00;00;00;25 - 00;00;11;06
Liz Kay
Hello and welcome to the Providence College podcast, I'm your host, Liz Kay, and I'm joined by producer Chris Judge of the Class of 2005 here in the Providence College podcast. We bring you interesting stories from the friar family.

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Liz Kay
Black History Month has begun, and this year's theme, established by the Association for the Study of African-American Life and History, is Black Health and Wellness. It's the perfect time to talk with Dr. Aisha Scott, an assistant professor with a joint appointment in black studies and health policy and management.

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Liz Kay
Scott joined the faculty in the fall and earned her doctorate at Stony Brook University, studying the history of race and medicine. Her research focuses on how black communities in the United States were and continue to be distinctly affected by the HIV aids crisis due to long term health care disparities.

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Liz Kay
Scott's work has now expanded to include disparities fueling the COVID pandemic as well. Dr. Scott, thank you so much for joining us.

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Dr. Aishah Scott
Thank you for having me.

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Liz Kay
So how did you first get interested in your research topic?

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Dr. Aishah Scott
Interestingly enough, what sparked my interest in AIDS research in the black community was that I took a course in undergrad called AIDS Race and Gender in the Black Community, a place that I have now taught many times over still very full circle for me.

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Dr. Aishah Scott
And I was astounded at the statistics that African-Americans accounted for nearly half of new infections since the mid-nineties. And you know, for some of my parents, actually before I was even born, volunteered with the early in New York City AIDS Task Force, and they told me stories about their experiences so that I was stunned that I had

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Dr. Aishah Scott
no idea that HIV aids was still a relevant problem in the 2000. Certainly, I thought of it as an issue of the 1980s of the 1990s, but not at present moment issue, and it's currently still affecting black and brown populations at disproportionate levels.

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Dr. Aishah Scott
So for me, it prompted me to start asking some new questions like when and why did the HIV aids epidemic brown and what forces allow the African-American community to be ravaged by this epidemic for nearly 40 years now?

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Liz Kay
So can we talk a little about that? What are some of the disparities? What what are some of the differences that have led to this in the community?

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Dr. Aishah Scott
So what we situate this in the moment that this started, right? You know this in the early 1980s and we're coming off of not quite the heals, but there've been about a ten year gap between the civil rights movement that was ideally supposed to serve as a bridge to equity along the American color line by doing more

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Dr. Aishah Scott
than quelling rampant violence and inhumane treatment of African-Americans. But these gaping disparities in employment, education, housing and health care persisted despite the corrective legislation from the 1960s and then the 1980s had a perfect storm of converging crises. There was a divestment in social welfare programs, increased unemployment in the early eighties and subsequently increased poverty that disproportionately impacted

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Dr. Aishah Scott
communities of color. This turn of events created a ripe environment for the almost simultaneous onset of the triple epidemic of crack cocaine, mass incarceration and HIV aids and black communities that were left vulnerable. five Disproportionate poverty.

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Liz Kay
Now, when we turn to talk about COVID and we started talking about this in the spring of 2020, it feels like there was recognition that communities of color were disproportionately affected by the pandemic. And can you talk a little bit about why that might be?

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Dr. Aishah Scott
It's interesting because some of the answers to this are obvious, and while others are less obvious, you know, W.E.B. Dubois conducted a study in the early 19 hundred that held if we controlled for poverty, that racial health disparities would disappear and black, Latino and indigenous communities experience disproportionate poverty when compared to their white counterparts, and low and

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Dr. Aishah Scott
low income translates into increased risk factors for contracting COVID and negative health outcomes. These increased risk factors include a higher probability of having a job that you cannot work remotely living in multigenerational households, limited access to health care and a higher likelihood of having one or more co-morbidities.

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Liz Kay
And the co-morbidities question. You kind of would imagine that most of the many of those would be abrogated and aggravated if without access to any health care, right? So that if you have high blood pressure. But if there it's uncontrolled high blood pressure, that's likely to be more of a problem with black.

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Dr. Aishah Scott
And people who are not connected to regular health care and have primary health care. Physicians who are monitoring their health over time are less likely to know when they have underlying conditions because often people are not finding out that they have issues until it's manifested in a way that they had that hospital.

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Dr. Aishah Scott
And then they. Find out that they are, and at that point, you're further along in your illness as opposed to if you went for your yearly checkup in your blood pressure starting to be elevated. Now it puts you on medication to regulate and control it before it becomes uncontrolled and starts doing damage to your heart and into

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Dr. Aishah Scott
other parts of your body.

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Liz Kay
And the same with things like diabetes or asthma.

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Dr. Aishah Scott
Which black people are definitely disproportionately having for health outcomes from those diseases. Even without food, let alone.

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Liz Kay
And is it that the incidence of things like diabetes and high blood pressure are greater in these communities? Or that the that there's less like? There's a lower likelihood that folks will be able to get the treatment that they need or regular treatment, consistent treatment?

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Dr. Aishah Scott
It's both of those things. So there is higher incidence, but there's also less access to health care. So. And also just not the same quality of health care. And when we're talking about lower income communities, generally, you look at typically won't.

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Dr. Aishah Scott
If we look at the certain central Brooklyn and in New York, there are a lot of people who are living in communities that have filling hospitals. And you know, if that's the case, then how were you able to rely on local health care when you don't trust the local hospital?

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Dr. Aishah Scott
You know, and that's one example of many that I'm sure exist across this country. But you know, people have to be able to trust that an investment is being made into their health. And that's part of where I'm sure we'll get into this a little bit more down the line with some of the distrust hands for black

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Dr. Aishah Scott
and brown communities we'll watch for decades as there haven't been much investment in public health infrastructure in their communities. And then all of a sudden, you know, there's a pandemic and we see that there is an ability to invest in public health infrastructure.

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Dr. Aishah Scott
And all of a sudden we can have mobile busses and pop up vaccines like a possibility that you can invest in the public health of these communities. You just have not. So, you know, this creates a sincerity issue in terms of trust between medical institutions and black and brown communities.

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Liz Kay
So, Dr. Scott, could you tell us a little bit about some of the lessons that were learned with the AIDS epidemic and how those might be helping with the COVID response?

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Dr. Aishah Scott
So back in 2019, I wrote that ultimately a cure for HIV aids can be found tomorrow and a new disease would emerge. Rigging the same havoc on the African-American community because of the structural racism that prevents access to necessary resources have not been addressed.

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Dr. Aishah Scott
And little did I know that these was less than a year away. With the onset of COVID 19 disproportionately impacting black and brown communities. Both COVID 19 and HIV aids have shown that closing gaps in access to affordable housing and health care are critical to combatting vulnerability and disproportionate negative health outcomes and black and brown communities.

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Dr. Aishah Scott
If we want to break down the issues of medical distress that begins with long term commitment and investment in these communities, and you know, as I was saying earlier, you know, you show up with mobile busses giving out vaccines and hundred dollar gift cards in the middle of a pandemic after decades of public health failures in underserved

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Dr. Aishah Scott
communities. Will be people who question the severity of those efforts. And the lesson that I hope we learn from COVID that we didn't learn from HIV aids is that we have to address the social determinants of health. If we want to protect the most vulnerable.

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Dr. Aishah Scott
And when I say social determinants of health, what I mean is economic stability, education, access, health care, access, safe living environment and housing.

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Liz Kay
It doesn't seem like those are things that could be addressed quickly took it took a long time to get to where we are now with these longstanding disparities.

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Dr. Aishah Scott
And I think that we have to make a conscious effort to start because we're 40 years in on HIV aids and, you know, we don't want to turn around. And you know, if this if COVID becomes endemic, we don't want to be here in 30 years having the same conversation about HIV aids and COVID and how it

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Dr. Aishah Scott
disproportionately impacting these communities. You know, we want to if we want to really start addressing the vulnerability of black and brown communities, then we have to start making conscious efforts to address the the systemic problems. And definitely, there is no quick fixes to this and there never will be.

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Dr. Aishah Scott
So we have to kind of just jump in and get started.

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Liz Kay
When vaccines first became available. There are a lot of headlines about lagging vaccination rates, and I think this kind of goes towards what you were saying about trust. Lagging vaccination rates among BIPOC communities, though, when I was looking at the data, it looks like the number of the percentage of black and white people who were receive vaccinations

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Liz Kay
were similar, at least as of November. That was the latest data that I could find. Can we talk a little bit about some of the reasons for vaccine hesitancy in black communities and what have been some successful ways to combat that?

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Dr. Aishah Scott
Bear with me here because the answer to this is complex and multilayered. But the early conversation about vaccine hesitancy among black people in the United States largely centered on the longstanding distrust between the black community and medical professionals for both historical and continuous neglect and experimentation due to systemic racism.

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Dr. Aishah Scott
You know, classic examples of this legacy date back to Dr. Marion fans experimenting on gynecological procedures. Honestly, black women, the Tuskegee experiment from the 1930s, where nearly 400 black men with syphilis were lied to and denied proper treatment for 40 years, the harvesting of the famous HeLa cells used to create the polio vaccine, among other things, from

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Dr. Aishah Scott
Henrietta Lacks, without her or her family's consent. However, historical memory is not the only source of this distrust. The current lived experiences of black people with medical professionals inform the current state of relations with the black community. Currently, black women are three to four times more likely to die during childbirth than their white counterparts, and the mortality

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Dr. Aishah Scott
rate of black babies are cut in half when the doctor is not caught. It's also black pregnant. Black women often find their voices pain and concern ignored by medical providers. Even tennis superstar Serena Williams found her voice ignored in a near-death experience following a C-section with her daughter and due to a history of pulmonary embolism.

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Dr. Aishah Scott
She warned a nurse of her symptoms and insisted she needed a CT scan. The nurse initially ignored her claims, but Williams continued to advocate for herself until, like Doctor, ran the scan and found several blood clots settled in her mind.

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Dr. Aishah Scott
And Williams story shows us that notoriety, income and gold star health insurance does not save black women from implicit bias and structural racism, while warranted distrust of medical professionals due to historical and contemporary instances of bias and neglect to the black community certainly impacted early vaccine hesitancy.

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Dr. Aishah Scott
I believe this narrative was also exploited to create a myopic view that most black people did not want to be vaccinated and lacked understanding of what the vaccine would mean for protecting themselves and their loved ones. However, data from the Pew Research Center told us as early as March 2021 that black adults in the U.S. across the

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Dr. Aishah Scott
board had heightened concerns regarding COVID 19 compared to the rest of the population, with 94% of black respondents wearing masks in public spaces. In fact, 61% of black adults surveyed said they would get vaccinated, lagging than the national average by only 8%, which is more consistent with what we're seeing right now in terms of data with vaccination

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Dr. Aishah Scott
. Nonetheless, we saw consistent reports that vaccinations in black and Latinx communities across the country were significantly lagging their white counterparts early on. While vaccine hesitancy surely accounts for a fraction of this disparity, it was also used as a scapegoat to avoid the more pertinent and costly task of tackling socioeconomic inequalities.

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Dr. Aishah Scott
Pediatrician and public health advocate Dr. Ray Boyd penned a New York Times article last night on why people need better vaccine access, not better vaccine attitudes, and gave an interview where she highlighted unequal access to broadband internet phone service.

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Dr. Aishah Scott
Regular health care providers, health insurance and resident proximate pharmacies as being at the root of low vaccination rates in black communities. Vaccine hesitancy provided a public narrative that pathologize black people as responsible for being disproportionately under vaccinated, as opposed to highlighting the systemic gaps that prevented equal access to the vaccine.

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Dr. Aishah Scott
What changed over time with access to the vaccine vaccine safe, open and trusted spaces in communities like churches? They also began began taking Walk-In Patients, which helps people circumvent the broadband internet access and sometimes phone access, and operate it for longer hours and weekends for those who were unable to take off from work between 9:00 a.m. and 5:00 p.m.

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Dr. Aishah Scott
. Additionally, state leaders began tapping members of the community based organizations like the National Commission on AIDS to serve as a bridge as a bridge to underserved communities. The president of that organization, Jermall at Home, was tapped in New York City to be part of the vaccine equity task force.

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Dr. Aishah Scott
So having people that trusted in these communities on this task force also build trust in what these efforts are trying to accomplish. And the National Black Leadership Commission on Health, formerly known as the National Black Leadership Commission on AIDS, has distributed over two and a half million masks and hosted over 2000 thousand events in black and brown

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Dr. Aishah Scott
communities to increase awareness about the COVID vaccine and ways to protect yourself. So as outreach methods more closely aligned with the needs of the community, vaccine inequality began to shrink.

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Liz Kay
Now, I mean, I think anyone who spent time last year refreshing and refreshing screens and anyone who's doing it now, trying to get either getting a vaccine appointment at a time or a booster shot or now in Rhode Island.

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Liz Kay
As we're trying to get testing, find those few appointments and schedule them can empathize with the value of broadband internet and and and having you know, the time and the bandwidth to be able to try to get these resources.

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Dr. Aishah Scott
I mean, I over the holidays, I I stood on line with my father waiting for COVID tests for about five hours outside in New York City. So, you know, it's it's really. It can really be a barrier, and, you know, my father is about to be about to turn 70 years old.

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Dr. Aishah Scott
That's a lot for someone to have to stand. We have to take charge so he can go, sit down in the car and warm up because this is like 20 degrees, right?

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Liz Kay
Right. I mean, this is not, you know, I feel like I read a similar New York Times op ed that said that if there were if they were lagging vaccination rates in low income communities, it was because compared to high income communities, you know, the South Bronx versus the Upper East Side, it's because COVID was not the

00;16;47;24 - 00;17;00;29
Liz Kay
biggest health care and the biggest crisis that folks in these communities are dealing with. Like if you're if you're trying to struggle between paying the rent and paying the grocery, you know, buying groceries, then COVID rank somewhere lower down on the chain.

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Dr. Aishah Scott
And that is another correlation between HIV aids as well. There is a out magazine published an interview of a young man named Ty Fortner, who contracted HIV as a young man in his late teens, really because he was a sex worker.

00;17;21;17 - 00;17;39;26
Dr. Aishah Scott
And then once he. Once he found out that he had HIV, he learned about housing assistance program, but you had to have an AIDS diagnosis in order to qualify for this. And he purposely sabotaged his health in order to qualify for this housing program.

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Dr. Aishah Scott
And it sounds like so absurd, right? But when you talk about people being in a space where they're not sure where they will be sleeping tomorrow, talking to them about a disease that might kill them in 30 years, you know, there's different there's different weights here of of what's most important in this moment.

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Dr. Aishah Scott
So what we need to do is make sure you know, one of the reasons why I drive home on this point of addressing social determinants of health. You know, if this young man had been given access to resources when he first became unhoused, then he may have never even encountered HIV to begin with, you know.

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Dr. Aishah Scott
So this is where we have to start talking about, do we actually care about making sure people who are vulnerable are protected? Because if we do, then we have to start doing that work?

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Liz Kay
Dr. Scott as a scholar of Black History, What does Black History Month mean to you? How do you hope that people will reflect on the month and its theme of Black and health, public health and wellness this year?

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Dr. Aishah Scott
So as a father of Black history, I appreciate the existence of Black History Month because for some people, that is the only time they hear about black history, which is unfortunate considering how intertwined American history is with African-American history.

00;18;50;11 - 00;19;08;29
Dr. Aishah Scott
You know, from slavery to reconstruction, Jim Crow, the civil rights movement of the 1950s and sixties, the Black Power movement in the 1970s, it's hard to imagine that something you hear about black history in February. But my hope is that we get to a point where we don't need a Black History Month because it has permanently and

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Dr. Aishah Scott
broadly been given its due place in the historical record.

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Liz Kay
Black history is American history.

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Dr. Aishah Scott
Yeah.

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Liz Kay
And what about black health and wellness? Is this an opportune time to think more about that?

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Dr. Aishah Scott
You know, I hope that, you know not to be a broken record, but I hope that people will reflect on the theme of black health and wellness this February that they consider the social determinants of health that leave black communities in the United States and globally.

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Dr. Aishah Scott
Disproportionately impacted by negative health outcomes. You know, I hope they reflect on disparities in education, housing, employment and ultimately poverty and how they converge to manifest these health disparities.

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Liz Kay
Given the the mantra, though, that Black history is American history as a Black Studies faculty member, how do you bring Black History Month into the classroom? Do you do you address it?

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Dr. Aishah Scott
For me, I actually see Black History Month as an opportunity for me to get students engaged in the black experience beyond the classroom because there's so much fruitful programing that's offered at this time. So in classes related to black studies, I have students attend programs of interest to them and reflect on what they've learned.

00;20;14;03 - 00;20;14;29
Liz Kay
And hopefully bring a friend.

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Dr. Aishah Scott
Hopefully.

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Liz Kay
So you'll be offering some programing this this February yourself.

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Dr. Aishah Scott
Yes, I will.

00;20;22;19 - 00;20;23;27
Liz Kay
Could you tell us a little about that?

00;20;24;01 - 00;20;48;09
Dr. Aishah Scott
I will be giving a thought. I'm really getting into some of these, these systemic and social determinants of health that I leave black and brown bodies vulnerable to HIV aids and COVID. And talking about how one, how HIV aids was kind of a precursor to looking at what we what we're seeing manifesting with COVID 19 currently.

00;20;48;28 - 00;21;02;17
Liz Kay
So we will share the information about the winter anti-racism series so that people want to register to hear more about these topics. Think they can go ahead and do that? We'll share that with our our show, notes Dr. Scott.

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Liz Kay
You arrived at PC this fall, so just formal. Welcome to you joining the faculty at you. What were some of the highlights of your first semester and can you tell us about the courses you're teaching this spring?

00;21;12;25 - 00;21;32;14
Dr. Aishah Scott
Sure. one of the highlights from my first semester was certainly student engagement, and I was delighted by the generative class, the discussion discussions where students really took a deep dove on the course material and developed thoughtful analysis. So currently, I'm teaching the introductions of Black Studies course, and I'm also teaching policy analysis for health policy and management

00;21;33;00 - 00;21;36;09
Dr. Aishah Scott
. So I'm excited to see what the students have to offer me this semester.

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Liz Kay
You kind of have both ends, right? Imagining the policy analysis is as upper class students in health policy and management.

00;21;43;15 - 00;21;56;11
Dr. Aishah Scott
Yes. Yes, I have the senior, the juniors and seniors who are preparing to be on their way out and the freshmen and sophomores who are interested in getting the basics. So I have a good mix this semester.

00;21;56;17 - 00;21;58;12
Liz Kay
Interesting conversations in both, I'm sure.

00;21;58;24 - 00;22;01;06
Dr. Aishah Scott
Yes, I'm I'm looking forward. They seem excited.

00;22;01;09 - 00;22;10;09
Liz Kay
The last year's two years have been so difficult for so many people. Could you tell us a little bit about what has helped you personally sustain and persevere through this pandemic?

00;22;10;13 - 00;22;31;24
Dr. Aishah Scott
Sure. The. It is almost I'm almost remiss to say that there have been this profound collective grief that everyone has been going through for loss of loved ones, loss of jobs, loss of way of life. For me personally, you know, COVID hit my family very hard.

00;22;31;25 - 00;22;50;11
Dr. Aishah Scott
Unfortunately, you know, my mother passed away from COVID related illness at the onset of the pandemic in April 2020, and living in New York City at that moment was like living through an apocalyptic movie. You know, it was very difficult to reconcile that the rest of the world keeps going when you have been hit with such a

00;22;50;11 - 00;23;11;06
Dr. Aishah Scott
devastating loss and. I think one of the things that kind of first helped me to not snap out of it but kind of continue pushing through it was that no sooner than people were sending me condolences. I was responding in messages saying condolences back to them within a week or two because it was just a rolling game

00;23;11;06 - 00;23;23;08
Dr. Aishah Scott
of death at that point. And there were three things that helped me push through this space and time. And for me, that was first my faith in God, and that helped me to just kind of think in myself and then.

00;23;24;12 - 00;23;35;14
Dr. Aishah Scott
Has intentionally make time to do things that bring joy. I think that we learned anything from the last two years. You know, tomorrow is not promised. You have to make sure to do things that bring you joy and I keep you centered.

00;23;36;06 - 00;23;50;08
Dr. Aishah Scott
And, you know, really taking, you know, we've been talking health care has been something that I think has become very important talking point throughout the pandemic. And I hope that all everyone is taking time and space to make sure that they take care of themselves.

00;23;51;26 - 00;24;09;14
Dr. Aishah Scott
And there is my parents unwavering support, an example of being changemakers and a voice for those whose other was what rules voices otherwise would be muted in public discourse. And my dad asked me how the book is coming along at least once a month.

00;24;09;14 - 00;24;26;17
Dr. Aishah Scott
So he's making sure that I don't forget that I have an obligation to be part of that as well. And pushing forward for me is also part of honoring my mother's legacy. I know it was part of her expectations for me, so that's how it would help me to push through and what has been definitely one of

00;24;26;17 - 00;24;28;17
Dr. Aishah Scott
the most tumultuous time that I've lived through.

00;24;29;03 - 00;24;49;23
Liz Kay
And I think you hit the nail on the head with that, that shared grief. You know, we're all I can't think of another not a historian, but I cannot think of another time when the entire planet. Everyone on this planet has been touched in some way by some sort of loss or change.

00;24;49;24 - 00;25;03;09
Liz Kay
So it is it is really astounding. And I'm so sorry for your loss. Dr. Scott, it's been wonderful chatting with you today. Thank you so much for joining us.

00;25;03;18 - 00;25;05;20
Dr. Aishah Scott
Thank you so much for having me. It was a pleasure to be here.

00;25;05;28 - 00;25;17;12
Liz Kay
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