term difference for the whole family.

Nurse-Family Partnership’s Sharon Sprinkle, co-director of nursing practice, and Jenny Harper, government affairs director, join hosts Mark Masselli and Margaret Flinter to discuss its founding, funding and how expectant moms sign up.

America’s Record-High Deaths by Suicide: APA Pres. Outlines Prevention Steps

More than 50,000 Americans died by suicide in 2023, the highest number on record. Data from 2021 found that over 12 million American adults thought about suicide and 1.7 million attempted it.

American Psychiatric Association President Dr. Petros Levounis, who’s finishing his term, is at the center of efforts to prevent suicides. His focus continues to be on substance use addictions. He and the 38,000 APA members have launched a campaign called “Confronting Addiction: From Prevention to Recovery.”

Dr. Levounis also talked about vaping, opioids, alcohol and the rapidly growing addiction to tech.

Join hosts Mark Masselli and Margaret Flinter for this encore presentation of the interview with Dr. Levounis.

The Urgent Need to Rethink Suicide: Lessons for Veterans & All Americans

Is the way we're going about suicide prevention all wrong? And how are those misperceptions affecting efforts to stop veteran suicides? Clinical psychologist Craig Bryan is an Iraq War veteran and studies the issue.

He's the author of “Rethinking Suicide: Why Prevention Fails, and How We Can Do Better” and says we need a better focus on firearm safety. In 2021, 72% of veteran suicides involved firearms.

The veteran suicide rate is currently 1.5 times the rate of the general population and the U.S. Department of Veterans Affairs says its top clinical priority is preventing suicide among all those who have served.

Dr. Fauci Talks About His New Book: 7 Presidents & the Challenges of COVID, AIDS

Five times during the COVID pandemic Dr. Anthony Fauci took time out of his incredibly busy schedule to share with “Conservations on Health Care” his latest insights. Now, he returns to reflect not only on COVID but also on the entire scope of his career, including his efforts to bring attention and resources to the AIDS fight in the 1980s.

Dr. Fauci explains he had to speak truth to power during the pandemic in order “to preserve…professional integrity and to fulfill my responsibility to the American public.” He continues to focus on sharing “just the facts.” In terms of the current COVID situation, he says the virus persists and “has an uncanny capability of continuing to evolve…there’s a new variant now…that evades some of the protection from vaccines and prior infection.”

Dr. Fauci’s New York Times best-selling autobiography, “On Call: A Doctor's Journey in Public Service,” takes readers through his life from growing up in Brooklyn to advising seven presidents through some of the world’s most harrowing health crises.

Join hosts Mark Masselli and Margaret Flinter for this important conversation with the most renowned and acclaimed physician and public health leader of our era, Dr. Fauci.

2020: Mark and Margaret reflect on the Year COVID-19 Took Over the World

This week, hosts Mark Masselli and Margaret Flinter reflect on 2020 at the end of a year like no other. When the COVID-19 pandemic began to take hold, they welcomed many of the world’s most renowned infectious disease, virology, and epidemiology experts. From Dr. Anthony Fauci to Dr. Ashish Jha, from New York Times writer and “Pandemic” docu-series producer Dr. Sheri Fink, to innovative scientists like Dr. Eric Topol, Dr. Zeke Emanuel, Dr. Michael Osterholm to US Surgeon General Dr. Vivek Murthy, we learned about this emerging pathogen from some of the most gifted people in health care.

What a Year! A Look Back At COVID’s Grip on 2021

This week, Mark and Margaret take a look back at COVID’s hold on 2021, the early promise of vaccines, the relentless march of mutations and the vicious rise of new variants leading to pandemic surges around the world. They revisit conversations with memorable guests from famed virologists and epidemiologists like Paul Offit and Michael Osterholm, to President Biden’s COVID team leaders Rochelle Walensky, Anthony Fauci and Rachel Levine. They revisited guests focused on other health news: Bill McKibben on climate change, and Planned Parenthood President Alexis McGill Johnson on the existential threat to women’s reproductive rights in the U.S. It was also a year to celebrate the dramatic discovery underway in the field of science, with Eric Topol, William Haseltine and NIH Director Francis Collins.

COVID’s 3rd Year: Experts Speak

We’re proud to have again served as a platform for trusted, informed experts during the third year of the pandemic.

This week “Conversations on Health Care” looks back on some of the most insightful comments from doctors and scientists who are on the frontlines of fighting COVID. In addition to NIH’s Dr. Anthony Fauci we had as our guests Dr. Peter Hotez from Baylor College of Medicine, Dr. Zeke Emanuel at the University of Pennsylvania, Dr. Michael Osterholm from the University of Minnesota, Dr. Mary Bassett with the New York City Health Department and others.

Listen in as hosts Mark Masselli and Margaret Flinter capture their insights about these extraordinary medical challenges.

Health Policy Moves in ’22 Set the Stage for New Year

The health care public policy debates that swirled in 2022 will continue to make news in 2023. These issues ranged from the Dobbs abortion decision to the outcome of the midterm elections.

Many of the nation’s leading experts joined “Conversations on Health Care” during the past 12 months to share their perspectives.

Join hosts Mark Masselli and Margaret Flinter as we look back at the year that was in health care policy.

2024 Rewind & Look Ahead for Health Care Issues

Conversations on Health Care hopes the new year is off to a great start for you! But before we completely turn the page on 2024, we want to look back on our top issues and interviews from the past year. We spoke to leading experts about the health care policies that were part of the presidential race; the promise and peril of artificial intelligence; the research into happiness; and many other issues.

As President Trump, a new Congress and other new leaders in the states prepare for office, hosts Mark Masselli and Margaret Flinter present this recap and look ahead to the ideas, innovations and insights driving health care.

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.”

Aaron Smith, co-founder and Executive Director of Young Invincibles

This week, Mark and Margaret speak with Aaron Smith, Co-Founder and Executive Director of Young Invincibles, a non-profit working to give young adults a voice in the political process. Mr. Smith discusses their impact on provisions in the Affordable Care Act affecting the "millennial" population and their national efforts to encourage young adults to participate in the Insurance Exchanges.

Nuance can help health field regain public trust: AcademyHealth CEO

Dr. Aaron Carroll raises eyebrows with statements that highlight contradictory health advice: “‘Eggs are going to kill you because of cholesterol’ — ‘oh, it actually doesn’t matter. Eat as many eggs as you like.’ ‘Red meat will kill you.’ ‘Oh no, read meat can be part of a diet.’ ‘Drink no alcohol’ … ‘Oh, no no. Drinking red wine is perfectly healthy.’”

Dr. Carroll has devoted his career to advocating for scientific and research communities need to improve how they discuss nuance, especially in health. Dr. Carroll, serving as CEO of the AcademyHealth, says “science is portrayed as binary — positive or negative — and that can breed mistrust from the public.”

“The way that we discuss nutrition and food [can] burn people’s belief in science, in that it feels like people are told one or the other,” Dr. Carroll tells “Conversations on Health Care” hosts Mark Masselli and Margaret Flinter.

For most people, ramping up or cutting out consumption of one particular food “can add a tiny bit of risk here or there. But the extremes that we are often sold, one way or the other, about what you should and should not eat are often not really well-supported by science,” he says.

It’s not that new data disproves old research, he says. But both add up to a more complex picture. “When you describe things in absolute terms … it creates a climate where people don’t trust exactly what you’re saying.”

Despite the constantly changing nature of science, nurses and doctors are still consistently held in high trust, Dr. Carroll says. One way to add nuance to public discourse is to use trusted voices to help people understand what questions to ask when they hear new information: Pre-buttal, as opposed to rebuttal, as he puts it. “[That] is much more powerful than trying to change their minds after they’ve heard things that are just not true.”

Adam Dole, Presidential Innovation Fellow

This week, hosts Mark Masselli and Margaret Flinter speak with Adam Dole, recent Presidential Innovation Fellow at the White House and former entrepreneur-in-residence at the Mayo Clinic. Mr. Dole discusses the fertile intersection between public and private entities generating a robust culture in health care industry innovation.

Leading Neuroscientist Dr. Adam Gazzaley Talks Drug-Free Brain Health Treatments Using Virtual Reality and Video Games

This week hosts Mark Masselli and Margaret Flinter speak with renowned neuroscientist Dr. Adam Gazzaley, Director of the Neuroscience Imaging Center and Gazzaley Lab at UC San Francisco. Dr. Gazzaley discusses his closed loop system designed to improve brain function through personalized game design and feedback, which are already undergoing FDA clinical trials for therapeutic interventions for a number of brain disorders including ADHD, aging brain, PTSD and addiction.

Propelling Primary Care Towards Value-Based Care: Adam Boehler, Director of the Center for Medicare and Medicaid Innovation at HHS on Their Bold Agenda

This week hosts Mark Masselli and Margaret Flinter speak with Adam Boehler, Deputy Administrator and Director of the Center for Medicare and Medicaid Innovation at the Centers for Medicare and Medicaid Services at HHS. They discuss ways the agency hopes to "blow up fee for service" and the efforts underway to propel the nation's primary care reimbursement structure towards shared risk and value-based care, rewarding clinicians for better outcomes.

Adriel Bettelheim, Managing Editor at CQ Roll Call

This week, hosts Mark Masselli and Margaret Flinter speak with Adriel Bettelheim, Managing Editor for Health at CQ Roll Call/Economist which boasts the largest press corps on Capitol Hill. Mr. Bettelheim discusses the legislative landscape impacting the Affordable Care Act as well as the emerging payment reforms aimed at reducing health care spending