Join us for an eye-opening conversation about the intersection of community and health equity with special guest, Pam Clark, the Minority Health Initiative Director at Community Action of Southern Indiana (CASI). We'll discuss how social factors and systemic issues can impact health outcomes and what we can do to promote health equity for all. Don't miss this insightful discussion!

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#healthyrelationships #healthequity #communityengagement

[MUSIC]

Start It up

Yo Welcome

Yo, this is your boy, Guelly Guel.

This is Common Convo

And as you know, we've started this

project with

Clark County Health Department.

As we're talking about health equity,

we're talking about

the challenges that we

face right here in Clark County and

surrounding areas

with opioid addiction or

just substance abuse as a whole, where

we are in our mental health journeys,

our wellness journeys.

And so I'm excited to consistently be

able to bring in different leaders,

different health activists, if we will,

into the studio and

have an opportunity to talk about where

we are in our community specifically.

Things that we're doing right, things

that we're doing wrong,

things we can do different.

And I think it's super important that

we stay focused on

the task of how do we

heal, right?

And for that, that's gonna mean

different things for different people.

And so today, I have the amazing, and

Pam Clark with me, I say

that super amazing,

cuz I mean, she is phenomenal and does

a lot in our community.

I'm gonna let her explain a lot of it.

And as we have this conversation about

how you play a significant part

of making sure that we do have equity

in all communities across what,

all racial boundaries, all ethnicities,

LGBTQ plus, etc, etc.

So Pam, we, and excuse the loud trucks

and airplanes that are gonna go by,

because we're in my studio and

apparently there's

construction down the street.

And when you have that, it's there.

So if I don't delete it, you

heard it, it's not my fault.

You didn't know who's watching, or if

you're listening to the podcast.

So but Pam, getting into here, will you

tell our audience, who are you?

And what do you do?

Hey, Miguel, thank you

so much for having me.

As he said, I am Pamela Clark.

I'm the Minority Health Initiative

Director at Community

Action of Southern Indiana.

I am funded through the Indiana

Minority Health

Coalition out of Indianapolis.

Who am I?

I have been in public

health for over 25 years, Miguel.

Wow, you don't look older than I think

you are in 25 years.

I know it.

[LAUGH] Thank you so much.

But 25 years, my

son, I think was three.

And someone asked if I was interested

in an HIV AIDS coordinator's position.

Okay.

At that time, I said, sure.

I had no clue about public health.

I wanted to go into business.

So I did that job for two weeks.

And then there was a

position open up to pay more money.

And the immunization

coordinator paid good money, okay?

All right, let's go.

So I took that position to immunize

every child by age two.

After I took that position, I adored

open an opportunity for me

to have my own nonprofit.

My own nonprofit, 501c3, was Southern

Indiana Minority Health Coalition.

Under Indiana

Minority Health Coalition.

I tell you, I had 13

diseases to address.

I wrote grants.

I had that coalition for 14 years.

I had plenty of volunteers, and it was

located in Clark County.

After that, I went to work, after I

lost my mom to cancer.

I went to work for the American Cancer

Society for nine years.

I covered the Mid-South Division down

in the Black Belt,

Alabama, Mississippi.

And that program was a

community-based program where we

educated women on breast cancer.

So, but Miguel, I have, this has been

like a roller coaster ride for me.

Because public health and losing so

many family members to

cancer, it became personal.

My job became personal to where I've

gotta make a

difference in my community,

where I live, where my children are

growing up, where my family lives,

where my friends live.

I wanted to make a difference.

You ever did something, I think you do.

You ever did something where it's work,

but you enjoy it so much.

Absolutely, doing this right here.

This is, I mean, it is.

It's a tedious amount of work, and just

on the technical side, being in it.

But the other part is, is that this

work for me is still

about social justice.

So much of what I cover, I had a

conversation with

Tia some years ago, and

was like, man, if I could just get

paid, figure out how to

get paid, earn an income.

Having conversations about how we fix

the problems in our community,

I'd be cool.

And so yeah, absolutely.

Good, so you know exactly what I mean.

When I start talking about even

relationships, when I start,

because you can't do

this job by yourself.

When I had my nonprofit, I

was the only one on staff.

But the key was community partners.

Clark Memorial Hospital,

Clark County Health Department.

Just churches and other nonprofits.

Sitting at the table and representing

the people you look like.

I represent, whenever I sit at the

table, I don't care where I am or

whose table it is, I

represent minority health.

I represent people of color.

I represent Clark County.

And when I say that, that's also to

identify resources

that in our community,

that our residents can use those

resources to help them feel better.

To help them get their screenings, to

help them get their medication.

But it's not always that easy, Miguel.

We talk about that.

We always had these

conversations about access.

We're saying, well, medical supplies is

out there, hospitals are out there,

doctors are out there,

nurses are out there.

Why is it that one community is saying,

hey, I have access,

or another part of the community

saying, I don't have access?

What makes it so complicated?

The difference is that when we look at

certain areas of Clark County,

there are bus lines, there are

daycares, there are jobs.

But when we look at some of the other

communities, there's not a bus line.

There's folks who may not have

completed a college education.

Education becomes an

issue, they may be low income.

There are people, Miguel, I would go

door to door in some of the communities

in Clark County, and I would ask people

about their health.

I want to know how you're doing.

I want to know if you know about the

family health center that's over across

the street.

Have you used their services?

So what I would do is I

would ask those questions.

If some women may need a mammogram, I

had one woman that

did need a mammogram,

found a lump in her

breast, but she was comfortable.

She said, I'm okay, what I

don't know won't hurt me.

Well, see, as black folks, we do have a

tendency to continue with those myths,

to continue to say what I don't know

won't hurt me, and that's not true.

So I stood there and had a conversation

with her, told her

about the family health

center, told her about the breast and

cervical cancer program.

How many people do you see?

And I know I don't hate to say this,

because you gotta go

to where people are.

And I know that may sound old cliche,

but you have to go and

you have to have that conversation.

This lady did end up going to the

family health center.

She did end up receiving services.

But if I had not knocked on her door,

she may not have went.

You're saying you have

to go to where people are.

And we talk about services, we talk

about opportunities.

So I think there's a couple things that

come to mind for me.

And one is sometimes we

don't know the services existed.

The other part is, is there something

that happens in the black community or

economically challenged communities

where there's a trust issue?

And so what I don't know

won't hurt me is more so

of a reflection of the

trust in the community.

I don't trust this facility.

I may not trust this doctor, I may not

trust this service.

I wanna remain private and I don't

trust that they won't share.

Right, right.

And part of that trust, when you start

talking about trusting your doctors and

trusting your provider, it goes back to

the Tuskegee experiment.

It goes back to history because we pass

that information down

through generations.

And what we have to do is to make sure

that we continue to

educate individuals on speaking up for

themselves when

you're talking about trust.

My own personal experience of trust

with a doctor was when

my son was an infant.

And they assumed I was on Medicaid

instead of having health insurance.

They didn't ask for my health insurance

card, they asked for my Medicaid card.

And I've never been on Medicaid, but

when I talk about trust,

I'm referring to making sure that we

have that open

dialogue between our provider.

And making sure that some people don't

trust the prescriptions

that their doctors give them.

The conversations that I have are, if

your doctor gives you a prescription,

do you understand what a

teaspoon, a tablespoon is?

A lot of people don't understand that.

It's really about health literacy and

again being your own advocate when

you're talking about

trusting your own provider.

Another example is I had a person in

the community said that they did not go

to this particular place for

care because no one looked like them.

And she was a woman, a black woman.

And being a part of the community and

having this particular

organization on my board,

I had a conversation with the executive

director and she made changes.

She made changes because you're not,

again, you're working in the community.

You're connecting them to resources,

but you're also being that ear.

You're also, as I said, when I sit down

at the table, I represent

the people that I serve.

I represent the community.

Let's address that sitting at the table

because I know sitting at the many

tables in this community,

we might be the only ones.

And what you just identified is why it

is important for us

sometimes to, for us as brown,

black people to be in

an awkward space, right?

Being the only one at the table because

when we do voice something, it may be

the first time that anyone on that

board or on that committee has ever

heard of that issue.

And if you don't advocate, if we can't

give agency to the

people who don't have agency,

then the growth that we

hope will come doesn't.

And you deliver that.

And so you can sit here and say, yes,

things have changed.

And I've worked with directors and

programs who said, man, we don't have

people of color who work here,

so we'll adjust that.

Now, not everybody does that.

Some people don't care or

they have rhyme and reason.

We'll just leave it like that.

As I said, I was going

to play nice on this.

Yes.

You are being really good.

You are because I know I

know how this could go.

But yeah, you are.

That's OK.

You know, sometimes there's a time to

carry a spear and

sometimes carry a pen in the book.

And on this series, I think it's more

about let's educate.

It's a hard conversation

no matter how we look at it.

And because go ahead.

Because you have to you have to have

that conversation about systemic

racism, discrimination.

If I feel it, if someone in your office

mistreated me and I just leave,

you're not going to hear about what

happened or why I left.

You're not going to follow up with me.

But if I see Pam on the street and Pam,

this is what happened.

I'm going to go back and we're going to

have that conversation.

It's a conversation

that we have to have.

When you're talking about

discrimination, stress

brings on a lot of issues.

Stress brings on headaches,

hypertension, heart disease.

It plays a role in a

lot of chronic diseases.

So if I'm feeling-- and I know you

understand this from 2020.

Because I keep going back with--

I know we're being recorded.

But (Maurice) Miguel, I keep going back to the

stress that I felt in 2020.

The marches that-- the headaches that I

had, the concerns I had.

Now see, that brings

social determinants of health.

So when I don't feel safe or if I'm

concerned about my teenage child,

that's part of public health.

Feeling safe is part of public health.

So I have to make sure that I address

those issues when it comes to safety,

when it comes to

discrimination, when it comes to--

so when I'm being mistreated, when I

don't feel like I'm getting the care

that I need.

And it's OK to speak up.

Just like you guys marched.

Y'all spoke up in 2020.

Yeah.

I mean, I think 2020, 19, it changed a

lot for a lot of people.

And I think for some of us--

and I'll backtrack a little bit.

I had a couple of clients that said you

shouldn't be out there.

And most people don't even

know how I got to the fact

that I was protesting anyway.

And it was weird because my daughter

wanted to go protest

in the first night the things that were

going on in Louisville

in terms of Breonna Taylor.

And so we're in night two, and I'm

watching it in the office.

And Teah and shug call.

I want to go downtown, and I have a

voice, and I want to

voice it in my head.

I said no.

And I've been telling this story.

And I was like, nah,

I'm not taking you down.

You have no idea what

that is going to look like.

And they said, well, who

better to take me than you, Dad?

You know what it's going to look like.

You know what it's going to feel like.

And I was like, you know what?

You're right.

What we don't later

understand is the amount of trauma

that we cause to ourselves being in a

volatile environment.

It was a war environment, right?

Brought on by both

government and people.

And so we have to address that.

But it gave such a new voice.

I remember sitting on one

SI's board for some years,

and we would introduce this thing about

social racism or social equity

or economics and the fact that black

folks were being excluded and yada,

yada, yada, and so on.

And we would continue to

have these conversations.

And they wouldn't really go anywhere.

It's the math didn't math at the time.

And I think what 2020 showed the US,

but very specifically at home,

was that we are not far removed from

the racial inequities that

happen across the country.

And in Clark County, Floyd

County, and across the river,

in Jefferson County, Lou, there are a

lot that are happening

that's intentional.

And it does create home, right?

It is a continuation of the inequities

that we face systematically.

And no matter how many

PAM's are in the place,

no matter how many Miguel's are in a

place, if the powers don't be,

if our mayors and our governors, people

who are ahead of our health

departments, people who are ahead of

organizations and banks

are not paying attention or don't want

a culture of equity,

then we have to

address these things, right?

Because we were not--

I would like to say we're not safe.

For a lot of people, safety in this

community, being Black or Brown,

doesn't exist, right?

We leave the home with a concern that

we live in an unsafe environment,

both from institution and individuals.

And I think part of this

conversation, I think the fact

that Clark County Health Department

said, let's have a conversation,

let's have an open dialogue about what

health equity looks like.

I asked the conversation--

during the 2020, we were all sitting in

these Zoom meetings because of COVID.

And I asked the question there, we

weren't talking about health equity.

We were talking about wealth and

economic positioning of the community

as a whole.

And I remember asking a lot of the

leadership in that room,

what does equity look like?

You're saying you want to create it,

but what does it look like?

And that conversation never happened.

The answer never came.

And we're in 2023.

I want to say the

answer still has yet been--

I have yet to hear it, but what I have

seen is a few people,

a few organizations say, let's step out

here and see if we can figure it out.

Because we don't

know what it looks like.

And we don't have a plan.

Now, there are some folks like Mayor

Treva Hodges or Mayor Treva Hodges

over in Charlestown (Indiana) has done some

really unique things in terms

of hiring practices and programming.

And she's been boisterous about it.

Yes, she has.

You've got CASI, who is

doing a great deal of things.

And so we have pockets

of folks in the community.

The fact that Dr. Yezel

with the Health Department

is out here looking at it

and saying, how do we fix it?

How do we implement things?

What's missing?

Right.

And we have to fix it together.

Yeah.

We can't-- we have to have--

when I say together, not just

with the health professionals and not

just with those folks who

are community health workers, we have

to bring those folks

to the table from the community.

We have to have that discussion, that

raw discussion from those

that it really impacts.

Because black men are still

dying from chronic diseases,

from hypertension, from strokes,

from seven years

earlier than white men.

And till this day, this is 2022.

And we are still at

the top of the chart

when it comes to health disparities.

The gap has not been closed.

I remember when I first started, we

talked about healthy people--

I think it was Healthy People 2018,

Healthy People 2016.

We're talking about

Healthy People Close to Health

Disparities Gap.

How are we going to do that?

We have to also-- we can't leave out

the part of advocacy.

We can't leave the part out

of going to the state house

and being that voice and being heard.

There was one time they wanted to--

you ever talk about cutting the Breast

and Cervical Cancer

Program dollars.

Who do you think

that's going to impact?

That's going to impact women of color.

And I don't know if you

want to delete this part,

but we're also talking about abortion.

At the state level,

we're talking about abortion.

We're talking about now--

we're talking about women of color

now going back to the alley to get this

botched up job done.

Because we are passing laws that are

going to be so strict

in the state of Indiana.

Even if a woman has been raped, she's

not going to be able

to get an abortion.

We've had this conversation

on a couple of the podcasts,

and what does the world

look like post-Rovy Way?

But here's the even

crazier question is,

what does our community

look like during Rovy Way?

Some communities were already bad,

Indiana being one of them.

I had Dr. Rita on

here in the last session,

and we talked about the

fact that one out of every four

young women will be

sexually assaulted and abused

before she leaves middle

school, and men one out of six

young boys.

And these are reported.

So we already live in an environment

that is dangerous in that relationship,

but here we are

passing laws that will--

a lot of times they

say we're passing laws

because we want to protect

an unborn child or a fetus,

and I respect that.

But at the same time, we're also

passing laws, I think,

who are protecting predators.

And I once asked a question

of some elected officials.

I said, when you pass

this law, who are you really

protecting your friends, who you know

are out here raping

and pillaging, or

the people that you're

supposed to legitimately protect?

And I think we have to

continue to have that conversation,

because there's--

I'm firm believer that we have to

protect women's rights.

There's no reason we

should be making laws that

dictate what a woman

should or can or can't

do with their own body.

That is not freedom.

That's not independence.

And that goes against the American

concept, in my opinion.

Exactly, exactly.

And another, we don't know how we're

going to come out post-COVID with

mental health in our youth.

That's another topic.

Absolutely.

We've had an increase.

And to me, one suicide is too much.

That's too many.

So this past summer for our

annual Back to School event,

I had Center Stone set

up a table just for them

to talk to parents and

to follow up with parents.

Because I want to make sure that our

kids are feeling safe,

able to have a conversation with

someone, some adults,

somewhere.

They've lost friends.

They've lost family to COVID.

So we don't know how this

COVID is going to impact

is going to have on our

children, the isolation.

I think still with going to school

and sitting in a

classroom for some is a challenge.

Is it safe to say that

COVID, the last couple of years,

there's no going back to a norm.

This is our new norm.

Exactly.

And we have to figure out how

to thrive and be safe in it.

I wonder, even in

that, I wonder how many,

when we look at the

diversity of our community,

how many therapists, how many

psychologists do we have?

Are there black, brown, or women who

are of other ethnicities?

Because we're not just a

black, white community.

We have Africans.

We have Hispanics from

all different regions.

So we really have a plethora of folks.

And are we really addressing the needs

of the people in the cultures?

Is there anything you want to share?

As we have these conversations.

I would like for

people to just get involved.

Something that I'm working on,

and I don't know when I'm going to be

able to implement this,

but it's been near

and dear to my heart,

which is crime in the

African-American community.

Something that I would

like to do is to start out

with a panel of discussion,

but I like doing things out the box.

I don't like doing the normal things.

I want to have someone

there from the trauma center,

from the funeral home.

I want to have a parent there.

I want to have, I want

to have a real discussion,

but I don't want it to end just there.

A lot of times we

have town hall meetings

and we voice our concerns.

We get up, we testify, we tell all

these great stories.

And then it just sits there.

And what happens after that?

Again, I'm only one person,

but if I can get the

community involved,

the community to share.

And when I say that community,

I'm talking about folks

that live in public housing,

folks that live in a

million dollar homes.

I want to get all these

people together in one room

so we can talk about it.

And then we come up with a plan.

Bring our mayors,

our local politicians,

bring all of those folks in

to have that conversation.

Is it going to happen overnight?

No, it's not going to happen overnight.

But Clark County always

say we're not in Oz anymore.

- No, no.

- It's not where I grew up.

I've been here all my life.

And it is not, when

I'm going to tell you,

I was in the hospital, I

was diagnosed with epilepsy

when I was three.

I was in the hospital.

I was in the basement.

- Basement?

- Yeah, I was in the basement

because black kids could not go.

Black people couldn't go.

If you went to the

hospital and you were admitted,

you were admitted in the basement.

- That's unheard of.

- No.

- I mean, it's not unheard of clearly.

That's crazy.

- No, I remember that.

- Wow.

- Yes, yes.

My mother never had any complaints

in terms of how I was treated.

She didn't have any

complaints about that.

But things have changed,

but then again, things haven't changed.

Things have been covered up.

- Okay.

- So we have to talk about that.

And you talk about Dr. Yazone,

you talk about Rita Fleming,

and you talk about Treva Hodges,

and those are just to name a few,

that are, I call,

they're on the front line

for all people, for people of color.

They're easy to approach.

They're approachable to discuss issues

that even one

individual has a concern about.

How can we get together

and have those conversations?

And sometimes we think,

oh, I'm just one person.

That's okay.

- You can be one person.

- One person can do a lot.

- That's right.

- It's the spark that moves things.

And I love the fact you said,

hey, let's move beyond conversation.

We have to have action plans in place.

And so if we're gonna

address equity at any level,

if we're gonna address the crime levels

that are increasing in key communities,

then how do we address that?

And it's not just about policing.

It is about those who are in the

community owning it.

Having some degree of ownership,

whether you have a

mortgage or you're renting it.

There's different levels of ownership.

And I think the other piece is,

is that we have to look at opportunity.

Why does crime happen?

What are the reasons?

What are the things

causing for things to occur?

And how do we begin to address that

versus just saying,

hey, this is

something we need to police

and somebody needs to go to jail.

I think that has to be a thing too,

because when we live in a community

that is focused on economic growth,

economic means, financial value,

and we have

communities that are ignored.

And we have communities that are

intentionally ignored.

And we have to address that as well.

- Because that's their problem.

- Yes.

- That's not really our problem.

- Yes, when tax

dollars came from everybody.

- That's right, that's right.

And something else I

wanna bring up real quick

is that I served on a policy

that the state of Indiana is working on

called direct service workers.

And direct service

workers, as you know,

are usually, they're like our CNAs

and folks that are

caregivers, even, you know,

I was a caregiver to my mom and

caregiver to my husband.

And caregivers, I'm

paid a lot of money.

If we could get,

if what they're talking about doing

is identifying a

career track, a career path,

but also making sure that

they have the resources.

If a CNA wants to become a nurse,

to make sure that she has those

resources to become a nurse.

Because if we can pull

them up to another level,

because we have more people aging,

we have an aging population as well.

- Yes.

- Okay, now we don't like to put our

folks in nursing homes.

They're trying to keep

folks out of nursing homes.

So if we can get our family members,

if we can take care for our loved ones,

if we can also get our

direct service workers,

if we can get behind them

and the state can pass those policies

to help our direct service workers

to become more self-sufficient,

that would also help

our economy as well.

- We've got a nice, we've

got a lot to think about.

- We've got a lot to think about.

- We've got a lot to work on.

- But that's my day.

- Yes, wow.

- If you ask me, Pam,

what are you doing today?

- That's a long list of things.

- I'm also working on infant mortality.

I was telling you about the local food

purchase the excess

grant that Community Action

just received and

working with BIPOC farmers

and working with black farmers

and working those 20 counties

and getting fresh fruits and

vegetables to those counties,

to those folks that

live in those 20 counties

and that there's only five grants in

the state of Indiana

that Community Action

is the lead agency on.

So if you ask me about that,

I'm also over here working with doulas.

I'm writing a grant to try to get,

I have a couple of doulas

that are gonna be working

with our Head Start families.

I have doulas that's gonna be working

and talking about breastfeeding

and talking about

nutrition and physical activity

and really focusing on

that, the low income families

and making sure that those

women have what they need

and connect them to resources as well.

- How do we get all of

that out there into the ether?

- Ooh.

- Like, I mean, I'm in certain spaces

and I don't always get to hear about

the different programs.

When I do pick up a newspaper,

I don't always hear about

the different new programs

and in Clark and Floyd County, we

really don't have news.

- We don't have news.

- So how do we get that

information out to the people

on an ongoing basis?

- We had over a thousand people,

individuals that attended

the Back to School event,

a thousand, every year

there's more and more.

We went to the media,

our community partners,

we were on TV, radio,

just trying to get that

information out there.

That's because people are

having a difficult time,

hard time with getting

jobs or even retaining the job

because so many people have been home.

It's hard to sit at a desk when you've

been home for a long time.

- That hustle is different now.

- It is, it's a little different, it's

a little different.

So what we do is we use

our community partners,

we use our churches to

try to get the word out.

I just started diabetes class last

week, every Wednesday.

A lot of us, we

still call it the sugar.

- Yeah.

- I don't want to have a late,

she told me she was

diagnosed with diabetes,

but she said, "You know

what I call it, sugar?

I can't say the word diabetes."

- Don't wanna own that disease.

- Don't wanna own it.

- Well, I'm in this already.

- And we're still, we've got people

still, that's okay.

- We don't have to quiet enough.

- Because we can address that.

But how do you, so are you teaching,

and I know we gotta wrap up,

so in that diabetes

class and that sugar class.

- In that sugar class, probably.

- Are we teaching new ways of eating?

- Yes, we are.

And it's not, when I

say I'm having a class

and it's facilitated by

an RN, registered nurse,

when I say I'm having a class,

it's not where she's coming in and

she's lecturing you.

This is interactive.

We're actually doing food demonstration

and we bring in partners to do this.

- Can I come film that one?

- You can come and you

get a little blender.

I mean, you're getting

some things to take home.

Every class that you attend,

you will get something to take home.

We have activities that you do.

We play bingo, you get a game,

but yet, and still, it's educational.

If you have free

diabetes, if you have diabetes,

or if you're a caregiver

to someone with diabetes,

please come out to our

class at Community Action.

We start at that class

every Wednesday at 4.30.

- So how do I get it out?

I don't know.

I think people just call me and say,

"Pam, what are you doing?"

Sometimes I don't know where to start.

- What if they don't know a Pam?

How do they find you?

- They can call Community

Action, just ask for Pam.

- Just ask for Pam.

- And they'll say, "Pam,

the minority health girl,"

and they'll put you through.

- And we need your help.

- We need your help, yes.

- From service to farm.

So when does the

farming program launch?

- That we started, we received our,

I'm gonna say in four months.

- In four months?

- Mm-hmm.

- You're gonna look for that as well.

You're gonna look

for some fresh produce

here in Clark County.

- Well, thank you for joining me.

- Thank you for having me.

- It's been most informative.

I hope that if you're

listening or you get to watch,

you picked up some information.

This is specific to

Clark County, Indiana.

But if you are watching somewhere else

or listening somewhere else,

ask yourself, what are you doing in

your own community?

What information do you have?

What information don't you have?

Are you not getting it

because you're not at the table?

And sometimes we have to

move out of our comfort zones

and show up in spaces so that we can

get the information

and then bring it

back to our community.

I'm with Pam Clark, we're at CASI

This is your boy, Guelly Guel

This is "Common Conversations"

with the Health Equity Story.

Thank you very much, and

we'll see you next show.