The killing of George Floyd on May 25, 2020 sparked weeks of ongoing protests against police brutality, bringing racial justice to the national forefront and inspiring companies, universities and local governments to take action. On June 29, 2020, the Hennepin County Board of Commissioners passed a resolution that declared racism a public health crisis.
Racism is a pervasive, insidious force in U.S. healthcare systems. For starters, African-Americans have never had access to safe, affordable health care in the United States. Before the late 1800s, most communities were tended by a town doctor; if a slave owner/human trafficker was unwilling to pay for a slave's care, they would not receive medical treatment. During the Jim Crow era, white and Black patients and practitioners were separated into different facilities. Today, access is largely determined by health insurance, which can mandate where a patient can go, how many visits they can have and how much it costs them. If someone is uninsured, healthcare expenses often result in bankruptcy. 
Access to health care forms the bedrock of equity in the medical industry - and that bedrock is layered with racism. Public health strives for equity by relying on a form of metrics called "social determinants of health" comprised of the environmental conditions in which people are born, live, learn, work, play, worship and age. "These conditions directly affect a wide range of health, functioning, and quality-of-life outcomes and risks," according to the Minnesota Department of Health. Ultimately, society attains health equity if all citizens have access to the same positive outcomes in the conditional environments of their daily lives. Unfortunately, the U.S. faces a long road to achieving genuine health equity.
A lack of entry to the healthcare field also creates a snowball effect of negative outcomes in medicine. For instance, if you only research symptoms or diseases in white bodies, students may not learn how to recognize symptoms or diseases experienced by BIPOC bodies (Big Think). Most often, a greater diversity of representation among medical practitioners proves to be the catalyst for expanding research and new medical practice among non-dominant populations.
According to the Association of American Medical Colleges, only 5% of licensed, practicing doctors identify as Black or African-American as of 2018, whereas 56.2% identify as white/Caucasian.
Similarly, a 2017 study revealed that only 6.2% of registered nurses identify as Black or African-American compared to the whopping 80.8% of nurses who identify as white/Caucasian. Today, almost 60 years after the Civil Rights Movement started, Black Americans still barely see themselves reflected in health care.
Naming racism as a public health crisis is an important first step so that communities can strategically respond, but there are also lesser-known grievances that negatively impact the way that Black and African-American patients experience health care. In particular, most patients who identify as Black, Indigenous or People of Color see their care significantly impacted by the implicit biases of doctors, nurses, receptionists and other medical personnel. Implicit bias is complicated because it is couched in unconscious behaviors, such as reacting favorably or unfavorably to embedded cultural stereotypes and assumptions about a group of people. A 2015 study by the Kirwan Institute for the Study of Race and Ethnicity helpfully identified some of the key characteristics of implicit biases:
Implicit biases are pervasive. Everyone possesses them, even people with avowed commitments to impartiality such as judges.The implicit associations we hold do not necessarily align with our declared beliefs or even reflect stances we would explicitly endorse.Implicit biases are malleable. Our brains are incredibly complex, and the implicit associations that we have formed can be gradually unlearned through a variety of de-biasing techniques.As a direct result of discrimination and implicit bias, people of color in the United States face disparities in access to health care, the quality of care received, and health outcomes. "The attitudes and behaviors of health care providers have been identified as one of many factors that contribute to health disparities," write University of North Carolina, Chapel Hill researchers. For now, researchers know three things:
Racial discrimination is known to yield poorer health outcomes for Black patients.Implicit bias influences why institutional racism persists in health care.Federal and state funding allocations will determine how and if Black patients' experiences improve.Naming racism is an important first step. A public health crisis begets funding to fix the problem and to address a lack of access, lack of representation and personnel's implicit biases. Where will financial support come from for these efforts? Will government agencies, hospitals or insurance companies pay for public health programs aimed at ending racist practices?
The answers remain murky. But one thing is clear: The world is ready for healthcare practices that build equity, create space for compassion and empathy across difference, and ensure that all who need medical treatment feel seen and heard.
Twin Cities PBS is here for you at every stage of learning. Read on to learn how Black Americans are navigating and challenging systematic racism in health care. This month's resources are brought to you by artists, educators, researchers, and illustrators. 

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Building Health Equity: Appetite for Change
“I had lost my sixteen-year-old son the previous year to gun violence… I was pulled to do something in the garden related to food, hearing that the universe would do healing for me there.”
Watch time: 6 minutes
Queer Women of Color Ask Who Cares and Who Gets Care?
Whether doctors use abusive language, refuse to acknowledge a patient’s chosen pronouns on medical intake forms or ignore the specific needs of LGBTQ+ patients, normative gender/sexual orientations still abound in the healthcare industry, leaving many with a difficult question: Should I even go to the doctor?
Watch time: 9 minutes
Inequity Is A Matter of Life and Death
Not being white in Minnesota is literally hazardous to your health. Startling gaps in outcomes by race and gender prove that a healthcare system designed by and for one culture isn't working well for others. Public-health experts dive in to understand why, and work with communities to change outcomes and create new possibilities for the future.
Watch time: 6 minutes
How Race Shapes Our Scientists And Our Science
Now a cognitive neuroscientist, Jonathan Jackson has achieved his dream of studying the disease for a living. But he said being a Black scientist has also pushed him down paths he wasn't expecting...“There is some currency in my Black skin for everyone but me," he says.
Read time: 10 minutes
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COLOR & REFLECT
 
Coloring offers space to reduce anxiety, create focus and bring about more mindfulness. Take time to reflect on what you learned. What surprised you? How do you feel? What questions do you have?
Click here to download this month's coloring page featuring Dr. Rebecca Lee Crumpler. 
 
This educational resource is part of the digital storytelling project Racism Unveiled, which is funded by a grant from the Otto Bremer Trust.


How Do We Know If Health Care Is Racist?

Diana Fraser

Minnesota consistently ranks as one of the healthiest states in the nation, often taking the top spot. And as the home to the world's first Mayo Clinic, Minnesota is known worldwide for its innovative solutions in health care. However, as the conversation around racial disparities and social inequities has risen to the forefront, research shows that Minnesota's portrayal as the home to healthy residents only paints half the picture. 
Census data shows that Minnesota's population is more than 80% white and just 7% Black. Despite this vast difference in population size, Minnesota's Black community is overrepresented in chronic health issues when compared to their white counterparts. 
Black men in Minnesota have a higher mortality rate from cardiovascular disease than white men. Black women die of breast cancer at a 24% higher rate than white women, although their incidence rates - how frequent a disease occurs in a population - are 22% lower. The difference in health outcomes between white Minnesotans and Minnesotans of color is so pervasive that it can be pinned down to a zip code. 
And the COVID-19 pandemic has exposed more healthcare inequities. According to state data, Black and Hispanic Minnesotans are testing positive at higher rates than the overall population. When adjusted for age, Black and Asian residents have the highest COVID death rates. 
These racial disparities in health are not unique to Minnesota, and are indicative of a systemic issue that is plaguing the nation.
To address these inequities, universities and healthcare institutions have begun to redefine their roles in training and educating healthcare professionals.  
One such institution is the University of Minnesota's medical school — the leading producer of physicians in the state which manages several hospitals and clinics across Minnesota. 
University students and faculty at several medical schools have called on their administrations to create programs that address racial inequities that have caused disparities in health, pointing to inequality in care, racial bias among physicians and the lack of representation found in their study material. 
Making a Change in How Race is Addressed in the Classroom
Constructing a racially and culturally inclusive curriculum has become a focal point for medical schools across the country as the classroom serves as the introduction to medicine for students. What students learn in their first few courses in medical school may influence their practice for years. 
To change their approach to educating future physicians, the University of Minnesota Medical School recruited Dr. Ana Núñez to head their inaugural office of Diversity, Equity, and Inclusion (DEI). Dr. Núñez serves as a Vice Dean in the medical school and was brought on after last summer's civil unrest sparked by the Minneapolis police murder of George Floyd. 
"One of the things that actually impressed me about coming here in the first place was how many had actually started doing the work," Dr. Núñez said.  
The medical school's curriculum has been a focal point in making institutional changes. Knowing this, administrators have brought medical students in on the process to give their input as they work to reconstruct their education. 
"As we talk about curriculum, what really matters is: What are the student's experiences when they come to us," Dr. Núñez said.  
"Because that's how you get it right in terms of that engagement piece, because people sitting in a little conference saying, 'This is how we're going to change stuff,' without the voice of the lived folks just never get it right." 
Medical students like Sally Jeon and Tegan Carr have worked to fix the medical school's approach to education. Both have served as their class DEI officers and are a part of the UMN Medical Education Reform Student Coalition (MERSC) that formed as a response to the police murder of George Floyd.  
"That was the straw that broke the camel's back," Carr said. 
Carr helped lead the Task Force for Change, a student group on the medical school's Duluth campus aimed at reforming the medical school's approach to racial inequity, which later coordinated with student groups like White Coats for Black Lives in the Twin Cities. This cooperation would create the MERSC.  
Members of this coalition met with the medical school's administration, faculty and staff after sending a letter that listed what changes they'd like to see in response to the nation's racial awakening. Those changes include emphasizing an equity-based curriculum, establishing plans for faculty development in health equity instruction, removing race as a biological indicator in medicine, diversifying their standard patients and strengthening ties with communities of color. 
You can read the full list of demands here. 
Though medical students want to be a part of this change, their studies and time reserved for clinical work off campus limits how much they can do.
"For me as a first-year coming in, I had a sense that maintaining sort of the momentum of this could be a challenge," UMN medical student Sally Jeon said. "While it is absolutely crucial to have student voices centered through this experience, students cannot do this alone."  
That's where school faculty comes in. 
Both Jeon and Carr have commended Dr. Núñez and Dr. Mary Owen, director of the Center of American Indian and Minority Health, for doing the work from within the institution that goes beyond school hours. Much of DEI's work in health care or other industries has been seen as a sort of caveat or add-on to the work, but Dr. Núñez believes that it should be integral to how medicine is taught going forward.
"In the course of the year that I've been here, we've sort of built infrastructure," Dr. Núñez said. 
All the school's medical departments now have committees and key individuals in DEI roles. Specialists like pediatricians and anesthesiologists must now have some understanding of equity in their practice.  
Medical school faculty have also received racial bias and microaggression training to recognize how prejudice can appear in their practice.  
"There is no area that is exempt from health disparities," Dr. Núñez said. "Not a one." 
Most Patients That Medical Students Serve Are White
To gain an accurate perspective on how they will practice medicine in the future, medical students have asked for more diversity in their material and the patients they encounter while in school. Areas of medicine like dermatology rarely include how skin diseases will show up on people who are not white, for example. 
"Students have voiced: How are we supposed to relate to each other and diverse patients if every standardized patient that we see, or community teacher that we interact with, is a white person?" Carr said. "We were only seeing white skin. In our lectures and pathology books. I mean I probably couldn't diagnose Lyme disease on my own skin." 
If there was representation or mention of other races, it often came with misinformation which saw race as a biological factor. 
"We know that race is a social construct. It is not a biological construct, and a lot of medicine was built in a faulty way — we also know that we can't just eliminate it," Dr. Núñez said. "Because people's lives are different based on who they are, where they live and their access to health."
Black individuals suffer kidney failure at three times the rate of white individuals and represent a third of patients in the U.S. receiving dialysis. For decades, physicians approached illnesses and diseases relating to kidney function with the racist notion that Black individuals have more muscle mass than other races. Muscle mass is relevant because it breaks down into nitrogen that taxes the kidneys, but medical institutions had internalized this racist trope from slavery and incorporated it into their care. The National Kidney Foundation recently announced the removal of race from estimating kidney function. 
Since being diagnosed with a chronic illness relating to her kidneys, Carr has experienced the dismissive attitude that harms other patients of color seeking treatment. She said that questions about her race were brought up at the start of many of her doctor's visits.  
While change is essential within educational institutions, it's also important to incorporate more racially conscious approaches to public health policy. 
Dr. Rachel Hardeman is the director of the Center for Antiracism Research for Health Equity at the University of Minnesota and was named the first Blue Cross Endowed Professor of Health and Racial Equity at the university's School of Public Health. Dr. Hardeman's work aims to collaborate with colleagues across the university on developing curricula, fostering community engagement and developing policy work. Though Dr. Hardeman's conversations with Blue Cross and Blue Shield began before Floyd's murder, she believes there is even more reason to commit to this work now. 
"My research, broadly speaking, focuses on the impact of racism on health outcomes and healthcare delivery for Black populations, but specifically for Black moms and babies," Dr. Hardeman said. "Minnesota is often ranked as the healthiest state in the nation, but when you start to pull back the layers and understand a little bit more about what's going on here, we actually start to fall towards the bottom of the list when we look at health outcomes by race."
Seeing those disparities in health outcomes firsthand when her grandmother's health deteriorated, Dr. Hardeman decided to pursue a career in health to help close that disparity and to provide everyone with high-quality care.
Black maternal and infant mortality rates are some of the most significant examples of health disparities between Black and white individuals.  
"What we know when it comes to public health is that infant mortality is a critical marker for community health and wellbeing," Hardeman said. "Black women are four times more likely to experience maternal mortality (meaning death during pregnancy, childbirth, or year following childbirth) in comparison to their white counterparts despite their socioeconomic status." 
And the U.S., Dr. Hardeman stated, is the only industrialized nation that has a rising maternal mortality rate. 
"Even when you adjust for education and income level, you're still seeing these disparities," Dr. Foster said. "A lot of time when you talk about solutions, they want to point to social determinants of health and resources are crucial in achieving health equity." 
The history of malpractice and mistreatment of Black women is rife in medical history. One offender was the "Father of Modern Gynecology," James Marion Sims, who experimented on many female slaves without anesthesia. For some people, the treatment of Black women in that era parallel how they are treated today. 
"While folks can say, 'That's in our past, that's our history.' We haven't actually sat down and reconciled with that history and really struggled with what that means on how implicit bias and racism show up in current clinical encounters," Dr. Hardeman said. 
Dr. Foster said that other issues within health care appear when looking at the cross-section of race and gender. 
"Black women were typically offered hysterectomy as the only option or it was presented as the best option," Dr. Foster explained.  "I know many women who had their uteruses removed in their 30s or 20s because of a few benign tumors. 
Dr. Hardeman recently received an appropriation from the state to develop an antiracism training curriculum for perinatal care providers in Minnesota. This preventative care is provided in the form of checkups, nutrition assistance, and monitoring any biological changes. The Dignity in Pregnancy and Childbirth Act aims to reduce these racial disparities impacting Black mothers and babies and has allocated nearly $300,000 to the Center for Antiracism Research and Health Equity.  
States across the country have begun to implement similar changes which focus on creating implicit bias and antiracism training while expanding in areas such as midwifery. 



What Medical Schools Can Do to Fix Systemic Issues in Health Care

Abdi Mohamed

A COVID-19 vaccine pop-up clinic at Morning Star Baptist Church in Boston | Credit: Boston Medical CenterThis article was originally published on NextAvenue.org.
Parents, siblings, grandparents and children: They are among more than 600,000 Americans killed by COVID-19 since it was first detected in the U.S. nearly two years ago. The coronavirus has been particularly devastating for people 65 and older. They represent a sixth of the population, but are among those hardest hit by the virus and its complications.
New data from the Centers for Disease Control and Prevention (CDC) show that the virus hits older Black, Indigenous and people of color (BIPOC) even harder. The CDC was able to collect race and ethnicity data on 83% of all COVID-related deaths, as of August 25, 2021. Of that, 1 in 4 were 65 and older BIPOC, according to a Next Avenue analysis of the data.
There are many reasons why. In Illinois, for example, some Black and brown Medicaid customers lived in understaffed nursing homes or in nursing homes with four other people in their rooms. This led to an increase in mortality compared to white Medicaid customers.
Others have been affected by structural racism, which can contribute to "poorer health outcomes for racial and ethnic minorities and other populations who experience health disparities," according to the National Institutes of Health
But experts and healthcare officials say one of the biggest reasons is the wealth and income gap. Generations of racist policies have stoked inequality in the BIPOC community and many in it cannot catch up to their white counterparts. The pandemic has intensified these challenges. And for many, overcoming those gaps is now a matter of life or death.
The Cost of Racism
More than 100 years before the U.S. was founded, African people were enslaved, brought to North America and used for labor. Harvard Kennedy School professor Khalil Muhammad has traced the roots of racial disparity to that colonization period, explaining that European settlers took Indigenous peoples' land and prevented Africans from participating in the economy. When African Americans were freed from slavery, new obstacles shackled them.
Jim Crow laws limited the education, jobs and housing opportunities that the BIPOC community could choose from. Many who opposed those rules would face fines, jail time or violence. The 1965, the Voting Rights Act marked an end to most Jim Crow laws, but racism lives on, taking many different forms.
Explore how racial covenants in Minneapolis continue to have an impact on access to affordable housing today in the documentary Jim Crow of the North.
Black students are disciplined at more than twice the rate of white students. Black college students are the most likely to struggle financially from student loan debt. Applicants with "distinctively Black names" receive fewer callbacks for a job interview. And Black people are denied home loans at more than twice the average rate.
Preparing COVID-19 vaccines at the Morning Star Baptist Church pop-up clinic | Credit: Boston Medical CenterWhen It Comes to Wealth, Little Has Changed
A report by the Federal Reserve Bank of Minneapolis found that racial wealth gaps have persisted for 70 years, and white families' wealth now averages at more than $118,000. Black families' average is $13,947.
"This country has racialized poverty," said Denny Chan, directing attorney for the nonprofit Justice in Aging - a nonprofit advocacy organization fighting poverty among aging adults.  "[Class and race] aren't proxies for each other, but they also are so deeply intertwined that you can't talk about one without talking about the other."
According to a May 2021 report by the federal Administration on Aging, Black people who are 65 and older now hold the highest rates of poverty among their peers.
Less generational wealth means fewer dollars to save for retirement or for the costs of prescription drugs and other healthcare-related needs throughout life. These disparities in health and health care even extend to dementia care and the ability to get a diagnosis, for example.
In March, the Alzheimer's Association released a report detailing how those disparities played out. It found that older Black and Hispanic people are more likely to have Alzheimer's disease or another dementia, and compared to older white people, were more likely to have a missed diagnosis. The survey also found that roughly 50% of Black people who were surveyed have experienced healthcare discrimination; two in five unpaid caregivers said that race made it harder to get excellent care.
"The decades of racism and discrimination and intergenerational poverty — it builds up on one another so that the disparities are particularly massive among Black or Latinx older adults, and other older adults of color, compared to white older adults," Justice In Aging Staff Attorney Gelila Selassie said. "It really baffles me because this is a generation that fought for civil rights, that lived through Jim Crow, that saw all these racist policies of the sixties, seventies and beyond. So for this to be how they advance in age, how the end of their life is, is really heartbreaking."
At-home care could improve aging adults' health, but Selassie said that many members of the BIPOC community cannot afford it. A national survey by Genworth supports Selassie, finding that yearly rates for at-home care can cost more than $54,900.
Nursing homes can be safety nets for families who qualify for Medicaid. But as we saw during the pandemic, these types of settings may exacerbate decades of inequality. And without enough savings or long-term care insurance, being able to afford a private room in an assisted living community or other long-term care setting may be out of reach.
An Improved System That Needs Reform
Wendy Cappelletto believes that the healthcare industry needs to change.
Cappelletto is a member of the National Association of Elder Law Attorneys and works for the Office of the Public Guardian of Cook County in Illinois. She said racial disparities can be found in the quality of care that nursing homes offer, and even in where the facilities are located.
"[Nursing homes] don't pay well. [There are] transportation issues to get to that place. If people don't have cars, you're not going to want to take a bus in the middle of the night," Cappelletto said. "The pandemic really brought it to the forefront, but there's been disparities before this. They just weren't as obvious."
And volumes of research show those disparities in long-term care settings have gone on for years.
A Workforce Made Up of Women and People of Color
A report by PHI, an organization working to create quality jobs for the direct care workforce, found that direct care workers' median hourly wage in 2020 is $12.80. That has barely increased in the past decade. Another report by PHI found 48% of all direct care workers are women of color and one out of five live in poverty. This workforce is also more likely to rely on public benefits.
The report concluded by saying, "Unfortunately, direct care jobs do not provide economic stability to women of color and their families."
Ironically, PHI projects that the long-term care sector will need to fill 6.9 million jobs in the next decade.
But as Cappelletto said, healthcare disparities were a concern even before the pandemic. A 2005 report cited by the American Bar Association found that BIPOC patients were less likely than white patients to get "appropriate cardiac care, to receive kidney dialysis or transplants." It also found they were less likely to receive the "best treatments" for conditions like stroke or cancer.
Those kinds of barriers and health inequities have led us to where we are today. And the pandemic has exposed all of it for the world to see. But change is starting to happen — at the local level.
Investing In Future Generations, Now
Earlier this year, Boston Medical Center's Dr. Sabrina Assoumou reviewed her hospital's COVID-19 vaccination rates. She nearly jumped for joy.
Assoumou had worked closely with the medical center to reach more people in Massachusetts, where research shows that five communities with the highest COVID-19 infection rates in the state are home to a majority of BIPOC residents.
Assoumou said that many Black Americans are hesitant to trust healthcare providers. Some may recall stories of the Tuskegee Experiment, in which Black men were knowingly infected with syphilis by the U.S. government.
Although penicillin was available at the time, participants were not offered that treatment. As a result of living with untreated syphilis, many lost their vision, experienced neurological damage or died. With that history in mind, Assoumou knew she would have to take a different approach.
Assoumou made televised appeals, acting as a trusted voice who assured people the vaccine is safe and effective. Then, the Boston Medical Center decided to bring the vaccine to the people. The center joined many local senior centers and community organizations in launching pop-up clinics where BIPOC could easily access them.
After the center launched the pop-up clinics earlier this year, Assoumou looked at the data: 40% of the people vaccinated at the medical center were Black. For context: Less than a tenth of the state is Black.
"When you bring the vaccine to people and you make it convenient for them, you can see changes," Assoumou said.
Though it's still important to address generations of health inequities, Assoumou said the community outreach is critical. That's because members of the BIPOC community face barriers besides the wealth and income gap, which can keep them from receiving quality health care.
"Start with social determinants of health, which describe the milieu of where a person is born, lives and grows up," Assoumou said. "[That] impacts the trajectory and impacts [the] access to opportunities, to education — access to wealth."
And all of that, she said, affects one's access to quality health care.
Data on coronavirus rates highlights how those social determinants may be affecting communities of color. Said Assoumou: "It didn't matter where you were in the U.S., but the curves always looked the same: where Black people, Latinx people and Indigenous people were disproportionately impacted by the pandemic."
Research organizations like the National Institute on Aging have recognized the effects social factors can have on communities' health. Those factors have hurt people for generations, but Karyne Jones says that could change.
Jones is president and CEO of the National Caucus & Center on Black Aging, a nonprofit focused on quality of life for aging people of color. It has worked to inform aging Black communities for decades, and now functions as a connector to other programs and resources.
Jones said people today have more health information at their fingertips and can benefit more from that knowledge compared to previous generations. But spreading health awareness is just one piece of the puzzle, she said.
It's also important to build a productive and healthy society, but that means getting everyone to invest in it, she noted.
"COVID was horrible to communities of color, both in the health aspect and financially. And that is because there has not been the kinds of attention and investment in ensuring that these fellow Americans deserve quality of life," Jones said. "We can't continue to think that we can keep the system that we have, and still try to get out of this situation where we have an unhealthy society."
This article was originally published on Next Avenue as part of The Future of Elder Care series, made possible through funding from The John A. Hartford Foundation.


The Racism Unveiled digital storytelling project is funded by grants from the Otto Bremer Trust, HealthPartners and the Saint Paul & Minnesota Foundation.


How COVID-19 Exacerbated Inequalities in Health Care for the BIPOC Community

Kyeland Jackson

Republican Lieutenant Governor candidate Donna Bergstrom and DFL Lieutenant Governor candidate Peggy Flanagan debated healthcare, housing, #MeToo movement and shared who their political heroes are. They also discussed the historic nature of the 2018 Election - Minnesota's next Lt. Governor will be an Ojibwe woman, regardless of who is elected Governor.
 


Lieutenant Governor Candidates Debate

Racism is not reserved to bad run-ins with police.
Since long before the word was said in 1902, racism has persisted in access to health care, poverty and in opportunities for Americans of color. These barriers to opportunity have created gaps between races that still exist today, but a growing tide of data has revealed where these disparities exist and what solutions can begin to solve them.
Allison Liuzzi, a Research Manager at the nonprofit Wilder Foundation, spoke about how such data is exposing racial disparities and why it is important for society to progress.
This story is part of the digital storytelling project Racism Unveiled, which is funded by a grant from the Otto Bremer Trust.
"The events of 2020 opened many people’s eyes to deep and rooted inequities that are an undercurrent in this country and the world. In the context of Minnesota the issue is magnified due to the Minnesota Paradox: the phenomenon that Minnesota ranks as one of the best places to live in the nation, but only if you are white. If you are Black, Native American or a person of color, it ranks as one of the worst. Information like this flies around like hot summer mosquitos: pesky reminders that won’t catch a hint." Writer and public-health educator Hadija Steen Mills looks at how we can collectively do better in a post-2020 world.
On January 28, 2021, the Twin Cities PBS digital storytelling project Racism Unveiled hosted a live Zoom panel titled “Flight, Fight and Flow: Self Healing” aimed at examining the ways in which Black Minnesotans are affected by trauma, and how we can begin or continue our healing journey. Packed with insight and guidance, discover the six key takeaways illuminated by the event.
Black people and people of color in America have been subjected to centuries of medical experimentation and abuse, a history that has spurred mistrust of the healthcare industry for generations. Discover how some Black doctors are addressing the legitimate concerns of their patients of color who are deeply skeptical of the COVID-19 vaccines. 


How Do We Measure Racial Disparities?

Between a global pandemic and police violence against people of color, 2020 underscored long-standing issues of racism as a public health crisis in America. Photo by Obi Onyeader via Unsplash.Have you ever had a cut in the most inconvenient place? One of those places that you continually bump and re-aggravate? That is the current backdrop of the United States, a festering set of wounds that are in the most used places of the collective body. There is a shared yearning for healing to mend the wounds that keep reopening. But healing does not mean there are no scars. It means altered tissue is rejoined into a new landscape. Moving toward a new future requires letting go of the pre-2020, because we can do better than before. 
The events of 2020 opened many people’s eyes to deep and rooted inequities that are an undercurrent in this country and the world. 
In the context of Minnesota the issue is magnified due to the Minnesota Paradox: the phenomenon that Minnesota ranks as one of the best places to live in the nation, but only if you are white. If you are Black, Native American or a person of color, it ranks as one of the worst. Information like this flies around like hot summer mosquitos: pesky reminders that won’t catch a hint. 
This is an oppressive environment that strips communities of their power and aggressions, both big and small, one that belittles and hurts. A new future requires naming the infections of oppression that fester in the wounds. 
Words like “public health” and “racism” have been launched into the realm of dinnertime conversation topics. In the last year, I have been asked for a definition of public health, whether or not something is racist, or what racism and public health have to do with each other. Although public health is a relatively young field, it is very much in a relationship with social inequities. 
Public health focuses on the prevention of negative health outcomes. Current systems have created an inequitable world where differences in the ability to access services and the way people are treated directly contribute to disease and unequal outcomes. 2020 was the year racism was declared a public-health crisis. It was a call for mobilization and movement toward a new future. 
A new future requires reattaching the severed pieces into a unified system. It requires harnessing the collective power. Minneapolis and Saint Paul make up the Twin Cities. They have their unique characteristics, but the major dividing line between these two locations is the mighty Mississippi River. Minneapolis is part of Hennepin County and Saint Paul is situated in Ramsey County, and all of that is a portion of Minnesota. So what does this all mean? It means there are five different systems to navigate: Minneapolis, Saint Paul, Hennepin County, Ramsey County and the State of Minnesota, all holding unique pockets of services and information, without working as a cohesive unit of support. 
The uncooperative, disjointed nature of these five different systems have been felt in the response to the pandemic; we have five different agencies that cover the same stolen land, that are fractured and that do not work together for the betterment of its citizens. This is not unique to the Twin Cities or the COVID-19 pandemic. It is echoed across the nation.
The reverberating impact of a severed system creates barriers. In the landscape of COVID-19, it looks like barriers to equitable care, testing and vaccines. The barriers to services have tangible outcomes. Currently in Minnesota, Latinx people are testing positive for COVID at three-times the rate of their white counterparts, and Black Minnesotans are testing positive at two-times the rate of white Minnesotans. A new future requires barriers to be lowered and responses to be accessible to the most vulnerable communities. 
The declaration of racism as a public health crisis is an opportunity. An opportunity to accept that there isn’t a before to go back to, to name the deep infection sickening us all, reattach systems into a cohesive unit and eliminate barriers. The motto of Minnesota is “L'Étoile du Nord” - the Star of the North. As a state with such different lived experiences and health outcomes, this is the chance to be a leader, a lodestar guiding the ship toward a more just future.
A post 2020 future requires us to dig deep, to that point between our belly button and tailbone - to the place that gets uncomfortable when we think about how much we must change to make the world better. This will not be our last crisis, and a new future deserves a reevaluation and reinvestment in how we will respond to that call for change. 
We need to blur the focus and allow the new future to come into view. What does it smell like, look like, taste like, feel like? Who is fed, who is safe? 
We must scratch that spot and aggravate it, get uncomfortable and work backwards toward the present. We must work toward eliminating the barriers that exist - not just throwing another bandaid on the problem because the wound will still bleed.
Hadija Steen Mills [they|she] was born and raised on Dakota land commonly known as Minneapolis. They received a Bachelor’s in Science from the University of Minnesota in sexual health with a focus on reproductive justice and health disparities. She has always been passionate about the creation of a world free of inequities and advocates for autonomy for the most systematically oppressed populations. Hadija’s work stems from a Healthcare Reparations ideology that pushes for unifying, creative and anti-oppressive approaches to a new world where Community Care elicits health. 
This story is part of the digital storytelling project Racism Unveiled, which is funded by a grant from the Otto Bremer Trust.
On January 28, 2021, the Twin Cities PBS digital storytelling project Racism Unveiled hosted a live Zoom panel titled “Flight, Fight and Flow: Self Healing” aimed at examining the ways in which Black Minnesotans are affected by trauma, and how we can begin or continue our healing journey. Packed with insight and guidance, discover the six key takeaways illuminated by the event.
Black people and people of color in America have been subjected to centuries of medical experimentation and abuse, a history that has spurred mistrust of the healthcare industry for generations. Discover how some Black doctors are addressing the legitimate concerns of their patients of color who are deeply skeptical of the COVID-19 vaccines. 
Whether doctors use abusive language, refuse to acknowledge a patient’s chosen pronouns on medical intake forms or ignore the specific needs of LGBTQ+ patients, normative gender/sexual orientations still abound in the healthcare industry, leaving many with a difficult question: Should I even go to the doctor? Four queer women of color, including Hadija Steen Mills, discuss barriers to LGBTQ+ women’s health care and share affirming ways to combat systems of oppressions through health education.


Responding to Disparities: A Look at a Post-2020 United States

Hadija Steen Mills

For just about everyone living in the United States, healthcare costs can skyrocket, even for seemingly routine procedures.
The costs of visits, prescription medications and healthcare premiums – for those who are insured – have all steadily risen for decades. According to data from the Kaiser Family Foundation, health spending on a per capita basis has increased over 31-fold in the last four decades, with health spending growth outpacing the growth of the nation’s economy.
And while the number of insured Americans has grown since the Affordable Care Act (the ACA) passed in 2010, insurance coverage alone cannot always prevent medical debt for low- and moderate-income families. In a 2016 report on medical debt, an estimated 26% of U.S. adults said they or someone in their household had difficulty paying a medical bill within the past 12 months.
“First and foremost, we have a healthcare system in the United States that is based on capitalism, productivity and profit,” said Family Tree Clinic Executive Director Alissa Light. “And there’s amazing people within that healthcare system who really care about the health and wellbeing of people, but the healthcare system isn’t set up to be working toward health and wellness; it’s disease-oriented and it’s profit-driven.”
While Minnesota has a long history of high-quality health care – at least for those who can afford it – access to basic and preventative services and health outcomes can vary widely based on one factor: identity.
A community organization in Saint Paul, Family Tree Clinic reaches an estimated 22,000 people a year through its sex education programming and clinical services. Their patients come from all over the Upper Midwest and even, at times, from Canada, largely because of Family Tree’s gender-affirming hormone clinic and focus on LGBTQI+ health care.
“Because there are so many barriers to insurance,” said Light, “to getting care that honors, respects or even sees your identity in any sort of way – and just the economic realities that health care is really, really expensive and usually pretty inadequate… When we launched our LGBTQ health initiative in 2010, we just learned very quickly that the need was really, really, really profound because of all of those things.”
Bias in the System
Christy Hall is a litigator with Gender Justice whose work often intersects with health care. Hall uses the law and policy to combat discrimination, including for LGBTQ Minnesotans. While Hall cites access to health insurance as a major barrier, she acknowledges the bias of providers as another major challenge her clients face.
“For example, we had a client who was trans and who was seeking access to in-patient mental health treatment,” said Hall, “and because [the provider] was trying to figure out if they belonged on the men’s floor or the women’s floor - they haven’t figured out that piece of it - so she just didn’t get access to health care.”
Amelia Schlossberg, a healthcare advocate working in Vermont, uses a patient advocacy approach to help people get coverage they need, finding gaps in coverage around things like gender-affirming care and gender-affirming surgery. Schlossberg considers their work in getting Vermont’s Medicaid program to update their gender-affirming care coverage a major victory. For Schlossberg, though, options based on income remain a significant source of frustration.
“Generally, your access to health care depends on who is paying for your health care,” says Schlossberg. “And if your income goes up, or if it goes down, you have limited options. Sometimes even just having $10 more per year can really limit your options.”
In Minnesota, for example, low-income adults may qualify for either Medical Assistance (Minnesota’s Medicaid Program) or MinnesotaCare. While both programs have income guidelines for participants, choices may vary significantly between them; as Schlossberg notes, choice can have major implications for patients’ health outcomes.
“Oftentimes, if you have more income, you have more choice,” said Schlossberg. “And something that’s been really important for the people that I’ve worked with is being able to find a doctor or a provider that really works well with you…  And the difference in the doctor that you’re just kind of putting up and they’re just putting up with you, versus a doctor that you really click with and that really is your advocate as well as your medical provider, that can make a difference between okay medical care… and someone really pushing to help you get the diagnosis, or get the medication or help you navigate that system.”
“Multiply or Deepen"
The 2020 COVID-19 pandemic has brought to light many of the challenges of our national healthcare system, including some of the vast inequities that exist for people of color. As the U.S. reckons with myriad racial injustices, those in health care can have particularly dire effects.
“There’s still a dynamic among LGBT folks that means that health problems will often multiply or deepen if the individual is a person of color,” said Phil Duran, the Director of Policy and Research at JustUs Health. “And so we’re really supportive of the fact that Hennepin County and others have been moving to call racism a public health issue, and that’s a conversation that we continue to need to engage in. Because you can take some of these specific conditions off the table, but that one is still going to be there.”
Alissa Light of Family Tree Clinic agrees.
“It’s interconnected and inexorably linked,” said Light, “so that the more identities you hold that fall outside that really narrow focus that the healthcare system is designed for – which is really white, cis[gender], assumed heterosexual men, usually – not only are you less and less seen, represented, believed and treated with dignity, but also because of compounding factors of deep structural and systematic racism [that are] rampant throughout every system in the United States and oppression based on other identity, including queerness, trans-ness, non-binary, the factors are compounded.”
Duran sees the need to dig far deeper into health disparities throughout the COVID-19 crisis and beyond, noting that as LGBTQ+ Minnesotans age, they face yet additional challenges, including isolation.
“Among LGBT older adults,” said Duran, “you see a disproportionate number of people who don’t have spouses or partners at that stage of their life. They don’t often have children or grandchildren who are there. Many older adults will turn to a faith community… and there has been historic tension between many faith traditions and the LGBT community, so people don’t have access to that. And so isolation is a real concern.”
Moving Forward with Hope
Alissa Light, Christy Hall, Amelia Schlossberg and Phil Duran all support the idea of some version of universal health care. They share the hope that, someday, all Minnesotans will be covered no matter how much money they make or how they identify. Even as access to insurance and high-quality, gender-affirming care continues to pose challenges for LGBTQ+ Minnesotans, they see opportunity to move forward in new and innovative ways. And they all feel hopeful about the healthcare conversations they are having locally and hearing nationally.
“I always have to be hopeful,” said Light, laughing. “I feel like there is no option, although I feel hopeless many minutes and hours of many days… It’s like we’re going to do everything we can to not go back and to really design the world we want to live in. And that’s what it’s going to take. And I do feel hopeful that we can keep building towards that.”
Writer Lindsay King-Miller shares her journey to parenthood with her trans husband and asks the question, "Why is the road to parenthood full or perils for LGBTQ+ folks?"
Whether doctors use abusive language, refuse to acknowledge a patient’s chosen pronouns on medical intake forms or ignore the specific needs of LGBTQ+ patients, normative gender/sexual orientations still abound in the healthcare industry, leaving many with a difficult question: Should I even go to the doctor? Four queer women of color discuss barriers to LGBTQ+ women’s health care and share affirming ways to combat systems of oppressions through health education.
Queer women are not statistically “safe” when seeking health care, but there are medical spaces that have been crafted so that they can be treated with the same dignity as any other patient. The documentary film Patient No More explores the barriers LGBTQ+ women navigate across healthcare systems, and how the never-ending hunt for affirming care affects their lives.


Why Is It So Tough for LGBTQ+ Folks to Get the Care They Need?

Alauna Yust

On July 21, 2020, Twin Cities PBS hosted a virtual panel to discuss how LGBTQ+ health care and coverage might be changing in the United States. 
Panelists dove into the details of President Trump’s ACA rule reversal, the recent Supreme Court ruling on LGBTQ+ employee rights, and shared what business leaders, non-profits, HR departments and employees need to know so they are following the letter of the law.
Moderated by Almanac's David Gillette (he/his), the conversation featured:
Christy Hall (she/her), a Senior Staff Attorney at Gender Justice, where she represents clients challenging gender discrimination.
Nathalie Crowley (she/her), Associate Executive Director at Family Tree Clinic, a regional leader in LGBTQ healthcare, evidence-based comprehensive sex education, and culturally responsive care.
Casey Nolan (she/her), Chief Human Resources Officer at HealthPartners.
Writer Lindsay King-Miller shares her journey to parenthood with her trans husband and asks the question, “Why is the road to parenthood full or perils for LGBTQ+ folks?”
Queer women are not statistically “safe” when seeking health care, but there are medical spaces that have been crafted so that they can be treated with the same dignity as any other patient. The documentary film Patient No More explores the barriers LGBTQ+ women navigate across healthcare systems, and how the never-ending hunt for affirming care affects their lives.
While Minnesota has a long history of high-quality health care – at least for those who can afford it – access to basic and preventative services and health outcomes can vary widely based on one factor: identity. A very real tension exists between health care and health insurance coverage in Minnesota and beyond, so we wondered: Why is it so tough for LGBTQ+ folks to get the care they need?


Are LGBTQ+ Healthcare Rights Changing in the U.S.?

When it comes to mental health in Black communities, we know a stigma exists. For some of us, we mistrust the medical community after centuries of being misdiagnosed, mistreated or manipulated. For others, we’ve developed or inherited a survivor mentality that believes seeking help is a sign of weakness. Whatever the reason, it’s important for us to overcome our apprehension. There are many societal factors that are out of our control, but our own healing is one area that we have influence over - and one step in that journey may be seeking the help of a therapist.
To demonstrate the healing power of therapy, Sanni Brown-Adefope agreed to attend a recorded session and explore the trauma that has affected her life. Dr. Sheila Sweeney, of Peaces ‘n PuzSouls, partnered with Sanni to take her through a healing reflection of her past. Dr. Sweeney is a psychotherapist with a special interest in the mind, body and soul connection. In this session, she demonstrates a multitude of ways that connection emerges as someone is allowed to speak their own story.
There is no one path on the journey to healing, and it may take several attempts to find the methods that work best for us. But if we stay persistent about taking care of ourselves, we begin to mend, not only our own wounds, but those of generations before us and the generations to follow.
This story is part of the digital storytelling project Racism Unveiled, which is funded by a grant from the Otto Bremer Trust.
On January 28, 2021, the Twin Cities PBS digital storytelling project Racism Unveiled hosted a live Zoom panel titled “Flight, Fight and Flow: Self Healing” aimed at examining the ways in which Black Minnesotans are affected by trauma, and how we can begin or continue our healing journey. Packed with insight and guidance, discover the six key takeaways illuminated by the event.
In a year that has proved to be a turbulent challenge for so many Minnesotans, the Black church has continued to serve the spiritual and health needs of its congregants of color. The Stairstep Foundation’s CEO Rev. Alfred Babington Johnson shares some of the ways in which the state’s Black churches are working together to provide shelter in what has been an onslaught of storms. 
Black people and people of color in America have been subjected to centuries of medical experimentation and abuse, a history that has spurred mistrust of the healthcare industry for generations. Discover how some Black doctors are addressing the legitimate concerns of their patients of color who are deeply skeptical of the COVID-19 vaccines. 


WATCH: One Woman Finds Healing in Therapy

Bobby Edwards

Anita White“The pandemic hit so quickly, didn't it? I mean, I think we're all still a little traumatized,” comments artist Anita White as she pulls out a sketchbook.
“Initially, I started poking fun at coronavirus and doing drawings, like, 'I used to draw a lot, but now all I do is wash my hands!'" White holds the sketch up to the computer screen, revealing one of the first drawings she made during the pandemic.
White has been drawing her way through life since she was a child. Her parents were both artistic and encouraged her to pursue art school. After art school, she had a 28-year career teaching art to children and, all the while, retained a regular routine of sketching.
Zorongo Flamenco, Anita WhiteIn her sketchbook, she captures the world around her, whether it be her travels, flamenco dancers (a common theme as she used to frequent Zorongo Flamenco performances), or simply capturing moments with family members and friends.
“Well, drawing is really interesting because it helps me pay attention to beauty or pathos. And it's been a navigational tool for me.”
White’s late husband of 39 years, Josh, had many ailments throughout his life, which increased in his final years. Hospital stays became a consistent part of their lives and, as a way to cope, she pulled out her sketchbook. Turning an extra chair into a makeshift easel, “I drew my way through all the medical challenges,” she says. She’s also quick to explain that this was in the “Way Back Time,” referring to a pre-pandemic world in which visitors were allowed in hospitals.
Diagnosis in Bite-Size Pieces, Anita WhiteShe’d sketch his latest diagnosis in an effort to grasp the gravity it had on their lives and to mitigate anxieties of the unknown. “Drawing just helped me get through because, otherwise, I would have been emotionally a lot more stressed out.” And when possible, she’d try to find the humor in the moment. “Humor does a lot for healing as well.”
She also turned her attention to the healthcare staff that floated in and out of the room, changing tubes, changing the garbage or changing the food trays. “People are basically kind of shocked to be drawn. And I usually ask them [for permission]. I try not to be too secretive…. It's a way of honoring and it's a fun way of connecting.”
The act of someone drawing your likeness (with permission, of course) holds a powerful allure: It means that they are paying attention to you. They see you.
All of her sketching led to a creative relationship with Hennepin Healthcare, where her husband received treatment. Working with Patient Advocate Sheila Moroney, Arts Program Coordinator Wenda Ballinger and Chief Academic Officer Dr. Meghan Walsh, White had an art show in 2017, “Drawing Through Crisis with Courage and Humor.” She then worked on the project “A Day in the Life of Hennepin Healthcare” from March 2018 until June 2019, by following various staff members around the hospital and documenting moments of their days.
“I followed an Ethiopian woman around in the medical ICU as she cleaned. I'd met a doctor, and so I did one called 'Doctor's Rounds'…. I ran with people, let's put it that way. I ran, ran with the guy who did translations as he ran from one place to another. I ran with Rosie, who greets people.”
Straddling roles as both a caregiver and an artist at Hennepin Healthcare offered a unique perspective on the people - the patients and the medical staff - who populate a bustling hospital. She was touched by the talent, care and the big hearts of all those who serve the public there.
“Anita has a unique gift of capturing a scene with keen observation and gentle humor. One of the comments I received from a member of our staff states, 'As both an employee and recent patient, I truly appreciate [Anita’s] whimsical, honest artwork. 'Love Me Just the Way I Am' particularly hit home as often when we are ill, people expect us to be how we were.  Thank you for so generously portraying the patient and family perspective so beautifully,'" relays Ballenger.
"Love Me Just the Way I Am" Anita WhiteWhite's husband, Josh, uttered the words, "Love me just the way I am," in a late-night farewell during a particularly challenging hospital stay - and they reflect his realization that life takes on a new shape when confronted by continual health challenges.
In the final weeks of her husband’s life, she noticed that her drawings became very symmetrical. “I drew very symmetrical, balanced drawings based on William Morris designs. And this really helped me because things were anything but balanced, anything but symmetrical.”
When her husband died in April 2019, “[I] drew my way through his death and actually have been drawing my way through my grief journey, too. So drawing is really interesting because it's like a key that opens the door, and it just helps me see and it helps me feel, it helps me empathize, in other very different ways.”
White's work revolves around empathizing with and honoring people that might not ordinarily be celebrated. She was ready to embark upon another project with Hennepin Healthcare in the spring of 2020, but the pandemic took hold and, for safety reasons, the hospital closed to most visitors. To lift the staff’s spirits, she sent weekly drawings from her previous projects. In more recent months, she has shared her interpretations of Hennepin Healthcare’s Stories from the Field, another documentary project by the hospital that focuses on staff experiences during COVID-19. The stories are poignant and heartbreaking, but show the resilient spirit of healthcare workers in this unrelenting time.
Now that she's spending far more time at home, her sketchbook reflects a more interior life. She captured her cats and window views of construction crews working on her street (she has, of course, learned the names of the crew and shared copies of her drawings with them to honor the work they are doing). She also doesn’t mind drawing what's on television, whether it be an address from the Governor or another program that moves her, like Twin Cities PBS's own Hippocrates Cafe: Reflections on the Pandemic.
And certainly her sketchbook carries a continuation of the grief she experiences due to her husband's death and the new grief of the life COVID-19 has bestowed on the world. “It's just one rollercoaster ride after another. Our sense of normal is really disturbed. There's just really a lot of grief and unexpressed grief. I'm really lucky because I've got my creative life,” she says, lifting up her sketchbook. She wonders how others are processing - or not processing - these important times.
Length of Grief, Anita WhiteIn a moment of reflection, she notes that her sketchbook now has symmetrical drawings in it, too, just as it did in the final days of her husband’s life. These are an expression of craving balance in an unbalanced time.
For White, drawing offers many things. It’s a way to process, a way to navigate, a way to honor and document those around her. It’s a way to process grief, anger and joy, and share in life’s journey. It’s been a way of life, a creative habit.
Credits: “A Day in the Life of Hennepin Healthcare” was curated by Wenda Ballinger, commissioned by Hennepin Healthcare and funded by Hennepin Healthcare Foundation’s Fallon Fund for Humanism. "Drawing Through Crisis with Courage and Humor" was curated by Wenda Ballinger and funded by Hennepin Healthcare Foundation’s Fallon Fund for Humanism.
 
This story is made possible by the Arts and Cultural Heritage Fund and the citizens of Minnesota.
If the wintertime scarcity of outdoor performances has left you with the blues, never fear: We have seven Pandemic Performances from local musicians that will bring a spring to your step.
For only a year and a half, the hardcore music scene in the Twin Cities rippled with exuberance, creative innovation and a healthy dose of grit. Check out the docu-series Minnesota Hardcore, which chronicles the short-lived, but pivotal, influence of hardcore music and the subculture that formed around it. 
When COVID-19 first showed up in the U.S., G. Phillip Shoultz III, like many Americans, had no idea what was ahead. “All of us naively thought this is just going to be a few weeks and we’ll get back to our lives,” he reflects. But the director of the VocalEssence Singers of This Age youth choir quickly realized that wouldn’t be the case. So the choir got creative and performed this rousing choral tune on a downtown rooftop.


Artist Anita White Sketches Her Joys, Her Grief and Life in a Pandemic

Brittany Shrimpton

Dayana Bella-Marie Campbell was loved on the night that she died.
It was an average day, and Dayana’s parents poured time into their first-born. Her mom, Stephanie Pollard, sat down to watch cartoons with her. A favorite was Princess and the Frog, a story about a Black woman struggling to be human again. Pollard bathed Dayana, washing her full head of hair, which had amazed doctors. And as the night ended, Pollard put Dayana in her father’s hands, kissed her and said, “I love you.” It was the last thing Pollard told her daughter. Pollard woke the next day to find that Dayana died in her sleep. She was three months old.
Dayana CampbellDoctors could not explain how Dayana died. They said she was healthy. One coroner said sudden infant death syndrome could be the cause. Whatever the reason, Pollard is now one of hundreds of Minnesotans whose child died before their first birthday. Many of them are Black.
African-American infants are dying at twice the rate of white infants, reflecting decades of health inequity that has been drawn by racial lines. The COVID-19 pandemic is bringing new challenges to the issue, and erasing that disparity means addressing systemic racism that has derailed the lives of countless families.
“A Horrible Bond”
The morning that Pollard found Dayana, she begged God to take her instead. When that didn’t happen, Pollard changed. She cried for days. Holding children felt unbearable, and even news of missing children reminded her of Dayana.
The pain is still there, but Pollard has found comfort in other mothers who also lost their infant children. Although their children passed in different ways, they share a history of being discriminated against.
“We get looked at a lot differently than some moms that lost their child [in] different ways. Sometimes people just want to come and hear the story and see if you did anything to your child,” Pollard said. Her second daughter, Ivory Campbell, cooed as she spoke. “It’s a horrible bond to have… But losing your child, it does help you create a bond with other moms that have lost their child as well.”
In Minnesota, most of those moms are people of color.
Data from the Minnesota Center for Health Statistics shows that infants of color are up to 2.6 times more likely to die than white infants. The highest rates are among Native American people, who make up just 1% of this state’s population. 
Minnesota Infant Mortality DataWith disparities in health care driving these unequal rates, many people have turned to doulas - professionals trained to support mothers before, during and after their pregnancy. Akhmiri Sekhr-Ra has been a doula here for decades and now works as a Chief Family Development Officer for the Cultural Wellness Center in Minneapolis. A lot has changed since Sekhr-Ra started practicing in the 80’s. But one thing remains the same: Few doulas are people of color.
“You’re more comfortable in your skin if somebody who looks like you is there. You don’t feel like you’re isolated and alone,” Sekhr-Ra said. “There needs to be more people who look like us in the field.”
Akhmiri Sekhr-Ra of the Cultural Wellness CenterJennifer Almanza, a certified midwife and clinician at University of Minnesota Physicians, has found that racial consistency in health care can halve the chances of Black babies’ deaths. Yet 90% of midwives in the U.S. are white.
“The U.S. is the only developed country with a rising maternal mortality rate. We know that many of these deaths and injuries can be prevented,” Almanza said. “We will not bridge the gap in maternal outcomes until we are able to fully address racial disparities in health.”
Jennifer AlmanzaCOVID-19 has worsened those disparities. More people of color in Minnesota are filing for unemployment, going hungry, and contracting and dying from the disease. Fewer have been vaccinated or have health insurance to help them.
Worse yet, Sekhr-Ra said COVID guidelines are separating more mothers of color from doulas and support systems that are vital to their babies’ health. Closing the gap in infant deaths means addressing what causes these disparities. Some experts say that the root cause is racism.
An Old Problem With New Solutions
Stephanie Pollard had heard horror stories of women dying or being misdiagnosed while pregnant, but she was not prepared to lose her daughter. Pollard journals to Dayana every day and says that her thoughts on the healthcare field have changed. She is more cautious now and feels that people should focus on the issue instead of sweeping it under the rug.
“Be more open-minded to treating African-American women and children a little bit better in the healthcare field and not just being like, ‘Since your family had cancer or diabetes, this is what’s most likely going to happen,’” said Pollard. “It doesn’t have to happen.”
Dr. Rachel Hardeman might agree. Hardeman studies reproductive health equity at the University of Minnesota and said that gaps in infant death rates persist, even when you account for healthcare access and risks such as smoking.
“At the crux of why we’re seeing these racial disparities, these racial inequities in infant mortality, is structural inequity and structural racism,” Hardeman said. “It’s not a coincidence that the two populations that have been historically oppressed, historically marginalized throughout our history - indigenous folks and Black folks -  have the worst infant mortality rates and the worst health outcomes.”
The proof is in and around the healthcare field.
Racial segregation points to infant mortality, Hardeman said, because the chances for an early, riskier birth increases. Minnesota is one of the most segregated states in the country, thanks in part to racial covenants that stopped people of color from buying homes. She also found that more run-ins with the police increase the chances for an early birth, which puts over-policed communities of color at greater risk.
The gap is so huge that Duke University says Black women with a PhD are more likely to lose their infant than white women who haven’t finished high school. It makes the issue personal for Hardeman, who has a 7-year-old daughter.
Hardeman believes that policies which target housing disparities, public safety and racial bias can address the gap in infant deaths. There has been some progress on that front: A bill that proposes to study maternal health and require anti-racism training is moving through Minnesota’s House of Representatives. Still, Hardeman has her doubts. 
“The fact that we have been tracking infant mortality rates since the 1800s or even earlier and we still see this gap makes me wonder, ‘What will it take?’” Hardeman said. “We have a responsibility to care for and protect our young and our vulnerable… If we can decide that every Black infant that comes into this world is valued, and make sure that we’re doing all that we can to ensure that they have a life where they get to be healthy and thrive and grow up in a safe place in a safe environment - and have what they need to thrive - that’s community health and wellbeing for everyone.”
Pollard is doing what she can to make that kind of change. She supports other friends and mothers who lost their children, and shares her story with them. She hopes that people find peace in hearing about her journey, and realize that they are not alone in this. 
 
Stephanie Pollard“Some people, they lost their child[ren] to SIDS twice. And some people lost their children to miscarriages,” Pollard said. “You’re not the only African-American woman. You’re not the only mother that has lost a child. If I could do it, I believe that you can do it.”
It’s now been two years since Pollard lost Dayana. Through therapy, doulas and support from others, she has been healing. Now when people look at Ivory’s full head of hair and say she looks just like her sister Dayana, Pollard can smile. It's likely that many mothers in Minnesota cannot do the same. 
This story is part of the digital storytelling project Racism Unveiled, which is funded by a grant from the Otto Bremer Trust.
In a year that has proved to be a turbulent challenge for so many Minnesotans, the Black church has continued to serve the spiritual and health needs of its congregants of color. The Stairstep Foundation’s CEO Rev. Alfred Babington Johnson shares some of the ways in which the state’s Black churches are working together to provide shelter in what has been an onslaught of storms. 
Black people and people of color in America have been subjected to centuries of medical experimentation and abuse, a history that has spurred mistrust of the healthcare industry for generations. Discover how some Black doctors are addressing the legitimate concerns of their patients of color who are deeply skeptical of the COVID-19 vaccines. 
To demonstrate the healing power of therapy, Sanni Brown-Adefope agreed to attend a recorded session and explore the trauma that has affected her life. Dr. Sheila Sweeney, of Peaces ‘n PuzSouls, partnered with Sanni to take her through a healing reflection of her past. Dr. Sweeney is a psychotherapist with a special interest in the mind, body and soul connection. In this session, she demonstrates a multitude of ways that connection emerges as someone is allowed to speak their own story.


Racism Is Killing Twice As Many Black Babies in Minnesota

On Memorial Day, shocking live videos surfaced on social media, showing a white Minneapolis police officer kneeling on the neck of a handcuffed black man – George Floyd – for 8 minutes and 46 seconds, while Floyd laid face down on the pavement and repeatedly said, “I can’t breathe.” Three other officers on the scene stood by without intervening. Instead, they prevented bystanders from interfering. Floyd was pronounced dead shortly after.
In the wake of the police killing of George Floyd, widespread protests and uprisings unfolded across the world, with Minnesota at the epicenter. These demonstrations are part of the larger Black Lives Matter movement, which addresses America's history of systemic racism and police brutality, particularly against the African-American community.
What is unique about this occurrence is that the world has also been gripped in a pandemic since March. The coronavirus (which causes the disease COVID-19) is highly contagious, and experts recommend that individuals wear a face mask and maintain a distance of at least six feet from others in an effort to prevent the virus from spreading. But with these mass gatherings, many people were unable to maintain a safe and healthy distance. And many people did not wear masks.
In response, the Minnesota Department of Health (MDH) officials recommend that those individuals who have attended protests, community cleanups, volunteer events and other mass gatherings should get tested for COVID-19. They’ve also advised healthcare providers to increase testing capacity. Though uncertainty remains over whether or not these recent mass gatherings will trigger a surge in COVID-19 cases, many health experts predict a second wave as the outcome.
Editor’s Note: As the COVID-19 crisis unfolds in Minnesota, certain details in our stories about the impact of the virus may become outdated within hours, days or weeks of our publication. For the most up-to-date information about the coronavirus in Minnesota, please visit the websites for the Office of Governor Tim Walz and Lt. Governor Peggy Flanagan or the Minnesota Department of Health.
As someone who has attended these gatherings, Twin Cities PBS producer Susan Thao (Sinclair) documented her experience with COVID-19 testing. After spending a morning at a drive-thru test site, she got her results back in 12 hours.
Wondering what to expect? She shares her tips on what to expect when testing for COVID-19:
Make an appointment, preferably through a healthcare provider. If through a healthcare provider, it's beneficial to have an online account for quicker access to test results.Drive-thru test sites are great for maintaining confidentiality.Bring tissues if you're uncomfortable with a nasal swab.Try not to get stressed out about the results. There are instructions for both positive and negative diagnoses.If you're uneasy with the results, retest! MDH actually recommends taking another test 12 to 14 days after attending an event (or 5 to 7 days after the first test).Since the start of the pandemic in March, testing in Minnesota has ramped up considerably - good timing given the thousands of individuals who have marched, volunteered and attended events in recent weeks, and who may now seek out answers to the question: "Do I have COVID-19?"
During a time when musicians and performers of all stripes are offering musical interludes from balconies and porches, revisit a time in history between the world wars when local communities gathered in Minneapolis parks to sing together in unison.
Many pregnant people during this time of pandemic have had to make some unexpected decisions about their original birth plans. Meet two women who chose to forgo hospital births for other options that made them feel more comfortable during this uncertain time.
Diagnosing and treating patients with the novel coronavirus comes with different challenges for rural and regional healthcare systems located outside major metropolitan areas. One Greater Minnesota reporter Kaomi Goetz interviews Essentia Health’s Chief Medical Officer Dr. Peter Henry about the challenges that rural medical facilities face during a pandemic.


What to Expect When Testing for COVID-19 in Minnesota

Susan Thao

As of 2019, there are no copper-nickel mines in the BWCA watershed, but Twin Metals, a Minnesota-owned subsidiary of Antofagasta, is hoping to change that. David Gillette traveled to Ely, Minn., the community closest to the proposed mine site, to learn about the geology, the environmental concerns and the competing politics behind this controversial project.
This story was published September 27, 2019.
Environmental stories on Almanac are sponsored by the Minnesota State Lottery.
 
Northern Minnesota is no stranger to change in recent years. As healthcare options for those living in rural communities have dwindled, residents are faced with difficult decisions, as One Greater Minnesota reporter Kaomi Goetz examines in this story on disappearing birthing centers.
Global warming is taking a toll on the tourism business in northern Minnesota, a region that depends on winter lovers in search of dogsledding and cross-country skiing adventures, among other cold weather pursuits. Discover more about how they're coping in the face of change.


What's at stake in the proposed Twin Metals copper-nickel project?

David Gillette

The budget forecast shows a $1.3 billion projected surplus - and Minnesota is also outperforming the nation and region, especially when it comes to the number of workers now moving into communities across the entire state, reversing a long-term trend that continues to plague other Midwestern states. Laura Kalambokidis, the State Economist, explained that Minnesota's economy is more diverse than surrounding states, adding that, while we don’t do entrance or exit interviews to know for sure, the state is buoyed by greats jobs and wage growth.
Budget officials celebrated the result, which saves $2.3 billion and allows the state to reach the finish line in its budget reserve target. In response to the news, Democrats who control the House expressed caution, saying that the twelfth surplus in 13 years without inflation factored in is a fictional dream - and they offered a sobering counterpoint. "The state is dealing with racial disparities, unaffordable healthcare, childcare," said DFL House Majority Leader Ryan Winkler.
Republicans who run the Senate say an income tax cut worked and they want to give the surplus back to taxpayers. “This is actually really, really good news, " said GOP Senate Majority Leader Paul Gazelka. "It shows 4 years of growth.”
Republican House Minority Leader Kurt Daudt added, “Last election, the number-one issue was healthcare costs, and next election it will be healthcare costs."
For his part, Rep. Daudt called for a complete repeal of the healthcare provider tax, which got a big no from the governor. “The provider tax… Really?" retorted DFL Gov. Tim Walz. “Do not talk about the provider tax this year." That's after a big fight to stop the automatic full repeal of the of the tax on healthcare providers.
Overall, the governor expressed enthusiasm at the prospect of $1 billion in forecasted surplus dollars. The news is evidence of several positive trends sweeping the state, including a dramatic increase in household formations and the number of people moving to Minnesota to fill job vacancies. “This is a state that works and values everyone," he said.
Stay tuned to Almanac, which airs on TPT2 on Fridays at 7 pm and on Sundays at 9:30 am, for ongoing coverage of what lawmakers decide to do with the $1.3 billion surplus.
As the Minnesota legislature put the finishing touches on the state's budget earlier this year, Almanac's David Gillette offered this illustrated essay on what did and did not make it into the budget.
One of the wettest years on record, floods wreaked havoc on Minnesota communities in 2019. Almanac reporter Mary Lahammer recently visited Henderson, Minn., a town turned into an island due to floodwaters this year. She investigates how the town would use some much-needed bonding money as state lawmakers tour projects around the state in need of investment.
In the wake of news about the state's budget surplus, one issue remains true: Minnesota's infrastructure is aging, and several projects across the state could benefit from bonding money. Mary Lahammer accompanied lawmakers on a trip to southern Minnesota to learn more about the area's needs.


Minnesota has a $1.3 billion budget surplus. Now what?

Mary Lahammer

Story published: May 4, 2020
Nurse practitioner Jennifer Murphy sees a patient through a video screen at Open Door Health Center in Mankato, Minn. The check-up would normally happen in person, but because of the pandemic and shelter-in-place orders, the clinic and the patient are instead using telehealth options.
"Good to see your face. Have you had a sore throat before in the last couple months? Murphy asked.
"No," replied the patient, who requested anonymity because of healthcare privacy.
"Any fevers, chills or night sweats?" Murphy prodded.
"A little bit," the patient answered.
Visits like this now make up about half of all care currently being administered through Open Door, a federally-funded safety net clinic that offers services on a sliding fee scale. Offering telehealth services was something the clinic had planned to research this year and perhaps start in 2021.
"But the problem was, because of the pandemic, our behavioral health team said, 'Whoa, these patients have to be seen, we’re going to have to figure out telehealth now,'" said Mandy Gault, a spokesperson for Open Door.
And in less than a month, they did. It was by no means easy, especially for a clinic that runs on federal and state funding, as well as private donations. And then there was the issue of whether patients, many of whom were low-income, had the devices needed for telehealth visits.
"Is this going to be a barrier for patients? Are patients going to be comfortable with the smartphone, the tablet? And we found in all cases that, yes, they are ready," Gault said.
Telehealth has been around for about 25 years, though it had primarily been used in rural settings to deliver specialty care. Funding came with restrictions, and not many patients took advantage of it overall. For example, in 2016, less than one percent of Medicare patients had ever utilized a telehealth visit, according to the Medicare Payment Advisory Commission. At nearby Mankato Clinic, they weren't doing it at all.
"The way it was governed by Medicare, Medicaid and CMS, a patient would have to go to an originating site for a telehealth visit. So if they wanted to have a visit with a specialist, they would have to get out of their house, drive to a clinic, check in to that clinic, go to a room with a  computer, and through their computer they would then see their specialist. And patients didn’t really want to do that," said Dr. Andrew Lundquist, chief medical officer of Mankato Clinic.
Editor’s Note: As the COVID-19 crisis unfolds in Minnesota, certain details in our stories about the impact of the virus may become outdated within hours, days or weeks of our publication. For the most up-to-date information about the coronavirus in Minnesota, please visit the websites for the Office of Governor Tim Walz and Lt. Governor Peggy Flanagan or the Minnesota Department of Health.
The pandemic has changed the equation. Restrictions were loosened to allow payer reimbursements to equal an in-patient visit. And healthcare providers such as Mankato Clinic quickly ramped up their telehealth capabilities. Lundquist reported that, in one week, all 180 of the providers at the clinic were trained and ready to go. He said telehealth now makes up 45 percent of all visits at the clinic.
"Physicians and nurses really like it also, it’s a great way to see a patient without having to see them - I mean that in a good way. It’s something that our patients are seeing a quicker response from us, they call us with a problem, and we can see them in 30 minutes, and they don’t have to leave their house," he said.
But one question remains: For how long with telehealth last? The payment structure is set to continue for only as long as the pandemic and various states' stay-at-home orders last.
"Once the genie is out of the bottle, we don’t know if we can put it back in," Lundquist said.
Jonathan Neufeld leads the Great Plains Telehealth Resource and Assistance Center at the University of Minnesota. He said the rapid conversion to telemedicine will leave a lasting imprint on how health care is practiced in the future.
"We don’t know how long this will last, and there may be resurgences of Covid-19 and other pandemics and that’s something we’re going to need to be prepared for going forward," he said.
Telehealth has also played a role in keeping healthcare providers afloat. Healthcare systems everywhere have struggled under bans on elective procedures and a spike in fears that some have over going into clinics. At Mankato Clinic, revenues are down by 70 percent, and some staff have already been furloughed. Despite telehealth replacing many in-person visits, Lundquist said that there are still a lot of people going without healthcare services.
"We do 200 mammo screenings a week, and we will diagnose breast cancer once every week. In the four weeks we’ve stopped, there may be four people with cancer out there who don’t know it," he said.
Diagnosing and treating patients with the novel coronavirus comes with different challenges for rural and regional healthcare systems located outside major metropolitan areas. One Greater Minnesota reporter Kaomi Goetz interviewed Essentia Health’s Chief Medical Officer Dr. Peter Henry to find out more about how rural healthcare providers are getting ready for an influx of coronavirus cases. 
As the approximately 6 million pregnant women in the U.S. face uncertainty due to COVID-19, one Twin Cities PBS producer plans to chronicle her story and that of others along the way. Check out Pregnancy in the Time of Coronavirus.
As Minnesotans looks for ways to show their support for healthcare workers on the front lines of the COVID-19 pandemic, we took a look back in time to celebrate the contributions that four women – all named Ruth – made to the state’s public health system. 


Minnesota Puts a Rush on Ramping Up Telehealth During a Pandemic

Kaomi Lee

Story published: May 11, 2020
The day begins on a beautiful spring morning - it’s hard not to feel optimistic when you have trees blooming and birds chirping all around. I'm getting ready to head down to the Mayo Clinic to get the COVID-19 antibody test.
The drive down to Rochester, Minn., is a journey I’ve done many times as an MS (multiple sclerosis) patient, but, in fact, my health is so good that I haven’t had to make the trip very often. I usually bring a family member - I like to have the company and someone else to help digest the information I receive. But this time, I decided to go it alone. I didn’t want to risk any exposure to family members who usually accompany me. So here goes.
Editor’s Note: As the COVID-19 crisis unfolds in Minnesota, certain details in our stories about the impact of the virus may become outdated within hours, days or weeks of our publication. For the most up-to-date information about the coronavirus in Minnesota, please visit the websites for the Office of Governor Tim Walz and Lt. Governor Peggy Flanagan or the Minnesota Department of Health.
First, let's talk about the science with Dr. Bharat Thyagarajan from the University of Minnesota Medical School. There have been good and bad tests flooding the market - not all of the immunity tests are created equal. The doctor is skeptical about the rapid tests, though he does trust the tests that came out later, have FDA approval and take longer to run because they have better sensitivity for COVID-19 without as much cross-reacting. He says that the tests underway at Mayo and U of M have undergone fairly extensive validation.
At the blood donation building on the extensive Mayo Clinic campus, my blood draw is straight-forward and doesn't take long at all. Now we wait for results.
What is less promising of late is the confidence in the staying power of antibodies or immunity. Dr. Thyagarajan doesn’t know the answer to that question and acknowledges that, "All we can say at this point is you’ve had exposure to COVID in the past. What it means for the future is really unclear. We hope antibodies will provide some level of immunity, but the data on this is not yet available." At this point in the flurry of global research, experts hold out the most hope in plasma donations from people who carry the antibodies as one way to help people with active cases.
So why I’m having this antibody test? Back in February, I contracted a severe upper respiratory illness, and then my husband quickly got it afterwards. He noted that, for weeks, he lost his sense of taste, an unusual experience to say the least. When I shared my symptoms and circumstances with my doctor here at Mayo, he ordered the immunity test for me. My aim is to know whether or not I’m at all immune - for my colleagues, for the public I interact with in my work at the Capitol - and to maybe be able to donate my plasma if I can help save lives. We hope to get results within about a day.
Dr. Thyagarajan thinks that people working in essential professions should get this test. "Yes, I think it does definitely make sense. When I said high-risk people  - I tend to think of them as healthcare workers, but they are not the only people who are at high risk. First responders, cops, people working in grocery stores, journalists."
His advice for the general public, people who may be watching and want to get the antibody test themselves? "If you want to get the antibody test, do that in consultation with your physician and not outside of the healthcare system."
About a week later, test results are in, and I find out I'm negative for the antibodies. My doctor says especially since my flu test was negative, it's possible I had A coronavirus, but not THE COVID-19 coronavirus.
Diagnosing and treating patients with the novel coronavirus comes with different challenges for rural and regional healthcare systems located outside major metropolitan areas. One Greater Minnesota reporter Kaomi Goetz interviewed Essentia Health’s Chief Medical Officer Dr. Peter Henry to find out more about how rural healthcare providers are getting ready for an influx of coronavirus cases. 
As the approximately 6 million pregnant women in the U.S. face uncertainty due to COVID-19, one Twin Cities PBS producer plans to chronicle her story and that of others along the way. Check out Pregnancy in the Time of Coronavirus.
As part of her reporting on the impact of the coronavirus in Minnesota, Mary Lahammer spoke with Commissioner of IT Services Tarek Tomes on the ways in which the pandemic has put a spotlight on the state's already challenging inequities. One issue that laced through their conversation? Minnesota's growing digital divide.


Almanac's Mary Lahammer Gets an Antibody Test for COVID-19

While talking on the phone with my grandparents, my Grandpa mentioned that their exercise class had been moved to their balconies. Momentarily confused, I asked him what he meant, and he described how the instructors led classes from the street through a megaphone while residents followed along on their balconies.
I needed to see this for myself. So on a bright Monday morning I set out to watch my grandparents run through their balcony routine at Trillium Woods, their senior living community in Plymouth, Minn. After seeing the balcony exercises, I talked to Colleen O'Neil, the community's Fitness Center Manager, and she explained that staff was inspired by videos of balcony singing and dancing around the world, and so the center decided to adopt their own version in an effort to continue providing wellness programming to their residents.
While unconventional and weather-dependent, the outdoor exercises allow the residents to interact with the instructors, and the experience gets them outside, where they can see their neighbors. O'Neil reported that the number of residents who participate is, in fact, higher than they had before transitioning to outdoor exercise and that the residents have responded very positively.
As for a true happy hour where residents can come together, glasses of wine in hands - that will have to wait until the pandemic subsides. But in the meantime, they get to socialize and exercise from the safe, socially distant perch of their balconies.
In April, one local long-term care facility got the all-clear in COVID-19 cases, one of the few in the state to reach such a milestone. Almanac reporter Mary Lahammer takes you inside Presbyterian Homes, which, as of the publish date, had only a handful of coronavirus cases among residents and staff.
As Minnesotans looks for ways to show their support for healthcare workers on the front lines of the COVID-19 pandemic, we took a look back in time to celebrate the contributions that four women – all named Ruth – made to the state’s public health system.
Since March 2020, we've been chronicling the impact of the pandemic on the state - and our collection, Coronavirus in Minnesota, dives into topics that range from what it's like to be pregnant in this uncertain time to socially distant geocaching tips to profiles of artists, healthcare workers and 2020 high-school graduates aiming in their quest to be good neighbors.


Seniors Make It Work with a Megaphone and a Balcony

Anne Guttridge

It's an open seat in a swing district. Voters here backed Presidents Bush, Obama and Trump. It's fiercely independent and hard to predict. Minnesota's First Congressional District has the attention of the nation. Control of Congress could be decided in this agricultural area of southern Minnesota that also boasts booming regional centers such as Rochester's world famous Mayo Clinic and the ever expanding college town of Mankato.
Republican Jim Hagedorn whose father represented the district has run and lost two times before, but he thinks three times is the charm and knows the seat could be a big pick up nationally for the GOP that's bringing "more money, more attention."  Democrat Dan Feehan is a teacher with a military background just like Democrat Congressman Tim Walz who's vacating the seat to run for governor, for Democrats to take over Congress he says "you have to hold on to what you have."
The candidates are approaching President Trump completely differently. Hagedorn says "I'm a conservative Republican that wants to keep the country moving in the right direction, so we offer the opportunity to stand with our president." Feehan responds "We're presenting a pretty clear choice, you can vote for an extension of the Trump administration or you can vote for an independent voice."
Agriculture and healthcare are the issues dominating the district and they're related. Farmers have struggled with healthcare costs and soybeans dot the prairie whose producers aren't sure about the global market for them. The last congressional race here decided by less than one percentage point, that makes this one to watch.
This story was published September 17, 2018.


First Congressional District: Top National Target

When George Floyd was killed under the knee of former MPD Officer Derek Chauvin on May 25, 2020, the world heard him say, "I can't breathe," and Minnesota's communities of culture (and those across the globe) felt a pinch in their own throats. After all, people of color live with the weight of racialized, history-rooted trauma every day - and when another Black person is killed, brutalized or treated unfairly by police, that boiling pot of trauma, roiling under the surface, spills over. As the trial of Derek Chauvin begins on March 8, 2021, communities of culture are going to experience that burning, suffocating feeling all over again. So we talked to trauma expert, therapist and author of My Grandmother's Hands: Racialized Trauma and the Pathway to Mending Our Hearts and Bodies, Resmaa Menakem about how people can cope right here, right now, as the trial stirs up old and new wounds.
If you or someone you know needs help dealing with the impacts of racialized trauma, here are some resources:
Heartful Healers' Coalition: Community Healing
"Community healing through Heartful Healers Coalition is a project that brings together not just Healing Touch providers but also other healers who provide psychotherapy and an array of powerful complimentary healing modalities."
National Alliance on Mental Illness, Minnesota Chapter: Resources for Diverse Cultural Communities
"Multicultural communities face unique challenges in accessing mental health treatment and receiving care that is free from racism, homophobia, and other biases. Furthermore, there may be higher levels of stigma, language barriers, and the healthcare system can be culturally insensitive. We must recognize these issues and provide resources and support to address them."
Minnesota Compass: Racial Equity Resource Directory
"The Racial Equity Resource Directory continues to serve as a hub for finding and connecting with people, programs and organizations working together to increase cultural competence and combat institutional racism."
Minnesota Department of Health:Resources in the Wake of Community Trauma and Beyond
"[A list that] includes tools for further action and education within family and communities about race and racism. Racism is a critical public health issue that impacts all aspects of our health, especially mental well-being."




READ THE TRANSCRIPT OF THE INTERVIEW
Resmaa Menakem:
Black and Brown bodies are dealing with this trauma that is unceasing, and if we don't give it context, we will put the defect inside of us. We will think that something is wrong with us.
Kyeland Jackson:
Hey, y'all. It's been almost a year since our Black and Brown communities felt centuries of historical trauma erupt with the killing of George Floyd. Almost a year, since our rage exploded into protest on the streets of Minneapolis, of Louisville, of communities across the world. Almost a year since we saw the system sworn to protect us, do what it always has, cut an uneven number of our lives short. Since then, times have been harder for people who look like you and I. The COVID pandemic has kicked communities of culture while we're down, destroying our bodies, draining our wallets and robbing us of opportunities to support each other. So this giant ball of trauma has festered in our bodies and now the trial of Derek Chauvin will re-traumatize us all over again.
Kyeland Jackson Cont.:
Downtown Minneapolis is looking more like a police state as authority secure the city. But just the sight of those barricades stairs up to pain for a lot of us. After all, barricades have been used to jail and divide unequal shares of Black people, not to protect us. So here's the question: How can we get through this time and maybe even find some healing?
Resmaa Menakem:
Well, when you live in a society where the white body has deemed itself the supreme standard by which all bodies humanity shall be measured. What happens is, is that you, before your Black body even lands on the planet, your mama's and your daddy's Black bodies have had to contend with white body supremacy with that piece. So that cortisol and stuff that's in their bloodstream, and them having to have to deal with this type of stuff, that does something that, by the time you get that and by the time they are raising you, you are learning from what their bodies are recoiling from in the structure and what their bodies are leaning into in this structure. So what happens is that all of that stuff never really gets dealt with when incidents like this happen, but they are present.
Resmaa Menakem Cont.:
When we then see brother Floyd or sister Brianna Taylor or the countless number of Black bodies, even going all the way back to the 4,500 lynchings that happened to our people that were purposely put in places where Black people would see it, so as to instill terror in our bodies. The barbed wire that they're putting all around and the 3,000 troops coming in in order to prep for the trial - all of that speaks to our bodies as horror and terror. Three months before the Chauvin trial, people may have been noticing this tightness, this constriction in the nervous system, this constriction in the space around them. And what you're doing is saying no, there's something to that. That the closer we get to something that has a potential to be dangerous or terrorizing or traumatic, the more our bodies can begin to kind of constrict and protect.
Resmaa Menakem Cont.:
And so this Chauvin trial three months before and three months after is when we need to watch for people that may be dealing with anxiety issues, issues around depression. Those pieces are so important to help people understand that it is not just personal, it is also historical. It is also intergenerational. It is also because our bodies, our Black and Brown bodies, our bodies of culture are dealing with this trauma that is unceasing, that this stuff may be triggering all of the other pieces. And so that stuff is not personal, it is structural. It is philosophical. So we must develop healing ways and healing methods and ways of holding each other communally, not just individually. Because our individual strategies are not enough to contend with the communal brutality, the communal terror of seeing a Black body destroyed like it was in front of our very eyes.
Kyeland Jackson:
Part of the trauma that we share is the belief that the system will acquit these officers. That once again, there'll be no justice for a Black life taken by police. Trials for the killers of Emmett Till, Philando Castile and countless others have reminded us that the system is rigged against our communities. And as officials build barricades in fear, that rage will shake Minneapolis. We can't help but think that history will repeat itself.
Resmaa Menakem:
This is why Black folks and bodies of culture, right now, before this trial are holding our breaths. You can see it in our face, there's this bracing. Because we know that so often in situations like this, the Black body does not get justice. So as we're watching this, hoping that we can have some justice, we're also bracing for the fact that we probably won't.
Kyeland Jackson:
So how do we make it through, how do we hold each other up? And how do we move ahead with the weight of traumas from the past and the present continuing to press on our necks?
Resmaa Menakem:
A lot of times we ask people, "How you doing?" And we really don't want to know how they're doing. And asking questions like, "Did you eat breakfast today? How are the kids? Are you sleeping well? Are you getting out? Are you breathing? Are you communing with people?" Those are the questions that actually help to support our ways of dealing with the persistent trauma and historical trauma that exists, especially for those of us in Black and Brown bodies. We have to create in our communities what I call wailing spaces, retrieval spaces. Spaces and houses where people can come and sit, have their mask on and be there with other bodies and rock, other Black bodies, other Brown bodies, other red bodies be there and rock. Not give advice, but rock.
Resmaa Menakem Cont.:
Let people cry and grieve because they're not just crying and grieving what is happening in terms of the trial. We're crying and grieving and needing to wail because of what has happened and continues to happen to our people and it shows up in an acute way in these types of situations. And so I'd like for us to start to begin to think about developing wailing spaces, be more softer with each other, beginning to create a context for what it is that we're dealing with, acknowledging that we're not defective. Like during this time we have to do it and we're going to have to do this for the next three years. So one of the things that happens that people don't pay attention to is that we saw brother George Floyd get murdered. And what I know as a trauma therapist is that usually from one to three years is the most acute time where that stuff activates around the same time each year.
Resmaa Menakem Cont.:
And because we don't have context for it, when we start to go into depression or we start to go into this, "Man, I don't know what's going on." We start to put the defect with us, something must be wrong with me. Not what happened to me a year ago and now my body, is it starting to kind of reactivate to that again, because it's the anniversary of it. And so what I hope that we begin to do is to begin to develop remembrances. Like I know something that they're doing over on 38th and Chicago, as people come to that place, they remember that. And so those vibrations, those feelings, those emotions, those thoughts, those images, all of that stuff can be put into context. That's one of the things that helps us heal through this stuff.
Kyeland Jackson:
Take care of yourself, Minnesota. Get help, share your story and show up for others. We've persevered through this before, and we'll get through this now. Peace and love.
This story is part of the digital storytelling project Racism Unveiled, which is funded by grants from the Otto Bremer Trust and HealthPartners.
To demonstrate the healing power of therapy, Sanni Brown-Adefope agreed to attend a recorded session and explore the trauma that has affected her life. Dr. Sheila Sweeney, of Peaces 'n PuzSouls, partnered with Sanni to take her through a healing reflection of her past. Dr. Sweeney is a psychotherapist with a special interest in the mind, body and soul connection. Watch the full session.
On January 28, 2021, the Twin Cities PBS digital storytelling project Racism Unveiled hosted a live Zoom panel titled "Flight, Fight and Flow: Self Healing" aimed at examining the ways in which Black Minnesotans are affected by trauma, and how we can begin or continue our healing journey. Packed with insight and guidance, discover the six key takeaways illuminated by the event.


Trial & Tribulation: How can Black Minnesotans find healing in the wake of George Floyd's murder?

Kevin Dragseth

"Traveling a path less worn requires constant calculation and readjustment. It involves celebrating milestones, as well as marking the hazards and pitfalls for those who come after. The experience can be both lonely and exhilarating," says Dr. Tseganesh Selameab, co-host of Art + Medicine: Speaking of Race, a new show from Twin Cities PBS and the University of Minnesota's Center for Art and Medicine.  
Lonely, exhilarating and traveling the path less worn can also be incredibly exhausting. Five physicians explore this theme through deeply moving stories and the lessons they've learned: Parrisha Roane, MD, examines this when advocating for equity for her patients and herself in the healthcare industry. For Anthony Williams, MD, his focus is on creating a place of trust in a climate of distrust. For Brenda Her, MD, her story revolves around seeking healing after a lifetime of traumas; and for Drs. Blanche Chavers and David Hamlar, their stories examine the demands for increased racial representation in medicine despite fatigue with its snail-paced progression. 
The Consequences of Advocacy
by Parrisha Roane, MD
I have come to understand that, in the fight for health equity, my presence as a black woman physician is welcome — so long as I am seen, not heard. This conditional acceptance has been a painful realization and dissent is not without its consequences, a lesson I learned one night while working on the adult inpatient medicine ward.
I received a call from the nurse of Patricia, a Black sickle cell patient. I learned that a pill found while cleaning out her handbag had been identified as a narcotic medication. Security and nursing staff requested our presence for a room search. Patricia's mental status had not changed, there had been no change in her vital signs or clinical status, and there was no indication that she had consumed any pills preceding security's presence. Upon relaying this to the nurse, and asking for time to review the policy, she paused briefly before asking me to confirm that I would not be participating in the room search.
I sat for a while in stunned silence. If a room search was indicated for Patricia, why had it not been indicated earlier in the week for my other patient, who happened to be a white male, when he left the unit, returned somnolent, and returned to normal when he got Narcan — the antidote for opioid pain medication overdoses?
I have come to understand that, in the fight for health equity, my presence as a black woman physician is welcome- so long as I am seen, not heard. 
Parrisha Roane, MDBy the time I'd learned there was no defined room search policy, it had concluded. When I visited Patricia later, she wept while recounting the indignity of being separated from her belongings and being patted down by uniformed staff. Nothing had come of the room search, but she was left alone to pick up the pieces of her mistreatment.
My internal response was a visceral thing — a living, breathing amalgamation of ancestral voices coalescing into a single, reverberating word: No. This was wrong. But, even rooted in the assurance of advocacy and social justice, an insidious, intoxicating fear pressed forward, determined to lull me into the safety of silence. Speaking up would be a radical act of defiance for a Black woman who has been conditioned to keep her head down, to be agreeable, to "not make trouble." The messaging to docile and non-threatening, has been passed down for generations within my family as a matter of survival. It had served me well over the years. Kept me safe.
When Patricia's nurse asked to debrief, I steeled myself in a stance of curiosity and asked many questions: What was the concern from a nursing perspective? How could we have improved our communication? How do we make decisions on when to implement a room search? What alternatives do we have? When invited, I shared my own perspective. Together, we created a plan to address similar concerns in the future. We shook hands and hugged. The chasm between us didn't feel so wide. While it wouldn't change what had happened with Patricia, we could prevent harm to another patient. And that was something. The next night, I was informed that nursing staff had filed a complaint stating I had been unsupportive and refused to act collaboratively.
First came shock, then anger. And then, when the anger was spent, an overwhelming emotional exhaustion. I cried for days afterward. It had taken me years of training and education to learn to abandon the lessons handed down by my forefathers to keep my head down, to be agreeable, to not "make trouble." I wondered if they understood that, through the weaponization of their feedback, they had taken something from me that I couldn't get back. What had they given up?
I had waited, patiently and politely, to join the ranks of the physicians of color fighting for equity. I was prepared to stand on the shoulders of giants, prepared to do the work. I was ready to have difficult conversations, to bridge the divide. But even though I had arrived — had been welcomed even — I am still subject to the same inequities that my patients face.
I think of Patricia often. I worry that the damage done to her is irreparable. I worry that progress is too slow and patients are being harmed while we strive for what could be. I worry that, while I believe being the dissenting voice was right, I may not have the fortitude to always be a voice for the voiceless.
A Human Space
by Anthony Williams, MD
"Are you the doctor?" Your frayed undertone alerts me to what's coming: grievances waiting for a scapegoat. I suppress a sigh. Seventeen patients to see and you were the only straightforward one — this is not how I wanted to start my day.
I fix my face. "Yes, I'm your doctor." My hollow words hang silently in the air. The most charitable observer would find no warmth in your gaze. The nurse's curt assessment of you is still fresh: 'difficult and standoffish'. 
"How are you feeling?" I silently repeat the mantra: 'I'm here to help, tell me your story…'; projecting a safe space that doesn't exist. You reject the mirage. The rigid lines etched into your face don't soften, but it's your eyes that speak the truth. Exhaustion has smothered everything, leaving muted embers of anger in its aftermath. Dread crouches at the periphery…waiting.   
"I came here because I can't breathe. I've been asked four times already if I do drugs. Why do y'all keep asking the same thing?" This question is not an extended olive branch. It's the crisp crinkling of a test booklet as you prepare to grade my answer. I'm restless. Precious time is leaking away. Weariness coils tightly around me, like a boa constrictor made of impotence and cynicism. My legs can no longer bear the weight.  
 "May I sit?" You nod. I settle in at the edge of your bed. There is no quick way through this conversation. I could say we ask all patients about drug use — normalize it and attempt to sidestep the traumatic undercurrents. I might acknowledge your distress and ask you to tell me more — the med school answer. I could even say "I'm sorry that happened", and then take control of the conversation by asking about your breathing — the hospitalist answer.
Suddenly, I'm back in college. An officer is approaching my black Honda Civic with his weapon drawn. He's shouting: "show me your hands!" They shake as I stick them out of the driver's side window. I'm taken to jail. I spend my phone call on a friend who doesn't pick up. I'm released the next day with a gruff apology from the officer: "You weren't the right guy. Sorry."        
I silently repeat the mantra: 'I'm here to help, tell me your story…'; projecting a safe space that doesn't exist.
Anthony Williams, MDMy doctor mask slips exposing the human beneath. My answer is all bitter edges: "Some people get the benefit of the doubt. Others don't. I can't promise it won't happen again, but I'll do what I can." I don't elaborate because I don't need to. You're already there, inhabiting the space of shared experience. Your eyes glisten with unshed tears. Your shoulders loosen. Only now can fragments of your story trickle into the silence.
At some point I ask you: "When did your symptoms start?" You have trouble answering me. I reach back to a conversation with my dad "I don't get why doctors expect us to know the difference between 'regular' discomfort and 'bad' discomfort. Life is pain. You work through it…until you can't."
I reframe the question. "When did life start getting harder than usual?" Your answer is instantaneous: "5 months ago". Gathering the rest of your history is easy. You're comfortable with my plan. You smile for the first time. "Thank you, doctor."        
Later today, we'll discuss your abnormal results and upcoming procedures. You'll cry. I'll sit with you again. You'll talk about the pressures of your job and the challenges of being a single parent.
When I look at you, I see family. Several generations of hard lessons discouraging vulnerability. You cannot afford to be less than invincible when shielding others from the struggle. And yet you're here— unable to go on. I can't resolve this cognitive dissonance for you. All I can offer is this small, fleeting space carved out with the keen edges of shared trauma. Maybe here you can temporarily afford to be human.  
Two days from now you'll ask me about life as a Black hospitalist. You'll listen as I talk about George Floyd, sick family members, protests, and COVID-19. I will no longer track the time during our visit. Flakes of clinical detachment will fall from me like a shattered cast, revealing the exhausted husk beneath.
The wall separating the personal from the professional will completely vanish, trapping me in a moment that is both cathartic and triggering. You'll extend an incredible amount of compassion as tears soak my mask and ragged breaths fog up my face-shield. You'll take my hand, lending me your resolve. Somehow, you'll know exactly what I need to hear: "Don't give up on us, Dr. Williams. You're not alone. We need you."
Healing Intergenerational Trauma
by Brenda Her, MD
My new therapist peers at me through Zoom and asks me to describe my childhood.
Where do I start?
In my culture, childhood begins before you're born.I am the daughter of Cher Thang Her and Xong Yang.I am a descendant of the Hmong people who fought during the Secret War, some who were shaman spiritual healers.I carry the imprint of trauma from war and genocide, sexism and racism, passed down from one generation to the next through parenting, modeling, and societal pressure.I carry the unhealed wounds of my mother, my grandmothers, and Hmong sisters living in a culture of silence ruled by patriarchy.
 I carry the imprint of trauma from war and genocide, sexism and racism, passed down from one generation to the next through parenting, modeling, and societal pressure.
Brenda Her, MDI witnessed my parents hide their wounds and suffer from the unresolved trauma they didn't have the luxury of healing. And so, they imprinted their children with the lessons of survival that they were given by our ancestors.
The survival lessons I learned in childhood continue to be my inner struggle. I learned that in order to survive as a Hmong woman in America, I had to please, perform, and perfect. No exceptions. No mistakes. Anything less was a failure.
I worked hard on fixing myself — cycling between podcasts, online cognitive behavioral therapy, and self-help books.
Searching for something to teach me how to balance my mother's worsening heart failure and dialysis-dependent kidney disease. To teach me how to make sure my brothers and sisters had what they needed to thrive in school. To teach me how to navigate grueling work hours while in the middle of a pandemic. To prove that I belong as a person of color and woman in medicine.
But all of my efforts only led to frustration when I fell back into old habits and gave in to the negative thought patterns, the critical inner voice, and the behaviors that I thought would help me fit in but instead dimmed the light of who I really was.
And that is what led me to that moment. Sitting on my couch. Laptop in front of me. Asking for help for the first time in a long time.
It was worth it.
Through therapy, I learned mind-body practices that have transformed my life. I learned to ask for and accept help, not just from my therapist but also from family and friends.
Healing meant going inwards, embracing my roots as a Hmong woman, finding community, and honoring the warrior in me who had overcome the challenges of childhood trauma and abuse, sexism, and racism. It meant learning to accept that my parents are human beings with their own unresolved trauma that they didn't have the luxury of healing.
Healing meant going inwards, embracing my roots as a Hmong woman, finding community, and honoring the warrior in me who had overcome the challenges of childhood trauma and abuse, sexism, and racism.
Brenda Her, MDMy journey to healing and understanding my own traumas has helped to shape and influence my career in medicine. It has inspired me to empower women, children, and people from underserved communities through healthcare and education.
Healing is a daily practice and ongoing journey. With it, I honor my ancestors and parents, their blood, sweat, tears, and efforts that led me to where I am today.
How the Medical Field Has Changed Racially Since the 70s
by Blanche Chavers and David Hamlar
Career-long physicians Blanche Chavers and David Hamlar discuss how Black physician representation has (and has not) changed since they entered the field in the 1970s. 
Curatorial Team: Jon Hallberg, MD; Maren Olson, MD, MPH, MEd; Jennie Magner- Parrisha Roane, MD; Tseganesh Selameab, MD; Ben Trappey, MD;  Anthony Williams, MD, MS
Production Team: Abdifatah Abdi, Elizabeth Crippen Allen, Daniel Bergin, Jonathan Camp, Julie Censullo, Peter Chey, Carrie Clark, Jack Davis, Alyssa Franklin Fuller, Adam Geiger, Anne Guttridge, Laura Hammerbeck, Ted Hinck, Jacob Kelso, Slade Kemmet, Jim Kron, Ben Malley, Eric Pagel, Jennilee Park, Michael Phillips, Brittany Shrimpton, Scott Trotman
These personal reflections are a part of Art + Medicine: Speaking of Race, a one-hour special funded by the Center for the Art of Medicine at the University of Minnesota Medical School. 
They are presented online by Racism Unveiled, TPT's digital storytelling project funded by grants from the Otto Bremer Trust, HealthPartners and the Saint Paul & Minnesota Foundation.
