¶ Welcome To the Show
[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.