CASAT Podcast Network

Hello and welcome to season three of CASAT Conversations.

I am your host, Heather Haslem.

This season we will explore the weighty topic of health equity.

Within each conversation, we will discover insights from researchers, practitioners and experts on this complex and important topic.

We hope you enjoyed today’s conversation today.

We’re welcoming Jose Melendrez.

Jose is the executive director with the office of community partnerships at the School of Public Health at University of Nevada Las Vegas.

Welcome Jose.

We’re happy to have you here today.

Thank you Heather.

Glad to be here Jose.

Please tell us a little bit about yourself and what inspires you to do the work that you do to promote health equity.

Well, I guess we’re gonna go get personal real quick.

Um, so the reason I do what inspires me to do health equity work many years ago when I was at the University of Michigan earning my getting my working on my master’s degree in social work.

Um I had been spent most of my professional career working with at risk kids, gang kids, getting them out of gangs and putting them on alternative pathways to a better life.

And at that point I was working for the Boy Scouts of America and did some work there with alternative programming for kids and gangs.

Um then had the fortune to go and work with work with the United States Senator harry Reid, where I did latino outreach latino community outreach and still dealt with working with not only latino families and everything, federal education issues, department labor, civil rights issues, things like that, but also there was still a component there working with the families and those kids who were in trouble.

And so, um years later, a friend of mine who was at the University of Michigan convinced me that I had to look at a degree in social work that everything I did with at risk kids and communities, There was a pathway in social worker and I had no idea.

Uh, and so I looked into it, checked it out.

And again, you know, my experience with social workers had always been negative because they’re the ones who break up the families are the ones who pulled the kids out of the house.

Uh, there’s historically social workers have not been the most positive interactions when it came to uh communities of color.

And so I had never even thought about a career in social work.

And so I looked into it.

Um, at the University of Michigan looked into it, my wife was getting her PhD, I looked into it so that there was a lot of options in social work.

And so I did, I went for it and got in and started my, my training there.

Um, The year that I graduated in 2003 with my degree.

And you know, the Lord’s funny the way he works when he or she depends who you’re talking to.

Um, but it’s funny how different things get put in our, in our lives And how we react to it.

So that year I graduated from with my master’s degree in 2003 and my father had been sick from diabetes and all these other things and he ended up the month that I that I graduated, the month after that I graduated May and june he ended up passing away from complications from his diabetes and I wasn’t able to be there um because I was, we were still in Michigan and so um so the diabetes, it causes hard to be to weaken over the years.

And so he went in for, and I think it’s called the angioplasty type where they run the tube through your veins to clear out your veins.

And he um um started having all kinds of complications with the process and he ended up passing away.

Um and two months later, two months later I was, I was working in Detroit for a different nonprofit group, working with at risk kids.

When a faculty member of my friend and colleague of mine contacted me as hey, would you consider moving into a different position?

I said doing what?

And they said, well, we have this project that the university of Michigan working in the joint called healthy lifestyles project and healthy pregnancies healthy eating lifestyles, quality of life.

But one of the major projects was working with communities and educating them around diabetes.

And so I had, I mean it was, you know, it was a done deal for me.

I said what?

And they didn’t have at that point, they didn’t have anybody on the team.

That was, that was a Spanish speaker, bilingual.

And so again, I say, it’s it’s funny how God works because, you know, four months earlier, my dad had passed away, Sarah was being offered an opportunity to go work on a major project in Detroit that the core of it was educating and raising awareness around diabetes and its impact on the quality of life for folks, you know, and the thing about diabetes, it doesn’t care what color you are.

Um if you don’t take care of your diabetes, you can end up in a very bad situation.

So here I was being offered the opportunity to start working on this project.

And so I did.

And that was that was my introduction as even though I’m trained as a social worker in community organizing, that was my introduction to um the intersection of social work and public health.

Mhm -8 years of diversity work at UNLV.

I’ve always been involved as a social worker in the public in a in a public health trajectory.

And that’s what had brought me into equity and diversity work and health inequities and dealing with those things in public health.

And six years ago I was offered the opportunity and I was working in the diversity office that, you know, six years ago now I was offered the opportunity to transition into the school of public health and take on this mantle for working in health equity initiatives and, and so, um it’s what I’m doing now and I love every minute of it, that’s incredible.

I love how um really this, how you were touched right by what your dad went through in this deep way and how it’s fueled your passion for supporting minority communities so that they can have healthy lives.

Yeah.

You know, it’s just an issue of, it’s an issue of uh, of understanding the process, having access resources, all the different things, you know, what the pandemic has done is really brought to the forefront, just how much inequity still exists in public health and medicine and all those other areas where where communities of color are, you know, when you look at any of the numbers during the core parts of the pandemic, you look at any of the numbers and at any given time, at least in Nevada, I’m sure it resembles across its reflective across the United States, but at any given time in Nevada, the communities who were getting sick or dying from the pandemic from the covid.

At one point in the lead was the African American community.

And another point, it was the latino community.

Um at another point, it was the filipino community and those three groups would kind of move within each other as to who was getting sick and dying.

And so I feel that I was very fortunate.

Um and I’m still fortunate to be in a place where I am able to serve Around outreach engagement, education of how to survive.

You know, not only the pandemic, the the impact directly impact of the COVID-19, but now that we’re seeing the fallout of the COVID-19 with mental health, suicide awareness prevention, um opioid abuse and and desperate mobile, all those things that are now coming to the forefront because of the increase in those areas, especially in the black latino communities.

That makes me wonder how would you describe the state of health equity within Nevada today?

You know?

Um I would definitely, yes, those inequities still exist, but I would say that Nevada is definitely on the, on the, on the front lines of of doing something very positive about that.

And it’s across the board.

You have, you have a group of state legislators with the black and the Latino caucus.

Recently, the last couple of weeks we have put forward laws bringing more equity in from a from a from a legal perspective, bringing more equity into our law.

So now you have an example, the every big health service provider in Nevada is required by state mandated to have cultural competence training.

Um so from the legal perspective, you see, you see that and there’s a bunch of other laws about how to capture all the different diversity data that needs to be captured how to document it, how to interact with those communities.

Um and then, you know, during the pandemic, you had Governor Steve Sisolak who declared racism as a public health issue.

Uh and that took a lot of that took a lot of work and a lot of courage.

Um but again, it’s elevated that to the forefront and my work with the my work through the, you know, the School of Public Health and the Nevada Minority Health and Equity Coalition.

We’ve been engaged by multiple entities, both at the federal level Region nine, the state level Department Health and Human Services to engage with the coalition to ensure that the diversity and equity voices are at the table with all of the work that’s going on first with the pandemic.

The Covid and now all of the fallout from the pandemic and the Covid with again with the mental health, suicide awareness prevention, opiate abuse.

We’re, you know, we’re at the we’re at those tables working hand in hand with those offices to make sure that diversity and equity is represented at the table um from the front end and not as an after after afterthought.

And you know, for example, tomorrow night, March one We’re holding another another one in a series of webinars looking at suicide awareness and prevention that is being funded by the state of Nevada day to chess behavior health offices were working with them on moderating that panel tomorrow night directly targeting the latino community.

And will you tell us a little bit about the coalition?

So about 11 years ago now we’re actually getting ready to write, write the historical paper on the coalition its existence in Nevada.

So about 11 years ago, um, it was the first time at the state legislature, we had a pretty significant group of black and Latino elected officials both on the assembly side and the and the senate side.

And so the black caucus and the Latino caucus there as they were doing their work and going through the legislative process.

That at that time they started asking a lot of questions about, they knew there was an office for minority health.

Um, but they didn’t really see a lot of things happening there.

And so certain people started asking questions and I will, I will always give him credit.

Former Assemblyman Tyrone Thompson who passed away, I think about three or four years ago now, passed away, unfortunately.

Um but he led those efforts and he was a core partner of the coalition back then.

And um, they started asking these questions about, well, what do we know this office exists?

But where are the resources, where’s the office, where’s the staff, what’s, what the, where’s the work that’s going on?

And, you know, no, no disrespect to the state folks.

They they’ve always got their hands full.

Um, but um, but nothing was happening.

I mean, realistic reality was nothing was happening in those areas.

And so the typical form, Well, let’s let’s research, do we need the question was asked, do we need an office for minority health?

And so I was fortunate enough to be in the right place at the right time.

And so the person they contracted to do that research reached out to me and said, hey, can you help me with this research again?

Back then, I was in the diversity office at, you know, v can you help us with this research?

I know you’ve got a foundation in public health.

I said, sure, I’ll be glad to.

And so we did.

We did.

And then down here in southern Nevada, I facilitated.

I think it was 57 1 on one interviews.

Uh five Town hall type of convenience where we had at least minimum 50 people at each.

One of those convenience.

And the question was, is the office of minority health needed in Nevada?

Well, overwhelmingly to the person.

The answer was yes.

Because when you look at the state of Nevada, especially in the last 10, 11 years, where’s the one place for sure that we’ve seen growth?

Well, that’s the diversity of our population.

So how could you have, that’s where your biggest growth is?

And how could you not have an Office of Minority Health.

And so to Assemblyman Thompson’s efforts.

Leadership.

Not only did they re established the office of minority health, but then they transitioned to to be out of the office of Minority Health and Equity to ensure that we were capturing everybody that needed to be captured Most of the time when you think about multiracial or multicultural initiatives, they tend to, they tend to focus on race, ethnicity, they might, they might open the door to gender.

Um, diversity and Equity takes it a whole lot farther.

Uh, and so it did, it became the Office of Minority Health and Equity.

Well, at the same time that they were establishing the new office and this is where my hat’s off to the state folks.

They acknowledge that they could have done a better job, could have been a better job of serving these communities.

And so part of my foundational work of what I’ve done and have strengthened is doing coalition building.

I’ve done a lot of that work I did in Nevada before I left in Michigan while I was there to try to help build the coalition there to support the work there.

So they asked me could I help build a coalition that would be partners with the new Office of Minority Health and Equity, both on the side of resources, administration, um cultural competency training those types of things.

And this is where my hat’s off to the state.

And when they weren’t doing the job right, that there would be a voice to hold them accountable.

And so the coalition came into existence.

It was created the state put their money where their mouth is.

Um, they gave us for two years.

They gave us seed money to get the coalition off the ground And we did.

And so we’re now, like I said, we’re now in our 11th year of operating last year, we had over 300 members of the coalition in all different areas.

Government folks, federal folks, state folks, local agencies, community based nonprofits, other community based organizations, individual leaders who care about this, about this area of health equity.

Uh and the coalition’s been at work.

And again, we have had a um, we really were brought to the forefront in terms of how to reach these communities during the time of the pandemic, the Covid And now that work continues with the mental health and all the fallout of the COVID-19 and so the coalition has been an instrumental part and continues to be an instrumental part of having an impact in Nevada.

To make sure that bipac L G B B Q I plus veterans, um, levels of education, people with disabilities, All those folks are represented in this work as we, as we started to make sure that everybody’s um, understands how to stay healthy, how to stay safe.

Um, understands why the vaccines are good vaccines and arms.

A lot of work revolves around vaccines and arms, the mask mandates that were recently lifted.

We were a big part of helping to message and get that message developed the message and get the message out into the community.

I’m curious what has been the most um Impactful thing that you’ve seen the coalition accomplish in the 11 years.

Well, I mean, I would have to say, I never, I never saw myself being on the front lines of a pandemic, you know, I I just had no idea.

And and so to have been, like I said, it’s been my honor to have been in a position two represent.

You know, I can’t begin to tell you how many different boards and councils and work groups I’m a part of right now um to represent the coalition, but more than just myself representing coalition is being able to make sure that the right information is getting to the communities that we serve so that they can access.

And so whether it’s faith based, whether it’s business, whether it’s it’s grassroots level, we’re on the front lines and I never, I never like most people, you know, and I never saw myself living through a pandemic.

And then on top of that being on the front lines of the education and outreach components of this pandemic to make sure that people were getting what they needed to get in order to survive it.

Um and so what I’m proudest of is that we’ve done a phenomenal job, I think myself, we have academic partners on the faculty side who worked with us closely.

Um we’ve been pulled into multiple grants to make sure that we have the resources to do this work.

Um, you know, we developed a tv commercial that was playing, which was one of the most it addressed the multicultural and diversity and equity of the populations we serve.

Um so messaging radio billboards, all those things that we did to get the word out about how to stay safe.

Uh and then followed up by then as the vaccine was coming out, vaccine messaging, helping people understand what the vaccine was and why it was important.

And then when it when it came out, um transitioning to vaccine equity work and making sure that everybody who needed it had access to getting the vaccines in arms.

And so I’ve been, for me, that’s probably right now the most proudest part of this work, that I’ve been a part of that team because there’s a ton of folks, it’s just not me, there’s a ton of folks who have been a part of this academic folks.

State folks.

Dr, Stephanie Woodard at the Department of Health and Human Services, Sheila Lambert, a part of her team are our Dean, Sean Gersten Berger, who has created the space in my everyday work to be able to contribute the majority of my time to doing this work.

Uh And so that for me the last three years, that’s probably been the proudest part that I’ve done or having been lucky to be a part of this effort to mobilize our communities around surviving this pandemic.

And now scary for me is that we’re now diving into all this work around mental health, suicide awareness and prevention and and it’s um that work is important to me because we, you know the issue of of suicide awareness got very personal for me a year and a half ago when my son um tried to hurt himself, I don’t think he’s trying to, trying to commit suicide, but he he did try to hurt himself and left a message that was a wake up call that wow, when you think everything is going right, um you know, you gotta check your own back door uh and be ready because that that took my wife and I by complete complete surprise um that our son and he was in a school, he was in a catholic school where they didn’t stop going, but just the all overall change of how we live our lives upended everything and we thought we had things under control and we did and it and it hit home, it got really scary and it got really close and so I think of those family and I’m and I’m a person with resources, I think about all those families who don’t have the resources or don’t have access to health insurance or you know, because I got to that morning when it happened, I was able to get on the, get on the call, get on a phone call and within the hour I had psychiatrists and psychologists and social workers and folks that I can connect my son too and were able to go shopping and find the right fit so that my son could get some help.

And I think about all the poor families who don’t have that, how critical we are in the sense of making sure we might not be able to connect with somebody, but we can for sure get them the information or somebody who can’t afford it.

Can we find them someplace where they can get services and not have to worry about about having to pay out of pocket for this or for that?

You know?

Um, at one point right now, I think right now the work that we’re doing around the suicide awareness and prevention, um, you have latino males and african american african american males who are at the top of the list of either either having thought about suicide or unfortunately completed.

You know, And those numbers get scary.

Uh, for me again, that’s another layer of where it gets very personal with the work that I’m doing right now.

Yeah.

And I would imagine that personal experience then fuels your passion to work even harder.

You know, I’ve, because of my background and diversity, I’ve been, I’ve had multiple opportunities over the last four because everybody’s jumping on the bandwagon.

We need a vice president for diversity.

We need a vice president for diversity and inclusion and higher ed.

And so multiple jobs have been sent my way.

And I like I like turned them down.

I’m like, no, I’m doing important work right now and this is where I want to be.

Mhm And you know, as we look at the fallout of the pandemic and the mental health needs and really the important work of suicide prevention right now, what do you see as the most important thing for behavioral health professionals to know right now?

That’s a good question.

I think I think it’s critical that we, because of my world that I deal in.

I think it’s critical that we approach this work from a place of openness, compassion and uh and maybe vulnerability, you know, I don’t have the answers to everything, but but I I like to consider myself a lifelong learner.

I think we have to be open to the process whether we agree with it or not.

That’s why I say so.

I say compassion, vulnerability and and open communication honest communication, intentional being very intentional about the work that we’re doing because a lot of people are suffering.

Um you know, the right now everybody’s excited because yeah, the numbers are going down.

Not as many people dying all that can some people getting sick, but the unfortunate reality Is I think I think that I think I heard the letter number like 70% of the United States is now vaccinated.

But the unfortunate reality is that while people remain unvaccinated, then there still is life in this, in this virus.

Uh and so we have to find different ways to be able to communicate to all those folks as to why this is critical and I think on the behavior health side is where a lot of that maybe we’ll find its home is finding its home and is the foundation for how we approach our work, you know, and there’s not one, there’s not one Um one answer, 1, this is the way you do it.

You know, we’ve all got to be open to that process and how we find ways to connect, communicate and continue to move our community in in a in a positive direction um you know, especially given what’s happening right now in europe, I mean I’m just, you know, that’s about to turn everything upside down if if we don’t stay on top of that and get that under control.

Mhm.

Yeah, we sit at a very pivotal moment in history, it feels like um and mental health, you know, as we come out of the pandemic, there was already an insurmountable feeling of stress um and now, you know, as we’re on the brink of whatever the world is on right now adds an additional layer of stress and concern.

Um what I heard you talking about that I think is important is this ability to connect with behavioral health providers as well as to communicate with behavioral health providers within minority communities.

And so I’m curious what you see as the biggest needs within both of those areas.

So connecting and communication I think on the health service providers and I think that’s why I say Nevada has really done a good thing recently um is the issue of cultural competence and cultural humility um for those of us who are in positions of authority or positions to work to help uh to provide services, we need to understand how to work with those communities, we have to we have to meet them where they are um so that we can then get them into the services or access to those services that they’re that they’re gonna need.

Um and that’s that doesn’t come easy for everybody and you know, and and but I think the mechanisms are in place, the laws are in place.

Um the resources are in place.

I mean we can always use more resources but it’s how we use those resources and how we facilitate these conversations and so you know, like I said, I’m one of those folks that sits in that kind of that middle of the road between the health service providers and the community.

They need to serve to help facilitate some of those conversations facilitate some of those trainings um facilitate those connections through the coalition and the work I do with the, you know, the school of public health, you know, and I take that responsibility responsibility very seriously because of at the end of the day, if we don’t do that right.

Um then it’s those families, it’s those kids.

Uh it’s those communities that are going to lose out.

And so I think we all have, we all have a responsibility from that capacity of understanding where our part is where our role is and and doing doing everything we can professionally and maybe even personally to facilitate those kinds of environments where people are connecting that need to connect.

Mhm.

And as you sit in the middle of those conversations, what are you hearing from the minority communities within the state as the biggest, you know, depending on who you talk to, there’s always more that can be done and granted, Yes, there, you know, if if every day you gave me a million dollars and I had everything I needed to do the work.

Great.

But then yeah, I hear you will do this tomorrow, we’ll work on that next week and we’ll reality is we don’t have that right.

Uh you know, identifying, continue to identify where the needs are continuing to recognize that there are still challenges to those communities um and owning that, you know, uh a lot of the work when it comes to cultural competence and cultural humility and those things is um when you start when you dig deep into those areas um in order for somebody to have an honest conversation about their place um on the continuum of am I, am I an ally, or am I anti this or that is you have to acknowledge where you sit, where you are.

And so when you start having conversations in public health about racism and its impact in our communities, um, it’s not an easy conversation because in order for somebody to acknowledge that that is an issue, they also have to own where they sit on that continuum.

And so it’s not an easy thing for somebody to sell.

I might be racist when I think about how I approach that work or or that, you know, for all of my years, I consider myself an ally, but I’m realizing that I don’t really know what I think I should know.

So all those, all those things come to the forefront right now.

Um, and that’s where the cultural competence and understand cultural humility are are critical in the world of public health um, as we approach that work and how we approach those communities.

Because, you know, again, at the end of the day, um, I I sit in my nice house.

I I drive my new explorer.

I come home at night.

Um, if my kid gets sick, I can run them over to the hospital, not worried about it because I’ve got I’ve got health insurance.

Um, there’s a lot of folks who don’t have that.

There’s a lot of folks that we have in Nevada, we have not only communities of color.

Um, but then we have a large undocumented population.

We have, we have folks who are some kind of immigration status and they don’t have health insurance, they don’t have the resources or maybe language is an issue and they don’t speak english or their understanding based on whatever country they’re coming from, Their understanding of the health system is very different from the countries they’re coming from.

And and so it falls on those of us who have the means, those of us who are in these positions.

It is our responsibility to meet those folks where they are.

And so I think, you know, you asked me how people, how folks on that on that end of it.

See it?

Yeah, there’s still, there’s always gonna be challenges.

There’s always more that can be done.

And I guess what I would say for my part of is, um, we have to continue having those conversations and understanding where we’re, where we’re not doing the job is the best that we could.

But the other side of that is we also have to acknowledge, well, given the resources we have, this is what we can do right now, and we’ll put that on the list and I commit to you that we’ll get to that the next round, you know, and so making sure that we don’t lose track.

We don’t lose sight of ultimately, where we want to end up, we may not get there.

It might take us a little while to get there, but we can’t lose sight of that.

Mhm.

And it’s it goes it does, and it to me it goes back to what you said about the importance of openness, compassion, vulnerability, even you talked about yourself being a lifelong learner, but that um all of us really need to be lifelong learners in um continuing to look at what we know what we think we know um and then open to learning from other people about their experiences.

Well said, Well said, so we know where you live.

Your zip code matters, what innovations are being done in the state to support the needs of people living in low income neighborhoods, all of our all of our work right now around the Covid around the um the fallout of the covid with the mental all that work.

Um It’s those zip codes that we target, I mean, we you know, and and those zip codes, they’ve not changed, right?

They’ve been the same zip codes, low income uh SCS all those other things that we’ve been working out for years when it comes to health disparities, but they’ve definitely been um they have definitely been elevated Um two more as a more high priority area.

And so all of our work right now that we’re doing again in response to the Covid in response to the mental health suicide of um those zip codes are the are the are the communities that we’re targeting for our work.

And so both through the coalition partners that represent those communities, you know, as an example, we recently were strongly encouraged to apply her Sir put out a grant another grant to address the issue of of vaccines and arms um with the priority.

But then there was other elements that you could identify.

So for our for our work, we identified um education engagement and vaccines and arms.

And it was, I think the top the 10 most impacted zip codes that we identified from our other grants that we’ve been working on again, brought them to the forefront and then what we did um, the way the coalition and the School of Public Health, our work together, we utilize the method called community based Participatory research.

And so through that method, we actually train our community partners to work with the side by side and whether it’s evaluation assessment in this case is going to be vaccines and arms.

So the grant that we wrote any time the coalition goes after grant, we try to make sure that if we land this grant, we can take those financial resources and put them back into the community where they need to be.

So we had 27 partner organizations co apply with us for this grant.

And that’s a that’s a huge number.

Yeah.

And so we know that if this grant gets funded, we know that we’re gonna have the right organizations on the ground ready to hit the ground, you know, ready to hit the ground running to do the work that we need to do and that’s and that’s how we operate.

So, you know, we were very aware of those zip code areas and the communities that live in those in those zip codes uh and that we know we are having a direct impact into those zip codes into those communities.

I’m also curious if you know of anything being done going back to the beginning of our conversation and diabetes um and the work that you’ve done in diabetes as we look at prevention, uh prediabetes diabetes etcetera, what’s being done within the state to address chronic disease and the prevention of chronic disease.

Well, ton of theirs through our we have at the School of Public Health, we also have the Nevada Children’s Research and policy Institute nick rip and they do a ton of that work with childhood obesity, uh family health, quality health living Dr Amanda Haboush Deloitte and Dr Erika Marquez are partners with us in the coalition and they kind of leave the academic arm.

So there’s a ton of that.

I mean you I don’t think you can approach, you can’t ask a question about quality of life um if you’re not understanding healthy lifestyles, if you’re not ending understanding healthy eating access to those resources, understanding the diabetes and the role that it plays with communities of color especially.

Um and so I I don’t know, at least in our work.

I can’t speak for other projects, but I know in our work those are always components or elements of thinking about the work that we need to do in those areas.

You know, from what I did, what I can tell, it’s ongoing work.

You know, the Southern Nevada Health district, The project that I was a part of in Michigan was a program was a project called Reach, which is a CDC funded initiative that stands for racial and ethnic approaches to community health.

And so the health district was, we were so excited because We’re now in year four of a Reach initiative that was funded here in southern Nevada.

And again, the Reach initiative, that’s big picture quality of life healthy lifestyles.

And so we are the coalition in the School of Public health is a partner with the health district in that Reach initiative.

And so that’s about healthy eating healthy living, smoking sensation.

Um all those different efforts that that they put in and we’re partners with them to continue that work here.

And if we do our job right?

Um that should get funded for another five years, you know, if we’ve been doing our job right?

And so, so that’s ongoing work.

Like again, I don’t know i in my world, you can’t address the public health issue without that being part of the conversation.

Yeah, agreed.

It’s such an important piece of part about the conversation on how do we support quality of life for all, all human beings.

What I hate to say, I think what I hate to say is that because of the pandemic, it did put a lot of those core issues kind of on the sidelines.

Um but I think as we, as we’re hopefully on the other side of this pandemic, I think all those issues are gonna come right back to the forefront real fast.

Mhm.

And we need to be ready.

Whatever the question we need to ask, what have we learned about the pandemic and how to handle a crisis like that and understanding that hey, you know what diabetes is still a crisis in the communities of color uh lack of access to quality food is still an issue for places to exercise, you know, in the summer here, if you’re not in the gym, if you don’t have membership in the gym, just like in Michigan, if you didn’t have access to a gym, it was very difficult to get an outdoor workout in the middle of winter and like here it’s very difficult to get a workout in the middle of summer if you don’t have access to a gym and the only place you can go to a public park or something like that.

Um you know, and you you want to talk about scary when you think about where we’re going with all this climate Impact and that things are two or 3° warmer now than they were 10 years ago or that this is the hottest year we’ve had on record uh in the United States.

So all those things are coming our way and the communities that are going to be impacted the most are are are those those zip codes you talked about earlier?

Mhm.

So you’ve been doing this work since 2003 and so you’ve seen, I’m sure quite a bit of change and evolution.

What are some of the biggest changes that you’ve seen and what do you see as the outlook moving forward?

Well, I mean, for me again, I’m proud that in Nevada, I think it it is an open door uh and very much a willingness by the policymakers, by the decision makers, by the people who make the laws, all those folks.

There is an understanding of that diversity and equity and inclusion are critical components d I are critical components of any work we do, you know, And and right now, I mean, I guess I would say maybe the last couple of government Governor administrations, Sandoval Cecil ac um they’ve all had their foot in the door in terms of understanding that that process is critical.

Uh and again with governor Sicily’s leadership, um understanding that racism is a public health issue, I think has really set the foundation for what the work that we need to continue doing in Nevada.

And so I guess that part of it makes me very kind of proud that we are in a state that is understanding of that, maybe we’re still figuring out the pathways um but but it’s it’s it’s on the agenda and we’re talking about it and we’re doing something about it.

That’s awesome and yeah that’s that is the critical piece right, showing up and having the difficult conversations and looking at what pathways are available walking down some that may work and some may not and then learning along the way, you know through the CDC.

We got we received a new grant Nevada got a grant um with specific the specific purpose of this grant is to increase the diversity of the workforce in public health and all the public health fields.

And so we, at the school Republican we got a small grant, I’m sure you and I got something I think high sierra, heck I know they got a significant size grant up in Northern Nevada, we’re working with them around increasing and we just put that we just put together another council statewide council on specifically working with the state of Nevada on increasing the diversity of workforce in the public fields.

And again that’s just another layer of the commitment to increasing how we reach and serve our diversity communities.

Mhm.

That’s awesome and super needed and exciting.

Um so as we wrap up anything else that you feel that is important for our listeners to know, you know, the only thing I would say is the whole issue with, I would say with misinformation, especially around these subjects, there’s just a, you know, there’s just a bunch of information that’s not right, it’s not accurate.

And and so whatever, whatever means they have to news to media too contacting, you know, I mean, I put out that they can call my office, I’m at the School of Public Health and um make sure that they’re getting the right information for whatever their concerns are, whatever the issues are, because misinformation, as we’ve seen, as we’ve seen during the covid time, you don’t get the right information or you’re going off the wrong information.

People are people died, people died because they didn’t get a shot in the arm, You know, and that’s, you know, 800,000, whatever the numbers up to now in the United States, Um um 800,000 people in the United States, a lot of them lost their lives needlessly because of misinformation.

And so that’s the only thing that for me is so concerning that um that we need to make sure everybody has access to the information has resources to be able to do something about it.

Uh and that they could have a voice at the table.

That would, those would be my my ending statements for for this work, yep, that makes perfect sense.

Um So I just want to thank you for your time and all the work that you do within the state really to um bring quality information about this important topic of health equity, providing resources and bringing all the voices together so that we can have these difficult conversations.

Thank you.

Thank you have a good day.

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