Episode 1: Race and Health Disparities: A Matter of Life and Death

Dr. Johnson: I continue to see people who look like me have worse outcomes due to no fault of their own.

Dr. Rogers: I was really starting to learn the importance of social determinants of health. And those are the things that impact us every day that some people don’t think about in terms of if you have a job, if you have health insurance, if there's pollution in your area, racism, you know, these are things that you have to consider and how they impact health.

Daniel Alexander: Just treat everyone with respect. Treat everyone the way that you would want to be treated.

MILLICENT: Hi Everyone! Welcome to Season 2 of Vital Voices, a podcast from Corning Incorporated, where we explore innovative ways companies can be a force for good in our communities.

I'm Millicent Ruffin, Director of Community Affairs in Corning's Office of Racial Equality and Social Unity.

SISSY: And I'm Sissy Siero. I've been working with Corning Incorporated for the past three years and I've been thrilled to collaborate with Millicent to bring these important and critical stories to the world.

MILLICENT: It's so great to be back in the studio with you again, Sissy and kicking off season two.

SISSY: I love that we keep going deeper and deeper into these important and pressing problems that you are bringing to light. I love working with you on it.

MILLICENT: We just have a lot of fun working together on these things.

SISSY: We do [laughs] We do. My only wish is that I was actually upstate NY with you in Corning and we could be recording this together. But, I’m so fortunate I love doing this with you.

MILLICENT: So before we jump in, I just wanna set the tone for who Corning Incorporated is in case we have listeners who are unfamiliar with us.

So years ago Corning started by making cookware - the white Pyrex dishes and the measuring cups that most of America is familiar with. And then we fast forward a little bit and people began to know Corning for our fiber optics. And then we fast forward even more and we became known for Gorilla Glass, or the glass that’s on the front of your cell phone or your tablets. Most recently, Corning is now getting recognized for the glass on the James Webb telescope.

SISSY: Mmmm.

MILLICENT: So if you've seen any of those phenomenal pictures, that's a Corning Incorporated invention.

SISSY:Gives me chills just thinking about that, what we're seeing out into the universe, right?

MILLICENT: But that's one of the things I really love about being a part of this company, is that we innovate on so many fronts to bring needed technologies into the world. And then at the same time, we have a reputation for being deeply rooted in the communities and caring, you know, for our communities. It's really part of our core values.

And one of the things that we often say is that we care about the whole life of our employee. And so we care about our employees at work, and we care about the environment that our employees live in and our employees' families live in. And so within the Office of Racial Equality and Social Unity, we decided to focus on the issues that matter most in all of our communities because we know we need to make people's lives better from an health standpoint, from an education standpoint, from an economic development standpoint.

And when we do all three of those correctly, then we have a community that can thrive. And those are the topics we’ll explore in this podcast.

SISSY: You know, in season one of Vital Voices, we showcased Corning's contribution to education through the stories of those affected by it. And now, in season two, we'll be discussing another topic crucial to Corning's mission. Health equity for underserved and minority populations.

MILLICENT: But before we bring in new voices for this season, let's return to a familiar one.

[Jackie’s Classroom Tape]

Jackie: Let's see if you can figure out this one. This is a what?

Kids: Hexagon, Hexagon

Jackie: That's a hexagon?

Kids: Oh, that's a Pentagon.

Jackie: A Pentagon. Thank you. What is a Pentagon?

Kids: A Pentagon. A shape. Five sided shape.

Jackie: Excellent job. Five sided shape.

[Classroom tape fades under Jackie’s line]

Jackie Dickens: Like I said last time, I guess that's just a part of life, just getting comfortable with being uncomfortable. People have been telling me that's where you grow, but I tell you, it's been challenging. It's hard.

SISSY: This is Jacqueline Dickens, but most people call her Jackie. When we met her in season 1, she was an Edgecombe Scholar teacher about to graduate from East Carolina University.

MILLICENT: The Edgecombe Scholar Teacher program is an initiative that created a pathway for Jackie to go to college, graduate debt free, and then come back to teach in her public school district. It also gave her the training she needed to develop her style as a teacher.

SISSY: Today, she's a first year teacher - we were so curious and wanted to check in with her and learn more about how it's going for her teaching third grade in Edgecombe County, North Carolina.

Jackie Dickens: I was honestly scared to graduate college like I was, I had gone through school for so long, I'd figured out the system in school. I, I'd become successful at that system. And then I had to prepare to jump into new territory, into new water. And I'm like, oh my goodness. I don't know if I'm gonna be able to do it.

I have the responsibility of making sure that 42 children are successful. I love my students, I love them. I tell them I'm not perfect. Like, this is my first year doing this, and for the most part, this is you all's first year being in third grade.

They're, they're the sweetest kids. They just make bad choices sometimes. They're not the kindest to each other. I want them to understand that kindness is important. Kindness is a superpower.

I thought it was gonna be so easy, da, da, da. But truly it's been a challenge and I take on that challenge and I take on that responsibility. I made the commitment to Edgecombe County and hopefully I can be that positive force in these children's lives.

SISSY: You know, Jackie was just, she was so great to talk to. I loved getting to catch up with her again this year so I could really hear where she was at. And to hear her experience as a new young teacher, you know, and what she's, the positive force that she wants to be in her community,

MILLICENT: And I love that she shared like all the sides of her experience with us. You know, we heard from her so much in season one where she was at the beginning of her teaching, um, experience, and now she's got a year under her belt - and there were some surprises. But she's committed and even through all of the rough patches, you know, she's still showing up for the children and she still recognizes how important it is for her to be the positive force as she, as she says, to be the positive force in their lives.

SISSY: Yeah. And I mean, last year, to me it was a no-brainer once you explained what we were gonna do, you know, and focusing on education. And here is the, you know, the proof of that, right? To have her come back and hear her say, wow, it's tough. But here I am and I'm, I'm committed to this. So you really see why, um, you know, and for this season with our focus on health equity, we're hoping to bring attention to the many inequities in the healthcare space.

MILLICENT: Right, right. And so as we pivot to look at health equity, let's start just with the baseline, right? Health equity is the idea of everyone having an opportunity to achieve their optimal health, but in reality, we're pretty far off from that ideal because of so many other inequities in our ecosystem that exist. And that's something that we recognize here in the Office of Racial Equality and Social Unity.

SISSY: You know, we'll get into the health issues that disproportionately affect people in underserved areas and the personal stories. They're so honest. I'm, I'm so grateful the way people are sharing with us.

MILLICENT: Yeah, we'll have some really heavy territory, um, but it's important to shed light on it, because that's the only way we're gonna move the needle. But we'll also learn a lot about what needs to change and we'll hear some really inspiring stories about work that's being done. And then hopefully everyone will get some ideas about ways that they can help. And we'll also share some things that Corning is doing to help.

SISSY: Yeah, I am, I'm really excited about some of the research and initiatives Corning's involved in to address disparities. I feel privileged to have heard these stories and to be connecting with the people that are making this happen. And we'll learn more about them throughout the season.

MILLICENT: An important aspect for us and why we’re here talking about this today, is number one, to increase awareness and to get life-saving knowledge out there to the community so the community knows what’s available to them, so the community is better positioned to advocate for themselves and hopefully start advocating for one another. I mean our goal is to work towards creating change and to continue to help build healthy communities.

SISSY: And to start it off, since we're looking to use our own voices and our own power on this podcast to make these important issues known, we wanted to talk to someone who's equally passionate about spreading awareness about healthcare disparities and bias in order to spark change. Our next guest, shares her own personal story where a medical emergency she experienced could have very easily been deadly.

Dr. Angela Anderson: The reason why I continue to speak about it is because one, what I faced in most cases is fatal. And by nature of the fact that I was spared, I felt like I had a responsibility to share what happened.

SISSY: This is Dr. Angela Anderson. She's a diversity, equity, and inclusion executive, bestselling author, and an internationally certified executive coach. Her health scare was one that was riddled with medical neglect and bias.

Dr. Angela Anderson: I believe that everything happens for a reason, and part of the reason why I had that experience in particular was because of the voice that I have. What are the chances of someone with a PhD who's married to someone with an MD who's working for a major pharma company on healthcare disparities to experience it firsthand? It potentially could have cost me my life.

I called one of my colleagues and I said, something is wrong. I've been in pain during the night. I cannot self soothe. And I can't reach it. Like it's clearly internal, something is wrong.

And so my colleague said, no worries, we'll clear your calendar. I said, I have to go and see someone. And so the first provider where we went - this was during Covid. And so, uh, they left us out on the car and informed us that what I was presenting with at the time, which was severe chest pain, they were not equipped to do any sort of x-ray, um, or providing the services that I may need. So they sent me to a second provider about 30 minutes away. So we arrive at facility two, and again, we're out in the car, uh, because of Covid protocol.

And it took a couple of hours before anyone even engaged to the point to where we had called in multiple times and my husband says, this is an emergency, something is wrong. These are the symptoms. At this point, I was standing outside of my car because sitting was causing too much pressure. Um, and so I was just standing outside and walking around waiting for someone to come out.

So finally, the provider comes out with the nurse and they give me a covid test and the nurse, I guess they were a bit upset because we were informed about what needed to happen. They didn't necessarily like the fact that my husband was providing information professional to professional. And so the nurse very forcefully conducted the COVID test to the point that it caused me to yell out.

My daughters were in the backseat of the car and they started to cry because they were able to see what had just happened. So now I'm experiencing chest pain. I am navigating a painful covid test, and I'm trying to make sure that my daughters are okay in the backseat.

And so the doctor comes and he doesn't take vitals. He listens to my chest, he puts the stethoscope against my back, and he says, Well, I don't hear anything. I think you're okay. And my husband said, no, she needs an x-ray. This has been going on for several hours now, and she can't sit down. She can't lie down. And he described the area of the pain and you know what the theory was around what it was. And so he was really insistent that I get an x-ray and the doctor says, well, I don't hear anything, but if you insist, I'll take it while you're here but I think you should just go home because I think what's causing the pain is that you have post nasal drip and that you should just go home and blow your nose a few times and that should take care of it.

And the reason why you're in pain is because you were coughing all night long, and that's what caused the pain. I had not reported a cough because I didn't have one. So he was explaining what was happening to me with symptoms that I never reported. So I said, well, we do insist on the x-ray, so we go inside and we take the x-ray.

And that in itself was a dehumanizing experience because I had to ask for privacy. The nurse, she just sat there and she was looking and I said, well, you know, I have to change. Do you mind stepping out? She wouldn't like that. But I said, well, it will make me comfortable, so can you please do that?

SISSY: After that, she finally got the x-ray she'd been asking for. But she noticed something …

Dr. Angela Anderson: Although I'm not a radiologist, I could see that there was cloudiness. And I said, what is that? You know, something isn't right. A normal X-ray doesn't look that way. And the doctor says, well, I can't really tell what it is because you have breasts. And I said, I'm sorry, what do you mean? He said, well, I have to wait for the radiologist. And so as we were waiting, they sent us home and he said, you know, if you're really in that much pain, you may wanna put your purse on the other arm. And asked me to leave.

So we left. I'm still in pain. I get home, I'm alternating, you know, acetaminophen, ibuprofen, just because I don't really know what it is, but I know something is wrong and I haven't gotten answers.

So fortunately, you know, my husband knew, uh, some of the administrators in the area where we went and she said, please, let me just send you to one more person. And so of course I said yes because I was still experiencing pain. I go to the third provider who looks at the x-ray that we insisted we receive, and she said, I need you go to go to the emergency room right now immediately. Do not drink anything. Do not eat anything. I need you to go directly there. When I arrived at the ER, I'm still walking around, you know, I'm in pain, but I walked in. And so the ER doctor says he checks my blood pressure, which was elevated, And he says, I'm going to have to keep you for a few days.

And I said, well, what's going on? And he said, well, you have a pulmonary embolism in your right lung. And the reason why you were in pain is because that was the tissue in your lungs dying. And that's what caused the pain. He said, typically a pulmonary embolism, there is no pain. You just pass away. And he said, you were actually moments away.

Sissy Siero: What? That’s unbelievably scary.

Dr. Angela Anderson: And it just gave me pause because at that time I'm the mom of two young daughters, married, you know, I'm a wife. And he said, yeah, you were minutes away. And so for the next five days, it was a series of several IVs of blood, thinner and iron. And he said, you also have pneumonia. So all of these conditions were occurring at the same time and it took three providers just for someone to listen and adequately, you know, observe what was taking place in my body. And so that provider, both of them, the ER physician as well as the third provider that looked at the x-ray, they saved my life.

Sissy Siero: Oh my gosh. I, I don't even know what to say.

Dr. Angela Anderson: It leaves you speechless, it leaves you speechless.

When you look at the paperwork from the hospital, it's documented per the provider, that I was all clear and there was no respiratory distress. So had I gone home and passed away, there would've been no documentation showing what happened to me. It would've said that I was all clear. So had I not gone to provide number three and just insisted, I would've lost my life.

SISSY: But what also left Dr. Anderson speechless was when a provider used a term she was shocked by.

Dr. Angela Anderson: So I am an African American woman and the second provider, you know, wanted to check my oxygen level. And so I put my finger in the pulse oximeter and he says, “Well, I'm not getting an accurate reading.” So he did check that, although he didn't take a blood pressure or temperature. And the reading, he said, “Well, I don't know. These don't typically, you know, sometimes it's hard for them to work on colored fingers.”

Sissy Siero: What?

Dr. Angela Anderson: And my husband said, excuse me. And he said it again. And so I looked at my husband and I said, it's time for us to go.

MILLICENT: So I had so many different reactions to that part of her story. From being referred to as colored in the 21st century… to false readings on a pulse oximeter based on skin color.

SISSY:Right, right. I never heard about that before.

MILLICENT: I hadn’t either. I hadn’t either. And so I had to put my chemistry hat on. So just indulge me for a few moments. I'm an analytical chemist. Chemistry was my first love. So let’s dig in.

SISSY:Yes, please - enlighten us with this.

MILLICENT: A pulse oximeter, you know, it's like a clip and they'll put it on your finger and it shines a red light through your fingernail. And the red light shines through the finger. So basically the tip of your finger just turns red. And on the other side of the clip, cuz there's a part on the top and a part on the bottom of your finger, it measures how much light gets through.

So if you have a lot of oxygen in your blood, it all gets absorbed by the light. Not a lot of light comes through. And when you look at how a pulse oximeter works. It only talks about it absorbing oxygen in your blood. The light goes in, it absorbs the oxygen in your red blood cells, not a lot of light comes out of the other side.

What it doesn't talk about is that it can also absorb melanin. It never describes that in the operation of a pulse oximeter.

SISSY: Huh?

MILLICENT: And then you have to wonder why, and, and then you think back, well, who did they do the studies on? Who were the doctors that developed the technology?

SISSY: Right.

MILLICENT: Right? These are all the questions that have to be asked when you think about what was missed along the way of developing and testing and how wide, you know, how wide of a sample pool was tested?

I, I don't know the answers to those questions. Those are my questions, but now that we know that, right, I should be able to see that information when I do a search. I shouldn't have to search for “do pulse oximeters work on dark skin?” Because that's how you get to the answer of what Dr. Anderson experienced.

And so both skin pigmentation and melanin in your skin can lead to inaccurate oxygen saturation reading. Because it's absorbing the light. And, and that's a perfect example of why diversity matters.

SISSY: Hmm.

MILLICENT: And how the absence of diversity propels inequities.

Dr. Angela Anderson: What's interesting is that the provider, number two also insinuated. Now I'm a person who will rarely even take, you know, a Tylenol. They insinuated, “Well, if, if you want something for pain, just say that.” So insinuating that I was drug seeking.

And I said, I've not yet asked you for anything for pain. I wanna know what the source of the pain is. So, you know, there's all those little red flags where, you know, bias is rearing its head, and those red flags are going off because I know them all.

SISSY: This moment, no matter how jarring, how awful it was, made Dr. Anderson think about other people who might come across that situation.

Dr. Angela Anderson: What happens to the elderly in situations like this? What happens to those who have English as a second language? What happens to those who aren't as versed in the healthcare industry? What happens to them? And it just made me so sad to think of how many people you know, didn't come out of situations like this with their lives.

The day that I got out of the hospital. Uh, I did an Instagram live about it, just to encourage people to make sure they advocated for themselves, for themselves, you know, in healthcare. I actually did that from the bed. It was like this immediate assignment. I felt like I had to make sure that nobody else went through this. At least if one or, or a few people could advocate for themselves as a result of what I had just experienced, I kind of threw myself into that, and that's what it has been.

I can remember about a year after it happened, I had to go for a follow-up visit and there were several appointments and several things that I had to do post experience to get back to a place of, of being healthy. There's still damaged tissue in my lung today. But I, I had to take the paperwork out to take it with me to a doctor's appointment, and I just started to sob. Because it was all new again for me and all the feelings of feeling unheard, feeling like what I was saying wasn't true, being doubted just because of how I showed up in the world, it came flooding.

And so I had to process through that and figure out how do I turn this around? And so that's why I have these conversations.

Sissy Siero: You turn it into love and service.

Dr. Angela Anderson: Exactly…exactly.

Sissy Siero: Wow.

SISSY: The instagram live caught the attention of a reporter, who featured her story in a Forbes article.

Dr. Angela Anderson: It's interesting because since the article came out in Forbes and with some of the other conversations, I've had people reach out to me directly and say, I read your article, and I was in the emergency room when I found it. And I advocated for myself. On the other hand, I've had people reach out and say, I wish I had seen it sooner because my mother or my sister or my daughter lost their life due to a pulmonary embolism. And it's because they told us it was something else.

It just speaks to the importance of why we must have conversations around bias in healthcare, why we must have training, why we must have conversations, why stories like mine, which unfortunately isn't uncommon, need to be told. Why future providers need to have this awareness around the fact that you're not just treating a condition. You're treating the person and every person that's connected to them. Hopefully it will challenge them to, you know, really become more educated around what these biases are and how to navigate them.

Sissy Siero: Right, right.

Dr. Angela Anderson: You know, every day I wake up and I'm just grateful for another chance.

You know, when you face your own mortality and when there are moments when you can remember counting the minutes. Literally, and wondering if you will see the next birthday, And, you know, it just makes me root every day in gratitude, and every day that I get is another chance. So I try to maximize it every, every day.

MILLICENT: You know, it's, it's always amazing to me that in a place where there's so many resources available that they can be made so scarce at the same time, and I, Hmm, I think I was a freshman or sophomore in high school when my dad had bypass surgery. And so he was 55 years old and five, I, I mean, I, I know people always talk about quadruple bypass surgery. Well, he had five. So what does that quintuple bypass surgery and it changed our lives. Right? It changed, you know, just his level of energy. It certainly changed because I don't think my mother bought butter ever again after that.

SISSY: Aw. Huh.

MILLICENT: And so, but it also impressed upon me just how important every day is. And while I didn't feel like we led an unhealthy lifestyle in any way, I mean, I grew up with two working parents who both had health insurance. You know, this is where we, we ended up with my father's health. You know, the reality is that my grandparents were sharecroppers. And so the way I grew up is very different from the way my father grew up because my father grew up in poverty. My father grew up, you know, during the depression and working in fields and a very different diet and very limited access to healthcare, you know, as, as a child. And so even though he was able to get an education, get a master's degree and create a different lifestyle, he was not able to erase those early days. And so, you know, even if you have access to healthcare as an adult, there are many factors that play a role in your health and they’re cumulative.

And that's what health equity is all about. Like, we have to look at the whole picture of someone's life. Every part of our lives impacts our health. It, it's almost like an imprint. And we have to examine all of those factors because they all play out into who we are from a health standpoint.

And so that's why I share the story of my father, because it's important for people to know the whole story of how he got to be where he was health-wise. And that's why it's also important for Dr. Anderson to share her story as well.

She sheds light on, not just the shortcomings of a system, but also on how to bring change and how to leverage her voice and her time and her talents to bring change. And it's also a reminder for me to use these opportunities. And to use my voice for change as well.

And so for these upcoming episodes, our energy and our passion is directed towards getting as much information out to everyone who is listening or willing to listen and share how important it is to know the signs, to know the symptoms, to eat healthy, to get preventive treatment, where available. Over the course of this series, we'll cover several other topics.

We'll talk about the importance of dental care.

Melissa Copella: there's a real reward in bringing somebody’s smile back when they haven't had one for a long time.

MILLICENT: We'll talk about the shortage of Medicaid providers and how that is impacting underinsured Americans.

We'll talk about different cancer outcomes in the black community with a specific focus on colorectal cancer and the impact in the black community.

Dr. Charles Rogers: It's a problem that I saw early, early, early on in my career and I’ve been a really a big advocate for black men because we have been the worst off for so long, too long.

SISSY: We're also gonna focus on the importance of health equity research and the impact that it has.

Dr. Michelle Johnson: We're trying to generate biomedical knowledge that's applicable to everybody. And it's impossible to say that it's applicable to everybody if we don't have representative samples.

MILLICENT: Coming up in Episode 2 – we’ll hear from a public health expert on health equity and a personal story about the consequences of untreated dental issues.

SISSY: Thanks for listening. You can find and listen to episodes of Vital Voices wherever you get your podcasts. For more information about the Office of Racial Equality and Social Unity and how its programs are impacting the community, click on the links in the show notes.