< PreviousTALK ACROSS PA 8 | TALK MAGAZINE • WINTER 2022 PHILADELPHIA by Kristen A. Graham Philadelphia School District students have large class sizes and often lack adequate support and staff. Most have limited access to extracurric- ular activities and higher-level classes, and they often learn in outdated and sometimes environ- mentally problematic buildings, Superintendent William R. Hite Jr. testified in a landmark school-funding case Tuesday. It follows, he said, that while 70% of Phila- delphia’s 120,000 schoolchildren graduate from high school on time, those credentials often mean less than they do in other, better-funded districts. “In many cases, they are really meeting a mini- mum standard because that’s all they have access to,” Hite said. Prompted by attorney Kristina Moon, Hite noted that in nearby wealthy Lower Merion, 95% of students meet standards in state English exams, 85% in Algebra I exams, and 92% in biology exams. At Philadelphia’s Overbrook High School, not far from Lower Merion, those num- bers are much more stark — 6% of students pass English exams, 5% pass Algebra I exams, and 2% pass biology exams. Lower Merion educates primarily white and wealthy students; Philadelphia’s student population is predominately made up of students of color, and students living in poverty. But there’s a large gap even between economically disadvantaged students in Lower Merion and at Overbrook. In Lower Merion: 80% of econom- ically disadvantaged students passed state exams in English, 72% passed algebra tests, and 76% passed the biology exam. At Overbrook, the numbers were much lower: 2%, 4%, and no students at all. That has nothing to do with Philadelphia students’ capability, Hite said. “It’s a clear indication in my opinion that when there’s an investment in more resources, even the economically disadvantaged children do better,” Hite said in testimony in Commonwealth Court in Harrisburg that was also livestreamed. The district is not one of the plaintiffs in the case filed seven years ago by six school districts, groups including the Pennsylvania NAACP, and parents — including one from Philadelphia. Pe- titioners allege the state’s funding system is both inadequate and inequitable, and violates the state constitution. The case’s outcome could have significant effects on school budgets in Philadelphia and throughout the state. Philadelphia schools, Hite said, “don’t have enough funds to meet the needs of our students.” For hours, he offered examples, from the number of certified librarians in the district (six, for 220 schools) to typical class sizes, up to 30 students in kindergarten through third grade and 33 students in fourth through 12th grades. Asked by Moon why the district doesn’t have smaller class sizes for its student population, which generally has higher concentrations of English-language learners, economically disad- vantaged children, and students who need special education services, Hite said it was a matter of money. “Understanding that our desire is always to have fewer children in classrooms, but based on our bud- get allocation, we have to set this formula in place because it’s what we can afford,” Hite said. He recalled the district’s disastrous financial shape when he arrived in Philadelphia in 2012: so broke it needed to borrow money to pay the bills. Hite had to close 24 schools and lay off 4,000 workers, including all assistant principals, counselors, and secretaries, to make ends meet. “It doesn’t instill a lot of trust in an educational entity when you are talking about opening schools with only teachers and principals, without many of the extracurricular activities and things for many children and for many families that would represent school,” Hite said. The district is alone among Pennsylvania’s 500 school systems, unable to raise its own revenue. It relies on Harrisburg and City Hall for the bulk of its funding. Philadelphia’s finances have improved since those doomsday cuts, but even on more stable footing, the situation remains precarious, Hite said. An infusion of $1 billion in federal COVID-19 relief money is a major help, Hite said; it has gone to pay not just for personal protective equipment but also some in-school supports. The district hired more counselors to help with students’ social and emotional needs. In the past, schools needed 900 students to auto- matically get a second school counselor; because of the stimulus funds, the district lowered that to 700 students. But that’s a temporary fix, Hite said. “If those moneys aren’t replaced by some other funding source, then we would have to remove those positions,” the superintendent said. Philadelphia also lacks adequate funding to maintain its large stock of aging buildings, Hite said. The average city school is more than 70 years old, and many have lead, asbestos, and mold problems. A 2017 analysis found that the school system has $4.5 billion in deferred main- tenance costs. To illustrate Hite’s points, Moon showed pho- tos from a visit to Roosevelt Elementary, where water intrusion caused lead paint to flake and peel, scattering paint chips and rusting the floor, and to Randolph Technical High School, where a leaking roof caused standing water in a science lab, rendering the room temporarily unusable to students. HARRISBURG Governor Tom Wolf today announced $2.5 million in state funding that will help grass- roots organizations across the commonwealth encourage hesitant Pennsylvanians to get the COVID-19 vaccine. A list of the 65 grants awarded through the COVID-19 Vaccine Out- reach Grant Program can be found online. “Vaccines remain an absolutely essential element in combatting the COVID-19 pandemic, however there are still Pennsylvanians who are hesitant to get their first dose,” Gov. Wolf said. “By providing funding to grassroots organizations for vaccine outreach efforts, we’re enabling them to serve as trusted messengers in vaccine-hesitant communities and promote the COVID-19 vaccine as a safe and effective way to protect themselves and their loved ones from the virus.” The grassroots efforts supported by the pro- gram build upon the ongoing statewide public health awareness campaign, PA Unites Against COVID-19. Grantee organizations will work to educate their communities on the COVID-19 vaccine to improve uptake of the vaccine for the health and safety of Pennsylvania. This program provides the necessary funding to community organizations to educate their community regard- ing COVID-19 vaccination to address hesitancy concerns and barriers and to provide direction on where and how to schedule a vaccine appoint- ment. “The Department of Health remains committed to eliminating obstacles and challenges that prevent Pennsylvanians from getting vaccinated,” said Phy- sician General Dr. Denise Johnson. “Thanks to our incredible vaccine providers, and the ‘PA Unites Against COVID’ campaign, we are continuing to do that by providing educational materials, events, vaccine toolkits and posters in multiple languages to help encourage people to get vaccinated. I am impressed by the tens of thousands of Pennsylvanians who are stepping up every day to get their first, second or third dose of vaccine to protect them- selves, their loved ones and their neighbors against Superintendent William Hite talks in a press conference at the Philadelphia School District Headquarters in October. continued on page 28TALK ACROSS PA WWW.TALKMAGAZINEONLINE.COM | 9 COVID-19.” Later today, Dr. Johnson will join Department of Community and Economic Development (DCED) Secretary Dennis Davin at the Bhuta- nese Community Association of Pittsburgh to celebrate the grant awards and further discuss the importance of grassroots vaccine outreach. “On behalf of the whole team, I would like to extend our sincere thanks to Governor Wolf’s admin- istration for the much-needed grant,” said Khara Timsina, Executive Director, Bhutanese Com- munity Association of Pittsburgh. “This grant is going to help us reach and educate families in the Bhutanese community in Pittsburgh that have been hard to reach and make sure they have the needed resources surrounding COVID-19.” MCKEESPORT By Julian Routh Austin Davis, the McKeesport-raised state representative who became the first Black candi- date to win a majority-white district in Western Pennsylvania, announced his run for lieutenant governor of Pennsylvania on Tuesday, picking up the immediate support of Democratic gubernato- rial frontrunner Josh Shapiro. Mr. Davis, speaking from a podium under the shadow of a John F. Kennedy statue in the memorial park in McKeesport, said he’s running because people all across the state crave compas- sionate, empathetic leadership in Harrisburg from someone who has an affinity for the working class, not the wealthy and well-connected. “As the son of a hairdresser and a union bus driver, I know what it’s like to come from a family that’s had to get creative to make ends meet,” Mr. Davis said. “My family has struggled with the same challenges that millions of Pennsylvanians face every day.” Long seen as an up-and-comer in the Demo- cratic Party, Mr. Davis has represented the 35th District — covering Clairton, Duquesne and McKeesport through South Versailles and part of West Mifflin — since 2018, and he serves as the chair of Allegheny County’s Democratic delega- tion to the state House. County Democrats paid their leader back by bundling up and hitting the park on a chilly Tues- day morning to support Mr. Davis and hear from Mr. Shapiro, Pennsylvania’s attorney general, who said his running mate is an “effective, capable voice and ready on Day One to get to work.” “In every step in his career, Austin has fought for those forgotten people,” Mr. Shapiro said. “He’s fought for working people to raise the minimum wage, improve our air quality, to reduce crime and, at the same time, to increase trust between law enforcement and the community that they serve. “I’ll tell you what, Rep. Davis has gotten a lot done,” Mr. Shapiro added. In Pennsylvania, candidates for governor and lieutenant governor do not run on the same ticket — meaning that Mr. Shapiro could win and Mr. Davis could lose, or vice versa. It’s uncommon for a gubernatorial contender to endorse someone for lieutenant governor. But Mr. Shapiro bucked the trend to endorse in the primary, and nearly the entire Democratic Party followed suit. Mr. Davis was joined outside — a few blocks down from his district office — by U.S. Rep. Mike Doyle, state Sen. Jim Brewster, Pennsylvania Democratic Party Chairwoman Nancy Patton Mills, and state Reps. Jessica Benham, Dan Miller, Brandon Markosek, Dan Frankel, Dan Deasy and Emily Kinkead. Mr. Davis’s former boss also attended: Al- legheny County Executive Rich Fitzgerald, who brought him on as an executive assistant in 2012. Mr. Fitzgerald said that in six years of work in that role, Mr. Davis threw himself into the goal of helping people — and has since worked to make sure that nobody is left behind. BEAVER By Nicholas Vercilla For the past four years, Paramount Pursuits, of Ambridge, have been offering their technical assistance to six Beaver County communities, as part of the county’s Main Street program. Paramount Pursuits has been working in the downtown areas of Aliquippa, Ambridge, Beaver Falls, Midland, New Brighton and Rochester, according to Jacob Charles, downtown and eco- nomic development coordinator for the Commu- nity Development Program of Beaver County. He said the Main Street program is meant to help improve the look to increase economic opportunities and the number of businesses of the six low-to-moderate income communities in the county. During a recent county commissioners' meet- ing, the board agreed to extend the contract for a fifth time to Aug. 31. The contract will then be re-evaluated for possible extension. The contract with Paramount Pursuits is paid using money that comes into the county through the U.S. Department of Housing and Urban Development. Charles said Paramount provides technical assistance to local revitalization organizations in each of the above-mentioned communities. “Monthly, these organizations meet to discuss nu- merous things, such as building vacancies, properties that are available for sale, new businesses that have opened or are thinking of opening, upcoming events that drive the local economies, and much more,” he said. Added Charles: “Paramount sits in on these meet- ings and works with these individuals on achieving goals that are designed to improve the community as a whole.” Paramount Pursuits President Trish Digliodo said each community in the county they help is different, with different ideas and volunteers. “Each one of these communities can use volun- teers,” she said. Therefore, Digliodo said the six communities are at different points of their revitalization pro- cess. Charles said the Community Development Pro- gram funds other projects in those communities, that compliment the Main Street program, but the main function of the Main Street program is to assist the local revitalization groups in improv- ing their communities. SCRANTON By Stacy Lange Good news for readers who like to take their time while diving into a good book: Lackawanna County libraries will no longer require you to renew to keep your books, movies, or games a bit longer. It's called Auto-Renew, and it's part of an effort to draw in more library patrons by removing one of the annoying parts of borrowing a book. As long as the library has up-to-date contact information, patrons will receive an email or text when their automatic renewal goes through. "It takes a lot of that—remembering to renew, to call or to text or go online—it's just more conve- nient to have that done automatically for you," said Jess Serrenti at the Albright Memorial Library in Scranton. But what does Auto-Renew mean for those dreaded library late charges? Scott Thomas, CEO of the Albright Memorial Austin Davis continued on page 28BUSINESS NEWS Jordan Hospitality Group Black Entrepreneur Generated Donatos has announced that the Jordan Hospitality Group has taken over the ownership and daily operation of the 21 restaurants in the India- napolis market, according to a press release. Ron Jordan, CEO of Jordan Hospitality Group, is a Columbus, Ohio, native who grew up eating Donatos pizza with his family on Friday nights and at other special occasions. Jordan is now the largest traditional Donatos franchise partner as well as the largest minority-owned franchise partner. "We're on a mission to be one of the exceptional players in experiential din- ing," Jordan said in the release. "But it's more than just building restaurants. We're creating experiences that thrill our guests. My inspiration to grow to be the best stems from the commitment I made to my grandparents years ago to create generational wealth for my family and future generations of not only Jordans, but for the people our company employs. It is especially rewarding to have the opportunity to do this through a company in Donatos that I have loved since childhood." "We are excited to have Ron Jordan and JHG join our family," Tom Krouse, CEO of Donatos, said in the release. "Not only does JHG bring experi- enced operational oversight to an already existing team of operators in the Indianapolis market, but they also bring tremendous energy and fresh per- spective that will serve the customers better and further grow the market." Jordan's franchising efforts are assisted by 22 Ventures, which is led by former NBA All-Star, Olympic gold medalist, and Ohio State University team captain Michael Redd. "Black entrepreneurs have long faced systemic barriers to growth, including access to loans and capital, biased community perceptions, and gentrification challenges," Jordan said in the release. "Having Michael Redd as a business partner gets us in front of the right people to scale our business." "This new partnership between 22 Ventures and Jordan Hospitality Group is a powerful combination and we are excited to bring our vision to the Greater Indianapolis market through Donatos," Redd, chairman and co-Founder of 22 Ventures, said in the release. "Both of our teams take a rigorous and evidence-based approach to development, which is why we will deliver consistent restaurant service and memorable experiences. Together, we will work to uplift Black and Brown businesses across the state, and we will do that here, starting with the management of the Donatos brand in Indiana." With 379 locations in 22 states, Donatos and its franchise partners oper- ate 169 traditional restaurants in Ohio, Indiana, Kentucky, West Virginia, Virginia, South Carolina, Alabama, Tennessee, Georgia, Pennsylvania, and Florida. Donatos' products are also served in 210 non-traditional locations (199 locations with Red Robin, 10 sports and entertainment venues, and one REEF Kitchen). Jordan Hospitality Group is a family-owned and operated hospitality group based in Columbus, Ohio. Ron Jordan, CEO of Jordan Hospitality Group. Provided. Meet Terry Foster, founder and CEO of Terry Foster Consulting, a boutique digital marketing agency that helps Black-owned brands scale to 7-figures and beyond with profitable paid traffic. He started the company six years ago after getting fired from a corporate job in 2016. Terry, who was born in Pittsburgh but now resides in Atlanta, has hired a team of over 20 people. Through the course of 6 years, he has managed over $15 million in ad spend and generated over $75 million in online sales and has helped 14 Black-owned businesses generate over $1 million in a single year with paid traffic. One of Terry’s clients is Nae Nae Naturals, a brand that creates safe and effective beauty products for women who want natural, toxic-free products for their hair and skin. Terry and his team helped this brand scale from $400 a day to $40K a day in sales. Recently, the brand hit $5 million in sales and has been able to move from a garage into a warehouse. Terry comments, “My passion is to help Black entrepreneurs scale up to the use of profitable paid traffic so that they can create the business of their dreams.” He adds, “One of the most important things to me is having an impact. That is why I created the TFC Scale Session where business owners can scale up their businesses with Facebook ads.” becomes largest Donatos franchise partner 10 | TALK MAGAZINE • WINTER 2022 for Black-Owned Businesses $75MBUSINESS NEWS WWW.TALKMAGAZINEONLINE.COM | 11 Philadelphia promotes itself as a friendly place to do business. But we often hear in our reporting that opportunities for funding, networks and other resources are harder to come by — both locally and nationally — if you’re a person of color. Responding to the first part of that call, a group of more than 30 small business-serving organizations and financial institutions called the Greater Philadelphia Financial Services Leadership Coalition has launched a fund to support Community Development Financial Institutions (CDFIs) in loaning money to Black and brown business owners in Philadelphia. The coalition was formed from the business community’s efforts to get the economy back on track amid the COVID-19 pandemic. In 2020, the Chamber of Commerce of Greater Philadelphia convened business and civic leaders in Philadelphia and surrounding counties to form the Philadelphia Regional Recharge and Recovery Taskforce. Last year, the coalition announced a four-year, $100 million fund made of a combina- tion of debt and equity to help Black and brown business owners thrive or grow their business amid the pandemic. That coalition has since grown to 30 financial institutions, including the Federal Reserve Bank of Philadelphia, Pennsylvania CDFI Network and Urban Affairs Coalition. The first phase of this latest effort: the Philadelphia Growth, Resiliency, Independence, Tenacity Fund — that’s the PHL GRIT Fund — which launched this month. Through the GRIT Fund, all 11 Philadelphia CDFIs will receive grants that will help strengthen their operations. The goal is to help the CDFI ecosystem grow, and better serve small business owners, especially those who face systemic barriers to accessing capital. Among business owners of color, there tends to be more trust in local financial institutions over huge banks, said Dan Betancourt, chair of the Pennsylvania CDFI Network Black & Brown Business Owners Receive Loans From Philly Financial Groups continued on page 28LATINO NEWS 12 | TALK MAGAZINE • WINTER 2022 Joseph Nuñez at first didn’t like Donald Trump. “I couldn’t stand the guy. I didn’t like the way he spoke about Hispanics or people in general,” he said. But by 2020, Mr. Nuñez had become a fan of Mr. Trump’s style and priorities, and he voted in favor of giving the president a second term. So did many Latino voters in this working-class city who had once backed Democrats or, like Mr. Nuñez, had skipped elections altogether. Now, as political strategists continue to sift through the 2020 election results, the emergence of these newly Republican voter is setting off alarm bells within the Democratic Party. Nationwide, Mr. Trump's share of the Latino vote grew by 8 percent- age points compared with 2016, an analysis by Catalist, a Democratic voter-data firm found earlier this year. New calculations by the firm find that while then-candidate Joe Biden won 61% of Latino voters, the shift toward the GOP meant that he carried the group by about 750,000 votes less than had Hillary Clinton, the Democratic nominee four years earlier. That erosion is a danger sign for the party given that President Biden’s winning margin in five state was less than 100,000 votes. With Democrats defending narrow majorities in Washington – a loss in 2022 of just a few House seats and one Senate seat would give Republi- can's control of those chambers – strategists in both parties are trying to determine why a larger share of Latino voters backed Mr. Trump and whether the shift is durable. One main conclusion: The social constraints that were once a barrier to voting Republican have eroded, in large part because the strong economy during much of Mr. Trump’s term caused many Latino voters to give the party a second look. “You had a set of Latino voters who weren’t especially partisan and who had seen it as socially unacceptable to vote for Trump in 2016,” said Carlos Odio of Democratic-aligned Equis Research, which conducted surveys and focus groups to understand the shift. “My friends and family will be mad at me if I do this.” You need a justification to do it.” “The economy, the issue on which they trusted Trump, unlocked the door to embracing him,” Mr. Odio said. At the same time, many Latino voters came to view the Democratic Party as untethered from their top concerns – unsupportive of law enforcement, too lax on border security and too focused on racial disparities, said Ruy Teixeira, a demographics expert and co-ed- itor of The Liberal Patriot newsletter. Among other things, this brought the GOP new votes from Hispanic voters who have a conservative bent but hadn’t acted on it, he said. “I think the bloom is off the rose for Democrats in terms of having an auto- matic pass from Hispanics,” said Mr. Teixeira. “They’re more suspicious and less sure that the Democratic Party is on their side.” Other Democratic analysts have taken a more optimistic view. Matt Barreto, who polled Latino voters for Mr. Biden’s 2020 campaign, said the important development is that Latino voters have grown more than other groups as a share of the electorate – casting 30% more votes in 2020 than in 2016 – and backed Democrats by large margins, helping to secure Democratic victories in several presidential swing states and Senate races. “If you have 30% growth over four years and you’re winning those folks 2-to- 1, that is a major accomplishment and should be recognized for part of what Democrats did right,” he said, assessing Mr. Biden’s share as larger than Catalist determined. Mr. Trump improved his 2016 showing among Latino voters in the rural Rio Grande Valley and bit-city Philadelphia and Bronx borough of New York – as well as in smaller cities. Reading is one of Pennsylvania’s poorest communities and home to a large con- centration of Hispanic residents – two qualities that traditionally would make it a secure Democratic stronghold. The city’s tidy row houses, which run for blocks, sometimes display the flag of Puerto Rico or a Latin American nation. Some 69% of city residents are His- panic, a larger share than in any other Pennsylvania municipality. Mr. Trump won only 27% of the vote here, but that was nearly 8 points more than in 2016, matching Catalist’s assessment of the national trend. As a result, Mr. Biden won the city with about 4,000 fewer votes than Mrs. Clin- ton had – a meaningful change in a state that he carried by just over 80,000 votes. Hispanic voters are more open to appeals from either party, said a group of seven voters convened here recently by Michael Rivera, a Republican, who in 2019 became the first Latino elected to the board of commissioners for Berks County, which includes Reading. 200020042008201220162020 0 20% 40% 60% 80% Democratic Republican Share of Latino voters supporting each party's presidential nominee Source: Pew Research Center analysis of exit polls (2000-2012) and validated voter study (2016, 2020) to GOP Hispanic Voters Are Shifting Why? 12 | TALK MAGAZINE • WINTER 2022LATINO NEWS By Steve Novak Allentown’s 43rd mayor is its first of Latino heritage. But that wasn’t the city’s only first on Monday. Matt Tuerk took his oath of office in both English and Spanish, taking charge of Pennsylvania’s third-largest city, where over half the residents are Hispanic, for the next four years. “It’s a new day in Allentown,” Tuerk, a Democrat and former vice presi- dent for the Lehigh Valley Economic Development Corp., said in a brief inaugural address. The council also welcomed its youngest-ever member, 21-year-old Natalie Santos. In so doing, it established the city’s first female- majority council. Taking oaths were returning council members Cynthia Mota, Daryl Hendricks and Ed Zucal. Mota was unani- mously selected by her peers to serve as council president for the year, with Zucal as council vice president. “This is our Allentown,” Mota said. “A city where a bare- footed girl from the Dominican Republic can grow to lead. A place where the inspired can thrive. The example when a community comes together — magia pasa — magic happens.” The reorganization meeting was held in person and broadcast live online. Santos was sworn in over a video feed. All those in attendance wore masks — a reminder of the ongoing COVID-19 pandemic. In his address Monday, Tuerk said he spent the day meet- ing with frontline city workers, whom he credited with keeping things moving during the pandemic. He pledged greater communication with council, businesses and residents. “It’s significant that a community that is 55% Latino has not had a voice at the table,” he said. “That’s part of the reason why I did this swearing-in in Spanish earlier. I want to set the tone for an administration that will hear all of the voices of the communities that make up this beautiful city.” Tuerk and the new council are now in charge of a growing city. Allentown’s population of 125,845 trails only Pittsburgh and Philadelphia within Pennsylvania, according to the 2020 Census. The city’s population grew 6.6% over between 2010 and 2020, compared to Pennsylvania’s 2.4% growth overall. The state’s growth was uneven with just 23 of the state’s 67 counties gaining residents, mostly across the southeast, including the Lehigh Valley. Tuerk succeeds Ray O’Connell, who took office in 2018 after Mayor Ed Pawlowski resigned in disgrace following his conviction in a federal corruption trial. Matt Tuerk is Allentown's 43rd mayor, and the first Latino to hold the office New day in Allentown City’s First Latino Mayor WWW.TALKMAGAZINEONLINE.COM | 13Mayor John M. Burwell Homestead Mayor Eddie Moran Reading Mayor Rohan K. Hepkins Yeadon Mayor Felecia Coffee Collingdale Mayor Betty L. Copeland Bridgeville Mayor Dontae Comans Wilkinsburg Mayor Joelisa L. McDonald Rankin Mayor Keith Jackson Rochester Mayor Thaddeus Kirkland Chester Mayor Kenya Johns Beaver Falls Mayor Cletus Lee North Braddock Mayors 2022Mayor Ciera Dent Steelton Mayor Kimberly Doss Ferrell Mayor Edward C. Gainey Pittsburgh Mayor Christopher Frye New Castle Mayor Delia Lennon Winstead Braddock Mayor Val Pennington Bellevue Mayor Dwan B. Walker Aliquippa Mayor Helen Thomas Darby Mayor Wanda Williams Hariisburg Mayors 2022 Mayor Matt Tuerk AllentownHEALTH NEWS 16 | TALK MAGAZINE • WINTER 2022 Not Used Equitably A medication typically used for treating diabetes, glucagon-like peptide-1 receptor agonists (GLP-1 RA), could also be used to prevent cardiovascular disease and major cardiovascular events, but a new study showed inequities in its use based on race, ethnicity, and socioeconomic status. Heart and Diabetes Drug Looking at four years of data, researchers from the Perelman School of Medicine at the University of Pennsylvania saw that the odds of using this medication were as much as 41 percent lower for some groups that are his- torically underserved by health care. This research was published in JAMA Health Forum today. “Cardiovascular disease is the leading cause of death among patients with type 2 diabetes and GLP-1 receptor agonists have been shown to reduce major adverse cardiovascular events,” said the study’s lead author, Lauren Eberly, MD, a clinical fellow in Cardiovascular Disease. “Our study demonstrated significant inequities in use among Black, Latinx, and Asian patients, as well as patients of lower economic status being less likely to be prescribed this therapy. Given well-documented racial disparities in the burden of diabetes and cardio- vascular disease, we feel that the differences in utilization of this therapy must be addressed to prevent worsening inequitable outcomes.” GLP-1 RAs are prescribed for diabe- tes because they help restore blood sugar balance in the body, activating receptors for the GLP-1 hormone in the pancreas to boost insulin while also tamping down the mecha- nisms that release blood sugar. In addition to improved blood sugar control, the medi- cation helps patients manage their weight. Recent studies have added a new facet to this medication’s benefits: reductions in heart health issues, especially those related to in- creased blood pressure. In fact, the American Diabetes Association recommends the use of GLP-1 RAs by patients with atherosclerotic cardiovascular disease, heart diseases caused by build-up and blockages in arteries. Knowing that patients who are Black have been shown to have higher prevalence of diabetes and heart disease mortality risk, Eberly and her fellow researchers – including the study’s senior author, Srinath Adusumalli, MD, an assistant professor of Clinical Medicine in Cardiology and assistant program director of the Cardiovascular Disease fellowship – examined data on GLP-1 RA prescription and use under the lens of race, ethnicity, and economic status. The goal was to shed light on whether uptake of this potentially life-saving medication has been equitable. The researchers accessed de-identified data on more than one million patients with commercial health insurance who were diagnosed with type 2 diabetes between October 2015 and the end of 2018. That period was chosen because it captured a time when the cardiovascular benefits of GLP-1 RA use were established and well-known. All of the study’s patients had continuous insurance coverage for at least a year before and six months after they were diagnosed with diabetes, which was important because a significant lapse in insurance could impact whether a patient could pay for a prescription. To establish the “usage rate” of GLP-1 RA, the researchers considered an insurance claim for a prescription fill by a patient a “use” of the medication. So those who were considered to not be using GLP-1 RA either weren’t prescribed the medication in the first place or hadn’t followed up to fill it. Overall, the usage rate of GLP-1 RA increased during the study period – although it remained low – rising from 3.2 to 10.7 percent. Among patients who had been diagnosed with atherosclerotic cardiovascular disease, the rate of use increased similarly, climbing from 2.8 to 9.4 percent. Increases in prescription use were seen once data was broken down further, too. Among Black patients, an increase was seen from 2.9 to 10.4 percent, 2 to 6.4 percent among Asian patients, 2.9 to 10.8 percent among Latinx patients, and 3.6 to 11.7 percent among white patients. But a deeper analysis showed that inequities were prevalent. Compared to white patients, Black patients were 19 percent less likely to have a GLP-1 RA prescription, Latinx patients were 9 percent less likely, and Asian patients were 41 percent less likely. “While we are unable to ascertain exactly the reasons behind inequitable use, these results persisted after we adjusted for numerous vari- ables, including clinical factors, socioeconomic factors, and even engagement with specialty care – including cardiology and endocrinolo- gy,” Eberly said. “Therefore, the results reveal biases in health care delivery, which must be rectified. We feel these results are reflective of structural racism, and unfortunately are one of many examples of how healthcare systems fail to deliver quality care for non-white patients.” In addition to the racial and ethnic factors, patients with household incomes of more than $100,000 were 13 percent more likely to use GLP-1 RA than those below that income. When use of the medication itself was examined, the researchers found that it more than tripled the likelihood that a patient had more than one visit with an endocrinologist in a year. “A visit to the endocrinologist was the strongest predictor of GLP-1 RA use,” Eberly said. “However, the majority of patients with diabetes are not cared for by an endocrinologist and, furthermore, there are barriers to obtaining specialty care among marginalized patient groups. Therefore, it is important for all providers who care for patients with diabetes to recognize the cardioprotective benefit of GLP-1 RA and take steps in their own practice to achieve more equi- table utilization of it.” Knowing that patients who are Black have been shown to have higher prevalence of diabetes and heart disease mortality risk, Eberly and her fellow researchers – in- cluding the study’s senior author, Srinath Adusumalli, MD, an assistant professor of Clinical Medicine in Cardiology and assis- tant program director of the Cardiovascular Disease fellowship – examined data on GLP- 1 RA prescription and use under the lens of race, ethnicity, and economic status. The goal was to shed light on whether uptake of this potentially life-saving medication has been equitable.HEALTH NEWS From Detection to Prevention: An Interview with Denard Fobbs, M.D. Black Health Matters (BHM): In the past black women were diagnosed with breast cancer less often, but had a greater risk of dying of the disease. That’s changing. Do we know why? Denard Fobbs, M.D.: We have things like Obamacare to thank for some of that. It’s really impressive when you look at the number of peo- ple who are coming into the system who have been out of the system for eight or 10 years. More people accessing care is really impressive. But African-American people have a tendency to avoid routine screenings and visits a lot, even when they have access. When you put these to- gether, there’s the situation where later diagnosis comes at a more advanced time. BHM: We talk detection, but not prevention. Why is this? Dr. Fobbs: This is America, where prevention is not part of the big conversation. General Electric doesn’t make million-dollar prevention machines; they make million-dollar detection machines. The conversation is framed by the money interests. The money interests make MRIs and mammograms. That’s one of the things that has frustrated me over the years, which is why I’m pushing the conversation toward prevention, even though the medical community doesn’t seem to want to talk about it. Did you learn prevention in medical school? Dr. Fobbs: It’s talked about in medical school for about 10 to 15 minutes. I still remember my first day in medical school. One of our sage pro- fessors got up and made a profound comment: When you finish this medical school and go out and do whatever kind of clinical practice you’re going to do, about 85 percent to 90 percent of all the problems you’ll see will be grounded in issues of stress and psychology. That was said on day one. It was never repeated again. We never really studied a curriculum that addressed that. We studied each and every thing about every symptom of every disease, but that seminal comment about the ground substance of disease was never mentioned again. That’s consistent with American medicine. We’re not entirely ignorant about this stuff, it’s just not what we do. You’re about to give a talk about breast cancer, about interventions that can reduce risk while simultaneously improving cardiovascular health. Let’s talk about these interventions. Dr. Fobbs: Most women in America have been misled into thinking hormones are dangerous. We try to reorientate so they’ll understand their normal hormones in proper balance are incred- ibly protective against chronic disease. One of those diseases is breast cancer. In the most jaded study, hormones reduce the risk by 10 percent, but lots of other studies suggest the reduction is more like 30 percent to 40 percent. That’s natural hormones that are well balanced. That same hormone balance also has the beneficial side effect of reducing heart attack and stroke risk by as much as 40 percent to 50 percent. OK … Dr. Fobbs: That’s one intervention. Some are the kind of boring ones you’ve been hearing your whole life, like, your diet. Artificial oils contribute to fat and are dangerous to your gen- eral health. We need to be moving back to the same fats our grandparents ate, with emphasis on olive oil and coconut oil. Even butter, as long as it’s organic, is pretty healthy in moderation. Stop throwing away egg yolks; it’s one of the most nutritious parts of the egg. We have to relearn eating because we’ve been taught a lot of inaccurate things. What else? Dr. Fobbs: One of the biggest contributors to cancer and disease is anxiety and stress. I know people who will work out four and five times a week, go on a pretty strict diet, but won’t lose weight because they refuse to deal with their stress issues. At a certain level in America, stress is almost celebrated. We look at stress as being something that means you’re a real go-getter and you’re working really hard. We’ve made it so that stress is embraced as a good thing. And it’s really not. What do you recommend to reduce stress? Dr. Fobbs: Most Christians don’t really know how to pray effectively. Meditation isn’t just for Buddhists or new agers. What has been proven in hundreds of studies is that the most effec- tive way to eliminate problems with stress is meditation. So we should practice prevention, work on our eating habits and eliminate stress. Tall order, right? Dr. Fobbs: It’s a lot of work. Some of it’s simple, but it’s not automatic. It has to become a labor of love. A person doesn’t have to do all of these things. Each is beneficial. When you combine several, even better. If biology could do math, you could add these up and have a 75 percent to 100 percent reduction in risk of cancer. But if you can reduce risk by even 50 percent to 60 percent, that’s huge! I’d like to see more women so busy doing what they can do to reduce their cancer risk— not to mention improve their general health— that they won’t have time to worry about breast cancer. I’d like to see them worrying little to not at all, but focusing on the things they can do. Though breast cancer isn’t the cancer that takes the most lives (lung cancer wears that crown), it is the kind of cancer that most scares women. For decades, black women were less likely to get breast cancer than our white counterparts, though we were more likely to die from the disease. But recent research from the American Cancer Society shows the first part of that equation is changing. Now we are catching up to white women in cancer occurrence rates. And in some states—Alabama, Kentucky, Louisiana, Mississippi, Missouri, Oklahoma and Tennessee—black breast cancer diag- nosis rates have surpassed those of white women. To learn more about why this shift is happening and how we can take steps to address it, Black Health Matters.com spoke to Denard Fobbs, M.D., a Fresno, California, gynecologist and the medical director of Fobbs LifePoint Institute for Women. WWW.TALKMAGAZINEONLINE.COM | 17Next >