In the middle of lively conversation over dinner with a friend recently, he paused, closed his eyes, and took a deep breath while placing his hand over his chest. The pain was evident on his face. When I asked what was wrong, he shared that he had been experiencing chest pains and fatigue with regular occurrence.
“Have you been to the doctor?” I asked.
“Nah. It’s probably anxiety. I’ve been stressed at work lately.”
We talked honestly about the severity of his symptoms and when they started. And because we’re cool, I asked about the results from his latest physical examination. Turns out, not only had he not seen a doctor about his recent episodes, he had not had a regular check-up in three years. I urged him to go to the doctor as soon as possible in the event that his symptoms were evidence of a significant illness.
Health is wealth.
If health is wealth, and it is, then many African Americans are guilty of not knowing the balance in our accounts. Meaning, annual check-ups and preventative care are not what we do. For my friend, it was a perceived lack of time that moved annual doctor’s visits to the bottom of his list of priorities. I can identify with him. While I do not skip my annual visits to my primary care physician and gynecologist, often when I am sick, I ignore the symptoms. My husband has to gently encourage me to call the doctor. Between keeping up home, shuttling our girls to their activities, ministry, and work, who has time to sit in a waiting room for hours?
For others, lack of insurance coverage, fear of disease, and historic exploitation of black bodies in medical science that fostered a distrust of doctors keeps them from scheduling preventative exams and following up on symptoms. The reality is that preventative care costs less than treating a preventable disease and browsing Dr. Google can invoke more fear that having concrete information and making informed decisions about your health. There is also the systemic racism, trauma and devaluing of our bodies that African Americans have and continue to face — experiences that have caused us to normalize pain to the point that we ignore the signs when our bodies are suffering. I am reminded of the woman recorded in Luke 13:10-17 who was bent over for eighteen years. The Bible does not tell us that at any point she sought healing. She went about her business living in chronic pain until Jesus saw her and healed her.
We are living in grind culture, where many of us skimp on sleep and spend countless hours scrolling on devices while eating conveniently packaged foods packed with sodium, fat, and sugar. And although African Americans are living longer in general, reports show that younger African Americans (18-49) are afflicted with and dying of treatable diseases like heart disease, stroke, and complications from diabetes at an alarming rate, according to the CDC. In fact, younger African Americans are living with diseases that commonly affected older adults. The stressors from unemployment, underemployment, poverty, and lack of access to healthcare negatively impacts their health. We are living longer, but we are getting sick earlier.
I shall not die, but I shall live, and recount the deeds of the Lord.
Psalm 118:17 (NRSV)
What are we to do? The first thing is to make a decision to live. Part of that decision is to make annual physical examinations a priority. As the proverb goes, “An ounce of prevention is worth a pound of cure.” I schedule all of my appointments—annual physical, gynecological exam, mammogram, and eye examination around my birthday. Doing so helps me to remember my appointments and also helps me to recognize the blessed gift of life that God has given me to steward. The other part of that decision to live is to listen to our bodies and to follow up with a doctor if even the slightest thing is off, with the recognition that we are worthy of care and that we do not have to live with chronic pain and disease.
Because our health is so valuable and important, I would suggest finding doctors that you feel comfortable with, that you can trust, and that are sensitive to your particular needs. Word of mouth from family, friends, and coworkers is the best way to find a good doctor. Developing a relationship with a doctor will also allow them to know your baseline levels, recognize patterns in your health, and know immediately when something needs additional attention.
The bottom line is that we have to see our doctors as if our lives depend on it…because they do. Whether you need to cram in a visit to the health center in-between college classes or you are scheduling your very first mammogram, here’s a list of the exams you need by decade, courtesy of Tri-City Medical Center:
For informational purposes only. The information in this article is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice.
Rev. Donna Olivia Owusu-Ansah is a preacher, chaplain, teacher, artist, writer, thinker, and dreamer who loves to study the Word of God, encourage others, and worship God. Rev. Owusu-Ansah holds a BS in Studio Art from New York University, an MFA in Photography from Howard University, and a Master of Divinity, Pastoral Theology, from Drew University. You can check out her website at https://www.reverendmotherrunner.com.
Trevis Hall, of Fort Washington, Maryland, credits a continuous glucose monitor with helping him get his diabetes under control. Makers of the device say that the instant feedback provides a way to motivate healthier eating and exercise. But experts point out that the few studies on the monitors show conflicting results. (LYNNE SHALLCROSS / KHN)
A continuous glucose monitor holds a tiny sensor that’s inserted just under the skin, alleviating the need for patients to prick their fingers every day to check blood sugar. The monitor tracks glucose levels all the time, sends readings to patients’ cellphone and doctor, and alerts patients when readings are headed too high or too low.
Nearly 2 million people with diabetes wear the monitors today, twice the number in 2019, according to the investment firm Baird.
There’s little evidence continuous glucose monitoring (CGM) leads to better outcomes for most people with diabetes — the estimated 25 million U.S. patients with Type 2 disease who don’t inject insulin to regulate their blood sugar, health experts say. Still, manufacturers, as well as some physicians and insurers, say the devices help patients control their diabetes by providing near-instant feedback to change diet and exercise compared with once-a-day fingerstick tests. And they say that can reduce costly complications of the disease, such as heart attacks and strokes.
Continuous glucose monitors are not cost-effective for Type 2 diabetes patients who do not use insulin, said Dr. Silvio Inzucchi, director of the Yale Diabetes Center.
Sure, it’s easier to pop a device onto the arm once every two weeks than do multiple finger sticks, which cost less than a $1 a day, he said. But “the price point for these devices is not justifiable for routine use for the average person with Type 2 diabetes.”
Without insurance, the annual cost of using a continuous glucose monitor ranges from nearly $1,000 to $3,000.
Lower Prices Help Propel Use
People with Type I diabetes — who make no insulin — need the frequent data from the monitors in order to inject the proper dose of a synthetic version of the hormone, via a pump or syringe. Because insulin injections can cause life-threatening drops in their blood sugar, the devices also provide a warning to patients when this is happening, particularly helpful while sleeping.
People with Type 2 diabetes, a different disease, do make insulin to control the upswings after eating, but their bodies don’t respond as vigorously as people without the disease. About 20% of Type 2 patients still inject insulin because their bodies don’t make enough and oral medications can’t control their diabetes.
Doctors often recommend that diabetes patients test their glucose at home to track whether they are reaching treatment goals and learn how medications, diet, exercise and stress affect blood sugar levels.
The crucial blood test doctors use, however, to monitor diabetes for people with Type 2 disease is called hemoglobin A1c, which measures average blood glucose levels over long periods of time. Neither finger-prick tests nor glucose monitors look at A1c. They can’t since this test involves a larger amount of blood and must be done in a lab.
The continuous glucose monitors also don’t assess blood glucose. Instead they measure the interstitial glucose level, which is the sugar level found in the fluid between the cells.
Companies seem determined to sell the monitors to people with Type 2 diabetes — those who inject insulin and those who don’t — because it’s a market of more than 30 million people. In contrast, about 1.6 million people have Type 1 diabetes.
Helping to fuel the uptake in demand for the monitors has been a drop in prices. The Abbott FreeStyle Libre, one of the leading and lowest-priced brands, costs $70 for the device and about $75 a month for sensors, which must be replaced every two weeks.
Another factor has been the expansion in insurance coverage.
Nearly all insurers cover continuous glucose monitors for people with Type 1 diabetes, for whom it’s a proven lifesaver. Today, nearly half of people with Type 1 diabetes use a monitor, according to Baird.
A small but growing number of insurers are beginning to cover the device for some Type 2 patients who don’t use insulin, including UnitedHealthcare and Maryland-based CareFirst BlueCross BlueShield. These insurers say they have seen initial success among members using the monitors along with health coaches to help keep their diabetes under control.
The few studies — mostly small and paid for by device-makers — examining the impact of the monitors on patient’s health show conflicting results in lowering hemoglobin A1c.
Still, Inzucchi said, the monitors have helped some of his patients who don’t require insulin — and don’t like to prick their fingers — change their diets and lower their glucose levels. Doctors said they’ve seen no proof that the readings get patients to make lasting changes in their diet and exercise routines. They said many patients who don’t use insulin may be better off taking a diabetes education class, joining a gym or seeing a nutritionist.
“I don’t see the extra value with CGM in this population with current evidence we have,” said Dr. Katrina Donahue, director of research at the University of North Carolina Department of Family Medicine. “I’m not sure if more technology is the right answer for most patients.”
Donahue was co-author of a landmark 2017 study in JAMA Internal Medicine that showed no benefit to lowering hemoglobin A1c after one year regularly checking glucose levels through finger-stick testing for people with Type 2 diabetes.
She presumes the measurements did little to change patients’ eating and exercise habits over the long term — which is probably also true of continuous glucose monitors.
“We need to be judicious how we use CGM,” said Veronica Brady, a certified diabetes educator at the University of Texas Health Science Center and spokesperson for the Association of Diabetes Care & Education Specialists. The monitors make sense if used for a few weeks when people are changing medications that can affect their blood sugar levels, she said, or for people who don’t have the dexterity to do finger-stick tests.
Yet, some patients like Trevis Hall credit the monitors for helping them get their disease under control.
Last year, Hall’s health plan, UnitedHealthcare, gave him a monitor at no cost as part of a program to help control his diabetes. He said it doesn’t hurt when he attaches the monitor to his belly twice a month.
The data showed Hall, 53, of Fort Washington, Maryland, that his glucose was reaching dangerous levels several times a day. “It was alarming at first,” he said of the alerts the device would send to his phone.
Over months, the readings helped him change his diet and exercise routine to avert those spikes and bring the disease under control. These days, that means taking a brisk walk after a meal or having a vegetable with dinner.
“It’s made a big difference in my health,” said Hall.
This Market ‘Is Going to Explode’
Makers of the devices increasingly promote them as a way to motivate healthier eating and exercise.
The manufacturers spend millions of dollars pushing doctors to prescribe continuous glucose monitors, and they’re advertising directly to patients on the internet and in TV ads, including a spot starring singer Nick Jonas during this year’s Super Bowl.
Kevin Sayer, CEO of Dexcom, one of the leading makers of the monitors, told analysts last year that the noninsulin Type 2 market is the future. “I’m frequently told by our team that, when this market goes, it is going to explode. It’s not going to be small, and it’s not going to be slow,” he said.
“I believe, personally, at the right price with the right solution, patients will use it all the time,” he added.
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.
In the hospital with covid-19 in December, Lavina Wafer tired of the tubes in her nose and wondered impatiently why she couldn’t be discharged. A phone call with her pastor helped her understand that the tube was piping in lifesaving oxygen, which had to be slowly tapered to protect her.
Now that Wafer, 70, is well and back home in Richmond, California, she’s looking to her pastor for advice about the covid vaccines. Though she doubts they’re as wonderful as the government claims, she plans to get vaccinated anyway — because of his example.
“He said he’s not going to push us to take it. It’s our choice,” Wafer said, referring to a recent online sermon that praised the vaccines as God-given science with the power to save. “But he wanted us to know he’s going to take it as soon as he can.”
Helping people accept the covid vaccines is a public health goal, but it’s also a spiritual one, said Henry Washington, the 53-year-old pastor of The Garden of Peace Ministries, which Wafer attends.
Clergy must ensure that people “understand they have an active part in their own salvation, and the salvation of others,” said Washington. “I have tried to suggest that taking the vaccine, social distancing and protecting themselves in their household is something that God requires us to do as good stewards.”
Many Black Americans look to their religious leaders for guidance on a wide range of issues — not just spiritual ones. Their credibility is especially crucial on matters of health, as the medical establishment works to overcome a legacy of experimentation and bias that makes some Black people distrustful of public health messages.
Now that the vaccines are being distributed, public health advocates say churches are key to reaching Black citizens, especially older generations more vulnerable to severe covid disease. They have been hospitalized for covid and died at a disproportionate rate throughout the pandemic, and initial data on who is getting covid shots shows that Black people lag far behind other racial groups.
Black churches have also suffered during the pandemic. African American pastors were most likely to say they had had to delete positions or cut staff pay or benefits to survive, and 60% said their congregations hadn’t gathered in person the previous month, as opposed to 9% of white pastors, according to a survey published in October by Lifeway Research, which specializes in data on Christian groups.
Washington’s 75-member church is in Richmond, which has the highest number of covid deaths in Contra Costa County, outside of deaths in long-term care facilities. The very diverse city, across the bay from San Francisco, also has one of the lowest rates of vaccination.
Offerings to Washington’s church plunged 50% in 2020 due to job loss among congregants, but he’s weathered the pandemic with a small-business loan and a second job as a general contractor remodeling bathrooms and kitchens.
To combat misinformation, he’s been meeting virtually with about 30 other Black pastors once a month in calls organized by the One Accord Project, a nonprofit that organizes Black churches in the San Francisco Bay Area around nonpartisan issues like voter registration and low-income housing. Throughout the pandemic, the calls have focused on connecting pastors with public health officials and epidemiologists to make sure they have the most up-to-date information to pass on to their members, said founder Sabrina Saunders.
The African American church is an anchor for the community, Saunders said. “People get a lot of emotional support, people get resources, and their pastor isn’t just looked upon as a spiritual leader, but something more.”
And guidance is needed.
The share of Black people who say they have been vaccinated or want to be vaccinated as soon as possible is 35%, while 43% say they want to “wait and see” the shots’ effects on others, according to a KFF survey. Eight percent say they’ll get the shot only if required, while 14% say they definitely won’t be vaccinated. Among whites, the first two figures are 53% and 26%, respectively; for Hispanics, 42% and 37%. (KHN is an editorially independent program of KFF.)
Among the “wait and see” group, 35% say they would seek information about the shots from a religious leader, compared with 28% of Hispanics and 14% of white people.
Grassroots outreach to Black churches happens in every public health emergency, but the pandemic has hastened the pace of collaboration with public health officials, said Dr. Leon McDougle, assistant dean for diversity and cultural affairs at the Ohio State University College of Medicine. The last time he saw such a broad coalition across Black churches, medical associations, schools and political groups was during the HIV/AIDS epidemic in the 1980s.
“This is at an entirely different level, though, because we’ve had almost half a million die in a year,” McDougle said of the covid pandemic.
Historically, no other institution in African American communities has rivaled the church in terms of its reach and the trust it enjoys, said Dr. Paris Butler, a plastic and reconstructive surgeon at the University of Pennsylvania Health System. Last month, he and a colleague spoke to leaders from 21 churches in Philadelphia to answer basic questions about how the vaccine was produced and tested.
“Being an African American myself, and growing up in a Baptist church, I understand the value of that trusted voice,” Butler said. “If we don’t reach out to them, we’re making a mistake.”
Leaders with massive social media followings, like Bishop T.D. Jakes, are also weighing in, publishing video conversations with experts including Dr. Anthony Fauci to inform followers about the vaccines.
Church attendance is waning among young Black adults, as it is for other races. But elders can set examples for younger people undecided about the vaccine, said Dr. Judith Green McKenzie, chief of the division of occupational medicine at the University of Pennsylvania’s Perelman School of Medicine.
“When they see their grandma go, they may say, ‘I’m going,’” she said. “Grandma got this two months ago and she’s fine.”
Encouraging vaccine trust is delicate work. The Black community has reason to be skeptical of the health system, said Eddie Anderson, the 31-year-old leader of McCarty Memorial Christian Church in Los Angeles. In one-on-one conversations, congregants tell him they fear being guinea pigs. The low vaccine supply also makes Anderson hesitate to recommend, from the pulpit, that members get the shot as soon as they’re able. He fears frustration with difficult online sign-ups would further sap motivation.
“I want to do that when it’s readily available,” he said. “I want to preach it, and then within a weekend a family can actually go get the vaccine.”
Despite the doubts and fears, Anderson said the majority of his 125-member congregation, about half of whom are senior citizens, want the vaccine, in order to be with loved ones again. One older member is desperately seeking a vaccine appointment so he can help his daughter, who is going through cancer treatments. But the online sign-up process is confusing and nearly impossible for his followers, Anderson said.
For now, he’s focused on asking several vaccinated members to write down everything about their experience and share it on social media. He also plans to record them talking about their shots — and to show that many people of different races were in the same vaccine line — and will broadcast the videos during church announcements.
While he can’t tell people what to do, Anderson hopes he can remove any potential spiritual barriers to the vaccine.
“My biggest fear is for someone to say, ‘I didn’t get vaccinated’ or ‘I didn’t get a test’ because it’s against [their] faith, or because ‘I don’t see that in the Bible,’” he said. “Any of those arguments, I want to get those off the table.”
When it comes to advice for managing your weight, it can be hard to separate fact from fiction.
Does drinking a concoction of maple syrup and cayenne pepper in place of meals really help you lose weight? Should you eat cabbage every meal? What about adding butter to your coffee – does that actually work?
Instead of opting for quick-fix schemes, Dr. Jain says to look for a weight-management strategy that’s sustainable and backed by evidence-based research.
“There are lots of ideas out there,” Dr. Jain says. “But it’s important to evaluate the science behind them to determine how and why the strategy works.”
Important for health
For example, research has shown that eating a moderate amount of nuts every day is a great way to help maintain or lose weight while improving overall nutrition.
“Replacing sugary snacks with a handful of almonds or pecans is a simple strategy that can prevent gradual weight gain and aid in weight loss,” Dr. Jain says. “Nuts offer tons of nutrients and antioxidants as well as healthy fats and fiber, which can help keep you feeling full.”
Maintaining a healthy weight is important for overall health, Dr. Jain says, because it can help reduce your risk for a broad range of conditions, including:
• Heart disease
• Some cancers
• Sleep apnea
“As we age, it can become harder to keep the pounds off. Adults tend to gain 1 to 2 pounds each year, so finding effective ways to keep your weight in check becomes especially important,” she says.
In addition to eating nuts, here are 10 more tips that can help manage your weight:
1. Drink water before meals
People who used this strategy lost more weight than those who didn’t. Thirst often masks itself as hunger, causing you to eat more than you should. Additionally, drinking water beforehand makes you feel fuller so you eat less during the meal.
The average restaurant meal totals more than 1,000 calories, but nutritional information is often not printed on menus. Look for ways to lessen your caloric intake when dining out. Split a meal or substitute starchy side dishes with a green salad.
4. Stay hydrated
In addition to drinking water before meals, it’s important to stay hydrated throughout the day. Increasing your water consumption will boost your metabolism by as much as 30 percent, which can help you burn extra calories as you go about your day.
5. Eat protein for breakfast
Research has shown that replacing a grain-based breakfast like oatmeal or muffins with protein, specifically eggs, will cause you to eat fewer calories for the next 36 hours. You’ll feel fuller throughout the day, so you’ll snack less and eat smaller meals at lunch and dinner.
6. Use smaller plates
Studies have shown that using smaller plates during meals help you eat less food. Called the Delboeuf illusion, your brain is tricked into thinking you’ve eaten a larger portion.
7. Rearrange your plate
Speaking of plates, aim to fill half your plate with vegetables, a quarter with whole grains and a quarter with lean protein. The Choose My Plate app available through the U.S. Department of Agriculture makes it easy to track how much you’re eating from each food group.
8. Get enough sleep
Adequate sleep is extremely important to maintaining a healthy weight. Lack of sleep can prompt your body to produce more of a hormone that increases hunger and less of a hormone that makes you feel satisfied. Therefore, you crave more salty and sweet foods. That’s why poor-quality sleep has been linked to an 89 percent increased risk of obesity in children and a 55 percent increased risk of obesity in adults.
9. Don’t drink calories
Sugary drinks like sodas and juices contain lots of empty calories that can lead to weight gain. In fact, liquid sugar may be the most fattening aspect of our diets. One study found that sugar-sweetened beverages increased the risk of childhood obesity by 60 percent.
10. Chew and eat slowly
Take your time when eating. One study has found that chewing 50 times per bite of food can reduce your caloric intake. Additionally, eating slowly will make you feel fuller more quickly.
Maintaining your weight requires dietary changes and lifestyle modifications — not fad diets. By implementing at least some of these evidence-based tips in your daily life, you’ll find it easier to manage your weight and improve your health.
Wilma Mayfield used to visit a senior center in Durham, North Carolina, four days a week and attend Lincoln Memorial Baptist Church on Sundays, a ritual she’s maintained for nearly half a century. But over the past 10 months, she’s seen only the inside of her home, the grocery store and the pharmacy. Most of her days are spent worrying about COVID-19 and watching TV.
It’s isolating, but she doesn’t talk about it much.
When Mayfield’s church invited a psychologist to give a virtual presentation on mental health during the pandemic, she decided to tune in.
The hourlong discussion covered COVID’s disproportionate toll on communities of color, rising rates of depression and anxiety, and the trauma caused by police killings of Black Americans. What stuck with Mayfield were the tools to improve her own mental health.
“They said to get up and get out,” she said. “So I did.”
The next morning, Mayfield, 67, got into her car and drove around town, listening to 103.9 gospel radio and noting new businesses that had opened and old ones that had closed. She felt so energized that she bought chicken, squash and greens, and began her Thanksgiving cooking early.
“It was wonderful,” she said. “The stuff that lady talked about [in the presentation], it opened up doors for me.”
As Black people face an onslaught of grief, stress and isolation triggered by a devastating pandemic and repeated instances of racial injustice, churches play a crucial role in addressing the mental health of their members and the greater community. Religious institutions have long been havens for emotional support. But faith leaders say the challenges of this year have catapulted mental health efforts to the forefront of their mission.
Some are preaching about mental health from the pulpit for the first time. Others are inviting mental health professionals to speak to their congregations, undergoing mental health training themselves or adding more therapists to the church staff.
“COVID undoubtedly has escalated this conversation in great ways,” said Keon Gerow, senior pastor at Catalyst Church in West Philadelphia. “It has forced Black churches — some of which have been older, traditional and did not want to have this conversation — to actually now have this conversation in a very real way.”
At Lincoln Memorial Baptist, leaders who organized the virtual presentation with the psychologist knew that people like Mayfield were struggling but might be reluctant to seek help. They thought members might be more open to sensitive discussions if they took place in a safe, comfortable setting like church.
It’s a trend that psychologist Alfiee Breland-Noble, who gave the presentation, has noticed for years.
Through her nonprofit organization, the AAKOMA Project, Breland-Noble and her colleagues often speak to church groups about depression, recognizing it as one of the best ways to reach a diverse segment of the Black community and raise mental health awareness.
This year, the AAKOMA Project has received clergy requests that are increasingly urgent, asking to focus on coping skills and tools people can use immediately, Breland-Noble said.
“After George Floyd’s death, it became: ‘Please talk to us about exposure to racial trauma and how we can help congregations deal with this,’” she said. “‘Because this is a lot.’”
Across the country, mental health needs are soaring. And Black Americans are experiencing significant strain: A study from the Centers for Disease Control and Prevention this summer found 15% of non-Hispanic Black adults had seriously considered suicide in the past 30 days and 18% had started or increased their use of substances to cope with pandemic-related stress.
Yet national data shows Blacks are less likely to receive mental health treatment than the overall population. A memo released by the Substance Abuse and Mental Health Services Administration this spring lists engaging faith leaders as one way to close this gap.
The Potter’s House in Dallas has been trying to do that for years. A megachurch with more than 30,000 members, it runs a counseling center with eight licensed clinicians, open to congregants and the local community to receive counseling at no cost, though donations are accepted.
Since the pandemic began, the center has seen a 30% increase in monthly appointments compared with previous years, said center director Natasha Stewart. During the summer, when protests over race and policing were at their height, more Black men came to therapy for the first time, she said.
Recently, there’s been a surge in families seeking services. Staying home together has brought up conflicts previously ignored, Stewart said.
“Before, people had ways to escape,” she said, referring to work or school. “With some of those escapes not available anymore, counseling has become a more viable option.”
To meet the growing demand, Stewart is adding a new counselor position for the first time in eight years.
At smaller churches, where funding a counseling center is unrealistic, clergy are instead turning to members of the congregation to address growing mental health needs.
At Catalyst Church, a member with a background in crisis management has begun leading monthly COVID conversations online. A deacon has been sharing his own experience getting therapy to encourage others to do the same. And Gerow, the senior pastor, talks openly about mental health.
Recognizing his power as a pastor, Gerow hopes his words on Sunday morning and in one-on-one conversations will help congregants seek the help they need. Doing so could reduce substance use and gun violence in the community, he said. Perhaps it would even lower the number of mental health crises that lead to police involvement, like the October death of Walter Wallace Jr., whose family said he was struggling with mental health issues when Philadelphia police shot him.
“If folks had the proper tools, they’d be able to deal with their grief and stress in different ways,” Gerow said. “Prayer alone is not always enough.”
Laverne Williams recognized that back in the ’90s. She believed prayer was powerful, but as an employee of the Mental Health Association in New Jersey, she knew there was a need for treatment too.
When she heard pastors tell people they could pray away mental illness or use blessed oil to cure what seemed like symptoms of schizophrenia, she worried. And she knew many people of color were not seeing professionals, often due to barriers of cost, transportation, stigma and distrust of the medical system.
To address this disconnect, Williams created a video and PowerPoint presentation and tried to educate faith leaders.
At first, many clergy turned her away. People thought seeking mental health treatment meant your faith wasn’t strong enough, Williams said.
But over time, some members of the clergy have come to realize the two can coexist, said Williams, adding that being a deacon herself has helped her gain their trust. This year alone, she’s trained 20 faith leaders in mental health topics.
A program run by the Behavioral Health Network of Greater St. Louis is taking a similar approach. The Bridges to Care and Recovery program trains faith leaders in “mental health first aid,” suicide prevention, substance use and more, through a 20-hour course.
The training builds on the work faith leaders are already doing to support their communities, said senior program manager Rose Jackson-Beavers. In addition to the tools of faith and prayer, clergy can now offer resources, education and awareness, and refer people to professional therapists in the network.
Since 2015, the program has trained 261 people from 78 churches, Jackson-Beavers said.
Among them is Carl Lucas, pastor of God First Church in northern St. Louis County who graduated this July — just in time, by his account.
Since the start of the pandemic, he has encountered two congregants who expressed suicidal thoughts. In one case, church leaders referred the person to counseling and followed up to ensure they attended therapy sessions. In the other, the root concern was isolation, so the person was paired with church members who could touch base regularly, Lucas said.
“The pandemic has definitely put us in a place where we’re looking for answers and looking for other avenues to help our members,” he said. “It has opened our eyes to the reality of mental health needs.”
Dr. Anthony Fauci and other national health leaders have said that African Americans need to take the COVID-19 vaccine to protect their health. What Fauci and others have not stated is that if African Americans don’t take the vaccine, the nation as whole will never get to herd immunity.
The concept of herd immunity, also referred to as community immunity, is fairly simple. When a significant proportion of the population, or the herd, becomes immune from the virus, the entire population will have some acceptable degree of protection. Immunity can occur through natural immunity from personal infection and recovery, or through vaccination. Once a population reaches herd immunity, the likelihood of person-to-person spread becomes very low.
The big lie is one of omission. Yes, it is true that African Americans will benefit from the COVID vaccine, but the full truth is that the country needs African Americans and other population subgroups with lower reported COVID-19 vaccine acceptability rates to take the vaccine. Without increased vaccine acceptability, we stand little to no chance of communitywide protection.
About 70% of people in the U.S. need to take the vaccine for the population to reach herd immunity. Whites make up about 60% of the U.S. population. So, if every white person got the vaccine, the U.S. would still fall short of herd immunity. A recent study suggested that 68% of white people would be willing to get the COVID-19 vaccine. If these estimates hold up, that would get us to 42%.
Latinos make up just over 18% percent of the population. A study suggests that 32% percent of Latinos could reject a COVID vaccine. Add the 40% to 50% rejection rates among other population subgroups and herd immunity becomes mathematically impossible.
Further exacerbating the problem is that mass vaccination alone won’t achieve herd immunity, as the effect of COVID vaccines on preventing virus transmission remains unclear. Ongoing preventive measures will likely still be needed to stop community spread. As the resistance to facts and science continues to grow, the need for credible information dissemination and trust-building related to vaccines becomes more important.
My research offers some possible explanations for lower vaccination rates among Blacks. Historical wrongs, like the Tuskegee Syphilis Experiments, which ended in 1972, have played a major role in contributing to Black mistrust of the health care system. In another case, the “immortal” cells of Henrietta Lacks were shared without her consent and have been used in medical research for more than 70 years. The most recent application includes COVID vaccine research, yet her family has received no financial benefit.
African Americans also disproportionately experience unequal treatment in the modern-day health care system. These experiences of bias and discrimination fuel the problem of vaccine hesitancy and mistrust. Lower prioritization for hospital admissions and lifesaving care for COVID-19-related illness among African Americans was reported in Massachusetts in April 2020. Massachusetts subsequently changed its guidelines, yet across the U.S. there is a lack of data and transparent reporting on this phenomenon.
The current messaging of vaccine importance may seem tone-deaf to those in a community who wonder why their health is so important now, at the vaccine stage. Black health didn’t appear to be a priority during the pandemic’s first wave, when race disparities in COVID emerged.
Questioning the scientific process
Perhaps even Operation Warp Speed has had the unintended consequence of decreasing vaccine acceptance in the African American community. Some ask why wasn’t such speed applied to vaccine development for HIV, which still has no FDA-approved vaccine? As of 2018, AIDS-related illness has killed an estimated 35 million people globally. It continues to disproportionately affect people of color and other socially vulnerable populations.
If African Americans were honored and acknowledged in these COVID vaccine conversations and told “we need you” instead of “you need us,” perhaps more Blacks would trust the vaccine. I encourage our nation’s leaders to consider a radical shift in their approach. They must do more than pointing to the few Black scientists involved in COVID vaccine development, or making a spectacle of prominent African Americans receiving the vaccine.
These acts alone will likely be insufficient to garner the trust needed to increase vaccine acceptance. Instead, I believe our leaders should adopt the core values of equity and reconciliation. I’d argue that truth-telling will need to be at the forefront of this new narrative.
There are also multiple leverage points along the supply and distribution chains, as well as in vaccine administration, that could increase diversity, equity and inclusion. I’d recommend giving minority- and women-owned businesses fair, mandated access to contracts to get the vaccine to communities. This includes procurement and purchasing contracts for freezers needed to store the vaccine.
Minority health care workers should be equitably called back to work to support vaccine administration. These issues, not publicly discussed, could be transformative for building trust and increasing vaccine acceptance.
Without a radical shift in the conversation of true COVID equity, African Americans and many others who could benefit from the vaccine will instead get sick. Some will die. The rest will remain marginalized by a system and a society that hasn’t equally valued, protected, or prioritized their lives. I believe it’s time to tell the truth, the whole truth, and nothing but the truth.