With more than a million children orphaned by COVID, faith-based groups look to mobilize support

With more than a million children orphaned by COVID, faith-based groups look to mobilize support

(RNS) — More than a million children around the world may have been orphaned by COVID-19, losing one or both parents to the disease or related causes.

Another estimated 500,000 lost a grandparent or another relative who cared for them.

The numbers are from a new study by researchers from the U.S. Centers for Disease Control and Prevention and others that highlight another grim reality in the sweeping devastation caused by the ongoing pandemic.

“These new estimates highlight the tremendous impact COVID-19 has had on children around the world,” said Elli Oswald, executive director of the Faith to Action Initiative.

Members of the Faith to Action Initiative, a coalition of faith-based child welfare organizations that includes Bethany Christian Services, World Vision and other nonprofits and ministries, responded this week to the study published Tuesday (July 20) in The Lancet, encouraging Christians to mobilize to care for those children and support surviving family members.

“We know when families are supported during these tragic times, they can provide the love and care a child needs to thrive. The church is best placed to respond to the needs of these children as it carries out the vision we see in scripture of God’s intention for family, and ensures that a child never needs to be placed in an orphanage,” Oswald said.

Researchers from the CDC, the U.S. Agency for International Development, the World Bank and the University College London used COVID-19 mortality data from March 2020 through April 2021 and national fertility statistics for 21 countries to offer the first global estimates of the number of children orphaned by the disease.

Their methods were similar to those used by the UNAIDS Reference Group on Estimates, Modelling and Projections to estimate the number of children orphaned by AIDS.

“Orphanhood and caregiver deaths are a hidden pandemic resulting from COVID-19-associated deaths,” according to the study.

Children who have lost a parent or caregiver are at increased risk for disease, physical abuse, sexual violence and adolescent pregnancy, according to a press release accompanying the study. They also risk being separated from their families and placed in orphanages or care homes, which researchers say have been linked to negative effects on social, physical and mental development.

The solution, said Chris Palusky, president and CEO of Bethany Christian Services, is “the loving care of a family, not another orphanage.” He pointed to Scripture passages that say God sets the lonely in families and call on Christians to care for those who have been orphaned.

“We urge Christians to support efforts to strengthen vulnerable families and communities, reunify families, and place children without caregivers in loving families, so that children never have to live in orphanages,” Palusky said.

Losing a loved one and caring for orphaned children also puts “immense” stress on remaining parents and extended family members, added Margaret Schuler, World Vision’s senior vice president of international programs.

“Yet efforts for care must be focused at supporting them in and through their families to prevent unnecessary separation,” Schuler said. “We encourage Christians and the Church to mobilize to keep families together in order to help children thrive.”

The study was published alongside a report by the CDC and other agencies titled ” Children: The Hidden Pandemic 2021.”

 

With Roots in Civil Rights, Community Health Centers Push for Equity in the Pandemic

With Roots in Civil Rights, Community Health Centers Push for Equity in the Pandemic

In the 1960s, health care across the Mississippi Delta was sparse and much of it was segregated. Some hospitals were dedicated to Black patients, but they often struggled to stay afloat. At the height of the civil rights movement, young Black doctors launched a movement of their own to address the care disparity.

“Mississippi was third-world and was so bad and so separated,” said Dr. Robert Smith. “The community health center movement was the conduit for physicians all over this country who believed that all people have a right to health care.”

In 1967, Smith helped start Delta Health Center, the country’s first rural community health center. They put the clinic in Mound Bayou, a small town in the heart of the Delta, in northwestern Mississippi. The center became a national model and is now one of nearly 1,400 such clinics across the country. These clinics, called federally qualified health centers, are a key resource in Mississippi, Louisiana and Alabama, where about 2 in 5 people live in rural areas. Throughout the U.S., about 1 in 5 people live in rural areas.

The covid-19 pandemic has only exacerbated the challenges facing rural health care, such as lack of broadband internet access and limited public transportation. For much of the vaccine rollout, those barriers have made it difficult for providers, like community health centers, to get shots into the arms of their patients.

“I just assumed that [the vaccine] would flow like water, but we really had to pry open the door to get access to it,” said Smith, who still practices family medicine in Mississippi.

Mound Bayou was founded by formerly enslaved people, many of whom became farmers.

The once-thriving downtown was home to some of the first Black-owned businesses in the state. Today the town is dotted with shuttered or rundown banks, hotels and gas stations.

Mitch Williams grew up on a Mound Bayou farm in the 1930s and ’40s and spent long days working the soil.

“If you would cut yourself, they wouldn’t put no sutures in, no stitches in it. You wrapped it up and kept going,” Williams said.

When Delta Health Center started operations in 1967, it was explicitly for all residents of all races — and free to those who needed financial help.

Williams, 85, was one of its first patients.

“They were seeing patients in the local churches. They had mobile units. I had never seen that kind of comprehensive care,” he said.

Residents really needed it. In the 1960s, many people in Mound Bayou and the surrounding area didn’t have clean drinking water or indoor plumbing.

At the time, the 12,000 Black residents of northern Bolivar County, which includes Mound Bayou, faced unemployment rates as high as 75% and lived on a median annual income of just $900 (around $7,500 in today’s dollars), according to a congressional report. The infant mortality rate was close to 60 for every 1,000 live births — four times the rate for affluent Americans.

Delta Health Center employees helped people insulate their homes. They built outhouses and provided food and sometimes even traveled to patients’ homes to offer care, if someone didn’t have transportation. Staffers believed these factors affected health outcomes, too.

Williams, who later worked for Delta Health, said he’s not sure where the community would be today if the center didn’t exist.

“It’s frightening to think of it,” he said.

Half a century later, the Delta Health Center continues to provide accessible and affordable care in and around Mound Bayou.

Black Southerners still face barriers to health. In April 2020, early in the pandemic, Black residents accounted for nearly half of covid deaths in Alabama and over 70% in Louisiana and Mississippi.

Public health data from last month shows that Black residents of those states have consistently been more likely to die of covid than residents of other races.

“We have a lot of chronic health conditions here, particularly concentrated in the Mississippi Delta, that lead to higher rates of complications and death with covid,” said Nadia Bethley, a clinical psychologist at the center. “It’s been tough.”

Delta Health Center has grown over the decades, from a few trailers in Mound Bayou to a chain of 18 clinics across five counties. It’s managed to vaccinate over 5,500 people against covid. The majority have been Black.

“We don’t have the National Guard, you know, lining up out here, running our site. It’s the people who work here,” Bethley said.

The Mississippi State Department of Health said it has prioritized health centers since the beginning of the rollout. But Delta Health CEO John Fairman said the center was receiving only a couple of hundred doses a week in January and February. The supply became more consistent around early March, center officials said.

“Many states would be much further ahead had they utilized community health centers from the very beginning,” Fairman said. Fairman said his center saw success with vaccinations because of its long-standing relationships with the local communities.

“Use the infrastructure that’s already in place, that has community trust,” said Fairman.

That was the entire point of the health center movement in the first place, said Smith. He said states that were slow to use health centers in the vaccine rollout made a mistake that has made it difficult to get a handle on covid in the most vulnerable communities.

Smith called the slow dispersal of vaccines to rural health centers “an example of systemic racism that continues.”

A spokesperson for Mississippi’s health department said it is “committed to providing vaccines to rural areas but, given the rurality of Mississippi, it is a real challenge.”

Alan Morgan, CEO of the National Rural Health Association, said the low dose allocation to rural health clinics and community health centers early on is “going to cost lives.”

“With hospitalizations and mortality much higher in rural communities, these states need to focus on the hot spots, which in many cases are these small towns,” Morgan said of the vaccine efforts in Mississippi, Louisiana and Alabama.

A report from KFF found that people of color made up the majority of people vaccinated at community health centers and that the centers seem to be vaccinating people at rates similar to or higher than their share of the population. (The KHN newsroom, which collaborated to produce this story, is an editorially independent program of KFF.)

The report added that “ramping up health centers’ involvement in vaccination efforts at the federal, state and local levels” could be a meaningful step in “advancing equity on a larger scale.”

Equal access to care in rural communities is necessary to reach the most vulnerable populations and is just as critical during this global health crisis as it was in the 1960s, according to Smith.

“When health care improves for Blacks, it will improve for all Americans,” Smith said.

This story is from a partnership that includes NPR, KHN and the three stations that make up the Gulf States Newsroom: Mississippi Public Broadcasting; WBHM in Birmingham, Alabama; and WWNO in New Orleans.

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Hospitals, Insurers Invest Big Dollars to Tackle Patients’ Social Needs

Hospitals, Insurers Invest Big Dollars to Tackle Patients’ Social Needs

PHILADELPHIA — When doctors at a primary care clinic here noticed many of its poorest patients were failing to show up for appointments, they hoped giving out free rides would help.

But the one-time complimentary ride didn’t reduce these patients’ 36% no-show rate at the University of Pennsylvania Health System clinics.

“I was super surprised it did not have any effect,” said Dr. Krisda Chaiyachati, the Penn researcher who led the 2018 study of 786 Medicaid patients.

Many of the patients did not take advantage of the ride because they were either saving it for a more important medical appointment or preferred their regular travel method, such as catching a ride from a friend, a subsequent study found.

It was not the first time that efforts by a health care provider to address patients’ social needs — such as food, housing and transportation — failed to work.

In the past decade, dozens of studies funded by state and federal governments, private hospitals, insurers and philanthropic organizations have looked into whether addressing patients’ social needs improves health and lowers medical costs.

But so far it’s unclear which of these strategies, focused on so-called social determinants of health, are most effective or feasible, according to several recent academic reports by experts at Columbia, Duke and the University of California-San Francisco that evaluated existing research.

And even when such interventions show promising results, they usually serve only a small number of patients. Another challenge is that several studies did not go on long enough to detect an impact, or they did not evaluate health outcomes or health costs.

“We are probably at a peak of inflated expectations, and it is incumbent on us to find the innovations that really work,” said Dr. Laura Gottlieb, director of the UCSF Social Interventions Research and Evaluation Network. “Yes, there’s a lot of hype, and not all of these interventions will have staying power.”

With health care providers and insurers eager to find ways to lower costs, the limited success of social-need interventions has done little to slow the surge of pilot programs — fueled by billions of private and government dollars.

Paying for Health, Not Just Health Care

Across the country, both public and private health insurance programs are launching large initiatives aimed at improving health by helping patients with unmet social needs. One of the biggest efforts kicks off next year in North Carolina, which is spending $650 million over five years to test the effect of giving Medicaid enrollees assistance with housing, food and transportation.

California is redesigning its Medicaid program, which covers nearly 14 million residents, to dramatically increase social services to enrollees.

These moves mark a major turning point for Medicaid, which, since its inception in 1965, largely has prohibited government spending on most nonmedical services. To get around this, states have in recent years sought waivers from the federal government and pushed private Medicaid health plans to address enrollees’ social needs.

The move to address social needs is gaining steam nationally because, after nearly a dozen years focused on expanding insurance under the Affordable Care Act, many experts and policymakers agree that simply increasing access to health care is not nearly enough to improve patients’ health.

That’s because people don’t just need access to doctors, hospitals and drugs to be healthy, they also need healthy homes, healthy food, adequate transportation and education, a steady income, safe neighborhoods and a home life free from domestic violence — things hospitals and doctors can’t provide, but that in the long run are as meaningful as an antibiotic or an annual physical.

Researchers have known for decades that social problems such as unstable housing and lack of access to healthy foods can significantly affect a patient’s health, but efforts by the health industry to take on these challenges didn’t really take off until 2010 with the passage of the ACA. The law spurred changes in how insurers pay health providers — moving them away from receiving a set fee for each service to payments based on value and patient outcomes.

As a result, hospitals now have a financial incentive to help patients with nonclinical problems — such as housing and food insecurity — that can affect health.

Temple University Health System in Philadelphia launched a two-year program last year to help 25 homeless Medicaid patients who frequently use its emergency room and other ERs in the city by providing them free housing, and caseworkers to help them access other health and social services. It helps them furnish their apartments, connects them to healthy delivered meals and assists with applications for income assistance such as Social Security.

To qualify, participants had to have used the ER at least four times in the previous year and had at least $10,000 in medical claims that year.

Temple has seen promising results when comparing patients’ experiences before the study to the first five months they were all housed. In that time, the participants’ average number of monthly ER visits fell 75% and inpatient hospital admissions dropped 79%.

At the same time, their use of outpatient services jumped by 50% — an indication that patients are seeking more appropriate and lower-cost settings for care.

Living Life as ‘Normal People Do’

One participant is Rita Stewart, 53, who now lives in a one-bedroom apartment in Philadelphia’s Squirrel Hill neighborhood, home to many college students and young families.

“Everyone knows everyone,” Stewart said excitedly from her second-floor walk-up. It’s “a very calm area, clean environment. And I really like it.”

Before joining the Temple program in July and getting housing assistance, Stewart was living in a substance abuse recovery home. She had spent a few years bouncing among friends’ homes and other recovery centers. Once she slept in the city bus terminal.

In 2019, Stewart had visited the Temple ER four times for various health concerns, including anxiety, a heart condition and flu.

Stewart meets with her caseworkers at least once a week for help scheduling doctor appointments, arranging group counseling sessions and managing household needs.

“It’s a blessing,” she said from her apartment with its small kitchen and comfy couch.

“I have peace of mind that I am able to walk into my own place, leave when I want to, sleep when I want to,” Stewart said. “I love my privacy. I just look around and just wow. I am grateful.”

Stewart has sometimes worked as a nursing assistant and has gotten her health care through Medicaid for years. She still deals with depression, she said, but having her own home has improved her mood. And the program has helped keep her out of the hospital.

“This is a chance for me to take care of myself better,” she said.

Her housing assistance help is set to end next year when the Temple program ends, but administrators said they hope to find all the participants permanent housing and jobs.

“Hopefully that will work out and I can just live my life like normal people do and take care of my priorities and take care of my bills and things that a normal person would do,” Stewart said.

“Housing is the second-most impactful social determinant of health after food security,” said Steven Carson, a senior vice president at Temple University Health System. “Our goal is to help them bring meaningful and lasting health improvement to their lives.”

Success Doesn’t Come Cheap

Temple is helping pay for the program; other funding comes from two Medicaid health plans, a state grant and a Pittsburgh-based foundation. A nonprofit human services organization helps operate the program.

Program organizers hope the positive results will attract additional financing so they can expand to help many more homeless patients.

The effort is expensive. The “Housing Smart” program cost $700,000 to help 25 people for one year, or $28,000 per person. To put this in perspective, a single ER visit can cost a couple of thousands of dollars. And “frequent flyer” patients can tally up many times that in ER visits and follow-up care.

If Temple wants to help dozens more patients with housing, it will need tens of millions of dollars more per year.

Still, Temple officials said they expect the effort will save money over the long run by reducing expensive hospital visits — but they don’t yet have the data to prove that.

The Temple program was partly inspired by a similar housing effort started at two Duke University clinics in Durham, North Carolina. That program, launched in 2016, has served 45 patients with unstable housing and has reduced their ER use. But it’s been unable to grow because housing funding remains limited. And without data showing the intervention saves on health care costs, the organizers have been unable to attract more financing.

Often there is a need to demonstrate an overall reduction in health care spending to attract Medicaid funding.

“We know homelessness is bad for your health, but we are in the early stages of knowing how to address it,” said Dr. Seth Berkowitz, a researcher at the University of North Carolina-Chapel Hill.

Results Remain to Be Seen

“We need to pay for health not just health care,” said Elena Marks, CEO of the Houston-based Episcopal Health Foundation, which provides grants to community clinics and organizations to help address the social needs of vulnerable populations.

The nationwide push to spend more on social services is driven first by the recognition that social and economic forces have a greater impact on health than do clinical services like doctor visits, Marks said. A second factor is that the U.S. spends far less on social services per capita compared with other large, industrialized nations.

“This is a new and emerging field,” Marks said when reviewing the evaluations of the many social determinants of health studies. “The evidence is weak for some, mixed for some, and strong for a few areas.”

But despite incomplete evidence, Marks said, the status quo isn’t working either: Americans generally have poorer health than their counterparts in other industrialized countries with more robust social services.

“At some point we keep paying you more and more, Mr. Hospital, and people keep getting less and less. So, let’s go look for some other solutions” Marks said.

The covid-19 pandemic has shined further light on the inequities in access to health services and sparked interest in Medicaid programs to address social issues. Over half of states are implementing or expanding Medicaid programs that address social needs, according to a KFF study in October 2020. (The KHN newsroom is an editorially independent program of KFF.)

The Medicaid interventions are not intense in many states: Often they involve simply screening patients for social needs problems or referring them to another agency for help. Only two states — Arizona and Oregon — require their Medicaid health plans to directly invest money into pilot programs to address the social problems that screening reveals, according to a survey by consulting firm Manatt.

The Centers for Medicare & Medicaid Services, which is funding a growing number of efforts to help Medicaid patients with social needs, said it “remains committed” to helping states meet enrollees’ social challenges including education, employment and housing.

On Jan. 7, CMS officials under the Trump administration sent guidance to states to accelerate these interventions. In May, under President Joe Biden, a CMS spokesperson told KHN: “Evidence indicates that some social interventions targeted at Medicaid and CHIP beneficiaries can result in improved health outcomes and significant savings to the health care sector.”

The agency cited a 2017 survey of 17 state Medicaid directors in which most reported they recognized the importance of social determinants of health. The directors also noted barriers to address them, such as cost and sustainability.

In Philadelphia, Temple officials now face the challenge of finding new financing to keep their housing program going.

“We are trying to find the magic sauce to keep this program running,” said Patrick Vulgamore, project manager for Temple’s Center for Population Health.

Sojourner Ahebee, health equity fellow at WHYY’s health and science show, “The Pulse,” contributed to this report.

This story is part of a partnership that includes WHYY, NPR and KHN.

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Black community has new option for health care: The church

Black community has new option for health care: The church

In this May 9, 2021, photo, Rev. Joseph Jackson Jr. talks to his congregation at Friendship Missionary Baptist Church in Milwaukee during a service. He is president of the board of directors for Milwaukee Inner City Congregations Allied for Hope, which along with Pastors United, Souls to the Polls and the local health clinic Health Connections, is working to get vaccination clinics into churches to help vaccinate the Black community. He’s also been urging his congregation during Sunday services to get vaccinated. (AP Photo/Carrie Antlfinger)

MILWAUKEE (AP) — Every Sunday at Friendship Missionary Baptist Church, the Rev. Joseph Jackson Jr. praises the Lord before his congregation. But since last fall he’s been praising something else his Black community needs: the COVID-19 vaccine.

“We want to continue to encourage our people to get out, get your shots. I got both of mine,” Jackson said to applause at the church in Milwaukee on a recent Sunday.

Members of Black communities across the U.S. have disproportionately fallen sick or died from the virus, so some church leaders are using their influence and trusted reputations to fight back by preaching from the pulpit, phoning people to encourage vaccinations, and hosting testing clinics and vaccination events in church buildings.

Some want to extend their efforts beyond the fight against COVID-19 and give their flocks a place to seek health care for other ailments at a place they trust — the church.

In this May 9, 2021, photo, Rev. Joseph Jackson Jr. talks to his congregation at Friendship Missionary Baptist Church in Milwaukee during a service. He is president of the board of directors for Milwaukee Inner City Congregations Allied for Hope, which along with Pastors United, Souls to the Polls and the local health clinic Health Connections is working to get vaccination clinics into churches to help vaccinate the Black community. He’s also been urging his congregation during Sunday services to get vaccinated. (AP Photo/Carrie Antlfinger)

“We can’t go back to normal because we died in our normal,” Debra Fraser-Howze, the founder of Choose Healthy Life, told The Associated Press. “We have health disparities that were so serious that one pandemic virtually wiped us out more than anybody else. We can’t allow for that to happen again.”

Choose Healthy Life, a national initiative involving Black clergy, United Way of New York City and others, has been awarded a $9.9 million U.S. Department of Health and Human Services grant to expand vaccinations and and make permanent the “health navigators” who are already doing coronavirus testing and vaccinations in churches.

The navigators will eventually bring in experts for vaccinations, such as the flu, and to screen for ailments that are common in Black communities, including heart disease, hypertension, diabetes, AIDS and asthma. The effort aims to reduce discomfort within Black communities about seeking health care, either due to concerns about racism or a historical distrust of science and government.

The initiative has so far been responsible for over 30,000 vaccinations in the first three months in 50 churches in New York; Newark, New Jersey; Detroit; Washington, D.C.; and Atlanta.

The federal funding will expand the group’s effort to 100 churches, including in rural areas, in 13 states and the District of Columbia, and will help establish an infrastructure for the health navigators to start screenings. Quest Diagnostics and its foundation has already provided funding and testing help.

Choose Healthy Life expects to be involved for at least five years, after which organizers hope control and funding will be handled locally, possibly by health departments or in alignment with federally supported health centers, Fraser-Howze said.

The initiative is also planning to host seminars in churches on common health issues. Some churches already have health clinics and they hope that encourages other churches to follow suit, said Fraser-Howze, who led the National Black Leadership Commission on AIDS for 21 years.

FILE – In this file photo taken June 6, 2021, first lady Jill Biden, center left, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, Choose Healthy Life public health navigator Linda Thompson and Choose Healthy Life Founder Debra Fraser-Howze, far right, speak to a person as they visit a vaccine clinic at the Abyssinian Baptist Church in the Harlem neighborhood of New York. The church is part of Choose Healthy Life, a national initiative involving Black clergy, United Way of New York City and others, that has just been awarded a $9.9 million U.S. Department of Health and Human Services grant to expand vaccinations and provide screening and other health services in churches. (AP Photo/Craig Ruttle, File)

“The Black church is going to have to be that link between faith and science,” she said.

In Milwaukee, nearly 43% of all coronavirus-related deaths have been in the Black community, according to the Milwaukee Health Department. Census data indicates Blacks make up about 39% of the city’s population. An initiative involving Pastors United, Milwaukee Inner City Congregations Allied for Hope and Souls to the Polls has provided vaccinations in at least 80 churches there already.

Milwaukee is one of the most segregated cities in the country, according to the studies by the Brookings Institution. Ericka Sinclair, CEO of Health Connections, Inc., which administers vaccinations, says that’s why putting vaccination centers in churches and other trusted locations is so important.

“Access to services is not the same for everyone. It’s just not. And it is just another reason why when we talk about health equity, we have … to do a course correction,” she said.

She’s also working to get more community health workers funded through insurance companies, including Medicaid.

The church vaccination effort involved Milwaukee Inner City Congregations Allied for Hope, which is faith organization working on social issues. Executive Director and Lead Organizer Lisa Jones says the effect of COVID-19 on the Black community has reinforced the need to address race-related disparities in health care. The group has hired another organizer to address disparities in hospital services in the inner city and housing, and lead contamination.

At a recent vaccination clinic in Milwaukee at St. Matthew, a Christian Methodist Episcopal church, Melanie Paige overcame her fears to get vaccinated. Paige, who has lupus and rheumatoid arthritis, said the church clinic helped motivate her, along with encouragement from her son.

“I was more comfortable because I belong to the church and I know I’ve been here all my life. So that made it easier.”

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Associated Press religion coverage receives support from the Lilly Endowment through The Conversation U.S. The AP is solely responsible for this content.

NIH director: We asked God for help with COVID-19, and vaccines are the ‘answer to that prayer’

NIH director: We asked God for help with COVID-19, and vaccines are the ‘answer to that prayer’

WASHINGTON (RNS) — Earlier this month, the White House announced a “month of action” to help ensure 70% of U.S. adults are at least partially vaccinated by July 4. Officials have since outlined a flurry of faith-based partnerships, hoping to leverage the clout and know-how of faith groups to aid in immunizing the public against COVID-19.

To help explain the role of faith groups in the national vaccine push, Religion News Service spoke with Francis Collins, an evangelical Christian who also serves as director of the National Institutes of Health. Collins discussed the program, as well as his faith and how he views the intersection of religion and science. This interview has been edited for length and clarity.

Why is the government is looking to religious groups for help in vaccination efforts?

It’s nice to be able to have this conversation. As a scientist and a person of faith, this is right in my sweet spot.

People of faith have issues (with vaccines), and every person has some different set they’re concerned about. When getting an answer from a guy like me, a scientist who works for the government, maybe they say, “Well, maybe he has a reason to want us to do this.” But if your pastor says, “I’ve looked at this information and I want what’s best for my congregation. I don’t want to see more people die from this terrible illness that’s taken almost 600,000 American lives. So I’ve educated myself, and I’d like you to know, from me, the benefits and risks. Can we talk about it?” — that gets people’s attention.

While vaccine hesitancy or anti-vaccine sentiment is not unique to any faith group, a recent poll found white evangelicals have a higher-than-average rate of vaccine refusals. But the same poll also found many of them said they could be persuaded by faith-based overtures. Have you seen evidence these overtures are moving the needle?

Yes, although it’s hard to collect really solid data to say how many people changed their minds because they heard from a faith leader. I could give you lots of anecdotes — although the plural of anecdotes is still not data.

I do think it is not a stretch to say, for all of us who’ve prayed for deliverance from COVID-19, the vaccines are an answer to that prayer. That is very much consistent with the way God often responds to our needs — by working through human capabilities that we’ve been given as a gift by the Creator. Why wouldn’t you want to take that gift and not just look at it, but open it up and then roll up your sleeve?

You noted federal government officials aren’t always the most effective messengers to some communities. But as an evangelical Christian, what about your faith compels you to want to embark on this vaccine push?

When you look at what we know about the time Jesus spent on this earth, it is interesting — read through the four Gospels — how many instances where he is involved in healing. If we are called to be followers, as I am, then shouldn’t we also find opportunities to provide healing as well?

If anybody asks you, “Has it been that bad?” Well, gosh, we’ve lost almost 4 million lives on the planet, and almost 600,000 right here in the United States of America. It’s not over, and if we don’t get the vaccinations up to a high enough level, we may see in the fall and the winter a resurgence — particularly in areas where vaccines were least adopted. Then here we are all over again with people in ICUs, people dying that didn’t have to. As believers, is that something we can look away from? I don’t think so.

Many religious communities of color have not only been disproportionately impacted by the pandemic, but also suffer from access issues when it comes to vaccines. Have you seen dividends from efforts by the White House and others to partner with faith groups to help combat those access issues?

Absolutely. That has included some churches that have volunteered to be sites for immunization — right in their fellowship hall. That’s a great thing to do. In this national month of action, we have done additional outreach to those communities that haven’t felt necessarily like they had access, making it possible to get immunized in the barbershop or in the beauty salon, or providing child care for people who might otherwise have trouble figuring out “How am I going to get a shot when I have these two little kids with me that are going to need my attention every second?”

The federal government’s partnership with faith groups in this vaccine push seems unusually robust. What is it about faith communities that makes them particularly beneficial when it comes to vaccination?

As the director of the National Institutes of Health for the last 12 years, we have had partnerships with faith communities for things like hypertension screening, diabetes management and asthma management, but nothing quite like this.

It has been an inspiring occasion, I have to say, to have the opportunity to work side by side with leaders of the faith community to try to get this healing information in front of people. And I hope when we get through COVID-19, which we will, that we won’t lose that.

As a medical expert and a person of faith, what do you think gets left out of disputes between faith groups and the medical community during this pandemic?

One of my goals as a person of faith and a scientist is trying to get people to see the wonderful complementarity and the harmony of scientific and spiritual worldviews.

But I think a lot of people in faith communities haven’t found that to be the case, and maybe have even heard things from the pulpit like “You can’t really trust those scientists because they’re all atheists.” Well, here’s one who’s not, and I’m not alone: About 40% of working scientists are believers in a God who answers prayer. There’s a lot of us out there.

Maybe this is another occasion to try to get a broader understanding about how science and faith are wonderfully complementary. Science is great at answering questions that might start with “how?,” and faith is really good at answering questions that start with “why?” Don’t you, as a person on this planet for a brief glimpse of time, want to be able to ask and maybe get answers to both those types of questions?

Have you seen some of that distrust slip away?

I have, yeah. Going back more than 20 years ago, it did seem like there was a lot of tension for me as an evangelical. There were times where I wasn’t sure I was welcome in the church, and then I’d go to the lab, and I wasn’t sure I was feeling welcomed there either. I wrote a book about this called “The Language of God” back in 2005, trying to put forward arguments about how science and faith really are different ways of looking at God’s creation. It got a lot more attention than I expected.

I think out of that, and a number of other efforts … I do see there has been a shift here, more of a willingness to consider what the harmony is instead of what the battle is.

Are you optimistic the U.S., with the help of faith communities, can meet this July Fourth deadline to partially vaccinate 70% of the adult population?

I am optimistic, but it’s going to be a stretch. It’s going to take the full efforts of lots and lots of people — and especially faith communities — to get us there over what is just another three weeks.

The number of immunizations happening each day is just barely on that pathway, and it actually looks as if some of those immunization levels are dropping instead of going up. We need everybody to line up behind this goal, recognizing this isn’t about pleasing Joe Biden, because a lot of evangelicals are not that interested in pleasing Joe Biden. This is about saving lives.

 

Trying to Avoid Racist Health Care, Black Women Seek Out Black Obstetricians

Trying to Avoid Racist Health Care, Black Women Seek Out Black Obstetricians

In South Florida, when people want to find a Black physician, they often contact Adrienne Hibbert through her website, Black Doctors of South Florida.

“There are a lot of Black networks that are behind the scenes,” said Hibbert, who runs her own marketing firm. “I don’t want them to be behind the scenes, so I’m bringing it to the forefront.”

Hibbert said she got the idea for the website after she gave birth to her son 15 years ago.

Her obstetrician was white, and the suburban hospital outside Miami didn’t feel welcoming to Hibbert as a Black woman pregnant with her first child.

“They had no singular photos of a Black woman and her Black child,” Hibbert said. “I want someone who understands my background. I want someone who understands the foods that I eat. I want someone who understands my upbringing and things that my grandma used to tell me.”

In addition to shared culture and values, a Black physician can offer Black patients a sense of safety, validation and trust. Research has shown that racism, discrimination and unconscious bias continue to plague the U.S. health care system and can cause unequal treatment of racial and ethnic minorities.

Black patients have had their complaints and symptoms dismissed and their pain undertreated, and they are referred less frequently for specialty care. Older Black Americans can still remember when some areas of the country had segregated hospitals and clinics, not to mention profoundly unethical medical failures and abuses, such as the 40-year-long Tuskegee syphilis study.

But even today, Black patients say, too many clinicians can be dismissive, condescending or impatient — which does little to repair trust. Some Black patients would prefer to work with Black doctors for their care, if they could find any.

Hibbert is working on turning her website into a more comprehensive, searchable directory. She said the most sought-after specialist is the obstetrician-gynecologist: “Oh, my gosh, the No. 1 call that I get is [for] a Black OB-GYN.”

For Black women, the impact of systemic racism can show up starkly in childbirth. They are three times as likely to die after giving birth as white women in the United States.

Nelson Adams is a Black OB-GYN at Jackson North Medical Center in North Miami Beach, Florida. He said he understands some women’s preference for a Black OB-GYN but said that can’t be the only answer: “If every Black woman wanted to have a Black physician, it would be virtually impossible. The numbers are not there.”

And it’s also not simply a matter of recruiting more Black students to the fields of medicine and nursing, he said, though that would help. He wants systemic change, which means medical schools need to teach all students — no matter their race, culture or background — to treat patients with respect and dignity. In other words, as they themselves want to be treated.

“The golden rule says, ‘Do unto others as you would have them do unto you,’ so that the heart of a doctor needs to be that kind of heart where you are taking care of folks the way you would want to be treated or want your family treated,” he said.

George Floyd’s murder in Minneapolis in May 2020, and the subsequent wave of protests and activism, prompted corporations, universities, nonprofits and other American institutions to reassess their own history and policies regarding race. Medical schools were no exception. In September, the University of Miami Miller School of Medicine revamped its four-year curriculum to incorporate anti-racism training.

New training also became part of the curriculum at Florida Atlantic University’s Charles E. Schmidt College of Medicine in Boca Raton, where students are being taught to ask patients about their history and experiences in addition to their bodily health. The new questions might include: “Have you ever felt discriminated against?” or “Do you feel safe communicating your needs?”

“Different things that were questions that we maybe never historically asked, but we need to start asking,” said Dr. Sarah Wood, senior associate dean for medical education at Florida Atlantic.

The medical students start learning about racism in health care during their first year, and as they go, they also learn how to communicate with patients from various cultures and backgrounds, Wood added.

These changes come after decades of racist teaching in medical schools across the United States. Adams, the OB-GYN, completed his residency in Atlanta in the early 1980s. He recalls being taught that if a Black woman came to the doctor or hospital with pain in her pelvis, “the assumption was that it was likely to be a sexually transmitted disease, something we refer to as PID, pelvic inflammatory disease. The typical causes there are gonorrhea and/or chlamydia.”

This initial assumption was in line with a racist view about Black women’s sexual activity — a presumption that white women were spared. “If the same symptoms were presented by a Caucasian, a white young woman, the assumption would be not an STD, but endometriosis,” Adams said. Endometriosis is not sexually transmitted and is therefore less stigmatizing, less tied to the patient’s behavior.

That diagnostic rule of thumb is no longer taught, but doctors can still bring unconscious racial bias to their patient encounters, Adams said.

While they revamp their curricula, medical schools are also trying to increase diversity within their student ranks. Florida Atlantic’s Schmidt College of Medicine set up, in 2012, a partnership with Florida A&M University, the state’s historically Black university. Undergraduates who want to become doctors are mentored as they complete their pre-med studies, and those who hit certain benchmarks are admitted to Schmidt after they graduate.

Dr. Michelle Wilson took that route and graduated from Schmidt this spring. She’s headed to Phoebe Putney Memorial Hospital in Albany, Georgia, for a residency in family medicine. Wilson was drawn to that specialty because she can do primary care but also deliver babies. She wants to build a practice focused on the needs of Black families.

“We code-switch. Being able to be that comfortable with your patient, I think it’s important when building a long-term relationship with them,” Wilson said.

“Being able to relax and talk to my patient as if they are family — I think being able to do that really builds on the relationship, especially makes a patient want to come back another time and be like, ‘I really like that doctor.'”

She said she hopes her work will inspire the next generation of Black doctors.

“I didn’t have a Black doctor growing up,” Wilson said. “I’m kind of paving the way for other little Black girls that look like me, that want to be a doctor. I can let them know it’s possible.”

This story is part of a partnership that includes NPR, WLRN and KHN.

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.

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