Dr. Oloku on, TikTok, right? All right, so this next panel, with no delay, is a wonderful, as you can see, all-woman panel. And this is Women's History Month so, yeah, let's give it up for our esteemed panel of ladies. Even though we're not going first, we are the first panel, so this is our ladies first panel. And but you'll be seeing everyone throughout the day. so first let's just say for decades, health outcomes have often been framed as a result of personal choices. Personal choices like we just heard about. Diet, exercise, compliance and willpower. But generational patterns of disease, mistrust, delayed care, lack of intergenerational conversations, asking Auntie, asking Grandma, about our health and our shortened life expectancy do not emerge just from individual failure.

They emerge from a systematic failure, right? Today's con-conversation is about the state of Black health and a redesign of that failure. How do we intentionally build generational health? Well, we heard a little bit about that. It doesn't happen by accident. I loved that takeaway that I got, I don't know about you, about generational wealth is not by accident, and neither is generational health. I mean, that's, that's on a T-shirt next. You know? You know, so how do we intentionally build generational health and so our present generation can get healthier and our next generation doesn't start from zero, right?

Because we have to hand it down. So I'm gonna start off, and ladies, when you take your first question, please introduce yourself to the audience so we can hear all about you.

And I'm gonna start here with Megan Wanzo first. Megan, as a leader in global health equity, how do you see breaking the generational health pattern as a fun- as fundamentally a systems issue and not an individual one? Oh, thank you, Kristen. And good morning, everyone. I'm Megan Wanzo. I'm the Associate Director of Global Health Equity Inclusive Research at Bristol Myers Squibb. I started my career as a clinical bioethicist. So during the pandemic I saw the disparities. I saw how big the gaps were, and I saw them getting wider. So I made the decision to go to industry so I could be a voice for those that did not have a voice.

So with this question, I think it's really important that when we're having these discussions, we're framing them, because generational health patterns rarely emerge from individual decisions alone. They often emerge from a combination of the individual decisions, but also the conditions and the systems that have impacts over a generation. When we think of some of the conditions like diabetes, heart disease, hypertension, and even some types of cancers, we see the accumulation of structural factors that really starts to impact not only someone over their lifetime, but also generations.

Yes. Absolutely. I, I mean, I totally agree. And, I mean, the numbers were just so startling. Mm-hmm. And when you hear things like only two percent of, Black Americans know, have health literacy, th-the amount of groundwork we have to make up is huge, right? Absolutely. So Dr.

Lawson, you know a lot about that as the former NMA president. Where do you see trust breaking down in the Black community, and what would it look like to build with intention before a crisis to help break these patterns? So good morning, everyone. I'm Dr. Yolanda Lawson. I'm an OBGYN by background. I'm a past president of the National Medical Association, and I'm currently an executive medical director with a health plan. And so when we talk about this breaking down, I personally don't feel like it exists, right? So I don't feel like we're in a trustworthy healthcare system.

Speak on that. As a, as a doctor- Yeah every day people- Yeah come into the office, and even if I or their other doctor, their primary care, whomever, gives them instruction, they leave the office and they go do what? They check with Dr. Google. They check with Dr. Google. Yes, they are. They have had a face-to-face interaction- Yeah and they go check with Dr. Google. The second thing, I remember a few years ago, I was listening to some of my family members, and, you know, I'm a doctor, so I'm thinking they know, they see me. They're saying, "Oh, well, we don't go to those appointments.

All they want is our co-pays." Oh. What? Right? Second thing. So, right? Let me go check with Dr. Google. Let me d- let me not do what they say because they're seeking financial gain. They want me to come back for my co-pay. and then thirdly, what I hear often in my office- Mm-hmm they're not listening to me. Dr. La They will leave their primary care doctor's office, come to my office, verify that this blood pressure medicine, this antidepressant is what I really need, Doctor, because they, they trust me, right?

Mm-hmm. So when you talk about our care- Yeah central to that has to be trust. Wow. There is a lot of ground that we have to make up. Again, Black doctor in itself is because that was the trusted voice in the community, Black doctors. In your own family, they're going to Dr. Google. That's right. A lot of conversation I anticipate today is gonna drive back- Mm-hmm to what Dr. Oluko said around health literacy. Yeah.Or my neighbor said this one, this medicine didn't work for her, so I stopped taking it. You know that I'm clear. Sherita, as a leader in advocacy, how can industry partners and communities work together?

Because it sounds like from what Dr. Lawson's saying, it's, it's not a one-on-one type approach. This is really, it's gotta be a combination of people working together. What we, what could we do to work together and to partner the actions between the healthcare leaders, communities, and industry partners beginning today? Yeah, I would say, first of all, Sherita Dorsey, I've had the privilege now of leading in multiple realms, starting off as a nurse practitioner, moving into, head of sales for different, organizations, and now advocacy. And I think that from, from the perspective of what Dr.

Luco was saying as well as, what Yolanda was saying, that it is so important that we understand that 80% of health outcomes are dependent upon what happens at the community level. And so what that means is that we have to put our resources at the local level where the decisions are made and where the abnormalities are taking place.

And I think that, from an industry perspective, we've been used to funding top down. The actual impact of what needs to happen and what we do moving forward has to be bottom up, and I think that that has to be the approach. And some of the things that we're really, really seeing and the impact that-that's really happening is when industry comes in, we collaborate in a way to where the patient, the community, and industry work together to close defined gaps that's happening in that particular community. I don't think that we're going to win looking at it from a national perspective.

We're gonna have to get dirty and grimy and figure it out together. But we should not be telling the community what they need. We have to show up early, we have to show up often, and we have to show up at the table in the boardrooms, and that's something that I really want us to drill into. If we're not at the table making the decisions, then we it's not gonna happen. The decisions are not gonna take place. And I think that's what we have to own, too. How do we lift as a, as we climb as a community so we're in the rooms making the decision? Sherita, that's powerful. That's powerful.

And what you're talking about also is flipping a model upside down. So when we talk about battling mistrust, now we're talking about changing the model. That's a lot of work we gotta do. I don't know, I've gotta bring you in, Dana. You're a public affairs leader in the industry. I mean, we're talking redesigning the industry here, moving it forward.

Sherita wants to redesign it, Dr. Lawson's saying we gotta practically rip it up and start over. I'm with her. How would you redesign it, Dana? Tell us, walk us through as a public affairs advocate, how would you do that and get us started? Well, well, thank you. And first of all, good morning to everyone. by way of introduction, my name is Dana Harvell. I am formerly the, vice president of International Public Affairs at AbbVie and have recently taken my career to starting my own consulting business called Core Strategic Advisors. And, and the crux of my business came from what I experienced being in the pharmaceutical industry as a pharmaceutical professional.

Sitting on the international side of a pharmaceutical company gave me tremendous perspective to see how healthcare systems work all over the world. And, and then I come home, and as a-an American and as a Black woman, and I see the care that I receive, and I know better. And it, it shakes me to my core to think about the challenges in our systems. And, and really it struck this desire in me to recognize that this is bigger than me, it's bigger than the pharmaceutical industry, it's bigger than your doctor. It takes all of us to really build the, and create the changes to really create true generational health and wellness.

And so that is my, my commitment, is how do we align and convene the right partners around the messages? And it starts with the patient, and they are at the center of it. And so I very much agree with Sherita's comments on starting bottom up, and, and making sure that the dollars are landing in the right places and they're actually working within our communities and building the trust and breaking those generational barriers to create change, and then making sure that those stories are get being told, because we've got a reputational problem a-as a industry.

And because of that, that mistrust continues to grow and swell, and I think that this is an opportunity for us to come together, because who doesn't want to live in good health? It's a health problem, it's a financial problem, and I think it's something that we need to come all together to solve. So I commend Black doctors for bringing us together today to have this conversation. Wow. Thank you so much. And, and I echo everything that you said. It flashes me back to, Dr. Luco talking about the blue zones and the areas around the world, and I'm thinking, "Oh, great. He's about to name some place that I know." I'm like, "Sweden?" Or you know, like, "What?" Like, is there anything a little closer to home?

But not so much. and there's a reason why. We're making the wrong choices, and the mistrust, like you said, is there as well. Which brings me to you, Dr. Wanzo. When we talk about mistrust, we have to go back to one of the largest areas of mistrust, and that's around clinical trials. And that's an area where while the mistrust is there, the need to participate in clinical trials is so high. How do we go, knowing the history, we know what we're up against, the stigma, the mis everything that's there, how do we take the, the facts, the information about how vital being a part of these clinical trials is, and get that information to the people that need to hear it, which is a lot of people in the Black community?

It is. And that's a lot to unpack there, so you all are gonna have to stay with me for a moment.

Yeah. So- Break it down for us we talk a lot about the history of mistrust, right?Um, Henrietta Lacks, Tuskegee. We all know those stories. But I want to add something that's also real to those stories. The exclusion of the Black community in clinical trials for decades, for years, and even we see up into present day that there's certain inclusion and exclusion criteria that excludes the Black community. So now we have this opportunity where several of our companies, including mine at Bristol Myers Squibb, are making an effort to be more inclusive with our research practices.

We look and we see that when communities are underrepresented, the evidence does not match the population that needs these medications, that needs these treatments. So for a long time, we were seeing that the evidence-based science did not exist for our community. So when I talk about participation in research, we talk about inclusive research, it's not about optics, it's about evidence-based science, it's about reliability. But to be clear, and to touch on something that Sharita said, clinical research participation also comes with context. When we think about participating in clinical trials, if the first time you hear someone's company name or see them is at the point of recruitment, we're already too late.

We need to be building that engagement early. We need to be present at school fairs, at community events. We need to be on front por-porches, barber shops, because that's where the community is. We have to come to them, and they don't have to feel like our clinical research is transactional, because it's not.

We're trying to make sure that our care is stable, it's reliable, and that the standard of care is actually standard for us now. So when we think about that, the one thing that we can do is establish relationships with a primary care provider. That's where those trusted relationships begin. It's where you can talk about clinical research. It's your regular appointments. But also, I just want everyone to be aware that there are local colleges and universities that have observational studies that you can also familiarize yourself with research. They're not treatment trials.

They're clinical studies. They're studies, observational studies that you can participate in, and they look at behavior, social lifestyle factors, and sometimes you can get compensated too. So we should really open our worldview to start participating, start engaging, but we also have to do that on the sponsor side as well. So I just want to add to that. Yeah. I think amazing points. Seventy-five percent of physicians are affiliated with health systems. So I do think there's an opportunity as it relates to trials for us to begin to start holding accountable as well the health systems as it relates to as we start to see trends that are happening throughout health systems, begin to start educating patients and bringing in and collaborating with, with partners before the clinical trials even start.

I think foundationally, if we wait to create health literacy after clinical trials or right when clinical trials are beginning, the trust hasn't had a chance to build.

So I would, I would just add, you know, 'cause it should be a takeaway as we leave here is what can I do when I leave here today? But I think that we have to begin to really, really as we lift where we climb, where we build, where we stand, all of those verbiages, I, I do think that from a clinical trial perspective, the trust has to happen early and often. But the health systems, I believe, are a key opportunity for us to work with the health systems in collaboration with the academic institutions, and community health worker programs. If I can build on that. Yes, please.

This is important. All of us got to- Yeah, we are. Very. We're all ready. I was gonna say, I'm looking at Dr.- We're talking out the bit here. I know you wanna go. I'm gonna go to Dana first. Yeah. I, I think to, to that point on trust, I think that making the clinical trial process transactional is, is an opportunity that I think industry can really support patients with. It's not just about gathering your data. you know, it's not-- it shouldn't even end in the trial period, if you ask me. Why don't we follow up with those patients? Why don't-- can we share with them what we've learned?

Can we support their personal health journeys? What are those incentives for patients that we, that we can offer that not only supports trust, I think, but also makes me feel like I'm a part of something bigger than myself? I just really wanna comment quickly. I just had an experience. I was just the PI on a, on this trial, and, one of my colleagues asked me-- So this trial was only enrolling Black women and transgendered women, cis or transgender women, so you really, like, really niche.

And they asked me, you know, "Are you having problems with enrollment?" And I was like, "No, because they trust us." Right? So we're in a community-based research center, and there's trust. And so as you talk about academic institutions and all of these things, if you do not have those clinical teams and researchers who look like the community, for-- I mean, NMA, we've been advocating for this a long time. It is the biggest sh-- game changer of all when we talk about enrollment, participation, right? Who can speak the language when you're consenting, and it is so important.

And so I say that because me, myself, and the journey I had to get to become a PI, right? Fibroids. I'm a Black OBGYN in the South. Fibroids, I take care of them every-- lunch, breakfast, din- Fibroids all day. Every other day. And I could not, I could not get selected-As a site for the fibroid drugs. Yes. Right? It made absolutely They told me, "Oh, you don't have a full-time research nurse," when I have the population. And so I cannot advocate enough when we talk about workforce development in, in researchers of color. Yes, yes. So how do you get around that? I mean, when we're saying the future is clinical trials, getting participation is clinical trials, getting more Black physicians to be PIs in clinical trials, that all of these things come together, but you're expressing the barriers.

You had the population. You had the skill set. What is the step that needs to happen as we talk about the state of Black health and what we can do?

What has to happen for clinical trials to be operated by Black physicians as PIs and for the participants, the Black community, to be able to participate in these clinical trials and feel safe and trusted? It goes back to what Sharita said earlier. It, it's not It's more than just sitting at the table, right? There, there's a sitting at the table, but there's also when you talk about leadership. Yes, yes. And do you have the leadership at your biotech company, at your pharma? Do you have the leadership that finds it's important? Because now that the FDA, right, we were moving towards this, the equity goals for all trials, that's been dismantled.

And so but it still doesn't mean that people don't do the right thing. The problem is some people won't do the right thing unless they're forced- and made to do the right thing. I'm gonna come up and totally- Can I say one thing? Oh. Yes. I'm just saying. Sorry. But go ahead. We're all off the script, buddy. We're rambling, right? Some things must be said. I'm just loving it. Yeah, yeah. No. Some things must be said. There's gonna be an amen corner over here. Yeah, amen. I'm saying it's, it's women's history, so the sisters get to speak. It's ladies first. We're taking over.

Go ahead, Sharita. Yes, please. Yeah, let me just add one thing. I think to Dr. Lawson's point, too, we shouldn't be counting on Black PIs to reach out to us as sponsors. We need to actively be seeking out Black PIs. Yes. We're actively going to sites. We're actively taking inventory to say, "Where are our patient populations at?" Because if we're putting trials where the patients are not, where if we have a multiple myeloma study or we have a sickle cell study and we're in an area where there's no Black patients, what are we doing?

Yes. So those are the things we also have to do in industry is be- make sure that we're seeking out the right leaders, the right patient population. Can we get a amen on that? Amen. Amen. Amen. Yes. One additive point, I think that we're focusing on the clinical trials when we need to be also focusing on the needs of the community first. And I say that from the perspective of we, we are in the community, we're in the hospitals, we're treating the patients. If we're looking at the trends within our own academic institutions and saying, "We're seeing an increase..." Because I can tell you right now, launching in the lupus space, launching in the, the renal space, launching into all these spaces, we knew in our community we had a kidney issue a long time ago- Yeah before the drug companies even came around.

So I think it is also in But we knew we had a lupus problem before lupus treatments came around, right? And so when we began to look at clinical trials, I'm gonna sp- specifically focus on lupus right now, we did not have the representation of Black patients in our clinical trials early, within the clinical trials. But we knew we had that problem. So I think we need to be anticipating and saying what is needed in our community. What are the top three diseases that we see we have gaps in? And we should also be advocating if a trial doesn't exist, we need to make the case that it needs to.

And we need to be bringing that level of excellence and data to the table, to the organizations, to the industry to say, "What now are you doing?" It shouldn't be them coming to us all the time.

It should also be us saying, "What are you going to do in this marketplace?" And I think- that that way we'll be front of mind, and we'll also establish ourselves as a subject matter expert, and they will have to come to us- to ask us what it is they should be doing before they even design the clinical trials in the first place. So I think- Well, yeah those are the things that it, it's bottom up and not top down. Well, let me ask you this, not to put you on the spot, but so we want to bring it to people and say, "Start a clinical trial." Who are the people? Who do we bring it to in the industry?

Well, we bring it to our own IRBs, to the institutions. We look at our data. We go to- Okay I can tell you the community health worker program, I live in Houston, so within Houston, we have Prairie View, we have, we have U of H, we have Baylor, UT. We have all of these health institutions, per, TSU. and so what I'm seeing happen, which I think is beautiful, you're beginning to get the data from the ERs. You're getting the data from- from the health, from the community, and we're They're working and putting together focus groups to begin to talk about what are the core, why, why is my community so sick?

Why are we getting people from the refinery cities of Texas City that are now showing up with cancer at MD Anderson? So they're having roundtables with industry, with the academic institutions- Got it and really saying, "This, these are case needs," and they're bringing that and bringing industry- into their problems.

Bringing them into the table. And then we're finding solutions. Bringing them to the table. Great. Dana, before I move on, you said you wanted to make another point, so I'm gonna let you, let you have a moment and everything, 'cause I was gonna ask you already, what are the 1% actions? We're talking about, habits earlier. I know 1% actions, it takes me back to Atomic Habits. I don't know if anybody else read that book. Absolutely. so when you talk about the 1% actions, related to it, what are those 1% actions? And tie that into your point. You know, we touched on some of them already this morning, and then I, I just, you know...Can't stress health literacy enough we need to educate people about their options.

All of their options. And I, I think that is a big gap in, in wellness for the Black community. if you do not know the names or, or about your disease, or the different opportunities are available to you, you don't know the right questions to ask your doctor- Mm-hmm. Mm-hmm when you walk into the office. And so they give you, you know, the, what they think is easiest for you- Mm-hmm when maybe you are willing to take more a, a risk profile, because it fits with your lifestyle. So these are the conversations that need to happen, around shared decision-making, and you need to have that, that bravery as a, as a patient to go into the office and just ta- ask questions.

So that's one piece. Mm-hmm. You need to understand what questions to ask, and I think we could do better as a, a community- Community.

Yes to really arm people with those questions. Mm-hmm. And then three, it, it starts at home, and it really does start around the dinner table. And, and I think there's a lot of shame, around talking about your health- in the Black community and- Yeah in talking about things like screenings and illnesses, and, and we can take that stigma away at our dinner tables every night. Yeah. And those simple actions can build a, I think, a community, a family, and a framework that I think can have lasting impact. Exactly. I know I wanted to talk to you, Megan, about those patterns and pattern recognition when it comes to mistrust in the community.

And Dana, you bring up something that, we talked about a lot on Black Doctor at the holidays in particular, having the conversations around that Thanksgiving table. Like, skip learning the TikTok dance. Do something that really- Yes means something at the holidays and find out, what did, what did Auntie pass away from? Big Mama, whatever. Like, don't just say she had the sugar. Like, what was it that she had, right? you know, and those are the kind of serious conversations though where we know someone passed away, but we don't know of what. We don't go to our primary care doctor, and when they ask us to fill out the family history, and they say, "Do you have anyone in your family who died of breast cancer or this one?" And you don't know what the family lineage is.

We don't know. We skip it. Can't we do that at the family reunion? Can't, can we do that at the family reunion?

Skip the TikTok dance. Absolutely. What can we do at the family reunion? Megan, tell me a little bit more about that and the patterns that are there along with it. Absolutely. So I think Dana makes a great point, right? Because often we do talk about our bad experiences. Yes. Yes. And those often take precedence over talking about just the facts. But when we talk about pattern recognition, it often is about those unfavorable experiences with the healthcare system. It's rooted in lived experience though, and we have to also acknowledge that. If your lived experience is with a system that didn't listen or believe your concerns, as so many Black women have experienced, or a system that bounced you around, and you didn't get answers, and you felt like no one was working with you, but they were working against you, we have to think about that.

And when I was at the bedside, I sat with families who were making incredibly complex healthcare decisions, and what struck me wasn't the lack of effort on the individual level, it was the exhaustion. The exhaustion of navigating a system that was never built with them in mind. And I think our Black communities have shown extreme resilience, but that should not be the business model of our healthcare system. We have to acknowledge the patterns, that they did exist, and then we have to start thinking about how do we redesign the system? And I think this is a point that all of us have made so beautifully already is that all of us sitting in this room, we have extreme privilege.

That's part of the reason why we're here. So when we go back out of this room, and not just to our jobs, not just our corporations, our organizations, but when we go back to our communities, we have to start that redesign together. We have to reshape those patterns. Yeah. There's, there's a lot there. There is so much to unpack there, and you're absolutely right. It starts with us, and that was a carryover from Dr. Aluko too as well. everything, the habits begin with us. The choices begin with us. And what we shape and what we show within our households as well. Dr. Lawson, can you speak on that?

Sure. Frame it- Yeah for me, what you want me to say. Yeah. No, I'm just saying, see, the, the personal, the personal responsibility I guess that go into shaping, breaking these generational patterns. You know, when you see the, the family lineage, and you see it being carried on, you know that 10-year-old didn't buy that fast food or make those choices. No, no, we're, we're quite clear. I mean, this is a constant day-to-day thing. We know that especially in this day and age, you know, I see a lot of adolescent girls, and, they don't really even eat what their mothers cook, right?

They're ordering DoorDash, they eat what they want 'cause we're struggling. You know, we're seeing such high rates of obesity, which leads to other things. That's body image, depression, so you see all of these things. And so but I think the big point here is to understand there's the interpersonal piece, and then there's the systemic piece, right?

So, you know, I'm dealing in both, right? From a systemic level when you talk about Black American, s- there's been research that's shown, multiple research papers, the two most important things we can do to establish trust for Black America is making sure there's enough And I'll, I'll even expand beyond Black America. Okay. I'm just gonna say minority populations- Mm-hmm is racially concordant or ethnically similar physicians. Okay. There's certain things culturally you don't have to, to skill up on, right? I get your Black hair and your Black skin. Right? And so there are certain things.

We know that that's one of the most important things. Only 6% of doctors in this country are Black.I was yes- yes- just yesterday, a woman told me, "Well, I wanna get me a doctor who graduated from Meharry." She lives in North Carolina. I said, "Ma'am, ma'am- there are 6% of doctors in this country. You could be looking for a doctor for a long time." "Just because you, 'I've just decided, I'm gonna get me somebody that went to Meharry.' Ma'am." So we have to understand that there is not enough of us to go around, number one. Yeah. But it's an important thing, so at every level, everyone here should be thinking about what these school loan caps mean, right?

Across all the healthcare professions. Yes. Yes. Dentists, doctors, we should be thinking about that. And then the second thing is bias training. So when we talk about the two things that could help establish trust, it's been bias training and ethnically diverse clinicians and healthcare workers.

I live in Te- we live in Texas. Implicit bias training is illegal there. So when you think about the strides we were trying to make, and we have been making, and you look at And, and mind you, I don't even think it's now in this administration. For me, ever since the Supreme Court overturned affirm- things have been unraveling, right? And so we have to recognize that, and then do what you say you're gonna do. We still haven't gotten our 40 acres and a mule. So how do you expect me to trust you at the system level when you haven't done what you said you were going to do?

And so all of these things I- I'm just speaking are just so, so, so important. So there's interpersonal pieces, and then there's systemics pieces. And my, my point is, we can't just be here. We have to work both. We have to take this in a multifaceted approach. If I, if I can add to that. sorry. Absolutely. Absolutely. I knew you would have something. It, it's so important, right? So I li- Yeah I'm live in the city of Chicago. And there is a horrible, horrible gap in life expectancy in the city of Chicago- from one side of the city to the other. So I live in the, in the Wicker Park.

It's like West, West Gal- Garfield area. From that area to downtown Chicago, the life expectancy of the residents is something like 20 years difference. 20 years of And it's only maybe five miles, if that. Oh, wow. So I don't think we can have this conversation without talking about access- Mm-hmm and systems at the same time. Yeah.

Where are the hospitals? Do they provide care? Yeah. Are they trusted in their community? Are they active in their community? Because that's, that's absolutely ridiculous and, and that kind of healthcare disparity is something that we should all be angry about as, as citizens, not just Black people. Everyone should acce- have the access to, the same access, not just looking for the doctor from Meharry because you trust them. You know? I should be able to find that doctor down the street at my hospital and- Yeah, absolutely let's ask why I can't. We should have that same access, right down the street.

Five miles, life expectancy. You're absolutely right. That's a systemic problem. That's not something right there, that's just by accident. so Megan, I wanted to come to you a little bit and talk about, when we talk about it's the bottom up. It's the, you know, flipping the model, that sort of thing. There's upstream and downstream investments that come into play here when we're looking at this from a public health perspective. Tell me a little bit about what needs to happen from both of those directions to be able to make a difference, at least to start. Absolutely, and I think we've covered it, right?

I think we've covered it on this panel. I think the fireside chat covered it. When we talk about upstream and downstream in public health, we think of downstream a lot when we talk about health. We think about emergency rooms. We think about hospitals. We think about treating chronic conditions.

But we need to think about that investment upstream across the patient continuum, across the lifetime of what does it mean to get screenings on time? What does it mean to get preventative care? What does it mean to invest in communities and not expect anything in return? So I think when we think about upstream and downstream investments, they're both important, but we really have to start seeing that we're increasing our upstream investments to let communities know that we're here to support you holistically and throughout the patient ecosystem. Interesting. No, absolutely.

And one thing we didn't touch on, and I, I wanted to bring it up, when we hear so much about, we talk about Dr. Google. We talk about all of those things. You know, we always hear now about AI and AI in health, and everyone's talking and getting their answers now from ChatGPT. Sharita, how does AI play into healthcare? Yeah, I would- And, and if you could also add in your final thought as we wrap up this session. All right. Well, thank you very much. So I would say AI, of course, is the, the hottest topic that you're, you're seeing right now, and I think that, very much so it fits.

It should be something that we're talking about, we're thinking about. Patients are using AI now to, it's replacing probably Google in some cases, chat, with chat. and so I think it's, it's quick, it's fast, it's easy. But I will tell you, NM- NAACP has done a fabulous job. If you have not seen it, they just put out a 75-page publication with industry around, removing health equity bias, with AI.

And I think it's something we should all take a look at. But it's really highlighting the fact that AI has a role to play. It's going to be huge, as it relates to efficiencies, as it relates to identifying patient, looking through patient profiles and charts that are relevant for clinical trials.Um, it's going to be helpful for creating cul- culturally competent resources fairly quickly. I know where we're using it is looking at landscape assessments before trials even take place to really understand about the communities before we even show up. so there's just a lot happening.

I think the area that we have to continue to look at is garbage in, garbage out. If we don't have the data to feed the agi- AI engine as it re- represent to represent our- ourselves, we're going to have to put some added oversight as it relates to, looking at the formulation of, of really pulling out bias, in the system. one of the areas that I think we should also take a look at too that within the tech space, there it on- in leadership, there's less than, 4% of representation, of African Americans in the tech industry as a whole. So as we look at the industry of healthcare, we need to make sure that we're at the table, HCPs, nurse practitioners, 'cause I have to throw that in there.

Nurse practitioners and the community in roles, and oversight committees that begin to work with the tech companies to begin to ensure that our data is in there. so I think those are some areas that we should take a look at as it relates to AI.

Thank you. And I'm gonna go to Dr. Lawson to, to also wrap up with her last thought, but I know d- I know you wanna piggyback on that in terms of the racial bias. Well, yeah. Yeah, so certainly from the National Medical Association, one of my presidential platforms has been digital health equity, and so I'm thinking about it, whether it's data, whether it's AI, or even these digital tools, right? There is so much coming at people. and then the data, the, the integrity of the data. Many companies now, they're using predictive modeling. You don't even know it. You don't know it.

When you get your drugs filled, when your insurance Everybody is using these models. They're using t- to help people identify who should be going where, what they should be doing. But the And I'm con- so concerned. Bias is a huge issue for us. Almost every medical organization, AMA, everybody's on board with that. The systems, who's building these systems and what that means, the data consumption around it, the integration with the EHRs, right? That data, they sell that data for people. Companies buy it. And so we've really It's a, it's a really big deal. You know, my concern, again, is the health equity piece of that.

Who's gonna get left out? So here we are talking about just health literacy. Who's gonna get left out? Now you gotta talk about digital health literacy because what I see with my patients in the community, they're just blindly typing in stuff in the ChatGPT and getting back, like she said.

ChatGPT can't see you, touch you, feel you. They ain't spoke to you. Your data's not in there. Mm-hmm. Your data's not in there, and so it's dangerous. And so it's highly concerning for us as doctors what people are doing to guide their decision-making processes. I mean, some of it I find almost predatory. It's predatory, and certainly from a women's health perspec- Women are extremely vulnerable, right? Now it's the menopause revo- revolution. It's the PCOS. It's all And, you know, menstrual. People can't even, don't even know how to count them as, without checking with ChatGPT.

So I'm highly concerned on what it's doing, but women are especially, especially vulnerable. Wow. Wow. Just wow. Yeah. Thank you. And we really are right at time, but I'm gonna let Dana go, and I'm gonna let Megan have the last word real quick. So Dana, just a one last final thought before we wrap up. I don't know how you follow that, 'cause that's a warning. I know. That's a warning we all have to heed, really. We really do. Honestly, I mean, there's so much to unpack here. But I think my final thought is just reemphasace- reemphasizing shared decision-making. It, it, is a community.

It, y- you need your doctor. You need your family. You need to think about the caregivers who are taking you to the doctor, how to support them, how to create flexible options for them, and if we can make those small actions, I think we can have huge impact. I love that. And Megan- All right. we're here to talk about breaking generational- We're here patterns, state of Black health.

I'ma wrap this up. What's your takeaway? Yeah. One theme. So my one takeaway is this: We have to move from episodic care to lifetime partnership across the patient care continuum because episodic care is rescue, and generational health requires infrastructure. So when we leave here today, we have a job to go out to build that infrastructure. Thank you. Thank you. All right. I told you guys it was gonna be powerful. The ladies brought it with the ladies first. All right. Thank you, everybody.