As a pandemic sheds a spotlight on long-standing health inequities for African Americans, California’s surgeon general looks to find lasting solutions.
Dr. Nadine Burke-Harris was named to the new position created by Gov. Gavin Newsom in January 2019. She is an African American pediatrician, entrepreneur and nonprofit CEO from San Francisco, where she founded the Center for Youth Wellness in the predominantly Black Bayview-Hunters Point area. She’s known nationally for work and research around health equity, early childhood and adverse childhood experiences, and toxic stress. She lists these as her top three priorities as surgeon general.
Dr. Nadine Burke-Harris spoke with The Sacramento OBSERVER Tuesday, sharing her role in the fight against the coronavirus, how COVID-19 can exacerbate the chronic stress African Americans often face, and the impact the virus is having on African Americans overall.
“We’re working in health and human services, looking at how many folks we project may get COVID-19, how many hospital beds do we need, how many ICU beds do we need, etc. In addition to directly responding to the virus, we recognize that everyone in the state of California is feeling a really heightened state of stress right now,” Dr. Burke-Harris shared.
“That increased stress will lead to lots of different things, some that we think of right off the top of our heads, things like intimate partner violence, child maltreatment, substance abuse and dependence, depression and anxiety, but it also means that we’ll likely see an increase in high blood pressure, diabetes, heart disease and other stress-related chronic diseases and we also need to be doing modeling related to that to understand them and so we can prepare and respond appropriately,” she continued.
African Americans are already impacted disproportionately by these things. The African American community has been hard hit by the spread of the coronavirus. Community leaders are demanding data for fear that underlying health issues will prove all the more deadly. Gov. Newsom said last week that racial inequities would be investigated by his COVID-19 Testing Taskforce. Dr. Burke-Harris is part of that group.
“African Americans tend to have disproportionately higher rates of what we call ‘core morbidities’ that make COVID-19 worst; things like diabetes, obesity, high blood pressure, asthma, etc. We’re really focused on being able to really get ahead of the curve in terms of preventing the worsening of these stress-related diseases. For me, that feels like a really important part of protecting our African American community.”
Dr. Burke-Harris said officials are “doubling down” on efforts to help health providers be proactive in reaching patients and saving lives. She also points to the governor’s executive order to expand telemedicine services on and their ACEs Aware Initiative that gives Medi-Cal providers training, clinical protocols, and payment for screening children and adults for ACEs (adverse childhood experiences), as detecting them early and “connecting patients to interventions, resources, and other support can improve the health and well-being of individuals and families.”
“We are going to be needing trauma-informed care now more than ever. That’s one of the pieces I’m really most excited about,” Dr. Burke-Harris shared.
“When we look, for example, at African American maternal mortality and we look at why Black mothers are dying at such a higher rate in childbirth, and there are many reasons for that that we have been talking about, whether its conscious or unconscious bias in healthcare, all these different reasons, is to what extent do the accumulated adversities play on our health outcomes? We know that the greater the level of adversities and the higher number of adverse childhood experiences a person has, the greater the risk of having low birth weight, of having high blood pressure during pregnancy, having a lot of these stress-related complications. If we are serious, if we really want to change those outcomes, every doctor in the state of California needs to understand the science of stress-related disease, how it gets under our skin and changes our biology, and what we can do about it.”
Dr. Burke-Harris has seemingly kept a low profile over the past month. Gov. Newsom gives daily updates on the pandemic and the state’s shelter-in-place orders.
Until last week, Dr. Burke-Harris hadn’t been seen at any of the tele-press conferences. Health information has largely been shared by her colleagues John Connolly, deputy secretary of the behavioral health for the California Health and Human Services Agency and her former Harvard classmate, Dr. Mark Ghaly, who serves as secretary of the California Health and Human Services Agency.
Dr. Burke-Harris joined Gov. Newsom for the first time to announce a number of actions leaders have taken to address the pandemic and its multi-layered ramifications, including the release of her Surgeon General’s Playbook For Stress Relief, which highlights measures people can take to stave off mental health issues before they arise.
Dr. Burke-Harris has also shared information on Twitter, including her participation in an interview conducted by “Scandal” actress Kerry Washington, facilitated in part by the World Health Organization. She’s also featured in a new PSA by First 5 California, aimed at children.
Some African Americans, in discussing the pandemic, posted questions online such as “Where is California’s surgeon general in all of this?” and “Where has Dr. Nadine Burke-Harris been during COVID-19 ? Has anybody seen that sistah?”
Visibility, she says, isn’t high on her list.
“My number one priority is doing the work,” she said.
“I have been incredibly focused on bringing together these resources, working together with our team to focus on addressing those stress-related health conditions that I think are going to most greatly impact our communities of color.
“In terms of getting up there every day and talking about where we stand in terms of testing and where we stand in terms of how many people have the virus and how many hospital beds that we have, quite frankly there’s an incredible amount of work to go around right now. I leave it to Dr. Ghaly to be out there at the press conferences and leading a lot of the conversation,” she said.
“We are here trying to support each other, I’m trying to practice some self-care and also to be available for my four kids. It’s not an easy time, but I’m grateful to have the opportunity to be here to represent,” she added.
The historic nature of her role isn’t lost on her — she’s the first person to serve as California’s surgeon general, the first Black person, the first woman, the first Black woman — and she knows that there are lots of eyes on her and the moves she makes.
“I’ve always been Black and I’ve always been female so showing up to the role in that capacity, it’s not that I feel added pressure. I think, if anything, as a Black woman in the role I feel grateful to be able to represent. I feel grateful that when people see our surgeon general for the State of California, there are many people across the state who see a person who looks like them, so that feels wonderful.”
Editor’s Note: See next week’s issue of The OBSERVER for the second part of our discussion with Dr. Nadine Burke-Harris, as she speaks about the need for more mental health providers of color.
By Genoa Barrow | OBSERVER Senior Staff Writer