[background sounds]. [background. [background sounds]. Thank you for coming and welcome to our Health Equity roundtable with Pete Buttigiege. We are here at nicholtown missionary baptist church. And we are so happy that all of you are here today. Health equity in healthcare is a major issue. Throughout South Carolina but in the africanamerican communities and we have, and esteemed panel. The discussion here today with Pete Buttigiege in regards to Health Equity with the African American community if he and when he becomes the president of the united states. Will go around our panel and ask everyone to take 30 seconds to a minute to introduce themselves, who they are and why theyre here. We would like to start with this young lady on the end and we will work our way around. My name is alicia, im healthcare from professional. Im in healthcare executive, i have lived in various areas of the country and have relocated here. Im undergoing a lot of change, and strong interest with my family here. And i want to grow with my career here to and how the politics will affect the community have a live and work in. If im here on behalf of the Community Group. We are a community of young African AmericanYoung Professionals who give back to low income communities by mentorship. A lot of that focuses around healthcare initiative. We want to exercise and that things a manager i am super excited to participate and see what is going to be done for our youth to make sure that we are able to have part in healthcare equity. Hubby thursday. I was like to say in the face and voice of our Community Climate health and to educate our people. Very excited to be part of this equality roundtable discussion to really bring some of those wishing to the forefront and how this is affecting our black and brown personalities. People are always asking what i do. I do business. Im honored to be here today. My name is alecia, im on city council and chairman of the democrat party. Also a ceo of healthcare which is a Contracting Service specifically the contracts different Healthcare Facilities and im here today to see how we should talk more about our great more things in the community. My name is tracy and i am the owner of and coowner of home care service. I was invited as well to be here as a Home Business owner and Health Professional to be able to hear more specifically the things that you plan to address. Good afternoon. I work here and also the Consulting Company where work primarily with educators and i teach folks about trauma on the brain and i work with a work for the long note on the people who work with young people in trauma the brain regarding healthcare. , psychiatrist and i decided to be here to advocate not only for a profession but also for our patients in the Mental Health things that i see day in and day out. Thank you. My name is caroline. And i am the ceo and executive director of mine health and care which is the Behavioral Health program that specifically deals with people who are returning from incarceration or families that have been affected by the criminal justice system. There are a lot of trauma, although the need for juvenile Mental Health. There is a lot of need for reentry Mental Health and behavior modification that is not covered by any expanded medicaid. Im also the Vice President where advocate for lgb tq folks. We are two very marginalized populations that are in need of Health Equity. So im very interested in seeing how this plan will address our issues. Everyone, we thank you for being here. I am the vice chair of the democratic party, and the blessing of being here and moderate this great discussion. We would like for the mayor to open up with a few words and get right into it. How about that. Mayor Pete Buttigieg thank you for moderating. Thanks to everybody for being part of this event. Its really an excellent combination of insights and experiences. I will try to be fairly brief in presenting what we envision as part of the campaign because i think this would also be a Good Opportunity to tell you stories. In the priorities that you see emerge and since we went and brought a few cameras with us, literally shined a light on some of the struggles and some of the solutions as well that you have seen and you have pursued and my hope is that we will be able to eliminate how different and better president ial leadership would be supportive of the work you are doing. One of the themes that you will see, especially when it comes to Health Equity is the belief that not all of the answers have to come from washington but more of the should because we see a lot of work that is happening at the local level. And where the regional level where the solutions are being developed especially when it comes to health inequities. We need to have more of the wind at your back in form of resources. We need to really tailor it on the ground. As i was hearing some of the statistics and challenges that you are all dealing with his specifically in South Carolina, state that has the ninth highest mortality rate for women and that is something that we know here and also across the country, is three times as likely to occur for black women as white patients. Here in South Carolina, 17th in the nation for adults with diabetes. It is now roughly one in six African Americans, reside in state are living with diabetes. We know from hiv, that the majority to diagnosis are in the africanamerican communities. So many of these issues, nor very close to home here. And as in different ways, close to home for us and the community that i served as mayor two times. A community where we saw the effects of violence and trauma and the need for care that is informed by understanding Adverse Childhood Experiences were a lot of these challenges of reentry were at stake. Bauer also allowing Creative Solutions like the partnership with 100 blackman that had barbershops, fighting men a little more willing there to for example the part of the screening for diabetes than they were in a clinical environment. These are exactly the kind of local collaborations i think we need to do a better job of supporting and funding. At the federal level. So part of what we proposed in the context is to dismantle the systemic inequality in the country is a real focus on intentionally dismantling the health inequities. That means within the first hundred days establishing a national Health Equity task force that will specifically map out where these inequities are. Also means creating and investing in what we are calling health inequities. This is an example of where that will be defined and decided by local partnerships, local government, nonprofits, community leaders, but should have federal funding to design a strategy. Then make sure that strategy can develop with support from the department of health and Human Services. I believe that we can end the hiv epidemic by 2030. Then we can tackle the diabetes epidemic is been heading in the wrong direction, in many ways in many communities. And then we can in this crisis of the mortality in a country that is lagging behind almost all of the developed nations especially for the experience of black and other minorities. Wesley make sur. We also need tot we are investing in the health equities. Things like often a lack of cultural incompetency. That means, training our Health Workforce to be anti racist and to combat these kinds of bias in the clinical environment and also meet simply recruiting and empowering more clinical professions, who come from various communities that have been excluded. We talk in other areas of the douglas plan investing in you. Its not just out of regard of the work that they do with the knowledge that the next generation of africanamerican doctors and nurses and researchers, need to be supported so we can dispose the disparities. Knowing that that bills cultural competencies at the local level. We also need to recognize that health is not only the job, the department of health and Human Services but that for example when we look at criminal Justice Reform and incarceration. We have things like the medicaid exclusion for those who are incarcerated that especially for those dealing with Substance Abuse or Mental Health challenges, is a huge population. Huge proportion of those are incarcerated. It makes it that much harder to get a continuity of care. When were talking about housing, its inseparable for the concerns of health. We saw it in our community for example, the challenge of forces. Im pleased to state with the lottery is not the problem. I was mayor of the water. Low income families in older neighborhoods, where houses were built before that 1978 ban on lead paint, most likely to show up with high exposure to lead. These of course were the neighborhoods where people were disproportionately redlined rated was over talking about things like housing desegregation, theres also Public Health issue. I need to be an office of Health Equity and justice not only in health and Human Services, but this needs to be in the consideration, and hud, and every department that is working on things that ultimately reflect on Public Health. I think the coverage is dominated the debate disproportionately print so i dont want to dwell on it too long but i do believe that it is necessary to ensure that everybody can get coverage. That is the idea of medicare for all. Everybody would have access to a quality. If it is low income folks, there will be subsidized the dont pay anything outofpocket. As your income rises, we still make sure that is never more than their income. I do believe that we need to establish monthly outofpocket fees on how much somebody can spend on prescription drugs. Right now even if you have insurance, a lot of times you have a yearly amount. You see people delaying filling a prescription or procedure recent so i can hit and right month month. It makes no sense medically. And of course most of us dont experience up on a yearly basis, the bills come every month. Want to mention a couple of other things than i know that are impacting South Carolina inns in particular need to be addressed. One is the injustice. 56 percent of africanamerican residents in South Carolina are in the same sense that part of the superfund. This points to the navy first told the increase of funding between the superfund and also look at housing segregation has played role in sending families into areas where theyre vulnerable to Health Issues simply by where they live. Later on, theres contamination like food deserts, even exercise deserts. Theres no place where a parent can take a child to play that is a pretty this also has questions to Public Health. In the need to support small utilities. And with community of denmark, im not the only one where there hasnt been the resources for lower income communities to be certain of access to clean and safe drinking water. So im proposing that there be a dedicated fund for supporting communities that are trying to enhance the water infrastructure. I could go on but im going to stop here because hopefully i give you the flavor for the kind of things and interventions that i believe that we can have. Its all based on this philosophy that weve start thinking about politics and government, first and foremost in terms of how it affects everyday life. The biggest impacts on everyday life, for those who have often been the most directly excluded. Now is our chance to get it right. Having laid down some of those markers, im very eager to get into a conversation and learn more about what is impacting the people you serve. Answer any questions i can about her vision and gathering input on how we can make it more tailored than ever. [applause]. I like the eagerness. What i was going to say was i probably have the least amount of healthcare background. Some really interested in how this conversation will go in to learn what everyone has with their experiences. You seem so very eager to answer the first one. A. For a few years i served for new horizons healthcare services. Along with this, you talk about making the medicare for all that was wanted but my concern would really be we can make it available and free even but the impact is how to get there. Thats the concern. I really want to know how that intertwines with the plans for the medicare for all. How can we even for you being a president , say this can be inclusive with making sure, that they can get there to make the appointment. Mayor Pete Buttigieg great point. For some it how to get everybody insured. But what good does that do if you cant get to a provider. If you dont have the transportation or the providers in your area are closed. Whether we are talking about the qualified health centers, which are doing such a remarkable job, are clearly under resourced. Were there we are talking about the closure of rural facilities. By the way, one thing that the majority of the rural facilities and a close, his they need to fully expand medicaid. So it is something that deserves to be raised in a time when you got a president who claims to be caring about rural america. For not saying that. The provider shortage i think, well theres two things, a shortage of providers and there are transportation issues pretty in the provider shortage is not only one reason we got to create a medicare for all but encourage people to go into other areas. Encourage people to go in areas of practice when there is not enough people to do it in particular i think that is true of Mental Health. While in by the way, the great thing about this is they have done often, a remarkable job of having primary care and Mental Health care right alongside each other. It is not just about physically locating them next to each other but it sure helps when youre trying to integrate them. Last believe that Health Funding has to be also with transportation funding we have to make it possible for people to actually access within eight. And so part of the funding we are proposing rural health in particular, is to address that issue. Otherwise, you might be insured but it doesnt mean anything if youre not able actually able to get there pretty. One of the things that we argue, being part of the Community Group and even my personal daily professional life, a lot of physicians and medical professionals, and one of the things that i see is we dont talk about enough in our community is that a lot of the issues are not, you mentioned present reentry. Diabetes, all these things but at the end of the day, i think all of these issues come back to economics. On two ends. The economic on one hand, things like volunteering on these organizations and you think about those organizations, the caregivers there, the people that are working there, theyre saying if i want to do good in my community, i have to make half of what my contemporaries are making. And in a larger facility, so that his financial and one side and on the other side, we do have transportation issues. We talk about healthcare equity, what does that really mean in heaven we get to the bottom of that issue from my perspective. Theres been a real economic financial gap that is causing this disparity. From a provider standpoint, i am sure you heard that a lot of people, are crippled or the Healthcare System so to speak, or get them to the place where one governMental Healthcare system. When we come back to that. What is your response to that. Mayor Pete Buttigieg especially when we are talking about racial inequities, everywhere from criminal justice to health, it comes back to Economic Empowerment as well. So to the first side of the coin you are talking about. The side of those who go into the profession. Its one of the reasons that we need to true up the universe but reimbursement rates. Youre providing for an underserved community. I also think that when we redo Public Service loan given us, we should do it with this in mind. You walk in Public Service, you get your loans forgiven. But almost impossible to take and manage it. You gotta do ten years straight before you get any benefit at all. So what i would do is make it user friendly, more generous and have a bigger sense of what counts as Public Service. If your Mental Health provider, and youre in an underserved community. I consider that Public Service whether youre in the Public Sector or not. That should qualify. Does the first what youre talking about. And the other is the Biggest Issue of lot. We can learn a lot with the work wage