This fall, each of the three inaugural Pozen-Commonwealth Fund Fellows in Healthcare Equity Leadership appeared on The Dose, a podcast on healthcare access produced by The Commonwealth Fund.
The Pozen-Commonwealth Fund Fellowship is a 22-month program that gives leaders in healthcare equity the opportunity to attend the MBA for Executives program with a focus on healthcare while also receiving specialized training and mentoring from experts in healthcare disparities. The inaugural fellows are Dr. Cecelia Calhoun, a pediatric hematologist at Washington University School of Medicine whose research has focused on improving outcomes for patients with sickle cell disease; Kennetha Gaines, director of nursing for the UCLA-Venice Family Clinic in Los Angeles; and Crystal Yates, who oversees Philadelphia’s emergency medical services as deputy commissioner of the city’s fire department.
Calhoun spoke to Shanoor Seervai, the host of The Dose, about her work treating sickle cell disease, a devastating blood disorder that mostly affects African Americans. She said that many of her patients are young people struggling with poverty as well as a disease that requires frequent care.
“This is a population that’s truly affected by social determinants of health,” she said. “So the things outside of the hospital, things external to the healthcare system that challenge the way that they’re able to manage themselves. So if you are just trying to figure out how to pay your bills or how you’re going to get from Point A to Point B, or what—where your next meal’s going to come from, it’s going to be a challenge for you until you have bad pain to think about, hey, maybe I should go see my hematologist, or hey, I know that I have this treatment scheduled but I don’t really have a way to get there and I have five dollars as my whole entire food budget for the rest of the week. I think it’s one of the areas that we really, really need to work on, commit to, and find solutions to if we really want to help children and young adults and adolescents with sickle cell disease, not just survive but thrive.”
Yates told Seervai about the complexities of overseeing EMS services in Philadelphia, where the fire department responded to 300,000 medical emergencies in 2018.
The daughter of a retired Philadelphia firefighter, Yates said that serving her own community helps her—and by extension, the EMTs she leads—to have a sense of empathy. When a new class of EMTs graduates, she said, “First thing I say to them is, ‘Listen, every person you encounter belongs to somebody. They are somebody’s mom, dad, child, cousin, best friend…. They are all important. And they need you at that time, regardless of whether or not we think it’s an emergency that they’re calling for; for them it’s an emergency. And I think as long as we are always looking at the people we serve as people, then we do a good job.’”
Gaines talked with Seervai about her work tackling the disparities between outcomes for black and white mothers and their babies, including infant mortality, preterm delivery, and low birth weight.
“What is it about being born black in America that has adverse and fatal outcomes on birth outcomes and maternal health?” she asked. “What research has looked at is that the day-to-day encounters with racial discrimination is actually linked to preterm birth in African American women based on chronic stress. So African American women live a more stressful life, which increases stress hormones that can have an adverse effect on labor… Chronic exposure to racism and inequality produces a link to prematurely aging the female reproductive system via stress-induced pathways that render a woman vulnerable to adverse birth outcomes before she can even become pregnant.”