Brown on Racial Disparity Amidst the COVID-19 Crisis

Jason and Carol, thank you for having me. Well, we are excited to talk to you, in part because you know you are very much on the front lines of this and you are dealing with an issue that Carol and I have been talking about a lot, which is the disproportionate effect this disease is having on folks with underlying conditions, with folks in communities of color, economically disadvantaged people. Tell us what you are seeing, What do we need to know that maybe we're missing beyond those sort of

broad strokes. So, uh, Jason, I mean, I think you have hit the nail on the head here. This uh bit nineteen pandemic has really shined a light on some existing problems in a very large way. You talk about people with underlying conditions, that's a hundred and thirty three million Americans um living with some kind of underlying condition. When you think about diabetes specifically, you are talking about thirty four million people who are diagnosed with diabetes, eight

millions who are diagnosed with pre diabetes. I'm one of these people living with diabetes and has have been thriving while living with this disease for sixteen years. But here's the issue. I think you've heard that for anyone who contracts COVID teen that has an underlying condition, the higher

rate of having a poor outcome is what's happening. This is demonstrate by data that is coming out across the state that out of the death that have occurred with COVID nineteen right now, there are the upwards of um in many states or more Jason, those people have had diabetes. When you double down on that and then you start to look at the UH numbers as it relates to people of color, you're talking to the upwards of seventy to seventy in some of these states that the depth

of coronavirus are people of color. This is a real issue that is affecting all of America right now in this CRISI. And this goes to a bigger conversation too, that we had earlier in the week that talked about Tracy. You know, unfortunately, the level of health care that you get is often contingent on the job you get, and the job you get is contingent on the education you get, and the educational access that you have is often, you know,

courtesy of the world that you are born into. And we know that minority groups are often left behind when it comes to that initial kind of gayway into a much better life. And so this is a big problem. How do we get at the core of it? So, uh, Carol, what you adjust articulate it is the social determinants of health, right like, these are all of the environmental UH factors that affect um people and uh particularly diabetes and again

other underlying conditions. And if you think about these social determinants of health, there's data out there that says that equates about eighty percent of poor health outcomes. Now, let's overlay, like we already had an issue pre COVID and you have just outlined, let us add on top of this the COVID nineteen crisis, with more than twenty six million people or more now filing for unemployment. The majority of those people when you lose your job, you lose your

insurance when you lose your job. Not only did you lose your insurance, you lose your income. Let me put the spotlight on this as it relates to someone who is living with diabetes. The person living with diabetes already has medical expenses that are two point three times more than a person who does not have diabetes. We already know that the lots of data out there that says

people who don't have insurance have horror health outcomes. And then now we have that if you have diabetes or an underlying condition, the likelihood of COVID nineteen leading to bad worth outcomes and or death. All of this now has just gotten um, you know, exponential. And so what you have, Carol, now is the people who need help the most are not getting the help. And if you don't have health insurance and you don't have income, you

can't get the medical medication that you need. If you don't have health insurance, you will not go to the doctor to care for your your body, which means you can get sick and sick er and then end up in the very hospital system that is already exploding right now. It's a bad, bad scenario, right It's a cycle that

just continues going down. So Tracy, talk to us about what you are pitching lawmakers regulators onto a aviate some of these problems in the short term, and then maybe we can talk about some of the more structural issues, because I know the cost of insulin and the ability to get insulin is a hugely important issue for folks with diabetes exactly. So Jason, there there are you know, three things that right now we are beating the drum

very hard on during this COVID nineteen pandemic. The first is as you talk about, but the last thing that we want is for people not to take their diabetes medication, whether that's insulin or the prescription drugs. And so what we're asking um both at the federal and the state level, is an elimination of all copais for insulin and other

diabetes prescription drugs. So that's not the end all, be all, Jason, but removing as much of the financial burden as we can so that people do not skip or rations their medication right now is what we're going for. So that's one. Two, we've talked about the need for continuity of health insurance coverage.

It's a huge so we are actually uh speaking and advocating very hard to say, Look, if Americans with diabetes lose their jobs during the wake of this pandemic, we want to make sure that they don't lose their health insurance coverage and so that there is continuity of coverage so that they can still get the care that they need. And then the third thing, Jason, as look the numbers

with COVID nineteen cases still continue to rise. We know the economic pressures and that states are looking at reopening. We have to have not only more testing, Jason, but the testing has to get to the communities and the people who are most at it and need it. So we we are advocating very hard not just more tests any or everywhere. Well, let's get the test to the community that now that's not happening, Tracy, and I will stay within my family, like I know a couple of

people who have diabetes. I will say also, I think once we get through this, and you're right, we need to make sure that those who have diabetes are getting their treatments. It's crucial. But I do also wonder take several steps back. We've got to figure out how to get diabetes under control and I'm a big proponent, Jason. I talked about it a lot with guests on our show. You know, doctors and you know people from the medical community about really focusing and this is a shift for healthcare,

is focusing on wellness. And maybe this is something where telemedicine can help us in the future because it makes it easier for everybody to reach out potentially to the medical community. But you know that we have such high numbers in the United States globally when it comes to diabetes. We've got to figure out how to roll back those numbers, I mean, and so I'm curious about your efforts along

those lines, Carol, like you equiitness said that better than myself. Listen, Um, this was a The diabetes is an epidemic that existed before this pandemic existed. And here's what we know. Eight five of people are walking around this country and they don't even know that they actually have pre diabetes. And I told you one out of two people have pre

diabetes or diabetes. What we have to start with is driving awareness and so we we we are trying to drive home a simple notion, Uh, Carol, every time people go to the doctors, you get your blood pressure checked. It's just like clothwork. That is not the same for your A one C. So I don't you know. I didn't even ask you. Do you even know what your

A one C is? Right? This should be a stand your eyes, very standardized check that happens every single time that someone goes to a doctor, a planic, healthfare or whatever. Because it starts with knowing. Then once you know where you are with diabetes or free diabetes. This is the thing that unnerves me. There is a lot of things that you can do to help manage your diabetes, and here here are the four things Carol one. You have

to be mindful of what you're eating. You have to be mindful of how you're moving your exercise, you must manage how you're sweeping, and you must manage your stress. All of these things cause havoc to your blood bluecoatter, your blood sugar if not managed. So that's type you know for a type to someone living with type two diabetes. If you can do those things, you can start to

get your diabetes under control. Those who live with type one, which is an autoimmune disease, listen, this is where insulent affordability becomes a musk, because we don't want people who need influence to live choosing do I pay my rent or do I get my influence? Do I put food on my table or do I get my influence? So that's the other thing that we're fighting for to uh, Carol.

But you're right, like we need to control the things that we can control, but it all starts with knowing, right, So, Tracy, I do wonder given your background, you've had some big corporate positions. You were the senior vice president operations and the chief experience officer at Sam's Club part of Walmart. Is our listeners very well known being the savvy business audience they are, Where does the responsibility lie and where do you see the most effort on that side, on

the wellness side, especially between the government and companies. I mean, I know, you know, we're very fortunate to work for a company that puts that front and center, but I know we can't say that for all companies. What do you hear from the corporate side, especially at this time when people are going to have to start to be

much more worried about the self health and safety of employees. Yeah, I mean, Jason, I think the responsibility all of us bear some responsibility in this entire eco ecosystem, from federal UH government, to corporate government, to state, local community to uh you know, even the insulin manufacturers, the drug manufacturers, the retailers, pharmacies, everyone including the individual we all own

a piece of this responsibility. And just to view, as you said, when I am talking to corporations and and and again someone who spent a lot of time at Walmart, Um, these corporations care about their employees. At least I know for our fact Walmart does, and they want healthy employees. But if you didn't care just about the human side of this, there's an economic side of it as well. Jason, diabetes cost this country three twenty seven billion dollars a year.

So there's both a human piece of this and an economic piece of this. And I think right now, all of these corporations they not only have the employees their own employees, but the communities in which they're located, right and and I and I will, and we're running out of time, but I will say to Tracy, I mean, you're right, it's economic. I mean in terms of healthier food and having access to it, it can be more expensive or you have to have the time to prepare it.

So there are so many things that go into this, but I'm so glad we got some time with you. Good luck with your efforts. Tracy Brown, President and chief executive officer at the American Diabetes Association, joining us on the phone from Arlington, Virginia. I have to say when we talk about health crisis, and of course nothing compares to I think what we're going through, but I do feel like diabetes is another one, Jason, that we've got

to figure out absolutely, Oh yeah, for sure. And I mean and the numbers that Tracy laid out are staggering and a good reminder not just about people, um you know, living with diabetes, but people living with pre diabetes, which obviously gets into a lot of those sort of underlying health issues which that you mentioned. Yeah, it's a big deal.