Oh, look at that. Okay, welcome Midwest, representing for sure. Fantastic, well thank you. So what that shows us, that's just a small demonstration of diversity. There are so many different layers of diversity that you don't always know them by looking at someone. Like I would not have known this entire room was basically filled with individuals from the Midwest, but now we know. So the reason why we wanna talk about diversity before we talk about health equity is because we really have to have that understanding of how things build upon each other. So what you see here, this is a diversity statement that an organization that I'm affiliated with came up with as an organization to kind of guide the way to what diversity means to them. And if you don't have a diversity statement at your place of work, I would encourage you to create one because it really makes a difference. So what you see here is that diversity is the similarities as well as the differences of people found in our workforce and in the marketplace, but also in the communities that we serve. So diversity includes many characteristics. Some of these characteristics are visible. You know, often the thing that we notice right away is someone's gender and someone's race. Some of them are visible, but there are many others that are invisible. So think about race, gender, appearance, age, but think about some of those less obvious characteristics, things like personality. I don't know your personality just by looking at you. How about ethnicity or ability, education, religion, gender, also sexual orientation or geography, which was just demonstrated, regional differences, work experience, family situation. All of these things are dimensions of diversity, and I guarantee you they impact the way that you show up in the world every day. And I want you to keep that top of mind because that's what we're talking about. Diversity is fantastic. You know, it's wonderful that we're all different, we all have similarities as well, but diversity on its own is not enough, and that's where inclusion comes in. So inclusion is about intentionally engaging human differences and viewing those differences as strengths and in both patients and team members, and that is incredibly important. The key to inclusion is that we value the perspectives and the life experiences of each person. These actions, they build an environment that fosters mutual respect, trust, and commitment. So think about that. So we show diversity in the room, but if we don't find value and strength and appreciation in those things, then individuals don't feel included. It's important to think about those things. Sometimes based on where you're from across the country, people make assumptions about you, things like that, and we'll be talking a bit more about that. So keep that top of mind. So I'm going to, now that we've talked about diversity, we've talked about inclusion, let's take a look at this slide. So just, you can just shout out. What do you see here? The child can't participate. The child can't participate, the person who uses the wheelchair. Very observant. What else do you notice? There's someone back on the bench. I think they're on a laptop or something. What do you notice about the bicycles in this picture? Right, the bikes, if you'll notice, every bike in this picture is the exact same size. It's the same bike. The person who uses a wheelchair got the same bike. It looks like the second person over, it looks like the bike fits her pretty well. But if you'll look at the third person over, that bike is way too big. It looks like it might even be a child, so the bike is too big. And then the poor guy to the very far right, his knees are like, you know, up in his, which can't be very comfortable, right? But this is an example of equality. And you hear equality a lot. Equality is important, equality for everyone, equality for all. But equality is providing the same level of opportunity and assistance to all segments of society. And while equality is good and it's important, there's something better. So what do you see here? Yes, so everyone has exactly what they need. So this is an example of meeting people exactly where they are. Equality is good, but equity is better. Equity is providing various levels of support and assistance depending on the specific needs or abilities to achieve those greater outcomes. So now the person who uses the wheelchair can have a fun day in the park. The poor guy to the right doesn't have to ride with his knees in his chest. So this is equity. So when I talk about health equity, equality is great for everyone, but there'll be some individuals who need a little bit more. And that is where we're headed. So health equity is what we're talking about. And I just wanna point out here that health equity is the attainment of the highest level of health for all people. No matter if you are a person with a disability, no matter if you're black or white or green or whatever the case may be, no matter if you're from the Midwest or the South, but health equity is the possibility that everyone can experience that. It's when everyone has that ability, that when no one is disadvantaged from achieving this potential, and especially because of their social position in life. If you are from a socioeconomic status or if you're a person who experiences homelessness, you should still have the opportunity to have good health. So we'll continue to talk about it. But in order for this to take place, in order for health equity to be available for everyone, we have to remove barriers, barriers that get in the way for individuals in accessing the care they need. And we're gonna talk about some of those barriers. So why is it important for us to even have a conversation about health equity? I think the two pictures that we just saw, that's one example. Everyone can't enjoy life without health equity. But we know that the burdens of disease and poor health and the benefits of wellness and good health are inequitably distributed in this country, unfortunately. We need health equity because we can prevent premature death and improve the misery and suffering of millions of human beings living in this culture. And simply, it is the right thing to do. So I like to share this image of this little goldfish in a bowl. And doesn't he look happy? He's just swimming around. His water is clean. I'll bet someone's feeding him because his little fins look good. So that's his environment. That's where he lives. That's where he spends every day. So imagine for a moment the same little goldfish. What if his owner stopped cleaning the bowl and it starts getting murky and things are floating around in there? Or what if they just stopped feeding him altogether? Or what if it gets a crack in the glass and slowly the water starts leaking out of his bowl? What's gonna happen to the little goldfish? Yeah, he can't survive. He definitely can't thrive, but he can't even survive in that setting. So when I start, we talk about the social determinants of health. These are things in the environments where individuals live that, just like this little goldfish, impacts their health. So the social determinants of health. How many people are familiar with the social determinants of health? Fantastic. Yes, so social determinants of health are all of those things outside of an individual's control, often taking place in the world around them. Things like economic stability, neighborhood and physical environment, education, food, community safety and social context, even healthcare systems. So just look at the first one, economic stability. If someone needs to, if their physician says, okay, I want you to eat right and exercise and take really good care of yourself. But what if they don't even have food? What if because of any number of reasons, they can't afford to feed themselves or their entire family? Health is probably not the first thing on the list. They're basically just trying to survive. But for many, that's important. People go to the ER and they go to get the care and then the doc sends them off with a prescription to go pick up those drugs and do this and take care of yourself. But what if you don't have money to buy the medication? And then we'll go even a bit deeper than that. What if because of bias of the physician, they don't even prescribe the best medicine for their specific condition? They don't have a fair chance at getting better or feeling better. Things like neighborhood and physical environment. We know that probably for most of the people in this room, and I don't wanna assume, but probably for most of us, it's not a big deal to pop into our car, drive to a Whole Foods or a healthy grocery store, pick up all the things we want. But there are many neighborhoods where people live. The only option for food might be McDonald's. If even McDonald's, it may be like a corner store that has honey buns and cinnamon rolls or something like that. There are no fresh food. There's nothing like that that would really help them to thrive. So neighborhood has a major impact. And then there's education. And we know that education is so key. We're all very blessed and lucky to have the ability to obtain education, but there are individuals who generation after generation in their family, they didn't have that opportunity, and that impacts the way they take care of themselves. I know there are many cultures who, if someone gets sick, they're brewing something that they're gonna store in the fridge, and that's how they care for themselves. And think about all of the individuals who, that's just how it's always been from one generation to the next. We know that food insecurity is a major social determinant of health. Just again, like we said, not able to afford food or not even being aware of what is quality and good food. And then of course, there are community systems. There's stress, there's, if you live in a city and you're at high stress all the time, or if you have a job that's high stress, all of these things, just if you don't have income, if you don't have safe housing, if you don't have all of those things, that impacts stress. And then of course, the health system, which is we're gonna talk about healthcare and our role in making sure that we can assist with that health equity. So this is a really good example of what goes into our health. So like I said, only about 20% of our health is really impacted by the care we receive. So we go to the doctor and we get checked out, and that is important, which is what we do, but that's only 20% of our health as a total person. You can see that over 80% is about the socioeconomic factors, things we just talked about, education, job status, income, all of those things, the physical environment, healthy behaviors, tobacco use, diet and exercise, all of these things. So I always like to say that I am hoping for health and wellness equity for all people, not just health. We know that 50% of an individual's current state of health can be traced back to their zip code. There are certain places in the country that you can pinpoint on the map. This community is probably experiencing high percentages of high blood pressure, diabetes, all of this just by location of where their zip code is. I probably don't have to tell you that there is not a Whole Foods in neighborhoods that are not affluent or neighborhoods where individuals will be partaking of those kind of things. So that's important to remember. A portion, 30% of our health, the way that we show up as adults has to do with those adverse childhood experiences. So if you were maybe a child raised in an abusive home, if you were neglected, any number of reasons or things that children experience while they're young can impact their health as adults. So that's something we have to think about. Someone shows up to our clinics and we're here to take care of them, but we might not know everything. They have one chief complaint, we gotta get to it and get them out, but there are so many other layers that we wanna be aware of so that we're providing the best care for everyone. Again, Healthy People 2020 and now Healthy People 2030 still supporting health equity, and that's important here. So now we wanna talk a little bit about health disparity. And health disparity is so important because these are those preventable differences in the burden of disease that individuals carry. Opportunities to achieve optimal health that are experienced by socially disadvantaged populations. So there are many health disparities. And just as an example, diabetes is very prevalent in the African-American community. An African-American who gets diabetes versus a Caucasian who gets diabetes, the burden of disease is far greater for the African-American because of life experiences, because of those different social determinants of health. And it's not all African-Americans, of course, but we do know that the prevalence is greater. So think about those health disparities. Sometimes the burden can be greater because there are other underlying conditions. We saw this with COVID-19. The impact that COVID-19 had in communities of color outweighed the impact that it had in others. And that's because there were a lot of these different determinants of health at play. So keep that in mind. But we can improve health risks and reduce disparities inequities by addressing those social determinants of health that we just talked about. And I do wanna just make the point that health disparities are preventable. There are some of these things that we can know about them and do something about them. So that is key. So I wanna talk a little bit about how unconscious bias can impact these health disparities. Sometimes individuals aren't receiving the care that they deserve, not because they are impacted by social determinants of health necessarily, but because of bias of healthcare systems, structural racism, lots of things are impacting the health. So let's talk about some of these terms so that when you see them, you have a clear understanding of what they mean. So the first one is unconscious bias. That's those attitudes, beliefs, and opinions about people that operate outside of awareness. That's unconscious bias. Think about, we all have unconscious bias. If you have a brain, you have a bias. Communities of color, and you'll hear me say marginalized groups or marginalized communities or historically underrepresented communities. That doesn't necessarily mean that that's all black people or poor people or whatever the case may be. That's just those historically underrepresented communities where they don't have the resources they need. So think globally, that can entail quite a lot of people. So those unconscious biases are those things that just kind of like happen immediately. You see someone and immediately you have a storyline of who they are, why they're here, where they came from, where they live, what they do. That's unconscious bias. And we have unconscious bias, not because it's a flaw inherently. We all have biases. And a lot of times, it's for our safety. If you see something, like okay, that looks like it's not safe, so I'm gonna protect myself. So some of those biases are necessary. But we wanna be aware of them because when they operate under the radar, then we can be behaving in ways that are not promoting the health outcomes of individuals. Judgments we make all the time. That's our own opinion whether something is good, is it bad, is it right, is it wrong. We do this all day, every day. We make judgments about people all the time. Not that I want you, that you'll ever stop making judgments or that you'll ever stop having bias, but it is important to be aware of it when it shows up. And then there are generalizations. If there's anything on the list that might be beneficial to us, it's generalizations. Because generalizations, they do really give us a starting point, a place to start. Generally speaking, this community has experienced a greater burden of disease than others. That helps us to kind of gain some information and then work from it. Stereotypes, we hear this word quite a bit. And we do it. Think about your day at the office. We have some, I work with a hospital system, and sometimes you hear things like frequent flyer in the ED or drug seeker. All of these are terms that are really stereotyping individuals when we don't have the full story. Now a term that I really want to kind of spend a little time on is microaggression. Microaggression is a term that has gained a lot of popularity lately. But microaggression, and I don't want you to be confused by the part of it that says micro. It's not micro because it's small. They are major. If you think about a rock and water dripping on a rock, if that one drop of water continues to drip on that rock, over time it'll create a little indention in the rock. That's what microaggressions are like. They're those nonverbal little environmental slights in the snubs that whether they're intentional or unintentional, they communicate hostile, derogatory, negative messages targeted to persons. But often based on their marginalized group membership. This is not to say that everyone doesn't experience microaggressions because we all do. But this term gained its, like it was created around marginalized groups. So just to give you an example. Let's say a Muslim patient enters the emergency department and one of the nurses says, oh, here comes the terrorist. That's a microaggression. What if you're, think about women experience microaggressions all the time. Imagine you're in a meeting and you have something, oops, I hit my mic. You have something important to share in the meeting but you're just really discounted like, because you are sharing your passion, you're passionate about the topic and you want people to hear what you're saying. But someone just like brushes you off and says, oh, she's just getting all worked up. You know, she's a woman, she's emotional. That's a microaggression. And we face them every day. And these microaggressions impact our health and they impact the health that we, the care that we give to others. And as we're talking about biases and things of the sort, I want you to become aware of your blind spots because we all have them. You know, there's probably terms you're saying every day that you've been saying always, and you don't think that it's a bad thing, but when you hear the experience of the person that you're saying that to, you realize quickly that that's probably my blind spot. So that's that unconscious bias, creating those mental shortcuts that help us to kind of quickly make sense of all of the millions of pieces of information that we get in a day. And it's not always bad that we have these blind spots, but awareness is key. Like, we need them. Like, you know that a doorknob is a doorknob. Like, you don't have to, like, see a new doorknob and think, now, is that a doorknob? You know it's a doorknob because you've seen a hundred millions of doorknobs. But you don't want to associate that doorknob to, let's say, an African-American patient comes in the room, and you already know who they are just because you've seen other African-American patients. So that's how the blind spots can get in the way. And again, it's not a flaw. It's just how our brains are wired. So what we have here are some microaggressive greeting cards, and they're not very gracious, but I do want to share them with you to give you an example of how microaggressions show up for different populations. So the first one is for Asian-American Pacific Islanders. These are some things that this group of individuals hear often, and while, you know, you think you're, like, you know, relating, you're being cool, and you can, you know, say these things, to them, it may not be a compliment. One of the ones, okay, if someone says, you know, you are so exotic, oh, my goodness, like, that's not a compliment to someone who, you know, doesn't look the same as you. That's not a compliment. Or your English is so good. Again, not a greeting card. In the center, we see Hispanic and Latino edition of this. So you see the first one is, well, you must love spicy food. And these are things we say, you know, think about that. You have a potluck at the office. What did you bring, you know, whomever? Oh, you must like spicy food, because of whatever their ethnicity is. These are not good. Or you're so feisty. I work alongside a number of Latinx women, and this is one of the main ones that they have shared. It's like, just drives them up a wall backwards. You know, oh, you're so feisty. It's rude, it's invalidating. It's not okay. And I'll have to say, growing up in life and here at the beach, one that I would always hear as an African American woman is, oh, you are so articulate. You speak so well, as if I'm like a unicorn, and that just should never be the case. So these are the things we have to be aware of, because they're microaggressive, they're subtle, and sometimes the person who's delivering it has no idea that it is. But this is how we learn. But this is how we can impact the care that we give to our patients, as well as how we interact within our clinics with each other, right? You know, if I work alongside someone every day, I'm probably not building a lot of belonging and inclusion if I'm making these kind of comments. There's one on there, you're so pretty for a black girl. Oh, these are things people hear every day. So keep these atop of mind, keep these atop of mind. We can take questions now, or we can wait until the end. If you, do you wanna hold on to that, or? Oh, no, no, no, no, no. No, these are not real greeting cards, and they're not very gracious, but they are examples of what people think are compliments, or I'm saying something nice, but really they're just microaggression. So keep those top of mind. Thank you for that. So in addition to the way that we interact, of course it has a lot to do with our communication. And we know that our non-verbal communication speaks volumes. You can see here that only 55%, 55% has to do with words that are not being said. Only 7% of the message that we communicate has to do with the exact words that we say. So think about that. Think about those non-verbal ways that you're communicating to patients, to each other. Like, you know, if someone has their arms folded while you're talking to them, like, you have an opinion about what that means. I don't have to tell you that. Or if you're talking to someone and they're not making eye contact, you're like, we all have an opinion of what that means, right? So there are different cultures have different ways of communicating. So we wanna be aware of that, especially as we're serving our patients. For some cultures, eye contact, direct eye contact is a show of disrespect. But in our culture in America, you know, eye contact, if you don't have eye contact, you're not confident, you're not this. We have made up all of these stories. But what about the patient who comes in from a culture where eye contact is disrespectful, so they keep their head down? You know, we may interpret that as though they don't care about their health. Why are we wasting our time? So we make a lot of assumptions about people. So keep those kind of things top of mind. And nonverbal communication, there's so many, you know, body language, you know, rolling of the eyes, how you hold yourself, how close you stand to someone when you're talking to them. All of these things create a feeling. So you wanna keep those in mind. And really, it all boils down to intent versus impact. So intent is the message that we mean to relay. You know, this is, you know, I said, well, I didn't intend it that way. I didn't mean to hurt Julie's feelings or who, you know. That's the intent. But the impact to Julie is when you said, oh, you're really pretty for a black girl. That took her somewhere that, you know, really made her feel less than, made her feel othered is a term that we hear a lot. So think about the intent versus the impact. And we really have to move beyond, oh, well, it wasn't my intention to hurt your feelings or it wasn't my intention to discount you or make you feel in some kind of way. We really wanna think about what impact are my words gonna have on my patient, on my coworkers, and keeping those things in mind. So we've talked about the social determinants of health. We've talked about health disparities and the burdens of disease being different for individuals more than others. But there is scientific evidence that tells us that racial discrimination impacts the health of people. And it's one thing to be unconscious and have unconscious bias and to have those microaggressions. But the culmination of that, when it's left unchecked, can become racism when individuals are being singled out, not treated well, based on a number of things that may show up. We know that racial discrimination, whether it is in the denial of goods, whether it is psychological stress, or even assault, it has a physiological impact on the health of people. You can see the list here. Mental health outcomes, anxiety, depression, substance abuse, misuse, cardiovascular disease, all of these things decrease birth weights. We're gonna talk about that also. But racism, when individuals are not, when they're mistreated based on any number of things, really does impact their health. So let's keep that in mind. There's a term called biological weathering. And biological weathering is a real thing. It's that the cumulative burden of chronic stress and life events, when the environmental challenges are so great, that it starts to weigh heavily on the health of people. So biological weathering is real. And when patients show up to receive care, we don't always know the whole story. We don't know the full story. You know, we do a health history, which we get to know these things, but we don't know what they're facing when they just walked in the door, or what they're gonna continue to face at the office, or wherever they operate in daily life. And that impacts health. So I want us to take a look at the current situation. And the current situation has a lot to do with health inequities that are taking place all around us, and the impact that it's having on certain communities. And how health equity, how something can be done about it, hopefully, so that people can experience those better, more positive health outcomes. So the first one that I want to share with you is the Black Maternal Health Crisis. The Black Maternal Health Crisis is taking place in this country right now. And it's not a small thing, it is major. Black women are dying in childbirth, during pregnancy, post-pregnancy, greater than any other demographic. You can see here on this slide that Black women face three times the maternal mortality risk as white women. And this number, based on new research, lets us know that the number has gotten higher. You can see this is based on deaths per 100,000 live births. This is pretty astronomical, which is why it's called the Black Maternal Health Crisis, because this is indeed a crisis. Just some statistics about Black maternal health. We know that Black women in the U.S., again, are more likely to die from pregnancy and childbirth than women in any other race group. Three times more likely to experience preventable maternal health, maternal death, compared with white women. So the key word there is preventable, right? That's crazy. Preeclampsia was the leading cause of maternal death, followed by postpartum cardiomyopathy, embolism, and hemorrhage. And the really unbelievable part of this is that Black women's heightened risk of pregnancy-related death spans income and education levels. I have on the screen, you see Beyonce and Serena Williams. They both had near-death experiences in childbirth. They had their babies, and they were experiencing symptoms after having the baby. And when they tried to express those symptoms to their provider, they were discounted. Like, oh, you know, it's nothing. It's, you know, like, oh, it's fine. This is a normal. And imagine that, the wealth that both of these women have, but their care, their physician, really wasn't listening to their concerns. So think about that. Think about just the average African-American woman who, you know, wants to have a good birth experience and, you know, expresses her concerns, but her concerns are discounted, whether that's because of bias, whether that's because of stereotyping, any of those things we just talked about, or it's just simply grouping a certain group of individuals into one bucket. Like, oh, you know, you're just not, you know, tough enough. This is, you know, where's your grit? This is a part of it. So think about that. And there was a study that was done in a Florida hospital from 1992 to 2015, and it showed that there's a direct impact on a physician's race and newborn survival. So the study was with 1.8 million hospital births, and when cared for by white doctors, black babies were three times more likely than white newborns to die in the hospital. The disparity was cut in half when black babies are cared for by a black doctor. And they saw the biggest drop in deaths, in complex births, and in hospitals that deliver more black babies. So when it was more of like the norm, the numbers dropped. Not great, but still dropped. And they found no difference between the physician's race with maternal mortality. So this is just about the survival of the newborn. So there's a wonderful act that has happened. Vice President Kamala Harris, along with Senator Cory Booker and some others, have come up with this, really, this legislation to really do something about the black maternal health crisis in our country. And it's called the Momnibus Act of 2021. I would encourage you to Google it, get some more information about it, because it really is important, because this is nationwide. We have to do something about our black mothers and babies dying in childbirth. So you can see here that the Momnibus Act, it addresses some of those things like housing, transportation, and nutrition, which are those social determinants of health. More diversity of the perinatal workforce. Those kind of things make a difference as well. So this is just the current situation of the black maternal health crisis in the U.S. We are not a developing country. We are, you know, this shouldn't be happening. But what are we doing about it is the real question. And we have to ask ourselves. So here is a little fish on his back. And when you see this, you know, what do you think? You're like, you know, oh, he probably didn't, he was not healthy, you know, just a bad day. He's out of here. That's probably what we think, right? Something's wrong with this fish. But when we see this, now we have to wonder about the environment. You know, it's not one African American woman dying in childbirth here and there, but three times more. We need to consider, is there something wrong with the system? So I encourage you, when you have some time, and if you have Hulu, to take a look at this documentary. This documentary is called Aftershock. It is by Spike Lee's wife, Tanya Lee Lewis and others. But it really talks about how the black maternal health crisis and how black women are experiencing childbirth and the ripple effect that it's having in families and communities all around. It's a wonderful documentary. I encourage you to take a look if you have not already seen it. So that's just one place where we see an obvious health inequity. We need to figure that out, what's going on. But there's others. So here, I want to talk to you about the inequities that persons with disabilities experience. This is quite another area where we can do better as a country. So just to define what I mean by disability, it is any condition of the body or mind, an impairment, that makes it more difficult for the person with the condition to do certain activities, which means activity limitation, and interact with the world around them. They have restrictions. They may be around mobility, cognition, hearing, vision, independent living, self-care. This is how they're impacted. You can see here that 61 million adults in the U.S. live with a disability. That's a major number. It's interesting that 20% of adults in the U.S. have that type of, have a disability, but it's also more prevalent in the South, which I thought that was fascinating numbers. Yeah. So interesting information about that, but we wanna make sure that we understand that just like anything else, a person with a disability should have the equal opportunity to have the best health outcome and everything they need and not be discounted based on their disability. So kind of like those dimensions of diversity, there are invisible and visible disabilities. Some of the invisible disabilities, meaning we don't know that a person has them unless we have a conversation with them in getting an understanding. So mental illness, MS, learning disabilities, autism, memory loss, neurodiversity is an invisible disability, and then in some cases, addiction may be considered a disability. So we wanna keep an eye on that. The experiences of those, and this is information shows us that individuals who have a visible disability versus those who have an, what did I say? Individuals who have a visible disability versus who have an invisible, their experience is very different. So imagine the care that individuals are seeking, so important there. So we know that persons with disabilities are the largest minority group. Some disabilities may even change over time. So these are things we wanna be aware of as we're caring for patients, and as we're in facilities and practices with individuals. Even if you personally do not have a disability, many of the people that you work alongside every day, they may have one. So it's important that we consider these things. So we've all gathered here today, and I don't know that closed captioning has been made available, but let's say there's a person in the audience who has a hearing impairment, or has an impaired hearing. We haven't really provided an equitable space for them. So those are the things you wanna think about when you hold meetings on Zoom, when you hold meetings at the office. Enable that closed captioning so that everyone has an equal opportunity to have the same experience. Think back to the bicycles, right? Another community that experiences health inequities is our LGBTQ plus community. This is so important because a great deal of our population includes individuals from the LGBTQ plus community. Just some statistics to share with you about this. LGBTQ plus youth are two to three times more likely to attempt suicide. So imagine that. If they're not seeking the mental health care they need, or if they're not seeing a physician because they're ashamed, or if they know they're gonna be discounted, they're basically suffering in silence for no reason. Women who identify as lesbians are less likely to receive preventative services and screenings for cancer. So much less likely to go to the OB-GYN for regular women's exams. We know that transgender individuals have a high prevalence of HIV and STIs, victimization, mental health challenges, and suicide, and they're far less likely than heterosexual or non-trans LGBTQ individuals. So you see that even within their community, there's some imbalance to be transgender versus to be just a heterosexual or non-trans LGBTQ. So those are things to keep in mind. A way to really remedy the situation or to really be more mindful and aware is education. And that's for everyone. Education around maternal black health, education around people with disabilities. The more we can educate ourselves, then the better able we are to serve the communities who need us. You see here that this is a wonderful website. It's genderbred.org. Take a look at this because it really explains how things work. You know, what does it mean, gender identity versus gender expression? Especially like in our medical healthcare setting, you know, we still rely heavily on the sex assigned at birth, but we also want to honor how individuals want to be referred to, what they want to be called. That's just another way to provide greater equity. I'll tell you a story why education is so important. There was a physician who, you know, was not familiar with caring for individuals from the LGBTQ plus community. And the provider, you know, goes into the patient room that the patient's already been roomed and goes in and, you know, is ready to like, you know, hi, how are you? Let's, you know, get started and pulls back the cover and is met with genitalia that he was not expecting. And whenever he was met with that genitalia, he like gasped, like, huh? So can you imagine what that does for the patient? Are they gonna come back? Are they gonna continue to seek the care they need? Probably not. So these are the things to keep in mind. Education is key. So you may have a question. So now what? Now that we know that there's health inequities, we know that there are social determinants of health, people are facing all kinds of conditions. So now what do we do? Well, I'm hoping to provide you here with some solutions. So you see quite a few things here on the screen. And I'll go through each of them because, you know, you may not be familiar with them, but it's good to, you know, have a refresher of some ways that we can help can afford health equity. So the first one is cultural humility and linguistically appropriate care. The next is increasing provider diversity. We're gonna talk about that one. Patient advocacy is huge. People first language. We've talked about that a little bit. Creating inclusive environments. Improving cross-cultural communication. And what we can all do is check our biases. So I just wanna talk a little bit about cultural humility and linguistically appropriate care. So that just means that individuals, and you probably see this, CLAS. So this just is respectful care that is respectful of and responsive to the health beliefs, practices, and needs of diverse patients. And when we have this, it ensures that all patients receive high quality care and achieve good health outcomes. So this could be, you know, if we, you know, we ask questions, are there any, you know, religious or faith-based reasons that you don't want to receive a certain type of treatment? Or if, you know, do you want your family present in the room, or can some women be present during, you know, if you're having like a OBGYN appointment, does it have to be a male, can it be a female? One of the big things as an organization, we've recognized that Asian women were not having mammograms as often as other races. And, you know, it took some learning to understand that there were a lot of, you know, questions about, you know, is it safe, you know, to completely disrobe in front of a stranger, all of these things are, you know, you've probably been having mammograms once you reach a certain age, you know, it's just what you do, you go in there, you put it on, and you do it. But there are certain cultures that are like, you know, I can't imagine doing that in the presence of someone who's not my husband or not my family. So that might just hinder them from ever receiving a mammogram, which impacts their health outcomes. So keeping that in mind. We have gone the extra step to provide linguistic education solutions. So think about that in your practices. Do you have your educational information in multiple languages? And sometimes, you know, you go to like the big three, and then you don't go any further. So it takes some effort finding out who is within your community to see what the needs are. That's about, you know, finding a bicycle that suits the person's specific needs. So we have lots of brochures created in Arabic, Burmese, Nepalese, Russian, Spanish, Vietnamese, because in certain areas around our organization, these populations are super, super high. And what you're gonna know is, whenever your clinic or wherever you practice, when the clinic mirrors or reflects the communities that you serve, people are more trusting to come to you for care because they see a face that looks like their own, and it feels safer. Some tips just for communicating across cultures. Just think about things. You know, we have to, you know, really be solid, know who we are, you know, just really, you know, confidently opening up to understand someone else's perspective. Using shared languages. I work as a part of a cross-cultural program where we help our physicians who may have barriers around language. And the one thing that I hear all the time is that, you know, we, as Americans, we use, like, you know, terms that we think everybody understands, like, you know, cat on a hot tin roof, or, you know, all the things that we say just without even thinking about it. But for another culture, they don't know what that means, so that creates a barrier. So just being aware of the language that we use, you know, not using those little colloquialisms to describe things. And really just taking your time. You know, hear people. If there's a struggle there, take that moment to have some empathy. And that's the last one. Develop empathy. That goes miles in understanding someone else's lived experience. And I should say, just because one individual from a certain group has a certain experience, doesn't mean that everybody within that group has the same experience. So really it's more about getting to know individuals for who they are. So I always like to show this little example when it comes to health inequities. So this is a park bench that you'll see has these little spikes in the bottom. So when you think about communities where there are people who experience homelessness or individuals, you know, they wanna keep the park clean and free of certain things. What they did in this specific community is they put little timers, so you had to insert quarters into the bench to keep the spikes down. When your quarters run out, you better get up. So we know that there are communities all across the country where individuals rest on a park bench or sleeping on a park bench is the only option to not have to sleep on the ground at night. But certain communities, you know, not thinking about equitable care or these are the things that happen. I know, it can be a lot, but knowledge is key. Another way that we can help as a solution to really decreasing some of those inequities is just it becoming more common knowledge, something that you see always. Like this is a picture of a black and brown baby inside the womb, okay? This is probably not something that you saw in textbooks when you were going to medical, getting your certifications and things of the sort. It's probably not something you see in your OBGYN's office on the wall. For some individuals, they've never seen this. So it is not the norm. It's not, you know, embraced and found to be beautiful. This young woman who created this image, and I think her name is on the slide, but she started creating these beautiful images of black and brown babies in the birthing process so that people start to really embrace it and it's, oh, this is just a normal thing. Maybe that would impact the maternal health crisis that's happening in the world. A lot of medical schools and nursing programs are starting to add these types of things to textbooks so that students come out of college having been exposed to this and it's not uncommon or not the norm. So just a few things that can be done. One very major solution to the health inequities that we are facing as a country is increase in provider diversity. This is so very important. The statistics are, you know, just disturbing. The proportion of black physicians in the US has increased by only four percentage points over the past 120 years. Is that not unbelievable? The share of doctors who are black men remains unchanged since the 1940s. In 2014, there were fewer African American males in the first year of medical school than there had been since 1978. And in 2019, and it's a lot, it's pretty close still today, that only 5% of providers of physicians are black, 6% are Hispanic, and less than 0.3% are indigenous people. So. Do you see that all the physicians are black? Male physicians, yes. We do see that there is a growing number of African American women who are practicing physicians, but for black men. And the reason why that's important is because we know that black physicians have an impact on black health. Kind of like we said, if we reflect the communities that we serve, the health outcomes are better, it's the same thing here. So in a study that was performed, here you'll see at the bottom, men, and men, black men especially, are not seeking care. And we know that as a community, the African American community, there's a great deal of mistrust. We saw that again with COVID-19 with the vaccines. Individuals have just an overall general mistrust of healthcare because of our history with healthcare. That it has continued to kind of trickle down over the generations. But we know that when black physicians care for black patients, the health outcomes are more positive. But if we don't have enough black physicians, then there tends to be a problem. And I'm not saying, and by no stretch am I saying that African Americans cannot get good care from non-black providers. They can. Many, I'm sure everybody in the room has many, and they do provide good care. But statistically, it has shown that the outcomes are better. So men are more likely to talk about other health problems when they see a face like theirs in the room. They're more likely to participate in those health screenings. Cholesterol, diabetes, those are screenings that need to be taking place. But if they're not, continue to decline in health. 56% more likely to get those vaccines. And 72% more likely to participate in cholesterol screenings and that's just a small thing. And this is just really a drop in the bucket. We haven't talked about the bias around prescriptions and not being able to get prescriptions, not being prescribed the best treatment, or all of these things play on health inequity. But I do want to share with you a wonderful documentary. The gentleman in the, sorry, he says I have a pointer. The gentleman in the center, his name is Dr. Dale Orkodudu. He came up with this wonderful documentary. He was a med student and he noticed that in all his rotations, all of his residency, everything, he didn't see any faces like his own. And you know, med school is not easy. But what he recognized is that there were very many black men around him. So he created this wonderful documentary and program that is Black Men in White Coats. And it's this initiative to get more young black men and women into medical school, getting more African American providers. So it's really exciting. In the corner you see the Black Men in White Coats Youth Summit. I'm actually, we are hosting one in Charlotte next weekend where we have like hundreds of young students who are going to come for the day. They are, we have over 100 black physicians who will be there in their white coats so that the students can see, yes, there are black men, you know, practicing medicine. I can do this too. And they get to have one-on-one, they get to have group time with the physicians. You know, they can look at hearts and they can look at dermatology. They have like even some, you know, different things floating around. They can make splints. But it really gives them an opportunity to have a hands-on opportunity. And the goal is that it really impresses upon them that you can do this. You too can be a black physician. So it's a wonderful program. If you haven't seen the documentary, blackmeninwhitecoats.org is where to go to check it out. So another thing, another solution to making sure that our patients receive health equity is patient advocacy. And in your role as medical assistants, you really are the patient advocate. You know, you have the opportunity to set the stage when a patient comes in and to really create an environment where they feel heard, they feel cared about. You know, all of the scene, all of these things are important. There's patient advocacy just really provides patient services, eliminating those obstacles in the access to quality healthcare. And there are patient advocacy organizations. There are, you know, certifications you can take to be better at being a patient advocate. But the key is to really, you know, having the back of your patient so they get the care they need. And really at the core, it's just about empathy. We know that patient advocates can help to make medical appointments. They can help with visits and tests. They can arrange for second opinions and follow-ups. They can help share treatment options. And really they just create that environment because imagine how individuals, if you're not confident interacting with healthcare, like if it like kind of makes you nervous and scared, then you're not gonna speak up when something is going on. You're not gonna ask the questions that need to be asked. So having someone advocate on your behalf is so impactful for health equity. Another thing is people first language. And you've probably heard me, I really make an effort to use people first language. That makes all the difference when patients come to see us for care. You know, rather than saying, you know, the diabetic in room five or the obese person in, you know, waiting in the lobby. That doesn't create an environment of inclusion, right? Rather we can say, you know, we can say, you know, the person experiencing diabetes or a person with obesity. That is how we want to address individuals. This is also called person first language. And it is just a linguistic prescription which puts a person before a diagnosis and it describes what condition a person has rather than asserting what a person is. And I think, and this is like a small, this is a small thing that we can do. So using people first language is key. So some examples of people first language you see here. So a person with an intellectual, cognitive developmental disability over some of the words you see that are not bolded. That's not how we want to refer to people. That's not inclusive, that's not kind, that's rude, disrespectful. Person with a disability. Person with epilepsy or a seizure disorder. And there are families and communities and cultures who, like I said, have used the same words to describe individuals for years and years and years. Don't think twice about it. Like, oh, that's my sister, that's what I call her or whatever the case may be. But going the extra mile to really make patients feel included and make them feel valued and seen, this is the way to go is with the people first language for sure. And here are just some different examples. And it really, it spans all across just diagnosis. Like there's one on here that I like. If someone asks, we don't, people first language says accessible bathrooms or accessible parking. We don't say park in the handicapped spot out front. Park in the accessible parking. Think about those terms and how we refer to individuals. And really, it's a small thing, but it goes a long way. And in doing all of these things, it really is about creating those inclusive environments. Creating inclusive environments. Here are just a few tips for how we can, and not just an inclusive environment for our patients, but again, inclusive environments for the coworkers we work alongside every day. Respect each person's differences as well as their similarities. Enjoy and learn from them. I always encourage people, tell your story. Ask other people, what is your story? Respectfully, of course. But getting to know people, getting to understand who you're working alongside every day. And learn to respectfully work through challenges. We're gonna have them, they're gonna show up, but we can be respectful. And I want you to really hold onto this one, is to be open. Don't assume that you understand people just because of where they were born, their sexual orientation, their skin color, their religious beliefs. I even span the list to say where they went to college, if they went to college, who their parents are, what neighborhood they live in. We can make so many assumptions. This ticker up there makes all kinds of things happen. We wanna be inclusive. Think of all the ways that you can include team members, ask for input. Oh, I see a person has a question. Was there a question? You know we only have 15 minutes to say, right? Yes. And we don't have 15 minutes, yeah, we don't have 15 minutes. Yes, yeah, and we'll talk about that. And I appreciate your question. The question was, we only have 15 minutes. You're exactly right. But I'll say this, just as individuals who we've sought care, right? In 15 minutes, either I feel heard, seen, understood in my doctor's appointment, that same 15, I can be made to feel discounted, not important, my care is not important, rushed out. So I'm not saying it's easy, but just as easily as it is to create a bad experience, it's just as easy to create a good one. But thank you, thank you for that. I understand that you all are under time pressure. I know how it works. I encourage you to have these conversations in your clinics around diversity inclusion, so important. Get to know someone who's different from you, whether that's your patients or your team members. And in seeking first to understand, whenever someone comes in and they have a complaint or whatever the case may be, seek first to understand. As individuals, we are geared to listen to reply. Like, okay, go ahead and finish talking because I got my reply ready. Rather than that, really hear what people are saying. Seek to understand rather than just to reply. Speak about concerns and really engage your leaders. You can have a health equity board in your break room just with a topic and that raises awareness. So let's say you have a board around LGBTQ plus care. Put it in the break room. You don't have to take away from any patient time. But on your lunch break, you might actually read it. So now the next time a LGBTQ plus patient comes in the room, it's gonna come back like, you know, I did read about. So maybe I'll just say, you know, what are your preferred pronouns? A small thing, doesn't take 20 minutes. It's just, it's easy to do, it's key. So here we arrive. So, and certified medical assistants, what is your role in health equity? Everything that we've talked about already is your role in health equity. Creating those environments of inclusion, using that people first language, you know, checking your biases, being, you know, getting to know people for who they are, not making those assumptions when they come in. But this is from your national website, and you are the patient liaison. And it says right there, and I love it, because it says that medical assistants are instrumental in helping patients feel at ease in the physician's office and often explain the physician's instructions. So you are the connector between the physician and the patient. So we know the doctor zips in, zips out, we want them to have, you know, practice health equity as well. But you have that opportunity. Everything that you do, while grabbing vitals, whatever you're doing, you can create that space and really initiate that feeling so that people will come back and get the care that they need. And another bit of information that I found is on your website, is that medical assistants who represent the communities and the clinics that they serve is an important part of providing that equitable care. So you're already out there, you're doing it. So this is so important for the care that you deliver. So I'll leave you with a quote from Malcolm X, and it says, if not now, when? And if not us, who? Right? Simple and plain. I just want to recap some of the things, and then we'll have time for some questions, but I just want to recap. We talked about some of those terms, diversity, inclusion, health equity, health disparity. We talked about the social determinants of health. We talked about what goes into your health, as well as some of those biases around health equity. I described the current situation in the black maternal health crisis, persons with disabilities, and individuals from the LGBTQ plus community. And hopefully I've given you some solutions and some things at least to start thinking about. So now, if you will, I have just a final activity for you before we go into questions. So what you can do is on your phone, if you'll go to www.menti.com and enter this code, I want you to answer this question. Please share just one word to describe how you feel about your role in promoting health equity. Are you feeling empowered? Are you feeling excited? Are you feeling nervous? Are you feeling like I can do it? Go up there and find that, and then I'm going to share this with you. Let's see. We're gonna see if this works here. Oh. Okay. Okay. Okay. So as you enter your words, they're gonna show up on the screen. It's right at the top. So enter your word, the one word, to describe how you feel about your role in promoting health equity. Confident, instrumental, positive. And if you notice the word that's the largest, that means more people are putting that word in. So the ones that show up bigger. Lots of words coming in. Good. Look at the word cloud growing. This is good. So you're feeling intrigued. Superstar. Love that one. Connection, hopeful. This is good news. Yes. This is great. Fantastic. All right, they're still coming in. So as the words keep coming in, I am happy to take any questions that anyone might have. Thank you for participating. I'm loving all the words coming through. They're still coming. Wonderful. Any questions? Yes. There's a microphone in the center if you'd like to go over there so we can all hear you. I love it. Love it. I was wondering how you felt about this. A few of us in the room read an article recently about a cardiology study in African Americans. And what they found were the doctors simply did, for some reason, African Americans were not admitted to the fancy floor for cardiology. And they were more likely to be admitted to a general floor. So what they did to encourage equity was to build an algorithm in the EHR. So when this diagnosis popped up and they're African American, the pop-up would say, this is an African American patient, and then would give a little statement about how there has been a diversity in this. So the pop-up encourages them to maybe admit them or do some more studies. And we could take this whole building an algorithm to a whole new level. But I wonder how providers feel about an algorithm telling them how to practice medicine. That's what I fear for the Gen X and baby boomer doctors. And then what if the pop-up becomes so common, they're just clicking off of it, clicking off of it, clicking off of it. And then it got me thinking, I can't believe we have to have an algorithm. So I wondered how you felt about that solution. Well, I thank you for your question. And that's a good one. And I think it kind of goes back to education. It goes back to awareness, understanding health disparities and why there's a need. I love what you said. You know, why do we even need an algorithm? I think really showing that this number of individuals are going to the fancy suite, this number of individuals aren't, that is a problem. Why? And what are we gonna do about it? And rather than like telling someone how to practice medicine, I shared that statement of diversity in the beginning. It really is a top-down organizational decision that we're gonna practice health equity. And if we see a gap in the care that we're providing, we wanna do something about it. So I think it's having that conversation with your physicians and the team and really embracing that we wanna give everyone the opportunity for the highest level of care. And right now we're not doing that. And then whatever it takes, let's get there. Thank you. There's someone at the mic. Yes. How do you, I guess, soothe a patient when you've asked someone who very obviously has a different dialect or accent, when you're doing your primary intake, oftentimes we're asked to post in our systems, what is your primary language? And there's a good reason for that, in that if you were ever physically compromised, you may also be mentally compromised and you may start speaking in the language that you learned first. And I've had patients that are very, very offended by it because they're like, I speak English very well. I don't need you to know. And it's, you know, when you try to tell them why, sometimes they feel insulted that, you know, that you're assuming because of their language, they may lose their mental faculties. And it can be a tough conversation. So I wondered if you had any tips on how to try to smooth that over or make them feel that they aren't being judged. Right, I think that, again, I think that's a really great point. Every individual, of course, is going to be different. I think it's important for us not to make any assumptions about what might happen if someone is frustrated or confused and really just taking time to kind of hear and understand what they're experiencing. Imagine, and it's also important, you know, to put yourself in someone else's shoes. Imagine you're not feeling well. You're out of the country. You don't speak the language or whatever the case may be. And you go in to receive care. Nobody understands you. You're trying just to say what's going on. You probably are gonna get a little frustrated. So give people grace. I think, and you know, this job is not easy. Healthcare is not easy. But I think really just, you know, taking as much time as you can and being patient and letting people know, you know, I am here to give you the absolute best care that I can. So if you can please help me with this, let's make sure we're giving you the best care. I don't know that there's any right, like a every situation answer. But I think it all comes back to empathy, like understanding what this person might be experiencing. But thank you for your question. Do you want, this person has a question, then you. Oh. It's kind of like, I'm pretty loud, but I can't hear what you're doing. It was kind of based on the previous question and comment. I think a lot of us, especially, you know, working in the field understand that we can do everything we can. A girlfriend, take your stuff to the insurance company because it seems like that is the driving force on totally different things. But if we can try to offer the best healthcare, offer the best prescriptions, that comes down to the bottom dollar. Whether insurance is gonna cover it or it's not gonna cover it. And I think, for me, personally, that was the biggest frustration in the field, more than anything. Because when you can provide the same care to everybody, then it comes down to the bottom dollar. Well, thank you for that. And her question is about, or comment is about, sometimes the care that individuals receive is because of the insurance they carry. They may not get the best because of the insurance they have. And I appreciate that because that is an example of the systemic racism that we're talking about. We know that there are certain types of benefits that physicians can see in the individual from one group and receive reimbursement of, let's say, $1,000. There's a whole other group of individuals, if he sees those same individuals, he's gonna get $25. So to be able to empower or invest in that physician to see the value, to give both people the same care, regardless of their insurance, is where the word comes in. And it doesn't stop here. There are so many levels. Those are some of those social determinants of health, that's one of them. Why is it that if someone goes in and doesn't have the best in care insurance, they're not gonna get the best care? But those are the things to consider, so I appreciate that. But what I will say to that, care is one thing. Remember, 20% of what we experience in life is that care. But think about those other spaces that we can create that can cause that individual to feel cared for, heard, listened to, that's gonna have intrinsic improvements in their health beyond what care they receive. So thank you for your question. Yes? The disparity is real. Patient, 55 years of age, shows up in the emergency room, complaining of, female, complaining of arms feeling extra tired, just kinda not moving so well, nausea, vomiting, been feeling this for two or three days. Shows up in the emergency room, the first thing they do is they leave him sitting in the emergency room. Person of color, female, 55 years of age. Leave her sitting in the emergency room where she stays for almost 12 hours. Meanwhile, they're doing tests. And then finally, somebody looks at those tests and decides, you know what, you need a stent. You may need two of them. And we need to get you to surgery ASAP. What if this is real, that person was me, okay? If I had not insisted that they do something and they had to sit me away, which is what they tried to do, and I told them no, because there's something not right. Fix this, we need to work on this. There are a lot of patients out there who don't have the medical background, who don't understand what's happening with their bodies. And as medical assistants, we have an obligation to educate and teach. And we need to help them understand and learn more about themselves so that when they are put in these predicaments, that they can really press the issue. If I had not had the know-how, the major artery across the heart was 98% occluded. If I had walked out of there, I would have not survived. So we need to be, the disparity is real, and we need to educate our patients, okay? We know these things, but we need to educate our patients. Absolutely. So. Thank you so much. Thank you. Thank you so much for sharing your story. That is so impactful. And like she said, it is real. And what, you know, it starts, you can only start with us, right? This is where we can start. There are systems in place that need help. That's why these conversations are important. And as often as we can have them, the more we can make an impact, because there are systems in place that are really, you know, contributing to health inequities. And people are, it's a life or death situation. It's not just fluff. It's not just nice to have a program. It's not, it is life or death. People need us. Thank you. Hi, my name is Jennifer, and I am from Central Pennsylvania. Thank you for putting this together. I was really excited to see this. And I actually skipped the LEAP Forum, which I usually attend every year. But I also came because I wanted to learn something new and hear a little bit more information so that I could take it back to where I work. I'm an educator, but I also work as a medical assistant with Keystone Agricultural Worker Program. Initially, our program used to be Keystone Migrant Health, but we changed it because we realized that it included more of a general population versus migrant. We work with agricultural industry, such as farmers, packing houses, and so forth. But my role as a medical assistant is going out to these labor camps. In Adams County, we have about 100 labor camps. And growing up, I grew up in this area. My parents were also in the Agricultural Worker Program. Long story short is we actually go to these camps. We provide basic healthcare needs, such as health screenings. We also provide them with education materials in their language. But it's not just the Spanish-speaking population. We also have Creole-speaking populations, and we're also seeing a little bit of increase of other languages, like Portuguese, which is really strange because of H-2A visa workers. So now, it's harder for farmers to find workers, so relying on H-2A visa workers. But other things that we also provide is we provide resources, such as for females, mammogram, OEGYN, pap smears. We also provide dental care education. That's one of the things we've noticed is an increase of cavities and lack of dental care. We're working with a healthcare organization for next year to hopefully do a mobile clinic for dental care. But it's really pretty neat. I just wanted to share that, what we're doing in that area. It's really exciting. I like to, I teach during the week, but in the evenings, I usually give my time out, especially since I'm bilingual in English and Spanish, to provide a little bit back for the community. So I do appreciate all the information that you provided. I mean, I'm hopefully gonna have time to view some of the documentaries there, but I could definitely connect. There is this little gap, and not a lot of people are aware of what is going on in their communities, and I just wanted to share what I do. That is great. Thank you for sharing. Wonderful, wonderful way to take it in your own hands, especially in your community, and just be a service to people. That's fantastic. Kristen? Julie Lorschetter, Wisconsin. When I heard that first lady come up here about that, what went into my head was, we have a medical assistant, a Winifred White. We work with the veterans of the VA, and she kind of went out of her way, because she had seen a person, he's African-American, I'm gonna believe, wheelchair, and she went to, he had to have a blood draw, blood draw, and then he says, okay, that he was not feeling well, and he just wanted to be wheeled home, or to the door to go home, and she convinced him, no, you're not. You don't look good to me. You're going to the emergency room, and she proceeded to wheel him, and he had to be admitted, but she had to convince him, because he was, no, no, I wanna go. You're being a veteran, being of color. He just didn't wanna be hospitalized, or he didn't think he was needed to be in the hospital, but she kind of could sense it, so there's a sprinkling of us medical assistants out there that we have to convince them, too, that something's wrong with you. Thank you so much for that. Yes, and that's going the extra mile, right? That is going the extra mile, seeing there's a need. I know there are 20 patients waiting, but you know what? This person needs a little bit more, and I care enough to do what is necessary to give them what they need. Thank you so much for that story. Are there any other questions? I see that we have our question has been answered. Mostly, everyone's feeling empowered and aware and compassionate. I'm going to attempt to stop my share here. Everyone's been very helpful. Okay, there we go, good job. All right. For the handout, we can go back to that if you want. So when it comes up, it'll have a little web address, and you click on that, and it'll open it up. Are we able to see the slides again? Wait, I'm supposed to do something over here. I might need some assistance. Okay. It was my pleasure to be with you all today. I'm going to share my contact information. If you would like, please feel free to send an email. My website, visit there. I couldn't get it back, sorry. Please do. Thank you so much. Thank you. All right, here we go. Thank you. Yes. I might be on this. All right, yes. Here we go. Yeah, there's contact information if anyone would like to reach out. Thank you. Thank you. Oh, you're very sweet. Thank you so much. Thank you. Now, I'm just going to... I hope next week goes well. Thank you so much. Thank you.

diversity

inclusion

health equity

social determinants of health

unconscious bias

racism

health disparities

Black maternal health crisis

disabilities

LGBTQ+ community

patient care

cultural humility

provider diversity