The intersection of health and community advocacy | Joseph Ravenell | TEDxGeorgeSchool

[Applause]

[Applause] there’s something special about being in

there’s something special about being in

there’s something special about being in the presence of someone that you trust

the presence of someone that you trust

the presence of someone that you trust in a place that you trust trusted people

in a place that you trust trusted people

in a place that you trust trusted people and trusted places those are safe havens

and trusted places those are safe havens

and trusted places those are safe havens I was fortunate to have many such places

I was fortunate to have many such places

I was fortunate to have many such places in my life as a child growing up aside

in my life as a child growing up aside

in my life as a child growing up aside from my family home the barber shop I

from my family home the barber shop I

from my family home the barber shop I would go I would go see with my dad

would go I would go see with my dad

would go I would go see with my dad where I would see tons of friendly faces

where I would see tons of friendly faces

where I would see tons of friendly faces and acquaintances the Quaker

and acquaintances the Quaker

and acquaintances the Quaker meetinghouse here at George school where

meetinghouse here at George school where

meetinghouse here at George school where I would see many of my friends who were

I would see many of my friends who were

I would see many of my friends who were going through the same period of angst

going through the same period of angst

going through the same period of angst discovery and uncertainty that I was

discovery and uncertainty that I was

discovery and uncertainty that I was going through and with my parents being

going through and with my parents being

going through and with my parents being pastors of a close-knit mid-sized

pastors of a close-knit mid-sized

pastors of a close-knit mid-sized congregation the church was always the

congregation the church was always the

congregation the church was always the most prominent of these safe places the

most prominent of these safe places the

most prominent of these safe places the church holds special significance for

church holds special significance for

church holds special significance for many African Americans because it’s a

many African Americans because it’s a

many African Americans because it’s a place in the community where we can get

place in the community where we can get

place in the community where we can get one-stop shopping for maslow’s full

one-stop shopping for maslow’s full

one-stop shopping for maslow’s full hierarchy of needs because of my parents

hierarchy of needs because of my parents

hierarchy of needs because of my parents pastoral commitments I’m confident I

pastoral commitments I’m confident I

pastoral commitments I’m confident I have no doubts that my brothers and I

have no doubts that my brothers and I

have no doubts that my brothers and I spent more time in church than any

spent more time in church than any

spent more time in church than any children in the history of the world but

children in the history of the world but

children in the history of the world but the more time I spent there the more I

the more time I spent there the more I

the more time I spent there the more I learned to enjoy it and I finally

learned to enjoy it and I finally

learned to enjoy it and I finally succumbed to the very strong temptation

succumbed to the very strong temptation

succumbed to the very strong temptation to join in and and participate all of

to join in and and participate all of

to join in and and participate all of these places the barbershop meeting for

these places the barbershop meeting for

these places the barbershop meeting for worship the church there were places

worship the church there were places

worship the church there were places where I felt not only encouraged but

where I felt not only encouraged but

where I felt not only encouraged but also compelled to let my voice be heard

also compelled to let my voice be heard

also compelled to let my voice be heard and to join in to the barbershop

and to join in to the barbershop

and to join in to the barbershop conversation or the meditation at

conversation or the meditation at

conversation or the meditation at meeting for worship or the

meeting for worship or the

meeting for worship or the call-and-response

call-and-response

call-and-response of the fiery sermon by the preacher

of the fiery sermon by the preacher

of the fiery sermon by the preacher or the for the fervent gospel song what

or the for the fervent gospel song what

or the for the fervent gospel song what I loved most about being in those safe

I loved most about being in those safe

I loved most about being in those safe spaces was the affirmation that I got

spaces was the affirmation that I got

spaces was the affirmation that I got from those around me not only because we

from those around me not only because we

from those around me not only because we were sharing the same physical space but

were sharing the same physical space but

were sharing the same physical space but because we were also sharing common

because we were also sharing common

because we were also sharing common values and experiences and sometimes

values and experiences and sometimes

values and experiences and sometimes common struggles and challenges trusted

common struggles and challenges trusted

common struggles and challenges trusted people in trusted places the countless

people in trusted places the countless

people in trusted places the countless hours that I spent in these safe places

hours that I spent in these safe places

hours that I spent in these safe places as a boy had a profound impact on me as

as a boy had a profound impact on me as

as a boy had a profound impact on me as a man and especially as a physician in

a man and especially as a physician in

a man and especially as a physician in addition to providing primary care at a

addition to providing primary care at a

addition to providing primary care at a public hospital I also work on what are

public hospital I also work on what are

public hospital I also work on what are called place-based interventions to

called place-based interventions to

called place-based interventions to adjust health inequities basically we

adjust health inequities basically we

adjust health inequities basically we develop solutions that are meant to be

develop solutions that are meant to be

develop solutions that are meant to be carried out in places outside of the

carried out in places outside of the

carried out in places outside of the traditional medical setting in order to

traditional medical setting in order to

traditional medical setting in order to improve health outcomes we do this often

improve health outcomes we do this often

improve health outcomes we do this often in non clinical settings and it’s

in non clinical settings and it’s

in non clinical settings and it’s carried out often by non clinical people

carried out often by non clinical people

carried out often by non clinical people trusted people in trusted places and I

trusted people in trusted places and I

trusted people in trusted places and I realize that part of what I do is I try

realize that part of what I do is I try

realize that part of what I do is I try to recreate some of my childhood safe

to recreate some of my childhood safe

to recreate some of my childhood safe havens but actually recast them for

havens but actually recast them for

havens but actually recast them for health care delivery and in particular

health care delivery and in particular

health care delivery and in particular health care delivery to minority men in

health care delivery to minority men in

health care delivery to minority men in the United States black men are more

the United States black men are more

the United States black men are more likely than any other group to die from

likely than any other group to die from

likely than any other group to die from certain preventable causes of death

certain preventable causes of death

certain preventable causes of death including high blood pressure and colon

including high blood pressure and colon

including high blood pressure and colon cancer the inequities we see from these

cancer the inequities we see from these

cancer the inequities we see from these causes of death are often due to lack of

causes of death are often due to lack of

causes of death are often due to lack of timely screening detection and

timely screening detection and

timely screening detection and intervention for colon cancer in

intervention for colon cancer in

intervention for colon cancer in particular screening is extremely

particular screening is extremely

particular screening is extremely important for reducing mortality because

important for reducing mortality because

important for reducing mortality because in the screening process we can actually

in the screening process we can actually

in the screening process we can actually detect precancerous growth that can be

detect precancerous growth that can be

detect precancerous growth that can be removed before cancer develops

removed before cancer develops

removed before cancer develops unfortunately black men experienced

unfortunately black men experienced

unfortunately black men experienced lower rates of colon

lower rates of colon

lower rates of colon screening sometimes because of lower

screening sometimes because of lower

screening sometimes because of lower engagement with primary care doctors the

engagement with primary care doctors the

engagement with primary care doctors the doctors who actually make the referrals

doctors who actually make the referrals

doctors who actually make the referrals for cancer screening tests so it’s

for cancer screening tests so it’s

for cancer screening tests so it’s extremely important that we find a way

extremely important that we find a way

extremely important that we find a way to reach black men for screening so that

to reach black men for screening so that

to reach black men for screening so that we can reduce mortality from this

we can reduce mortality from this

we can reduce mortality from this preventable cause of death but there are

preventable cause of death but there are

preventable cause of death but there are well-known barriers to black men

well-known barriers to black men

well-known barriers to black men accessing primary care including lack of

accessing primary care including lack of

accessing primary care including lack of health insurance sometimes the

health insurance sometimes the

health insurance sometimes the perception that if there’s nothing wrong

perception that if there’s nothing wrong

perception that if there’s nothing wrong with me right now I don’t need to go and

with me right now I don’t need to go and

with me right now I don’t need to go and sometimes mistrust in the medical system

sometimes mistrust in the medical system

sometimes mistrust in the medical system either due to historical or personally

either due to historical or personally

either due to historical or personally experienced mistreatment at the hands of

experienced mistreatment at the hands of

experienced mistreatment at the hands of medical providers we found that we could

medical providers we found that we could

medical providers we found that we could actually address and overcome some of

actually address and overcome some of

actually address and overcome some of these barriers with place-based

these barriers with place-based

these barriers with place-based interventions and safe places such as

interventions and safe places such as

interventions and safe places such as black barbershops in Dallas Texas we top

black barbershops in Dallas Texas we top

black barbershops in Dallas Texas we top barbers how to measure blood pressure

barbers how to measure blood pressure

barbers how to measure blood pressure and how to use their influence to help

and how to use their influence to help

and how to use their influence to help their customers get the health care that

their customers get the health care that

their customers get the health care that they needed we realize after a

they needed we realize after a

they needed we realize after a successful randomized trial of this

successful randomized trial of this

successful randomized trial of this concept that what we were doing was

concept that what we were doing was

concept that what we were doing was actually training barbers in the

actually training barbers in the

actually training barbers in the centuries-old tradition of the community

centuries-old tradition of the community

centuries-old tradition of the community health worker community health workers

health worker community health workers

health worker community health workers are men and women without a formal

are men and women without a formal

are men and women without a formal medical degree who are trained in a

medical degree who are trained in a

medical degree who are trained in a specific health related task that helps

specific health related task that helps

specific health related task that helps to bridge communities to healthcare when

to bridge communities to healthcare when

to bridge communities to healthcare when we observed that barbers could be very

we observed that barbers could be very

we observed that barbers could be very effective community health workers to

effective community health workers to

effective community health workers to help adjust the problem of high blood

help adjust the problem of high blood

help adjust the problem of high blood pressure in black men we thought that

pressure in black men we thought that

pressure in black men we thought that other community leaders such as pastors

other community leaders such as pastors

other community leaders such as pastors could actually work in other trusted

could actually work in other trusted

could actually work in other trusted settings such as churches to adjust the

settings such as churches to adjust the

settings such as churches to adjust the problem of colon cancer in black men the

problem of colon cancer in black men the

problem of colon cancer in black men the perfect illustration of this concept was

perfect illustration of this concept was

perfect illustration of this concept was Reverend Theodore Hickman

Reverend Theodore Hickman

Reverend Theodore Hickman and we called him for short Ted Ted was

and we called him for short Ted Ted was

and we called him for short Ted Ted was the pastor of a Presbyterian come

the pastor of a Presbyterian come

the pastor of a Presbyterian come congregation in Brooklyn New York he was

congregation in Brooklyn New York he was

congregation in Brooklyn New York he was an incredibly kind and gentle man who

an incredibly kind and gentle man who

an incredibly kind and gentle man who had this presence and charisma that was

had this presence and charisma that was

had this presence and charisma that was very characteristic of the

very characteristic of the

very characteristic of the african-american preaching tradition Ted

african-american preaching tradition Ted

african-american preaching tradition Ted did not have any formal medical training

did not have any formal medical training

did not have any formal medical training but he was a master communicator and he

but he was a master communicator and he

but he was a master communicator and he had a way of reducing the size of the

had a way of reducing the size of the

had a way of reducing the size of the room no matter how big it was – just you

room no matter how big it was – just you

room no matter how big it was – just you and and and him and he had a way of

and and and him and he had a way of

and and and him and he had a way of identifying men who had been resistant

identifying men who had been resistant

identifying men who had been resistant to colon cancer screening figuring out

to colon cancer screening figuring out

to colon cancer screening figuring out what the barrier was and not only

what the barrier was and not only

what the barrier was and not only convincing them of the need to be

convincing them of the need to be

convincing them of the need to be screened but letting them know that he

screened but letting them know that he

screened but letting them know that he was going to be there with them every

was going to be there with them every

was going to be there with them every step of the way thanks to Ted our Men’s

step of the way thanks to Ted our Men’s

step of the way thanks to Ted our Men’s Health Initiative in New York City

Health Initiative in New York City

Health Initiative in New York City reached over 20,000 New Yorkers with

reached over 20,000 New Yorkers with

reached over 20,000 New Yorkers with cancer prevention education and outreach

cancer prevention education and outreach

cancer prevention education and outreach Ted personally navigated scores of black

Ted personally navigated scores of black

Ted personally navigated scores of black men for colon cancer screening and a

men for colon cancer screening and a

men for colon cancer screening and a randomized trial we found that the men

randomized trial we found that the men

randomized trial we found that the men who talked to Ted were twice as likely

who talked to Ted were twice as likely

who talked to Ted were twice as likely to go get screen compared to those who

to go get screen compared to those who

to go get screen compared to those who receive a standard referral for

receive a standard referral for

receive a standard referral for screening in another study Ted’s showed

screening in another study Ted’s showed

screening in another study Ted’s showed that he as a community health worker

that he as a community health worker

that he as a community health worker could actually communicate knowledge

could actually communicate knowledge

could actually communicate knowledge about prostate cancer screening more

about prostate cancer screening more

about prostate cancer screening more effectively than physicians and he was

effectively than physicians and he was

effectively than physicians and he was equally good at making them feel

equally good at making them feel

equally good at making them feel comfortable about their decision to

comfortable about their decision to

comfortable about their decision to screen Ted was incredible

screen Ted was incredible

screen Ted was incredible a trusted person in a trusted place Ted

a trusted person in a trusted place Ted

a trusted person in a trusted place Ted passed away unexpectedly this summer and

passed away unexpectedly this summer and

passed away unexpectedly this summer and I was surprised by my own reaction to

I was surprised by my own reaction to

I was surprised by my own reaction to his passing I hadn’t realized that Ted

his passing I hadn’t realized that Ted

his passing I hadn’t realized that Ted actually had become one of my closest

actually had become one of my closest

actually had become one of my closest friends and without me knowing it I had

friends and without me knowing it I had

friends and without me knowing it I had made Ted one of those trusted people

made Ted one of those trusted people

made Ted one of those trusted people in my life and because of Ted my

in my life and because of Ted my

in my life and because of Ted my workplace had actually become a safe and

workplace had actually become a safe and

workplace had actually become a safe and trusted place so there’s growing

trusted place so there’s growing

trusted place so there’s growing evidence of the effectiveness of

evidence of the effectiveness of

evidence of the effectiveness of community health worker based

community health worker based

community health worker based interventions and place-based

interventions and place-based

interventions and place-based interventions and Ted showed us why it’s

interventions and Ted showed us why it’s

interventions and Ted showed us why it’s because the people make the place

because the people make the place

because the people make the place community health workers like Ted make

community health workers like Ted make

community health workers like Ted make trusted places portable Ted was able to

trusted places portable Ted was able to

trusted places portable Ted was able to make wherever key was that trusted place

make wherever key was that trusted place

make wherever key was that trusted place so let’s increase the ranks of the Ted’s

so let’s increase the ranks of the Ted’s

so let’s increase the ranks of the Ted’s of the world increase the number of

of the world increase the number of

of the world increase the number of trusted people who are able to make

trusted people who are able to make

trusted people who are able to make trusted places in order to improve

trusted places in order to improve

trusted places in order to improve health and in doing so we can move more

health and in doing so we can move more

health and in doing so we can move more towards our goal of achieving health

towards our goal of achieving health

towards our goal of achieving health equity thank you very much

[Applause]

[Applause] [Music]