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.

Subscribe to KHN's free Morning Briefing.

Slave-built infrastructure still creates wealth in US, suggesting reparations should cover past harms and current value of slavery

Slave-built infrastructure still creates wealth in US, suggesting reparations should cover past harms and current value of slavery

The Port of Savannah used to export cotton picked by enslaved laborers and brought from Alabama to Georgia on slave-built railways. Cotton is still a top product processed through this port. Joe Sohm/Visions of America/Universal Images Group via Getty Images
Joshua F.J. Inwood, Penn State and Anna Livia Brand, University of California, Berkeley

American cities from Atlanta to New York City still use buildings, roads, ports and rail lines built by enslaved people.

The fact that centuries-old relics of slavery still support the economy of the United States suggests that reparations for slavery would need to go beyond government payments to the ancestors of enslaved people to account for profit-generating, slave-built infrastructure.

Debates about compensating Black Americans for slavery began soon after the Civil War, in the 1860s, with promises of “40 acres and a mule.” A national conversation about reparations has reignited in recent decades. The definition of reparations varies, but most advocates envision it as a two-part reckoning that acknowledges the role slavery played in building the country and directs resources to the communities impacted by slavery.

Through our geographic and urban planning scholarship, we document the contemporary infrastructure created by enslaved Black workers. Our study of what we call the “landscape of race” shows how the globally dominant economy of the United States traces directly back to slavery.

Looking again at railroads

While difficult to calculate, scholars estimate that much of the physical infrastructure built before 1860 in the American South was built with enslaved labor.

Railways were particularly critical infrastructure. According to “The American South,” an in-depth history of the region, railroads “offered solutions to the geographic barriers that segmented the South,” including swamps, mountains and rivers. For inland planters needing to get goods to port, trains were “the elemental precondition to better times.”

Our archival research on Montgomery, Alabama, shows that enslaved workers built and maintained the Montgomery Eufaula Railroad. This 81-mile-long railroad, begun in 1859, connected Montgomery to the Central Georgia Line, which served both Alabama’s fertile cotton-growing region – cotton picked by enslaved hands – and the textile mills of Georgia.

Sepia-toned lithograph of six Black men and women in sunhats and overalls in a cotton field
Picking cotton outside Savannah, Ga., in 1867. Library of Congress

The Eufala Railroad also gave Alabama commercial access to the Port of Savannah. Savannah was a key cotton and rice trading port, and slavery was integral to the growth of the city.

Today, Savannah’s deep-water port remains one of the busiest container ports in the U.S. Among its top exports: cotton.

The Eufala Railroad closed in the 1970s. But the company that funded its construction – Lehman Durr & Co., a prominent Southern cotton brokerage – existed well into the 20th century.

Examining court affidavits and city records located in the Montgomery city archive, we learned the Montgomery Eufaula Railroad Company received US$1.8 million in loans from Lehman Durr & Co. The main backers of Lehman Durr & Co. went on to found Lehman Brothers bank, one of Wall Street’s largest investment banks until it collapsed in 2008, in the U.S. financial crisis.

Deep knowledge, daily. Sign up for The Conversation’s newsletter.

Slave-built railroads also gave rise to Georgia’s largest city, Atlanta. In the 1830s, Atlanta was the terminus of a rail line that extended into the Midwest.

Some of these same rail lines still drive Georgia’s economy. According to a 2013 state report, railways that went through Georgia in 2012 carried over US$198 billion in agricultural products and raw materials needed for U.S. industry and manufacturing.

Black and white image of an old train depot
The 1872 Vicksburg & Brunswick Depot, a passenger and freight station in Eufala, served the Eufala and Georgia Central rail lines, among others. Library of Congress

Rethinking reparations

Savannah, Atlanta and Montgomery all show how, far from being an artifact of history, as some critics of reparations suggest, slavery has a tangible presence in the American economy.

And not just in the South. Wall Street, in New York City, is associated with the trading of stocks. But in the 18th century, enslaved people were bought and sold there. Even after New York closed its slave markets, local businesses sold and shipped cotton grown in the slaveholding South.

Black-and-white lithograph of a wide street lined with large buildings
Wall Street around 1850. New York Public Library

Geographic research like ours could inform thinking on monetary reparations by helping to calculate the ongoing financial value of slavery.

Like scholarship drawing the connection between slavery and modern mass incarceration, however, our work also suggests that direct payments to indviduals cannot truly account for the modern legacy of slavery. It points toward a broader concept of reparations that reflects how slavery is built into the American landscape, still generating wealth.

Such reparations might include government investments in aspects of American life where Black people face disparities.

Last year the city council in Asheville, North Carolina, voted for “reparations in the form of community investment.” Priorities could include efforts to increase access to affordable housing and boost minority business ownership. Asheville will also explore strategies to close the racial gap in health care.

It is very difficult, perhaps impossible, to calculate the total contemporary economic impact of slavery. But we see recognizing that enslaved men, women and children built many of the cities, rail lines and ports that fuel the American economy as a necessary part of any such accounting.The Conversation

Joshua F.J. Inwood, Associate Professor of Geography Senior Research Associate in the Rock Ethics Institute, Penn State and Anna Livia Brand, Assistant Professor, University of California, Berkeley

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Why people with disabilities are at greater risk of going hungry – especially during a pandemic

Why people with disabilities are at greater risk of going hungry – especially during a pandemic

Stocking up on food can be tough when using a wheelchair, motorized scooter, walker or cane. Paul Hennessy/NurPhoto via Getty Images
Melissa L. Caldwell, University of California, Santa Cruz

The COVID-19 pandemic has revealed uncomfortable and distressing truths about American society: namely, the struggle many Americans face just getting by.

Yet, while the pervasive food insecurity that has always existed in the U.S. became more visible, how the problem disproportionately affects people with disabilities has received less attention.

As an ethnographer of food, poverty and welfare, I study how people respond to economic scarcity through caregiving networks. Although caregiving networks like neighborhood mutual aid groups and pop-up food banks quickly emerged to support vulnerable groups during the pandemic, people with disabilities have continued to face additional challenges.

High risk of food insecurity

An estimated 25% of U.S. adults have some form of physical or intellectual disability. Functional disabilities – such as the inability to walk more than a quarter of a mile, climb stairs or lift objects weighing over 10 pounds – are among the most common.

People with disabilities are more likely to experience other chronic health conditions such as anxiety and depression, arthritis and cardiovascular problems. They also have higher rates of unemployment and economic instability. In 2019, the poverty rate for Americans with disabilities was almost 27% – more than double the rate of those without disabilities.

Collectively, these factors put them at greater risk for food insecurity, which the USDA defines as limited or uncertain access to adequate food.

Yet people with disabilities are underrepresented in accounts of pandemic-related poverty and food insecurity. Given their reduced access to food shopping, they are less likely to be included in research on disruptions to the food system. This is prompting demands from health researchers and disability activists for greater attention and solutions.

Shopping with a disability

Even before the pandemic, limited physical access to food shopping and preparation for persons with disabilities led to greater reliance on precooked and heavily processed foods.

In the early stages of the pandemic, many Americans endured long lines and stocked up on groceries to avoid repeat trips to the stores. But these inconveniences – as well as going from store to store in search of scarce goods – can be physically and emotionally grueling for people with limited mobility or stability, or who are easily exhausted. And although many supermarkets created special shopping hours for elderly and disabled customers, getting there at specific times required people to either be able to drive or navigate the scheduling uncertainties of public transportation.

Once inside stores, disabled persons are further disenfranchised by the physical limitations of shopping. Shopping for one to two weeks – as public health officials had recommended – is especially difficult while using a wheelchair or motorized scooter that holds only a small basket of goods. The same is true for pushing a cart or carrying a basket while using a walker or cane.

Customers who are able to drive themselves to shop may also find themselves unable to get their items from the store into their vehicles. Stores that once offered assistance stopped these services in order to protect their employees.

Food donation and delivery programs attempted to meet some of these needs by providing meals and groceries for several days or even weeks at time. Despite these efforts, demand outstripped the availability of both food supplies and volunteers.

For some individuals with disabilities, going to a food bank or community service center was also an important social encounter – an opportunity to visit friends, access news and interact with social workers. Once those programs were shuttered or made contactless, many people were further isolated in their homes. Studies have shown that social isolation among people with disabilities reduces not only access to food but also the motivation to prepare and eat food.

While new digital technologies have allowed customers to outsource their food shopping to gig workers, they require basic infrastructure, equipment and knowledge that may be unaffordable to low-income people with disabilities. Moreover, reliance on others to choose one’s food can cause people to feel a loss of control and autonomy over their food choices.

In many ways, the stories that have been most visible around food insecurity have been those of the people who were in fact able to stand in lines, stock up on groceries and even barter with neighbors for supplies. During a pandemic that has made life much more difficult for billions of people around the world, I believe the experiences of disabled persons have become further marginalized and less visible.

[Insight, in your inbox each day. You can get it with The Conversation’s email newsletter.]The Conversation

Melissa L. Caldwell, Professor of Anthropology, University of California, Santa Cruz

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Finding Faith and Community on Virtual Campuses: An Interview with Shaylen Hardy

Finding Faith and Community on Virtual Campuses: An Interview with Shaylen Hardy

Last year the pandemic disrupted the world as we know it–leaving most college students grappling with how to live in a world without access to community, coupled with the pressure of continuing their education. 

For Black students, the exposure of racism locally, nationally, and globally made the Great Disruption even more difficult. The nation witnessed the deaths of Black men and women at the hands of law enforcement and vigilantes while being forced to quarantine. White supremacy and racist rhetoric were often unveiled from the mouths of people who identified as Christian, which left many students wrestling with their faith on multiple fronts without the normal practices and people to help encourage them. 

But in the midst of the turmoil and testing, leaders of campus ministries sought to support  Black students. I had the opportunity to interview Shaylen Hardy, the President of Intervarsity’s Black Campus Ministries, about her experiences and insight leading one of the largest networks of Black campus ministries through the pandemic. Some highlights of our conversation are below, and the full interview can be viewed above and on UrbanFaith.com!

The interview has been edited for clarity.

 

Allen:

I’ll open up our first question, Shaylen. From your perspective, what are some of the challenges that you have seen Black students face in the last year as they’ve lived through this pandemic and the social unrest in our country? 

 

Shaylen:

Yeah, I mean, I think you named some of the major things that they’re facing. I think another thing with Generation Z is mental health issues. We already knew coming into this year, or pre-pandemic, that Generation Z experiences significantly higher amounts of mental health issues. So as you think about it, some of the racial reckoning that we’re seeing in the nation, plus the weight of the pandemic, are actually just compounding the mental health issues that those students were experiencing already. So some of the ways in which they may have negotiated or worked through their mental health challenges, like being with friends, or engaging in activities that are life giving to them, were taken away instantly. So, the challenges of coping with mental health complications are something that we’re seeing. 

And also their academic coursework. I mean, many of us remember getting up in the morning, going to class, and just the weight of that. But there’s a different [pressure] when you have to be virtual and on Zoom calls all day long.  They are expected to retain everything that they’re hearing without the personal interaction with their teachers and other students, and just the fatigue. Many of us working via Zoom for this last year were also experiencing fatigue, but we’re not being tested week in and week out on what we heard during those calls.

 

Allen:  

That makes a lot of sense. A follow-up question that I have is, how are the students able to gather together in life giving ways with organizations like Intervarsity, or with one another? How, in the midst of being virtual, are they finding community?

 

Shaylen:

Yeah, I think part of it is being somewhat creative. And so we recognize that one of our only ways of interacting is virtually. And we know that we’re inviting them to come back into a virtual space after they’ve spent most of their day on it. But we think through developing community in a couple of different ways. 

Yes, we still do our Bible study, and yes, we still have prayer meetings and things like that. But we host virtual game nights where we invite students to come play Spades or stUno, and we have virtual movie nights where we play a movie and students can chat about what they’re experiencing. So we think that community is still very, very vital to their mental, emotional, and spiritual well-being. We just have to be creative in how we use virtual mechanisms to help build that community so that when we are able to go back to the new normal, they can pick up where they left off with one another

 

Allen:

Yeah, that makes a lot of sense. I think that hybrid is kind of the future of the world at this point, right? Like, things are not going back to the way that they were. You just mentioned how people are using these hybrid mediums in order to engage in order to strengthen themselves and their faith. What are some of the ways that you’ve seen students really be able to feed their faith or keep themselves encouraged?

 

Shaylen:

I think part of it is we do small groups on different campuses and across the country, and we have had a national virtual conference for students to engage. I think one of the things that we’re learning about Generation Z is that because they have so much content available to them, just showing them a video  isn’t enough. They’re like, help me figure out what I’m supposed to do with what I just heard. And so we’ve actually been able to have a couple breakout sessions [that are]  conversations about what’s happening in the world and what Jesus has to say about justice. And students are like, “Yeah, that was great.” And then we have to follow up by sharing the next two steps to take if you want to figure out how to be more active and engage in what’s happening in the world. So I think part of it is yes, content. But if you think about it, this generation has more access to more content than anyone has ever had. So what we’re seeing is this generation is like, “Yeah, give me content. And when you give it to me, make sure it looks good, but also help me figure out what you want me to do with what I just heard.”

 

Allen:

Wow, that’s huge. The application part makes a big difference for them. Now, the other thing that has been impacting us is not just a pandemic, but also this racial unrest. And I’m really curious, how have you been hearing Black students talk about this deal with this with their faith? How is the racial unrest been impacting them in particular in these times? 

 

Shaylen:

I think in some ways, it’s connected to some of the mental health issues.  Like, it is hard for me to show up because of all of the trauma that I’m experiencing, and so that is compounded with that mental health tension, and then I have to show up and engage academically. But also, I have to be social and be competent in my interaction with my classmates. So it’s like they’re having to pull it all together to be okay, when they don’t feel okay. So that’s definitely a tension that they’re experiencing. 

I will say that we’ve tried to have conversations to help students think through what Jesus has to say about what is happening right now. And I think that a lot of people who would challenge the Christian faith or the Christian perspective will point to broader White evangelicalism of: “That is why Jesus cannot be trusted.” And so some of our students are trying to wrestle with, if this is the fruit [meaning racism], and they say they love Jesus,, can this be compatible with me following Jesus? 

Part of what we’ve had to do is actually expose some of the lies of White evangelicalism. And yes, you can fully follow Jesus as a Black person, as a nAfrican American, as an African [person]. All of those things are compatible with Jesus. But in some ways, I think in order to make that case, we’ve had to k pull back the curtain and say things like, “These are the lies that have been intertwined with American Christianity, and this is why Jesus is trustworthy.” On the one hand, [we] also speak to what Jesus has to say about the Black experience. And I think that there have been moments when [for Black students and myself] I see what’s happening in the world and I live as a Black [person] experiencing it [and], I’m like, “Lord, when will you show up?”

 

Allen:

That makes a lot of sense. What are some of the other ways that you’re coming alongside these students or ministering to them with Intervarsity? Or even the wider campuses? I know that you guys do work, not just with students, but with folks who are supporting students on campuses. So what have you all been doing in the midst of all this to support campuses?

 

Shaylen:

I think I’m connected to some of our spaces. So we’ve had a psychologist come in and talk about racial trauma, sharing her insights. And then we had breakout rooms where students were able to discuss what they were experiencing. And then from that point, we have prayer ministry rooms. So we’re getting into spaces where students can actually share their story and not just about what they have been experiencing, but also connect to prayer ministry. 

And similarly, at our virtual student conference we had over 300 students and about 10 faculty join us. So we had a conversation and then invited people into prayer ministry rooms. One of the things that was really surprising to me is that I felt like we recruited really well for our prayer ministry rooms, but we were continually having to call in reinforcements because the need and the hunger for prayer was so strong. In a virtual space, we had a Zoom room with music playing [where people could wait for a minister to be available].  There was one point, when I was recruiting people in there who jumped on 20 minutes after we started because they needed people. And there were students just waiting quietly in the prayer room until somebody was available. I think that that was such a stark picture of how we categorize youth often, like they aren’t interested in spiritual things or they don’t love Jesus. [But] they are hungry for what Jesus wants to give them. These students sat through an hour and a half or two hours of programming. And they are sitting in a Zoom call, listening to worship music because they want somebody to pray with them. 

I think just giving those opportunities for people to have encounters with the Lord [is important]. One of the things that we’re learning about Generation Z is that they want access to experts. I think millennials want to be the experts. Generation Z is like, “Just connect me with somebody who knows what they’re doing.” I don’t know that we anticipated this or actually know how it would work virtually. But offering that prayer ministry space has been super significant for students. 

And then I think the second piece that I mentioned earlier, is just opportunities for helping them figure out how to actually do it– how to apply the message to their lives.

 

Allen

So that provides a really great segue for another question I have, especially for a lot of the folks in our audience. We’re touching people who are Christians and especially churches all over the place. And it sounds like there’s a space for the church and an opportunity to reach some of these students. What kind of roles do you think the church can offer to these students as they’re dealing with things on campus and going through this this time?

 

Shaylen

I think one of the things that as I’ve been working on and trying to identify is, how do we actually care for Black college students, and what are the support structures that exist on college campuses? For HBCUs, there’s much more of a community of people already there who can pour into you and to develop you. For students who end up at predominantly White institutions, that looks quite different. 

[On HBCU campuses] there are often support structures and Black professionals who can help pour into you in the same way you were used to in high school. It sticks out to me that Generation Z wants to be developed. They want people who know what they’re doing to guide them.But on PWI campuses, it is very hard to have access to that. And that’s compounded. Most PWIs are surrounded by churches. White churches have money, so they surround the campus. But in most campus contexts, Black churches are about 10 to 15 minutes away from most campuses. And then basically, you’re saying for a Black college student to be connected to community, or to be connected to an older people who could pour into them, pray for them, and care for them, they have to find a way to get there. 

And so I think that my question would be, are there ways that Black church communities can be intentional about supporting Black students on college campuses? Now that’s a little bit complicated due to COVID because we just don’t know how accessible campuses will be, right? But as they open [there are opportunities]. 

My church has been thinking through things like, how do we care more for Black college students? And so I [gave them suggestions’ and  we actually started partnering with a student organization. We attended their meeting every so often and brought a whole bunch of food–wings, pizza.e would let them do their meeting, then do an icebreaker and ask if anyone needed prayer. 

And then we ended up having a college day later in the semester, and we had never had so many college students at our church. I want to say that over 100 college students came over to the event. And part of it was because they saw us being active on campus–they saw us caring about them. We didn’t do a full church service. That’s something we could consider down the road. But basically, we were saying, “We just want to know what you’re going through.” We want to support you. 

Churches might think that they have to have a robust strategy for recruiting for building a whole separate ministry, but I don’t think that they need to do all that. Are there two or three students that somebody in your congregation has trust with? If the answer is yes, ask them, or, for Generation Z, tell them how you want to support them. Say, “Hey, I know that I have meetings on campus. Would it be okay, if our church sponsors dinner for you at one meeting per month? We would just love to meet them and see if there’s a way for us to pray for them.” And then figure out ways that you can invite them to partner with you for something that you’re doing in the community or invite them to church. We don’t have to have a whole robust strategy. It can really start off with relationships.

 

Allen

Wow, I love that relationship piece. And just allowing us to again build relationships as churches with students and be able to support them where they are. So my last question is, with all of that’s going on, are there other people who may be around campuses who  can continue to make an impact with Gen Z?

 

Shaylen

Yeah, so we have a ministry in a university that’s targeted towards Black graduate students and Black faculty. It is called Black Scholars and Professionals, and they recently had a prayer call with Black faculty across the country. I want to say there were 45 faculty who jumped on [the call]. art of that was for encouragement and to tell testimonies of where they’re at and to pray together. 

As we think about faculty, they are carrying tremendous weight. There is the leadership that they already have on campus, but often for Black faculty, they have the unwritten roles of caring for Black students and speaking for diversity issues. And so they are carrying tremendous weights. One of the things that we try to do is to see how we can care for this spiritual life and help a faculty. As we think about wanting to see transformation on campus, students are there for four to five years, but faculty actually have significant influence on both students [and campuses]. If we can care for the spiritual life of faculty, they have access into [students’] lives in ways that we don’t. 

We’re trying to think through what faculty need so we can be present to their needs, but also for prayer and fellowship. On the student side of things, we have a point person on most campuses  who can provide discipleship and engagement. But also, we’ve been trying to kind of brainstorm how to do this work, even if we don’t have a staff available. 

The reality is, for the amount of Black students who are on college campuses across the U.S., we don’t now, nor will we ever,  have enough campus staff to reach all of them. How can we actually empower students to reach other students? How can we empower volunteers to reach other students? We are trying to be creative [about] how to partner churches, alumni, people in the community and students  to do the work of reaching other people on campus.

 

Allen

Absolutely. I thank you for naming just the needs of the faculty because they don’t get thought about a lot. Is there anything else you wanted to just say?

 

Shaylen

So, I would say that being in college is a really, really important time. You’re figuring out who you are, what you believe, and also what you’re going to be about. A lot of the decisions that you make in college shape who you are for the next 40 to 50 years. One of the difficult parts about college is that those decisions are made when you’re the most distant you’ve ever been from your spiritual community and [broader] community. So I want to encourage college students to look for people who can support them on the journey, because it’s significant– these are important decisions. Ask your parents and pastors who they know in the school or college town. If they don’t know anyone, reach out to different networks to try to figure out who in your community will support you. 

I think about my local church community when I moved into the town. They were so extremely helpful people wanting to pour into me–people wanting to know what I was  passionate about. Generation Z, doesn’t like the idea of taking the risk and going to somebody’s church or a place you don’t know. Having to socially interact with them in person might seem very, very risky. But I think thatB the benefit will far outweigh the risk.  That’s where you can have intergenerational fellowship. I think you will get much more than you are giving, and it will be worth much more than you risk. Ask your spiritual community where you are, if there’s any connections to where you’re going, and then seek those out. And if they aren’t a good  fit for you, I promise there’s someone in the community who can help you develop into who the Lord is calling you to be.

Allen  

Well, thank you so much for this interview, Shaylen. It has been fantastic. It’s awesome work that the Intervarsity Black Campus Ministries is doing all around the country. You guys are impacting so many students, faculty, and grad students. It’s wonderful to be with you again. And I hope that people are able to take something from this. I know that I’ve learned a lot about what’s going on on campuses, especially in the pandemic with racial unrest.  God bless you in this work.

Shaylen 

Thank you. And lastly, I’ll just say, we are on social media if people kind of want to see some of the things that we’re doing. It’s under Black Campus Ministries on Instagram, and we’re on Facebook. If you want more information, you can check out our website at BCM.intervarsity.org 

Remembering the Black Wall Street Massacre

Remembering the Black Wall Street Massacre

Black Wall Street

Our rural and urban Black communities deserve better. Take the stories and biblical connections in
Building a City on a Hill and use them to make a difference.

On May 30th, 1921, in Greenwood, Oklahoma, a blood-thirsty mob burned down a wealthy and prosperous Black community because of a false accusation.

Tulsa’s north side was a prosperous community, exclusively Black because Jim Crow law had prohibited Negroes from living in white neighborhoods, where it was said more than 3,000 Klu Klux Klan members resided in the area. At that time, there were countless all-Black communities like Greenwood scattered throughout the US. 60 in Oklahoma territory alone. Greenwood, however, was the jewel of Negro America. Though white Tulsan’s called it Little Africa, Booker T. Washington gave it the name we know today, Black Wall Street. And it was the wealthiest Black community in America where Black men and women came to pursue the American dream. It boasted Black-owned banks, pharmacies, grocery stores, movie theaters, restaurants, churches, newspaper publishing, law offices, a bus company, its own school district where the average student wore a uniform with a suit and tie, a business college, a hospital with an entire Black staff and an internationally acclaimed surgeon, Black millionaires, which Greenwood was known to have had more millionaires residing there than the entire United States combined.

One of the only two airports in the state of Oklahoma was for the half dozen private airplanes owned by its Black oil tycoons. To top it off, the minimum wage and living standard of a resident of Black Wall Street far exceeded Tulsa’s average white citizen, but on May 30th, 1921, all that changed. Dick Rowland, a shoeshine boy, entered the Drexel building elevator to use only a few colored bathrooms in downtown Tulsa. On the top floor, Sarah Page, a 17-year-old white elevator operator, began operating the elevator when it lurched, causing Rowland to stumble. He bumped into Sarah, and she screamed. Rowland knew what Frederick Douglass had penned as the truth regarding the treatment of Black men in America. To be accused was to be convicted, and to be convicted was to be punished.

In this case, when it came to a white woman’s accusations, punishment meant death, and knowing her scream was a likely death sentence, young Rowland ran away. He was later seized and apprehended with the intent of being lynched. Word of a Black man raping a defenseless white girl spread throughout the Tulsa area. Dozens and then hundreds of white men grew to a mob of over 2000 white men gathered at the County courthouse demanding justice. But justice for what? Sarah Page wasn’t assaulted, her clothes weren’t ruffled, and though her story wavered during questioning, she ultimately affirmed she was not harmed.

Moreover, she refused to sign a statement saying that she had been raped. But don’t let the facts get in the way of a false accusation of a Black man who needed to be put in his place — at the end of a rope. The Tulsa Tribune headlines screamed, “A Negro Assaults a White Girl.”

And later, “To Lynch Negro Tonight.”

With no basis and fact for the allegations of rape, the mob persisted in their demand for justice of a white girl who emphatically stated that no injustice had been done. Walter White of the New York Evening Post wrote, “Chief of police, John A Gustafsson, sheriff McCullough, mayor T.D. Evans and many reputable citizens, among them a prominent oil operator, all declared the girl had not been molested, that no attempt at criminal assault had been made. Victor F. Barnett, the managing editor of The Tribune, stated that his paper had since learned that the original story that the girl’s face was scratched, and her clothes torn was untrue.”

And there you have it, fake news. But the damage had already been done, and the wheels were set in motion. Armed Black World War 1 veterans were among the less than 100 members of the Greenwood community who came to prevent another lynching of a Black man, as thousands had been lynched since the generation of reconstruction. A verbal confrontation led to a shot being fired, triggering what would soon become the bloodiest racial conflict in American history. Some 500 members of the white mob were armed and deputized by city officials, and those who didn’t own weapons looted stores to obtain guns and ammunition along the way. Thousands of angry white men descended upon “Little Africa” as a few white families provided sanctuary to those fleeing from violence.

For 24 hours, the mob looted, murdered, and raised the wealthiest Black city in America to the ground. Eyewitness testimony stated a dozen or more planes circled the Black area, dropping burning turpentine balls over Greenwood’s city and firing bullets at Black residents, young and old, gunning them down in the streets. It was the first and only time Americans used planes to attack and kill their own citizens, as it destroyed an entire city. Authorities engaged in a concerted effort to prevent help from arriving until considerable damage was done by cutting off communication, requesting help, blocking transportation ways of firefighters and ambulances, and even preventing the Red Cross from coming in earlier to help the injured and terrorized community.

“As they passed the city’s most traveled street, they held both hands high above their heads, their hats in one hand, as a token of their submission to the white man’s authority. They will not return to the homes they had on Tuesday afternoon, only the heaps of ashes, the angry white man’s reprisal for the wrong inflicted on them by the inferior race,” reported the Tulsa Tribune.

Following the massacre, insurance companies refused to compensate the residents though the city and its officials were found negligent in preventing it. Decades of silence about the terror, violence, and theft passed. There were no convictions for any of the charges related to the murders or violence. Not one white person was ever held responsible for these crimes, though dozens of Black men were indicted for inciting a riot. Government and city officials not only failed to invest and rebuild the once thriving Greenwood community but blocked efforts to do so and even actively sought to appropriate their land. The crime wasn’t acknowledged by the city or the state of Oklahoma for over 70 years, rarely mentioning it in the history books, classrooms, or even in private. Most residents grew into middle age, completely unaware of what had taken place. Even a report detailing Tulsa’s fire department’s history from 1897 to 2017 made no mention of the massacre.

And on that Memorial Day weekend, June 1st, 1921, Greenwood, Oklahoma, was brought to an abrupt end. Black wall street was wiped off the map. 300 African Americans murdered, possibly more. Thousands injured. More than 10,000 left homeless. Forty city blocks burned to the ground. And the few homes left were completely looted. The Tulsa Real Estate Exchange estimated property losses amounting to the equivalent of more than $32 million in today’s money. Unbeknownst to most, Tulsa’s Black Wall Street wasn’t the only Black town to be ethnically cleansed in America. It wasn’t the only city forgotten, nor was it the only Black town no one was ever arrested, prosecuted, or where victims were never compensated. Time has passed, memories have faded, and survivors have died, taking the knowledge of not only how the cities were destroyed but arguably even more tragic, the knowledge of how these countless all-Black towns were built. Can a biblical blueprint be extrapolated from what we found? That is indeed our challenge, to cooperate, coordinate, and collaborate to turn our desolate neighborhoods into thriving communities and build them up by utilizing the keys to economic and societal development. Let us rediscover, let us reunite, and let us rebuild a new Black Wall Street.


Black Wall Street

The death penalty’s last gasp?

The death penalty’s last gasp?

(RNS) — On Wednesday (May 19), Quintin Jones is scheduled to be executed in Texas. It is the first state execution of 2021, and the first time a state has executed anyone in nine months.

 

It’s been 40 years since we’ve gone this long without a state execution.

Quintin is not the only person currently scheduled to be executed in Texas this year. So are four other people. Typically, Texas accounts for about half of the executions in the U.S., but this year it could account for all, or almost all, of them. Five of the six executions planned for 2021 are in this one state. Until just this year, Texas has had a law called the “law of parties” that allowed people not directly responsible for a murder to be executed for the crime, sort of guilt by association.

And, even now, Texas considers “future dangerousness” during sentencing, an idea that’s been debunked by most criminologists and experts because it is impossible to predict who someone will become. In some cases, like Duane Buck, court “experts” have even suggested race can be a determinant of future dangerousness … not even subtly suggesting black people are more likely to be violent than white people. Perhaps one of the many reasons African Americans account for a disproportionate number of our executions and of the death row population.

In contrast to other Texas cases like Rodney Reed, where it is quite clear there was a wrongful conviction, Quintin does not claim to be innocent of the crime for which he faces execution. He was 20 years old and addicted to drugs when he killed his great-aunt, Berthena Bryant, with a baseball bat. It is terrible, and he knows it. Early on, he too was convinced he deserved to die, and even attempted to take his own life. But over the past 22 years, Quintin’s story has taken an incredible, grace-filled turn.

His family, and the victim’s sister in particular, have seen the power of forgiveness, redemption and mercy. They are among the most vocal opponents to his execution. Every time they speak you can feel their authentic faith shine through the cracks of their pain. They have seen the changes in Quin’s life, the ways he has embraced his faith, tried to heal the wounds he inflicted, and the steps he’s taken to change his life.

Speaking of his faith, in a viral video produced by The New York Times, Quin quoted a passage from the Bible that says, “When I was a child, I spoke as a child, I understood as a child, I thought as a child: but when I became a man, I put away childish things” (1 Corinthians 13:11). Quin went on to say if he is executed, Texas will be executing the child he was, not the man he is now. He and tens of thousands of others are asking for Texas Gov. Greg Abbott to stop his execution.

Many of us who are asking for Quin’s life to be spared are Christians. And at the heart of our faith is the belief no one is beyond redemption. We are praying. We are calling the governor. We are hoping this is a moment Abbott can show the best of his faith tradition as a Catholic. Pope Francis has called for a worldwide abolition to the death penalty, and the Catholic catechism teaches that the death penalty has no place in modern society.

And yet one of the tragic realities in America is, up until now, the Bible Belt has been the death belt. In the very part of the country where Christians are most concentrated, and under the leadership of Christian governors like Abbott, the executions continue. Despite our claims to be pro-life, Christians have been the firm base of support for the death penalty. But this too is changing. Recent polls of millennial Christians (born after 1980) show overwhelming support for the abolition of the death penalty.

There are many things we are excited to see return to “normal” in our country as it begins to open back up after the massive death and sickness from COVID-19. Worship services. Going to coffee shops and concerts and on a date to the movies. Playgrounds and swimming pools. But resuming state executions is not something on that list.

State executions are not something most Americans want to see “return to normal” after the pandemic. Many of us would like to see the nine-month halt on state executions be “the new normal.” For the first time in my 45-year life, a majority of Americans are done with the death penalty.

Even though it is partially true that it took a pandemic with a massive death toll to slow down the machinery of death when it comes to capital punishment, there’s more going on. Let’s not forget that the Trump administration set a record number of federal executions during the same period state executions were hitting a record low (there were only seven state executions in 2020, the lowest number we’ve seen since the 1980s). After 17 years without a single federal execution, former President Donald Trump carried out 13 executions in the last seven months of his presidency. He executed people at a rate we haven’t seen since the 1800s, and he did it in the middle of the pandemic. When Trump left, federal executions stopped, and President Joe Biden has pledged not to carry out any more.

Meanwhile, a lot of states are recalibrating, trying to figure out if the death penalty has a future. State by state, the number of executions has been dropping nearly every year. So have new death sentences, which are the lowest they’ve been in a generation. Nearly every year, a new state abolishes the death penalty. Early this year, in March, Virginia made history, becoming the first formerly Confederate state to abolish the death penalty.

There is reason to hope the Supreme Court, even a conservative-leaning court, could deem the death penalty unconstitutional — not only because it is cruel, but because it is “unusual.” Executions are rare and arbitrary, and most of the country is ready to move on, along with the majority of the world, from executing people. A mere 2% of the counties in the U.S. generate the majority of executions. Right now, Texas is on the wrong side of life, and Texas is an outlier.

It is also noteworthy the states that continue to hold onto the death penalty are not only the states in the Bible Belt, but they are also the states of the former Confederacy. The states that held on to slavery the longest are the same states that continue to hold on to the death penalty. Where lynchings were happening 100 years ago is precisely where executions continue to happen today.

A generation from now we will look back on the death penalty like we look back at slavery — with shame and horror, with many of our grandchildren asking how Christians used the Bible to defend such a thing. So this is a time for courage. It does not take courage to say slavery was wrong generations after we abolished it. But it took courage to say slavery was wrong when many people thought it was acceptable, even God-ordained. This is a time for courage.

(Shane Claiborne is an activist, author and co-director of  Red Letter Christians. The views expressed in this commentary do not necessarily represent those of Religion News Service.)