The stress of racism and its effect on cardiovascular events

Testing closed captions captions will appear here Testing closed captions captions will appear here (Music plays) >> Good morning and welcome everyone Thanks for joining us on another episode of House Calls Real Docs Talk I’m Chelsea Helms coming to you live here in Arkansas I just want to say, there it is

We have some drilling going on above was The building is under construction so bear with us as that goes on throughout the day This is really an important topic for today I’m so happy to be joined by so many of you to be discussing what I think is going to be a helpful discussion this morning Now for those of you who don’t know, House Calls is a great opportunity to ask questions, come together and ask these questions of health experts and walk away with the immediate answers that we all want Today we are discussing how racism and health disparities can affect a person’s health Like I said, a very big topic today I think everyone will agree that we all deserve the opportunity to enjoy a longer, healthier lives, but unfortunately, that’s not the reality and it doesn’t happen equitably Subcommittees face health disparities simply because of where they live, learn, work, play and even worship As you know, it’s a tough topic but it’s one that’s very important and we know you have a lot of tough questions for us So if you do have a question you would like us to address today or maybe in the future, this is those at tough questions for us this is those at tough questions for us So if you do have a question you would like us to address today or maybe in the future, this is those@heart.org/House Calls Submit your question and you can even submit it below We are going to do the best to grab those and get the answers right away When HE was any of those as we can If you’ve been with us before, you’ll know a big part of this show is really important and we so appreciate that so many of you have been involved I was looking at Facebook comments and LinkedIn comments before we even went to live and so many of you were already chiming in so we appreciate that Today, I have two things to ask you guys Throughout the show we are going to break for a few questions and we hope you will respond using our easy text answer feature All you have to do is text AHA lives to 222 222323 — 222333 We’re not going to ask you for your name or anything like that, it is just a fun and easy way to answer After that, we want to take that share button or start a watch party or whatever is easiest for you Let’s get more people involved in such an important discussion today It looks like we already have a great audience And monitoring our Facebook live in Darlington and you guys are joining in and we are so excited So let’s go ahead and get started With me this morning is Dr Eldrin F Lewis, chief of carter vascular medicine at Stanford University Dr Lewis, welcome >> Think very much, Chelsie I’m really excited to work with you today and get a chance to talk with you about racism >> Will be are super excited to have you and I know a lot of people at home are looking forward to hearing from you On the topic of access to healthcare, let’s start with our first year response question How often do you see your healthcare provider? So why don’t we go ahead and look at the responses there I want to hear from you, Dr Lewis What is the recommendation for how often we should see ours? >> I think a lot of it depends in your underlying medical issues If someone is healthy and trying to prevent heart disease or prevent progressive disease, it’s best to see her doctor once a year But if you have other conditions such as heart failure, coronary artery disease, strokes, then you have to follow the diagnosis of your doctor That could be up to two to four times a year If he notices a change in your symptom, you should reach out to your doctor >> That is good to know Let’s take a look at our options We have the once a year for annual checkups, like you just talked about Another option, I have a new specialist and see them as needed C, I tried to stay away from doctors and D, I am unable to afford preventative medical care Looks like we have a pretty good mix on the board there The only one I’m seeing no one answer for his eye try to stay away from my doctor So that is good news So many people can’t afford their medical care >> This is a state-by-state issue but because of the Affordable Care Act that was passed under the above administration, preventative care, at least the annual visit , should be covered A lot of times people really don’t know and it’s cumbersome to try and sign up But the most important thing is seek the care It is worth the investment to try to find out how you can see a doctor at least once a year >> And I think too there are resources available out there that sometimes people don’t even know are available to them So maybe a little extra research can help with that Alright, let’s go ahead and get started with our first segment, health in the headlines >>

This is the (inaudible) helpline and it’s titled racism as a health crisis, why aren’t we treating us like one? Dr Lewis, do you consider racism a health crisis? >> I do think racism is a health crisis I think one of the reasons we don’t treat it like that is because we think of racism, we think of a lot of the social injustices, things that we see prominently on TV People don’t really think about how racism affects their own health There are many different ways that can happen I think the first array is just stress And this is something that’s hard to measure We know Q stress can actually cause — acute stress can actually cause risk of stroke and heart disease We see this, there’s something called a broken heart syndrome, when someone has a dramatic event happen to them when I’ve lost someone who’s very close to them, especially if it was in a sudden way, they develop this dilated heart and they develop heart failure We know that’s called (unknown term) or the late-term is broken heart syndrome What we don’t know is the impact of chronic stress Another people are facing racism on a daily basis can have chronic stress and that can actually cause increases in activation of your white syndrome or the adrenaline That can actually to hide the pressure or stroke and other issues I think the other issue is lack of access to just housing and food You know, if you have a co-pay of $15 if you have a co-pay of $15 and you are struggling to pay your rent or to buy food, it’s hard that that $15 can be instrumental So people will stay away from the doctor sometimes speaks of the coping I would say reject your doctors because there are many times when they can work with you with co-pay You should not stay away from healthcare because of that I think that their issues trust If people have experienced racism , they may have missed trust not only among a group of people but may also have mistrust of their doctors That can be because of a variety of reasons including some of the history of research in this country But it can also impact not only the willingness of people to go see the doctors, but their likelihood of actually following recommendations It’s amazing how many times I hear people say, well, I don’t necessarily trust what the medical establishment is saying I think going to look to other sources This is a major problem Then the last thing which is probably the most difficult one is if there is structural racism or inequity in healthcare delivery I think when we have this, it becomes a major problem There are situations where patients may not feel comfortable going at the hospital because they feel that their care is different than other patients, just because of the colour of their skin And whether this is real or perception, the impact is exactly the same and people are unlikely to go and get access I think we need to work hard — harder to do this I would actually say that in the midst of COVID-19 where we are right now, increased over 5 million people who have developed COVID-19 (inaudible), I would say racism is kind of like the virus A virus need the host to replicate That’s why there is social distancing for COVID-19 If you don’t have a host for racism, it can’t dissipate It can’t migrate from one person to another And I actually think the antidote for racism is like and body In that antibody is kindness If we basically treated everyone the same and everyone like we want to be treated , it would actually go a long way to reducing racism I think that will translate into (inaudible) >> I love everything you just said, Dr That was incredible The analogy there was also really well The analogy there was also really well received So we appreciate that Look, we want to keep hearing from you sir going to go right ahead and move on to your next segment, you asked, we answer segment, you asked, we answer >> And you ask, we answer, we focus on your burning questions each week questions each week We ask you to submit your question and we want you to answer — We answer them wise If you want to submit a question, visit House Calls website at heart.org/HouseCalls and you can find all previous episodes

This week we are looking at racism’s effect on health health Our first question for Dr Lewis comes from Anthony in Baltimore He asks coming talk about racial bias in medicine and healthcare delivery? Is it connected to a lack of trust in the medical community by African-Americans? >> It is First I think there is racial bias There are structural inequities It’s one of the things that’s going to be hard to measure For instance, if someone comes in with just paid in the midst of an acute hardtack — chest pain in the midst of an acute heart attack, if you are a woman, sometimes people may say this is anxiety That is a bias If you are African-American, they say, have used cocaine? Is that the first question you would get ? If that’s the first question a doctor asks when someone comes in in the middle of an acute heart attack, that’s judgemental If that’s the first question, patients may shut down and not only interact with you — not not only interact with you, but may also not give you the detailed history you need to make a decision and actually try and come up with a better strategy for managing the acute event The issue with a bias as well is that it absently impacts access to care It is not only the fact that some patients may not get treated in certain areas But the other issue is patients may not feel comfortable (inaudible) I remember when I was in Boston for about 25 years , I was surprised that my hospital was in the middle of a dominant play African American community but yet they would choose to go to the hospital that was predominantly previously called the Boston City Hospital A lot of it was because there was a bias A lot of it was because there was a bias In general, you received the healthcare at the City Hospital Using is repeating across the country Even when people have private insurance , or we accept all insurances, patients felt that they weren’t welcome That’s something that we as doctors have to do We have to create a welcoming environment and make sure the patient feels comfortable at the most vulnerable time >> Absolutely Like we’ve talked about already, it’s tough to make that decision to even get in the door, let alone you have to make a personal conversation with the doctor So upset the right Tanya from Chicago wants to know about what is above the implications of underrepresentation of certain communities in healthcare and research? >> This is that a very sensitive topic because it really boils down to do you need to have (inaudible) or similar providers providing care for their patients and does it actually impact care? And they have done some research in this area and in general, that research has been mixed However, there are some benefits to having congruence between the provider and the patient The first thing is related ability When I sit down and talk to my American patients, I can share some of my experiences when I was a child growing up in Mississippi And I can actually use that to help change behaviour For instance, hypertension is prevalent in the African-American community community When you let salt intake is on the risk factors for hypertension and controlling your salt intake can go a long way So when I sit down and I talk with my patients about strategies to reduce their hypertension in addition to and your hypertension (inaudible), in addition to — in addition to hypertension medication, I use my own family expenses to help relate to patients Secondly, I’ll talk about traditional foods I eat as a child until we have to look at low-salt options and there are ways of fixing these foods without using salt I even reframed cookbooks So by having that relationship and that kind of common background can actually be effective in counselling The other reason I think it’s important is because you never know what motivates a particular person Sometimes (inaudible) a female doctor, African-American or Latin next patient seems one from their culture will help them relax and show things they may not share with other providers So I think we have to increase the pipeline

The problem with this is become start increasing the pipeline in medical school This starts in high school I want people to see me and say, I can be just like him and then work to try to achieve that By having a large cadre of (inaudible), not only will it allow us to provide culturally sensitive care what it will also allow us to reach areas that have actually been quite inaccessible in the past, rural areas, inner city These areas are where a lot of our under represented minority providers go to practice >> This next one coming to us from right in the battle Many studies show that African-American churches complain important role in healthcare and churches have been successful partners in the fight against high blood pressure which affects one half of Afghan American adult What’s your perspective here, especially given what we have seen as a result of the current health crisis? >> Yes, I think churches play a vital role There’s something called unity participatory research and I think this concept was double at first and now I think it’s not Womack The reason is because of the lack of trust that we often have in of the lack of trust that we often have in the community by having the church, it’s a place that a lot of people go And what we can do is train people in the community to help was answer questions It helps that people don’t necessarily have to drive for distance in order to enrolling studies and allowances to answer some simple questions and really have programmatic, simple solutions Every miser that I was getting my Masters of public health in Harvard School of Public Health I went back home to Mississippi to visit my family and I was telling my uncle and he asked me what it was doing and I said I was doing and able Mac And he asked why and I said I wanted to prevent heart disease because it was so common He said, you don’t need a fancy degree from Harvard for that Tell people to stop eating fried chicken It seems like a simple solution in a simple answer I could probably do a thesis on that But those simple solutions can actually have very impactful results So in the community, not only can we devise simple strategies for controlling hypertension or for screening for high blood pressure or diabetes, things that are common in the community, but we can also think about how to do and in limitation strategy One example I’m sure a lot of you have heard about is the barbershop and the beauty salon project There are many people who walk around on diagnosed with hypertension for years It’s a silent killer You don’t know until you’ve had a stroke or you had chronic kidney disease and run dialysis or hardtack and heart failure In those cases, then you say that your blood pressure is to over 100 A lot of people don’t go for prevention A lot of people don’t go because of the co pay, because of the cost So going to the barbershop or the Bluetooth salon to measure heart group — high blood pressure is away temperament this treatment This works to control high blood pressure more effectively >> Interesting, I had never heard of that Thanks for sharing it We have a lot to cover but let’s take a break for another poll question so we can hear from all of you again Grabbed her cell phone and get ready to text in your answer As a reminder, all you have to do is text AHALIVE to 222333 222333 If you’ve already registered, you don’t have to do it again have to do it again Just get ready and send in your answer to 222, 333 Do you believe Grace plays a role in the quality of healthcare that a person receives? Let’s go ahead and take a look at the poll questions and while we do so, I want to give a shot dead to our friends watching We have Frank from Temple joining is Arlington stream We have Christina from Romania and we have Lily from Brooklyn Thanks for joining us today So excited to have so many people around the country and the world The questions are yes or no, do you leave that race plays a role in the quality of healthcare a person receives Dumas, and we’ve talked about this extensively, but I’ll open it up to you to comment if you like

>> My gut reaction would be I want the answer to be no If we could get to the point where the answer is no But unfortunately because of what I’ve seen over the last 25 years, I would say the answer is yes And it’s not everywhere and it’s not to the same degree But even if it’s a small impact on the quality of healthcare, that’s a problem The real issue is it’s challenging to measure You have to do an incredible social experiment for you would have actors going to the emergency room with exactly the same script and see if they receive different care What’s difficult when you already have a burgeoning and emergency department system is already overwhelmed So it’s hard to execute these studies But we do need to look at this The other thing that’s really frustrating is the fact that in as (inaudible) or genetic code, as you mentioned earlier in the instruction, that that has a major impact to an audible mark >> I love the way you put that, your ZIP Code That’s a great way to associate things and it’s a great example This is a really timely issue and given the topic today, we’ll talk about it again It’s the EmPOWERED to Serve Business Accelerator It is accepting applications right now It is accepting applications right now but the deadline to apply is soon It’s August 31 so make sure you do it stop we can watch this short video so you can see for yourself just how much this program is helping break down barriers in local communities Watch Watch (Video plays) >> Accelerator has been a great, eye-opening experience A chance to step back from yourself and step back from your work at an institution Look at your goals and missions in a different way and reflect on what you’re really doing >> I never had a business background I started a nonprofit because I was passionate about food justice and food insecurity It was frustrating because I was trying to find a group who was responsible for this problem and you should be doing something about it I realized that that someone wasn’t doing something on this >> This accelerator has been tremendous for as to come together with multiple on spinners on the same issue and no longer feel alone >> The this accelerator for the American Heart Association has given me all the skills necessary to develop a sustainable organization >> Thank you so much American Heart Association for this opportunity, it is been wonderful My efforts have gone into developing the sugar in a black watch that better fits the lifestyles of diabetics >> I love to see how many people are affected by that Love it Let’s get back to the topic at hand and address a few more questions This comes to us from Marcella in Ohio If you could do one thing that would make a significant impact in addressing structural issues in healthcare and healthcare delivery, what would it be and why, Dr Lewis? >> I think that what I would recommend is mandatory training training and training on structural inequities and structural racism The reason is because no one will look at themselves and say, “I am a racist” Those But if you work through some workshops with a very focused curriculum, you can look and identify further bias is And how that bias could influence how they see a particular person I think that would have a major impact The other, which would be more challenging would be to use digital health So if you use digital health and you contract each person’s individual experience in real-time, you can see exactly how long it’s taking them to be seen if they come in with various medical conditions It was a lie was to easily be able to understand whether or not patients are treated differently just based upon certain demographics >> Definitely and I think that goes back to what we are talking about a little bit earlier Charles from Oakland wants to know the patient/physician relationship and the ability to build rapport, there important What can patients do to find doctors who are great fit for them? Great question >> Great question I often say the most important relationship you have in your healthcare is the physician So that patient/physician relationship has to work So if you don’t trust your doctor, then once

again as I mentioned earlier, you’re not going to listen to what he or she will say You’re not going to necessarily follow their guidance You’re not going to be forthcoming with information that could be helpful in terms of trying to allow that doctor or that provider to help you So I think there are couple of easy steps The first is to do your research, to actually see what their expertise is and to see whether or not they can make it work for you Look at the location So for instance, if it’s going to be challenging for you to go and see the person because of your work schedule, depending on your health care needs and the specific care that you need to receive, you may not want to go too far away from where you live That’s why it’s so important that we have doctors for patients live The other thing is to be prepared I will often say if you are having your taxes prepared, you want and going to your accountant or the tax preparer’s office with nothing and say, “So am I getting a refund?” You had come with your W-2s, your expenses, your deductions, your donations etc I think similarly when you go in to see a doctor , you should be prepared Here are the questions I have, the symptoms I have Write them down a sheet of paper Because otherwise, in the short time, you may not actually notice or forget some of the things that are important It turns out that the doctor is not willing to go through your list of questions, then you probably need to find a new doctor Because yes, we’re busy but you have that one interaction with your provider and if they are not actually answering your questions in a timely way on answering each of your questions or basically saying, I can’t answer all of them but why don’t you give me the list and I will answer them next week or will see you in a few weeks and we will work through this So I think that’s important A phrase that I always like is “Why should you care what someone says if they don’t care about you Mike if you don’t feel that they care about you?” So if you feel your Dr doesn’t care about your health, you need to find a new provider >> Great advice I agreed to with writing things down I’m always jotting things in the note, my cell phone so I can pull it up when I see my doctor Good advice and I hope all of you are taking that into consideration Our final question is from Monica in Dallas She asks, why is it that a good education and higher paying jobs in some pockets of Hispanic and African-American communities don’t necessarily exempt them from the same poor health outcomes that those with less resources face? >> Yes I think part of it is culture The culture of our society So we were to go back hundreds of years , and we don’t even have to go back that far, we look at certain parts of the population, I would say healthcare was akin , and this is controversial , but healthcare was akin to a veterinarian provided health You want to make sure they are healthy so they can work This is what happened historically during the slave era Unfortunately, over the years, healthcare was not preventive was reactive So if you had an acute issue, you had distressed And that you a kind of say , I’m not going to see a doctor Some of this was because of inaudible Mac And things that you hear in the community I’ve heard this back in Mississippi People saying, Leroy was healthy until he saw a doctor and he died three weeks later and yet Mussina Dr 25 years years There was a reason that after 25 years, he decided to go see the doctor So I think certain groups in our community who are upper-middle-class, that mindset may stay the same “I don’t see doctors I’m not going to do primary prevention.” It’s amazing, when I look at people who come from more affluent backgrounds, they come prepared They’ve done the research, they know who I am and what my strengths are and they’ve actually done some Google-based research on their healthcare When we move , you know, even if you look at there is one study that I like where they look at one study — where they look at African-American and Latinx populations in different classes and their healthcare disparities don’t change The fat that means is we need to do a better job of education , education about what’s important , education about what’s important

, how we can actually achieve better health and then really change and transition or mindset from reactive , saying , “If I don’t see the doctor, then nothing is wrong.” I see this a lot Then change to proactive Actually say, “I need to be proactive.” The other issue, this is not based on science but from personal experiences, when you have inaudible Mac and you’re focused on your health at the same time, there were people who will say, I’m just going to have faith and everything will be fine I’m not seeing a doctor I often say that faith without action is not going to work as effectively and so you have to kind of do things as well So I wonder if that is a contributing factor that there is an anxiety about the unknown, anxiety about, “I have hypertension.” Anxiety about conditions I’m going to do something that I didn’t anticipate, but I will end it here Hypertension, as he mentioned Chelsea, is prevalent in 50% of the African-American community and is prevalent in about 75 to 80% of people in my family I.e low-salt, I exercise, I keep my weight down, I don’t drink alcohol, I don’t do any of these things Of course I don’t smoke About six years ago, I developed hypertension I checked my blood pressure at least once a month, just to make sure, because I knew I was at risk just because of my family history, because of who I am Someone I did that, at first I didn’t want to share with people I felt a failure, a cardiologist with I felt a failure, a cardiologist with hypertension It made me realize that hypertension by itself is not a disease What the problem is, if you don’t treat hypertension, then it becomes like those termites that are at the base of the house If you knit them in the blood, there are no long-term consequences for the house It can stand for a long time But if you kind of ignore it and hope that because you don’t talk about it, it doesn’t exist, that you develop a long-term consequences and the house crumbles That’s when hypertension leads to stroke, to heart attacks, to heart failure, to dialysis, to blindness, to a variety of medical conditions conditions So I would say, if I can just touch one person, don’t be afraid of what you might have Because ignoring it will just allow the matter to get bigger and then it may get to a point where it becomes inaudible Mike (inaudible) But if you’re proactive, you may be able to put in the budget have a long, healthy life >> I hope people are listening to you and taking in everything you just said Deftly appreciate everything you just said there there That’s not something that’s easy to do so I appreciate that very much I think it’s so important when people can relate to somebody, that cardiologists have similar issues We have a lot of questions that are still We have a lot of questions that are still coming in and unfortunately we’re not going to be able to cover the mall in today’s live show Before we do move on, I wanted to address one more thing that I have been seeing a lot of our comments mentioning There are those who still do not believe fully that racism and its effect on healthcare Israel Israel So talk to his Dr Lewis about the evidence in data What information do we have that can help shift that mindset >> I think part of it is , it’s challenging You can always try to use a multivariable model to try and explain away thanks I’ll give an example We published a paper in the fall of last year, their collation heart failure or reluctant my formal Hospital, (unknown term) Hospital We felt that we were providing equitable care In my experience, I noticed In my experience, I noticed that my own patients were African-American and Hispanic and were not admitted to the cardiology unit So back to look at this data over a ten-year period Patients who went to the emergency department We adjusted for everything We did something called (unknown term) scoring which is as robust as you can do We basically found that if you are self-described African-American or Latinx , you’re much more likely to be admitted to a general medicine service as opposed to a cardiologist service People might say, “Well that doesn’t explain anything.” I wouldn’t call it racism, we called structural inequity By shifting the term a bit, it allows us to

have the conversation But I think we need to look at it We publish this and presented this at the American Heart Association, there were tons of people who came around and said, this is great, I know exacting what you’re talking about We see this in our hospital We even saw this and other countries where they were saying, we see this as well But it’s not published And the reason is because it’s kind of embarrassing No one wants to admit that there is a difference in how we treat patients So that’s just one evidence But it’s observational data Like I said, the way to really answer the question would be to have actors portraying patients have to go into the healthcare establishment with the exact same script , symptoms, signs, etc and see if they are treated differently If that’s the case, then the question is, is the only difference is the colour of their skin, that would prove it But it will be a hard study to do That’s the best way to actually prevent Just like prove it You can actually just talk to patients and ask them specifically Right now, we have very few people of colour who get enrolled in clinical trials Some of it is because patients don’t trust Rose They don’t trust us It goes back to the (unknown term) experiment and up to 1971 , I sponsored a study about the history of syphilis in black man Coming call it racism? It’s hard to know But what we do know is that there is inequity When there was a cure for syphilis in the 1940s, you will go that long, over 30 years without actually treating somebody of something that can be cured >> Thank you for answering all those questions so thoughtfully You have added so much value to this conversation We are so lucky to have you here, Dr We’re volunteer next segment and keeping her with us It is what would you say? >> What would you say is another opportunity to hear from you at home If you’ve been with us to read today’s show, you know what to do Get ready to text your answer to 222333 Our first question is, have you or a loved one ever experienced overt racism from your healthcare provider? Yes or no Those are our two options You got personal with his earlier today, Dr So I be interested to hear if you felt like you’ve experienced racism for many of your medical care providers throughout your life >> I would say in receiving healthcare, the answer is no for me Probably because I’m a doctor But in terms of being a doctor, the answer is yes I have heard things I wouldn’t call it racism per se I would say it’s a bias And so the bias is that as a black man, I’m not going to be a doctor So remember going in to see a patient inaudible Mac as a cardiology consultant when I was a trainee and the patient said, I don’t need transport and waiting for cardiology And I said well I’m here They apologized for that and I prioritized taking care of the patient So I have definitely experienced that But it has my health care, no >> I’m happy to hear terms of your healthcare but it is unfortunate to hear that on the other end I do want to say that a lot of the people who have answered say they are not experiencing overt racism from a healthcare provider Are you shocked to hear that? >> I’m not, I’m actually happy to hear that Most times it’s not overt A lot of times, especially with patients, patients don’t always know what they know and what they don’t know in terms of access For instance, if I look at in able (inaudible) , if I look at the number of healthcare cases in the states of Florida, Georgia, the deep South basically, you see a large number of people with heart failure who never even get approached for heart transplant The question is, why is that? Why is it the people in their 20s and 30s he needed transplant aren’t even referred to? We did a study we looked at heart failure in the wheezy Anna versus Boston’s — in Louisiana versus Boston to look at attitude I was surprised that 0% of patients had inaudible (inaudible)

A copy affordability or can be access to care If you can’t see a cardiologist, you can’t If you can’t see a cardiologist, you can’t get a heart transplant I think awareness is incredibly important Because those opportunities become a problem The last thing about to give you is there times I have been on the phone with three people yesterday who have medical problems and seeing their hair called Dr — there seeing their healthcare doctors and their calling me and there’s a lot of things that their doctors didn’t tell them Is it because they are busy ? Probably Or is because they are African-American and they didn’t even tell them? So when they share the data with me, I can say, these are the things I’m concerned about and this is what I recommend That was three people yesterday, two of whom our family and one French I think this is something that makes it challenging to highlight this question >> We can see almost 40% people answering yes now, saying they have extremes raising from a provider, which is unfortunate We are having some technical difficulties, it looks like my shot went down But we can see Dr Lewis and that’s we want to see anyway We’ll keep moving on with the show until we can hopefully get this fixed, everyone Question is we want to know what you feel walking away from today’s show Would you like us to continue this conversation around racism? In future episodes, I’m hoping the answer is yes Until we keep having these conversations, things will be changing, right? >> That’s correct >> Let’s see were going to say I’ll give a shout out to real quick to people watching us watching us We have (inaudible) from California, (inaudible) from Germany and (inaudible) from Kentucky Thanks for watching guys With 50/50 I’d be interested in hearing why some of you don’t want to have this conversation the future? Are you surprised? >> Not surprised I think one thing that’s really challenging is is a topic that people don’t really want to talk about Because of what’s happening in the country and because of George Floyd and because of videos basically , and young people , there’s been more conversation about racism and differences in treatment this year than in a lifetime , that in 50 years An ending that part of that is because with COVID-19, there wasn’t a lot to do You didn’t have distractions But I think the other issue is by tackling this issue , it allows us to address racism in a very vulnerable part of our society All the social injustices are wrong but when it comes to healthcare, when someone is acutely ill, there is an opportunity to save a life You know, we want everyone to have a chance to have a long, healthy life And that starts at birth and that starts with trying to eliminate a lot of the problems that don’t touch healthcare but touch people and that prevents people from actually achieving the best healthcare >> Absolutely It looks like we have a lot more people saying yes, they would like to see this conversation again in the future So we are excited to see that Dr Lewis, thank you so much for guiding us through really what is a difficult topic for many people This is really been an eye-opening topic in a conversation that really can’t be tackled in one show So I hope that we can all agree that we need to continue this conversation I also hope that we can agree that access to healthcare is one of the most pressing issues of our time and COVID-19 has exposed that in a new way for all of us to see So Dr Lewis, I would look to open the floor for you for any final thoughts So go ahead and take it away >> Thank you very much Chelsie, I really appreciate it But I would like to thank you all for the opportunity It’s a topic that people don’t necessarily want to talk about, but I think it is important And I think just as we try to work to have everyone to live long, healthy, satisfying lives free of heart disease, I think it’s also important to realize the role that racism plays in shortening life expectancy So I think that by working together, by treating each other the way we all want to be treated, we can actually help pull each other up so that we all have equal access and also

equal opportunities for long, healthy life I’d like to issue health and safety I’d like to issue health and safety Mike I’d like to wish you health and safety as we continue to this pandemic >> The same to you, my friend I hope that people of been taking in what you’ve been saying You provided us with a lot of great personal experiences, some incredible information and tips to take away So we have appreciated having you and I definitely look forward to furthering this conversation in future Thanks again for joining us Before we set off, we have a thing to share with you and that is our weekly health tag (Music plays) >> Health facts is brought to you by stories of the around was, the American Heart Association’s podcast You can go to heart.org, iTunes or spot if I find it You will find many amazing stories and conversations on a variety of topics so go check it out Share your views and share it with your friends and family This week’s health hack is coming to us from you Hello Maggie, thank you for sending it in Maggie recommends using your crockpot to get a jump on dinner while juggling work and kids Great idea She’s just putting all the ingredients in a container in the fridge overnight so everything spawned by morning, then there the tougher veggies, like potatoes and cabbage at the bottom and then put the more tender ones, like maybe zucchini RP is on top This of course is a good one, especially with everything that going on right now, a lot of craziness in the world We feature a tip every week so if you do have one, send it to others at heart.org/HouseCalls and maybe Osier idea week on the show There are always a lot more questions than we have time to answer so if we did not get two years — two years so we will try to get them on a channel or on our AHA podcast You can find some of our previous episodes at heart.org/HouseCalls I’m so sorry everyone that the feed went down but I don’t think you need to see me to appreciate what a great conversation may have had throughout the show So thank you so much for taking the great time to watch with us today and we hope you’re going to join us again next Monday Once again, I’m Chelsea Helms coming to you live from the studio in Arkansas I hope you guys have a great week (Music plays) >> There more about House Calls real docs — Real Docs Talk and submit your questions at heart.org/HouseCalls