Med Student Voices

The podcasts gathered on this page were created by students in “Using the COVID Pandemic to Understand Structural Drivers of Health Disparities” led by Drs. Giselle Corbie and Gabrielle Harris in Fall 2021. Students were tasked with recording a 20-30 minute episode on a social determinants of health topic covered in class for their final assignment. RADx-UP projects led by community-academic research teams working to address COVID-19 inequities were also included.

The UNC Center for Health Equity Research is sharing these podcast episodes under the series name Med Student Voices. This course was led by Dr. Gabrielle Harris in Fall 2022.

Fall 2022

Broadening Understandings of Vaccine Hesitancy

Hosts: Evan Trice, Ismael Gonzalez and Quiara Shade

Guests: Dr. Deidra Crews is a board certified nephrologist and professor of medicine at Johns Hopkins School of Medicine. She holds several appointments (in the departments of School of Nursing, the Welch Center for Prevention, Epidemiology and Clinical Research, and the Center on Aging and Health). She is also the Deputy director of the Center for Health Equity at JHMU and focuses her research on the social drivers affecting kidney disease and hypertension outcomes. Dr. Crews is a member of the Aging Fast and Slow podcast which can be found on Spotify.

In this episode, Dr. Deidra Crews, certified nephrologist and professor of medicine at Johns Hopkins School of Medicine, joins us to discuss COVID-19 vaccine hesitancy. In our conversation with her, we take a deeper look at the factors promoting vaccine hesitancy among minority populations, recognizing that they are layered, nuanced, and continuously evolving over time. We also offer a reframing of why vaccine hesitancy is present in certain populations, and we suggest shifting the perspective of hesitancy rooted in mistrust to hesitancy rooted in fear due to systemic racism. Lastly, we discuss methods to combat vaccine hesitancy by providing patients with reputable community sources in order to promote understanding and informed decision-making.

Additional resources and references:

• Jaiswal J, Halkitis PN. Towards a More Inclusive and Dynamic Understanding of Medical Mistrust Informed by Science. Behav Med. 2019 Apr-Jun;45(2):79-85. doi: 10.1080/08964289.2019.1619511. PMID: 31343962; PMCID: PMC7808310. 
• CNN rolls the tape on Fox News hosts’ anti-vaccine rhetoric (video)
• Hoffman KM, Trawalter S, Axt JR, Oliver MN. Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites. Proc Natl Acad Sci U S A. 2016 Apr 19;113(16):4296-301. doi: 10.1073/pnas.1516047113. Epub 2016 Apr 4. PMID: 27044069; PMCID: PMC4843483. 
• KFF COVID-19 Vaccine Monitor: Media and Misinformation
• Washington, H. (2010). Medical apartheid the dark history of medical experimentation on Black Americans from colonial times to the present. Paw Prints.

Rural Health Chatham County COVID-19 Response

Hosts: Elgin Yalin, Rebecca Schopfer, Khar Dieng-diatta and Amaya Martinez Mesa

Guests: Dr. Laura House, Family Medicine with Chatham Hospital, Scotti Weeks, Paramedic and Field Training Officer with FirstHealth of the Carolinas, and Kailee-Lane Graumann, Paramedic with FirstHealth of the Carolinas

The podcast is about COVID-19 response in rural North Carolina, using Chatham County as an example. During the episode, we mostly focus on Siler city, Chatham County. With our guests, we had the opportunity to dive into how the emergency response team was set up to tackle the pandemic. We also explored the healthcare disparities highlighted by the COVID-19 pandemic, and the COVID-19 psychological effect on front line healthcare professionals. To conclude the episode, we visited possible future adaption to plan for a more robust pandemic response.

Additional resources:

• Coronavirus Data (Chatham County)
• Chatham County, NC COVID-19 Vaccine Tracker (Citizen Times)
• Chatham County (Data Commons Place Explorer)
• Chatham County, NC (Covid ActNow)
• Community Assessment Executive Summary
• Support for Public Health Workers and Health Professionals (CDC)
• Health Care Professionals (NAMI)

References:

• Location, location, location (CDC)
• QuickFacts: Siler City town, North Carolina (U.S. Census Bureau)
• Melvin SC, Wiggins C, Burse N, Thompson E, Monger M. The Role of Public Health in COVID-19 Emergency Response Efforts From a Rural Health Perspective. Prev Chronic Dis. 2020 Jul 23;17:E70. doi:10.5888/pcd17.200256.
• Murthy BP, et al. Disparities in COVID-19 Vaccination Coverage Between Urban and Rural Counties – United States, December 14, 2020-April 10, 2021. MMWR Morb Mortal Wkly Rep. 2021 May 21;70(20):759-764.
• Chen, Yea-Hung, et al. COVID-19 Mortality and Excess Mortality Among Working-age Residents in California, USA, by Occupational Sector: A Longitudinal Cohort Analysis of Mortality Surveillance Data. The Lancet Public Health; 7(9), Elsevier BV, Sept. 2022, pp. e744–5.

Farmworkers and the COVID-19 Pandemic

Hosts: Vivi Santana, Briana Stevens and Adie Ramirez

Guest: Dr. Moore, Medical Director of NCDHHS Farmworker Health Program

Farmworkers are a crucial, but often overlooked community in the United States. In this episode, we discuss healthcare access for farmworkers and the impact of the COVID-19 pandemic on farmworker health. We also dive into the housing, language, and legal barriers that farmworkers commonly encounter. We invited guest speaker, Dr. Modjulie Moore, a family physician and medical director of the NCDHHS Farmworker Health Program, to share her experiences providing medical care during the pandemic and to reflect on the challenges expanding healthcare access across NC for farmworkers. Together, we aim to raise awareness of the many inequities farmworkers face today and what steps we, as a community, can take to better support them.

Additional resource:

• Harvest of Shame (video)

References:

• National Center for Farmworker Health 
• Equal Justice Initiative   
• National Farm Worker Ministry 
• Southern Poverty Law Center 
• Hidden Farmworker Labor Camps in North Carolina: An Indicator of Structural Vulnerability 
• Center for Worker Health  
• NC Farmworker Health Program  
• National Immigration Forum (Factsheet with Statistics for tax data) 
• FWD.us Immigrant Farmworkers and America’s Food Production (Statistics on H2A and undocumented status) 
• The impact of language barriers on the health care of Latinos in the United States: a review of the literature and guidelines for practice 
• US DEPARTMENT OF LABOR INITIATIVE SEEKS TO PROTECT NORTH CAROLINA’S SWEET POTATO FARMWORKERS FROM WAGE THEFT, OTHER VIOLATION (not in the final cut but an important example) 
• Duke Health: The Importance of Addressing Language Barriers in the US Health System 
• Music from Pixabay Royalty Free Music: Playing in Color

A Local vs. National Evaluation of Community Resilience to COVID-19

Hosts: Anameeka (Annu) Singh, Grayson Privette, Peter Said and Rizk Alghorazi

Guests: Dr. Nancy Messonnier, M.D., Dean and Bryson Distinguished Professor in Public Health, UNC Gillings School of Global Public Health, and Ms. Debra Farrington, Chief Health Equity Officer for NC Department of Health and Human Services

The community response to COVID-19 looked different across the world and even within a single country. This podcast engages two public health leaders in conversation about a variety of topics (vaccine retention, vulnerable communities, future directions for achieving health equity and improving disaster preparedness) to capture a unique evaluation of community resilience to COVID-19 in the United States. Join us as we juxtapose the local and national perspectives with Ms. Debra Farrington (the newly appointed Chief Health Equity Ocer for the NC Department of Health and Human Services) and Dr. Nancy Messonnier (new Dean of Gillings School of Global Public Health), respectively.

References:

• COVID-19 Response, Recovery, Long Term Change (video)
• Dr. Nancy Messonnier named dean of Gillings School of Global Public Health
• We May Have Only a Few Months to Prevent the Next Pandemic (NY Times, paywalled)

Fall 2021

Language Access for limited English proficient patients during the COVID-19 pandemic

Hosts: Cameron Morrison, Gema Rodriguez and Grace Ellis

Guests: Meagan Clawar and Daniella Runyambo of Refugee Community Partnership

COVID helped spotlight many of the issues within our healthcare system. One of these being the health disparities created when physicians do not speak the same language as their patients. In today’s podcast episode, we discuss the role COVID played in exacerbating language access disparities. We touch on language justice, interpreter services and how healthcare is delivered to non-English speakers in the United States. We invited three community members to share their thoughts on these topics, allowing us to explore the perspective of a community organization, a patient and a provider during the pandemic.

We would like to thank the Refugee Community Partnership members Meagan Clawar and Daniella Runyambo for sharing their thoughts. Finally, a special thanks to Keny Murillo for voicing and helping with the patient story translations.

We hope you enjoy the podcast episode!

The Impact of COVID on the Re-Entry Experience of Justice-Involved Individuals

Hosts: Oby Nwamu, Charlotte Smith and Sahana Raghunathan

Guests: Evan Ashkin, MD, Department of Family Medicine at the UNC School of Medicine, Director of the Formerly Incarcerated Transition (FIT) Program and Antonio Malone, Formerly Incarcerated Transition (FIT) Community Health Worker

Individuals who are involved with the criminal legal system face many barriers when reintegrating back into society. The COVID-19 pandemic added new difficulties to this vulnerable transition period. We explore these challenges with two experts: Dr. Evan Ashkin, a Family Medicine physician and Director of the Formerly Incarcerated Transition program, and Antonio Malone, a Community Health Worker who himself is formerly incarcerated. Together, we brainstorm and discuss how we, as a community, can help support individuals during this time of transition.

Additional resources:

• Dr. Brewer’s research site.
• NC fit program.

Lifting Communication Burdens: How does perception of COVID information impact communities differentially?

Hosts: Aidan Walker, Laura Wiser and Justin Ochalek

Guests: health informatics researchers and practicing nurses:

• Adriana Arcia, Ph.D., R.N., Associate Professor of Nursing at CUMC
• Suzanne B. Bakken, Ph.D., R.N., FAAN, FACMI, Professor of Biomedical Informatics, Alumni Professor of the School of Nursing

Laura, Aidan and Justin are second-year UNC medical students interested in how Covid-19 information is shared and understood among various diverse communities, as we all find ourselves in a very unique time of vaccine hesitancy in a worldwide pandemic. We have met with and interviewed two health informatics researchers and practicing nurses from Columbia University: Dr. Adriana Arcia and Dr. Suzanne Bakken. They are both health informatics researchers and professors, sharing information about their RADxUP project, a ReDIVis toolbox that aims to mitigate health disparities by creating culturally congruent and interactive infographics intended to provide accurate and accessible Covid-19 results and information. Our podcast includes information on their project, cultural competence, COVID vaccine hesitancy and how to integrate local community outreach with a larger, centralized Covid-19 task force.

Reference:

Doherty, Irene A., William Pilkington, Laurin Brown, Victoria Billings, Undi Hoffler, Lisa Paulin, K. Sean Kimbro, et al. “COVID-19 Vaccine Hesitancy in Underserved Communities of North Carolina.” PloS One 16, no. 11 (2021): e0248542. https://doi.org/10.1371/journal.pone.0248542.

COVID-19 susceptibility, prevention, and vaccine hesitancy in the American Indian community in Pembroke, North Carolina

Hosts: William Garrison, Alisa Suen-Wallach and Sean Connelly

Guests: anonymous Lumbee healthcare worker and Dr. Jada Brooks

We will be discussing how structural drivers of health contribute to COVID-19 susceptibility, prevention and vaccine hesitancy in the American Indian community in Pembroke, North Carolina. Our first interview is with a Lumbee healthcare worker who wishes to remain anonymous about how they have seen the COVID-19 pandemic affect their community. Next, we’ll speak with Dr. Jada Brooks, an Assistant professor at the UNC Chapel Hill School of Nursing who is leading several projects to identify health disparities in the Lumbee community, as well as in American Indian women in general in order to support community engagement and health initiatives.

The Intersectionality of Race and Vaccine Hesitancy Amongst Healthcare Workers

Hosts: Jonathan Smith, Obi Achuko and John Farhat