Creating Conditions for Generational Wealth and Eliminating Health Disparities

NBCSL panelist Dr. Shamarial Roberson, President of Human and Health Services at Indelible Business, grew up in a Florida town that had no grocery store and ranked last in everything in the state, including non-medical health drivers such as education, economic development and housing. But, she said, her experience and understanding of how Black and Brown communities are impacted gave her leverage to write her own policy and help bring federal funds to her state to address health disparities. The purpose of the funds was to help public and private sectors collaborate and positively impact the community for a brighter future.

The key, said Dr. Roberson, is looking at the data because the quicker issues are known the quicker something can be done about them. For example, Black males are four times as likely to die from a stroke as their counterparts when everything else is held constant. Also, Black women, even if they have an advanced degree, are more likely to die post-partum or during birth than someone with less than a high school diploma.

Dr. Roberson explained the importance of capturing data on a quarterly basis via multisector partnerships to leverage public health skills and communities to move the needle. She urged lawmakers to make sure it’s written into their plans and budgets and, even if they get federal funding, make sure funds are applied appropriately to help solve these persisting problems.

Alan Williams, senior advisor for public engagement and intergovernmental affairs in the Office of the Vice President, agreed with Dr. Roberson about the significance of having data. The NBCSL panelist said the Biden-Harris Administration has been trying to address these health issues as well, including Black maternal and reproductive health, which Williams said Vice President Harris has been unabashed and unapologetic about supporting. Williams also pointed to the passing of historical laws that lower healthcare costs such as insulin at the record-low price of $35.

Williams also explained how the White House is carrying over an Obama-era process of getting money directly to cities, counties and entitled communities instead of giving it to the governors and letting them appropriate it. This, said a state senator from Alabama, is critical to ensure state legislatures can deliver on their issues of health and wealth.

What can be done to help create wealthy Black billionaires? Not such an easy answer, admitted Williams, but while President Biden has already taken a lot of great actions, executive orders can only go so far. Instead, Williams encouraged lawmakers to take the roadmap and model from these executive orders back to their states and use the power of the bully pulpit alongside facts and information to convene and get things done at the local level.

Williams reminded state legislators that sometimes in debate and committee, people come with incorrect information. “We want to make sure you’re armed with the data and information on the issues,” he said. “We stand in lock and step with you today, tomorrow, next year and beyond that.”

Data and information around HIV in Black communities is abundant. NBCSL panelists Ramon Gardenhire, Director of Government Relations for ViiV Healthcare, and Amna Osman, CEO of Nashville Cares, said many people think the HIV/AIDS epidemic is behind us—a foregone epidemic. But, they argue, there are 1.2 million people living with HIV in the U.S, and of them there are 40,000 new HIV infections every single year with Black Americans making up more than half of those. Furthermore, of all women affected, 60% of Black women in the south are infected with HIV.

“I call it a pandemic in the Black community because we aren’t talking about it,” said Osman. “More than 50% of new HIV cases are in the South, and we comprise 38% of the U.S. population. We need to think of HIV in the Black community as a public health issue that needs legislators, leaders and community-based health organizations to really pay attention to it.”

The good news is that there are biomedical intervention options such as HIV PrEP (Pre-Exposure Prophylaxis) to slow the spread of the communicable disease and reduce the risk of infection after exposure, but there is a lot of work to be done to make sure there is equitable and appropriate access to it.

“Over 50% of HIV infections are Black people, but only 14% of PrEP users are Black,” said Gardenhire. The issue, he said, is that barriers to access, health care and insurance in some states are preventing access and use maintenance, so it’s important that legislators make recommendations about how healthcare providers should provide PrEP.

In addition, Osman said funding is critical to continue focusing on sexual health and improving health equity in this space. She shared how during the pandemic, Tennessee opened drive-thru testing to alleviate barriers around social determinants and access to healthcare for Black and Brown community members. They remained in their car and took an HIV test and learned their HIV status in two minutes. If people tested positive, they were linked with a peer who currently lives with HIV and also linked with a healthcare provider to receive medicine for their diagnosis. The rapid initiation of HIV antiviral therapy allowed Black people to have labs drawn, receive a diagnosis, see a provider, get medicine and go home all within a maximum of 72 hours. For those people who couldn’t travel, they implemented HIV tests at home and saw skyrocketing results. Mobile units were sent to the homes of people who tested positive so they could receive their care.

Housing is a key factor in creating health equity, shared NBCSL panelist Senthil Sankaran, managing principal of the Amazon Housing Equity Fund.

“In order to eliminate health disparities, people need access to quality affordable housing in high opportunity areas where they are close to services, amenities such as school, transit, healthcare, parks and more,” said Sankaran.

As existing affordable housing decreases at alarming rates, the Amazon Housing Equity Fund is helping reverse the trend by creating more affordable housing and delivering low-interest subordinate loans. They’re also working to increase the number of developers of color by creating a two-year developer accelerated program who can build these equitable homes in Black and Brown communities with access to critical services and amenities.

Dr. Troy White, executive director for the Metropolitan Development and Housing Agency in Nashville, oversees more than 6,500 affordable housing units. For the first time since the 1940s, they have 400 units under construction and are changing the landscape of the city’s affordable housing opportunities.