May 19, 2023
Join us this week on Talking Pediatrics as James Burroughs shares his honest conversation with award-winning journalist and author, Roxane Battle, about health equity, community and belonging.
Dr. Angela Kade Goepferd: This is Talking Pediatrics, a clinical podcast by Children’s Minnesota, home to the kid experts where the complex is our every day. Each week we bring you intriguing stories and relevant pediatric health care information as we partner with you in the care of your patients. Our guests, data, ideas and practical tips will surprise, challenge, and perhaps change how you care for kids.
Welcome to Talking Pediatrics. I’m your host, Dr. Angela Kade Goepferd. On this episode of Talking Pediatrics, our guest host James Burroughs, Chief Equity and Inclusion Officer at Children’s Minnesota shares an honest conversation with award-winning journalist and author, Roxane Battle, about health, equity, community and belonging.
James Burroughs: Welcome to Talking Pediatrics. This is James Burroughs coming to you from the Equity Inclusion Suite. I’m the Senior Vice President and Chief Equity and Inclusion Officer at Children’s Minnesota, and I’m glad to be here today with one of my favorite people, Miss Roxane Battle. How you doing, Roxane?
Roxane Battle: James, it’s great to be here with you. I’m doing well. Thanks for the invite.
James Burroughs: Well, thanks for coming. And you know about the show and the show goes out to a variety of pediatricians, clinicians, people in the community who are caring about our kids. We’re the kid experts at Children’s Minnesota. We care about families. And today we’re going to just talk about a variety of things related to equity, about human care, human touch, how we need to be there for each other, and also too what those things mean to us as a community and how we grow. So easy first question, who are you?
Roxane Battle: I’m a storyteller, have been my whole life since I was knee-high to a duck. Started wearing little suits when I was 11 years old after I saw Barbara Walters on TV interviewing somebody famous. And I was struck by the fact that, wait a minute, you can ask somebody a question and they’ll answer you back and you’ll learn something? And that was the genesis of my journalism career. And so yeah, I went to graduate school and undergrad, studied journalism at the University of Missouri, Columbia, University of Minnesota. Came back here to my hometown in Minneapolis after some small market experience. And many of you may remember my days as an anchor reporter and talk show host in KARE 11. I never pursued television with the idea of being famous. That was not the goal. The goal was, and still is, to tell stories. And that’s what I’ve done as a book author and as a mental health advocate, and the story I just told here on your podcast.
James Burroughs: Okay. Well, you have been a great storyteller, your books are amazing. Anybody influence you, I know you talk about Barbara Walters, but any other people influence you as a young person when you were a kid to do what you do now?
Roxane Battle: Carole Simpson, she was the first Black woman to anchor the evening news on ABC. I remember as a young girl turning on the television set and seeing Carole Simpson with her beautiful hair and she had this very distinct way of speaking, and I was like, “Holy cow, I can do that.” And I think when it comes to the next generation, when it comes to our children, that’s a really key point is providing them with examples of who they want to be. They’ve got to be able to see it to believe it or really feel that way. And I think about all the beautiful Black women, successful women in my life. My mom took me to the Ebony Fashion Fair Fashion Show when I was a little girl, and I remember standing there and looking at these gorgeous Black women with their six-inch eyelashes.
James Burroughs: I remember that.
Roxane Battle: And I was like, “Oh my gosh, I can be that. I can do that.” And throughout my life you see these examples, and when you get to a point in your adulthood and you have these flashbacks of what happened as a child, you start to connect the dots. What if I hadn’t seen those examples? Would my trajectory or would my path be the way that it was? Or would I have taken a different route? But by holding that sort of north star in the back of your mind, I’ve seen it, I can do it. And I think that’s really important when we talk about our kids.
James Burroughs: I remember Carmen Harlan, who was a news reporter in Detroit in the eighties, was my keynote speaker at my eighth grade graduation. I remember Diana Lewis, another Black woman. And I remember seeing those things saying, “Okay, if I want to do that, I could.” And you didn’t know this about me, I was a performing arts major in high school.
Roxane Battle: Look at you.
James Burroughs: So I used to do plays, radio, TV, public service ads and those kind of things, and they inspired me to do that, seeing those images of what I could be. Because a lot of times what you saw was negative images as opposed to positive.
Roxane Battle: Right. That positive imagery. You don’t know what impression you’re going to leave when a child’s mind. Carole Simpson will never know that I was awestruck watching her on television until I went to the National Association of Black Journalist Convention in Chicago and I met her face-to-face and took a picture with her and thanked her for being the role model that she was. So seeing though that imagery doesn’t make our children’s dreams possible, it makes our children’s dreams probable because they’ve seen it.
James Burroughs: Let me ask you this, how do you think that impacts kids’ mental health and mental wellness? Because there’s a lot of things that we’re talking about at Children’s or we’ve expanded our mental health unit for inpatient care and our behavioral health unit as well, because our kids are suffering.
Roxane Battle: Yes.
James Burroughs: In mental health. How do you think those images or those positive things you talked about, impact kids’ mental health?
Roxane Battle: When you look at what’s happening to our teenagers as a result of the pandemic, as a result of the influences on social media, there’s statistics out right now talking about one in three, one in four young people have considered taking their own life, and you look at body imagery and that kind of thing. So we’ve got to get to this now. Otherwise, mental health will be the next pandemic. Our children need to understand and be given permission to be vulnerable with their emotions and with their mental health to speak what they know with respect to what they feel. And they’re not going to be able to put a name to what I’m feeling if they’re not seeing that being modeled. And I think caregivers and parents and aunties and that village has got to model that behavior of normalizing talking about their feelings, normalizing addressing epigenetics and generational trauma and working through those difficult conversations as a family so that those patterns don’t repeat themselves in future generations.
In my book, Pockets of Joy, I write about raising my son after my divorce as a single mom, and how just spending time and being present with him to help him feel seen and to create those spaces where he can say I’m sad, or where he could, if he needed to, cry. Normalizing that kind of behavior, then we’re getting away from that sort of hard behavior that can lead to dysfunctional relationships and marriages, and people are being able to see each other and communicate and work through some of the difficulty that just sort of can spin out of control if we don’t address our emotions, particularly from a male standpoint.
James Burroughs: And as a young person growing up, I didn’t realize that. I didn’t realize it. Just that presence, even if I’m not saying anything, even if I’m not talking…
Roxane Battle: Absolutely.
James Burroughs: Has a strong impact.
Roxane Battle: We are never going to get to a place of healing and wholeness if we don’t open up these conversations and break these false constructs. We’ve got to be able to talk about mental health the same way we talk about physical health because mental health is health. And you know the stats that if mental health issues aren’t addressed and you’ve got comorbidities, that’s going to send healthcare and the cost of healthcare through the roof, it’s going to exacerbate an already difficult situation if we don’t get ahead and address mental health concerns. And that means giving people permission to talk to a therapist, to express their emotions, to create safe spaces where they can do that, where they can be vulnerable. And that takes a certain level of leadership, modeling, and community, and the willingness for us all to be open to have these conversations.
James Burroughs: Let’s talk about community. So how do you and how have you engaged community around the talk of wellness, whether it be mental health wellness, physical wellness, spiritual wellness? How have you engaged in that work and what are some of the hints you may have or tidbits you may have?
Roxane Battle: I was working with this health care app called Sanvello, and we got approached to do some mental health work in one of the communities around the George Floyd neighborhood. The teachers were stressed out and they needed some help and they wanted us to come in and provide some mental health counseling, whatever, and I’ll try to keep this story short. And so we said, “Well, we’ll provide you free subscriptions to the app. How about that? The parents can just download the app and then they can do the meditations.” Well, that’s kind of difficult to do. A, you don’t have access to a device, and B, English isn’t your second language. So one, how do we engage community? We broaden our thinking about what the community needs. We think about those social determinants of health and then try to do a workaround to get people the help they need.
So in this particular instance, we didn’t give them the app. I went to the school, met with the instructors, talked about mental health, mental wellbeing, gave them the app so they could be a little stressed out so that maybe during their engagement with the parents and the students, that they’d be a little stressed out, a little better to engage, a little better to enter in those spaces where they can understand the needs and what the parents need. Everybody can take a collective sigh. So this long, the short of the story is how do you engage a community? You don’t assume that it’s an even playing field and you look for what’s not being said and then try to address that need. Whether it comes from a socioeconomic standpoint or a mental health standpoint or a health standpoint, you’ve got to get at the root of it in order to address it.
James Burroughs: What’s not being said can help solve the root cause of the problem, which we talk a lot about in medical circles.
Roxane Battle: I’m sure your pediatricians do that all the time.
James Burroughs: Root cause analysis, scientific method. But you got to look for those things, they’re not there. Let me ask you this, does it make a difference about who the messenger is coming to a community or how they either deliver the message or listen to a community? Does that make a difference?
Roxane Battle: I think so. The stats of maternal health, Black women are dying at a higher rate than white women and across socioeconomic and educational stratus. Okay, so it’s purely racism because people feel that there’s a difficult time they’re not being believed by their caregiver. And so yes, it makes a difference and here’s how we sure up that difference. And it’s through something, the cultural competence but I like to call it cultural humility.
James Burroughs: Yes.
Roxane Battle: Because you don’t have to look like me and you don’t have to understand my life experiences to believe me, and that’s cultural humility. I may not have the same experience as you do, but I believe what you’re bringing to me. Because so many times when we’re looking in health situations, women, people of color, marginalized groups aren’t getting the help because they’re not being heard and they’re not being believed. So yes, it definitely makes a difference. The mindset of the caregiver has a huge impact on delivery of care and you know this James.
James Burroughs: Mm-hmm. And then as we talk about solutions, help me let you craft it with you.
Roxane Battle: Right. Help me see what you’re seeing. Help me understand what it is that you’re seeing that perhaps I’m not, because that will open up the spectrum of care and get people to a place they need to be.
James Burroughs: So we talk a lot about, and I’m going to ask you to talk about what they are, the social determinants of health. And before I got into the medical field four years ago, I had heard of them on the periphery, but I didn’t know what exactly that they were.
Roxane Battle: Well, isn’t it the ESG, environment…
James Burroughs: Social.
Roxane Battle: Social.
James Burroughs: And governmentship.
Roxane Battle: And governmentship. But it’s a big fancy term that says, do I have what I need? Do I have food, housing and food security? Do I have access to education opportunities? Do I have a sense of community? Do I feel that I belong? And that’s in the mental health space, feeling that you belong goes a long way towards helping you thrive in life. That there’s a group of people that I feel comfortable being my authentic self with. I don’t think we talk about that so much because we’re so focused on the tangibles, the food, the housing security, the education, but creating environments where people feel like they belong, the safe spaces. Do a lot of talk about psychological safety, where I can bring my authentic self, where I feel that I’m heard that I won’t be reprimanded or suffer negative consequences because I’ve raised my hand or expressed an opinion or a different voice, but that voice is respected. We can then move through whatever issues where there might be conflicts. But to me, James, social determinants of health starts with belonging.
James Burroughs: If I start with belonging and I belong there and I can bring my full self. When you talk about services, I always look at it this way, when George Floyd was murdered, a lot of folks who don’t look like me, were like, “James, we got to do something. Can we go bring food to the community?” And a lot of them packed up boxes from their areas came to the community, just dropped off food and left. They were like, “Okay, here’s some food.” I said, “Don’t do that because, one, you haven’t created a sense of who that person is, the value…”
Roxane Battle: It’s performative.
James Burroughs: Exact, very performative.
Roxane Battle: What you’re talking about is belonging means, okay, I got to do something, so I’ll go, I drop off food and I leave and did my good deed. That’s performative. But engagement creates belonging. Go bring the food and have a conversation so that you can understand the full impact of what’s occurred.
James Burroughs: Yep.
Roxane Battle: That’s where its solutions are birthed.
James Burroughs: Absolutely. And I tell people all the time, even before you bring the food, put the food in your car, just pull up, stop and start talking to somebody. See what they need. And it could be food, it could very well be food insecurity, but it could be they just need a heart to hear them right now.
Roxane Battle: That’s right.
James Burroughs: They need a voice to say, hey, I matter right now. They need someone to say, okay, when it comes to housing, these are the frustrations I have. Don’t just refer me to an agency, but talk to me about homeownership. What does that mean? What does homeownership mean? What does it mean to have a stable neighborhood? I tell people right now, especially in North Minneapolis, somebody just closed an Aldi’s, they just closed the Walgreens, a pharmacy. So Aldi’s is a grocery store for those who don’t know. So now we talk about food insecurity, but you’ve closed things in that community that folks need.
And if you come into my community to talk to me, talk to me about what my needs still are in that community, how I can work together and how you can invest. One of the things I push here, and I want to hear more about it from you, is healthcare systems. We talk about social determinants of health. We say that it’s 80% of how it determines a person’s wellbeing, and we’re only 20% between these walls here, serving them in a medical way. But I don’t know if we do enough to address them in the community themselves. How can we do more in healthcare as healthcare providers and or healthcare payers? So those two, how can we do more in community to address those social determinants of health?
Roxane Battle: Having worked with a health care provider, one of the things that we talk about all the time is filling the pipeline with culturally competent or expanding opportunities in healthcare providers for people of color so that we’re addressing those people can go into a doctor’s office and they can see somebody that looks like them, definitely would increase the likelihood that they’d get the care and they feel open enough to ask for the care that they need. So first we’ve got a staffing issue. It’s a pipeline issue. I believe really filling the pipeline with providers that look like all of us is a really good place to start. And then having those conversations, creating those community events, getting into the community, whether if it’s Pride Month or Juneteenth or whatever like that, but not just wait for a date on the calendar.
James Burroughs: Say that one more time.
Roxane Battle: But not just wait for a date on the calendar.
James Burroughs: Mm-hmm. Yes.
Roxane Battle: That’s really where we’re going to move the needle.
James Burroughs: Absolutely. I talk about all the time, they say, oh, well, what are you doing during Black History Month? Well, I’m doing a couple of things, but during March I’m going to do some more stuff and April do some more stuff.
Roxane Battle: I just did a LinkedIn post and I said, it’s Black History Month. It’s still Black History month and I’m still Black and I have been for, oh, yeah, all of my life. Okay. So here’s what I have to say about it.
James Burroughs: Exactly. And my women friends, I tell them all the time, like, oh, so March is just your month, now you only get March. Women’s History month is just March. After that, we going to go back to the misogynistic ways that we have as men.
Roxane Battle: No.
James Burroughs: It’s ridiculous, because it’s about changing the lens and changing how we view history, context, people, and bringing your authentic and full self all times.
Roxane Battle: And we all win. You’ve seen the reports, you know that diverse teams, whether it’s in the medical field or whatever field, are more productive, more innovative, get more done when you hear from a diverse set of voices. We’re talking about really addressing not only racism, but ableism, and ageism, homophobia, whatever it is. But to really look at people as their whole self, you bring more to the table than the particular group that you identify with. We’re all better for it.
James Burroughs: So as a person who’s worked in this field and all the things you’ve done, the books you’ve written, and the places you’ve been, what advice do you have as far as addressing health equity? So if you said to those group, got them, capture audience on this podcast, what can they do? And some of them may not be people of color, some of them may not have any experience with those communities, but what can they do personally and as a system to make it better?
Roxane Battle: Well, personally, I think you’ve got to have a hard conversation first with yourself about addressing your own biases. Ibram Kendi said in his book, racism doesn’t make you this big green-eyed ugly monster. It’s not who you are, it may be a belief system that you hold or something that you’ve done that you’re unconscious about. And so really taking a deep look internally first about what do I believe about this group of people? How am I expressing those beliefs, and how can I challenge myself to do better? Having that internal conversation and then having a level of vulnerability to begin the dialogues and the conversations that not necessarily you’re asking people of color to educate you, because the onus certainly is on all of us, but having an open and honest conversation about what you hold to be true and maybe challenge that.
And that’s difficult work, but it’s ongoing work. Just like you said, Black History Month isn’t one day or one month, it’s a reality. And then the other thing that I would say is to listen, and that’s across the board. Listen, as a parent to your child. People talk about quality time. Well, like you said a moment ago, just sitting side by side can be quality time. It doesn’t have to be this big huge extravagant planned vacation event. It could just be going to run ice cream or sitting and watching TikTok videos together. Not that I want to advertise extra and use of social media because I don’t, but you know what I mean.
But really just taking the time to listen and, as you said, be in the space with someone to make them feel seen. James, that’s what we’re really talking about when it comes to mental health, when it comes to health equity is making people feel seen, and we do that through listening and through searching and examining and evolving through our own preconceived ideas and previous held beliefs so that we can grow and evolve together in the same space.
James Burroughs: Systemic racism is a big lofty, where structural racism is another one. And it’s about the systems, how they’re build the structure, how they’re built on racist foundation and there have a lot of them. Healthcare is one of them. But it also means if you grew up in that system, your tendencies and behavior are a part of that. So check in who you are, your biases, how they influence others and the impact they have on them, especially the language, how we communicate is so important. And then I love the listening piece. You’re listening, and listening not with respect to just acting or listening to say, I’m going to do this. Just listening, being there, being in that space as well.
A lot of times people in medical health care will say, hey, you know what? We understand all the social determinants of health that need to be treated, we understand mental health, but at the end of the day, we get paid by insurance companies that reimburse us for the tests, the exams, the surgeries and all that. And that’s how we sustain our model. What do you think we can do, or can we do anything around that to kind of marry those two together to address all the things we’ve talked about, but in a way that’s still sustainable for healthcare?
Roxane Battle: So there’s like evidence-based outcomes, and then there’s value-based outcomes. Help me with the terminology here because I’m really stretching within my depths here, but the outcomes that look at how people are getting better. What are we applying? What system structures, what procedures, processes are we availing to people that’s helping them get better? And that sounds like an overstatement of the obvious, but rather than billing rates, it’s evidence-based outcomes. That’s where I think the majority of the focus should be. Does that make sense to you?
James Burroughs: Yeah. So value-based care, which I’m learning these terms too, is like…
Roxane Battle: Yeah.
James Burroughs: Before you even get to the piece where you need all those treatments, medicines, all those things that we are typically associated with a doctor’s office, how do you get value-based care to prevent that from even happening and prevent that 80% of stuff happening to you, leading to worse outcomes.
Roxane Battle: Right. And definitely the evidence-based, is it working? Where are the metrics? What does it say that this is a way to go with this particular situation?
James Burroughs: Okay. Data’s important, but also too, who reviews and interprets that data.
Roxane Battle: Right.
James Burroughs: Is just as important because I can go in the neighborhood now and say, hey, here’s the data bond, what your family’s doing, what your education community is. And they’ll say, well, that’s one aspect of it, but here are the other things that you don’t see through this data collection that is done with also that lens through systemic racism and structural racism as well, so.
Roxane Battle: I think that brings us back to conversations and listening.
James Burroughs: Absolutely.
Roxane Battle: Really and going, and like you said, going into those conversations with the expressed goal of learning something you didn’t know before, which will then could very well impact how you view that data or how you assess a certain treatment, so.
James Burroughs: Absolutely.
Roxane Battle: Not a medical professional, to just been had an opportunity to tell some stories in the mental health and health equity space and I appreciate the opportunity, James, to share my thoughts and opinions.
James Burroughs: Part of coming to Talking Pediatrics is I grant wishes. I grant three wishes. And the wishes have to be related to how do we make this place better? Well, it could be around health equity, it could be around communication, it could be around making the world a better place. So if I grant you three wishes right now, what would you wish for?
Roxane Battle: I would wish for an opportunity to help make a difference. I would wish for an opportunity to see the world through the lens of my children, and that lens shows an arc of change for the better. And I would wish for a seat at your table at your annual gala.
James Burroughs: You will be there as well. So we got you covered those wishes. Well, Roxane, thanks for stopping by Talking Pediatrics. We really appreciate it. This has been a great time to just talk and just learn about you.
Roxane Battle: Okay. I enjoyed it.
James Burroughs: And how we could do things better. And this won’t be our only time talking, I’m sure. So thanks for coming.
Roxane Battle: Thank you, James. I enjoyed it tremendously and all the best in all the good work that you’re doing here at Children’s.
James Burroughs: Thank you.
Dr. Angela Kade Goepferd: Thank you for joining us for Talking Pediatrics. Come back each week for a new episode with our caregivers and experts in pediatric health. Our executive producer and showrunner is Ilze Vogel. Episodes are engineered, produced, and edited by Jake Beaver. Amie Juba is our marketing representative. For more information and additional episodes, visit us at childrensmn.org/talkingpediatrics, and to rate and review our show, please go to childrensmn.org/survey.