Rotary Hosts Panel of Local Experts Discussing Health Equity

Health Equity panelists Dr. Del Smith, Dr. Mona Fouad and Dr. Anne Schmidt with RCB President Brenda Hackney and Rotarian Brantley Fry.

On February 16, 2022, the Rotary Club of Birmingham hosted a panel of local experts to discuss health equity. The panel included Dr. Mona Fouad, Professor of Medicine, Director of the Division of Preventive Medicine, Edward E. Partridge, M.D., Endowed Chair for Cancer Disparity Research, and Senior Associate Dean for Diversity and Inclusion in the Heersink School of Medicine at the University of Alabama at Birmingham; Dr. Anne Schmidt, Blue Cross and Blue Shield of Alabama Senior Medical Director; and Dr. Del Smith, CEO and co-founder of Acclinate. Rotarian Brantley Fry, Southern Research VP of People and Community, served as moderator.

Ms. Fry: As you all can see, we have a very distinguished and impressive panel and it’s my pleasure to welcome them here today. So let’s dive in. We’ll start with Dr. Fouad. Throughout the COVID pandemic there’s been a lot of media coverage and policy focus on the idea of health equity. As we noted in your introduction, this is not new. Your work in this field long predates Covid. Can you tell us how you define health equity and give us a little background on how you came to work in this space?

Dr. Fouad: You are right, health disparities and inequity have been around for a long time. I think what COVID did is just shed the light on it. We all of a sudden looked and we found that there are several groups of our population who became high risk. Their mortality rates were higher, their infections too were higher. They were really neglected and didn’t have access to the same ways that we can do testing and vaccinations like other groups. So, health inequity has been there for a long time. We’ve been studying health disparities for a long time, but I think we need now to move to health equity. Now we need to, from what we’ve learned, move to what we call implementation, which is access to all. We need to have equal access to everyone, meet them where they are, provide them with the healthcare that they need, but also with the quality care.

Ms. Fry: Dr. Smith, Dr. Fouad talked about her definition of health equity and part of health equity is social determinants of health, or people refer to SDOH sometimes. This access to healthcare is one of those determinants. Can you talk about how Acclinate seeks to address that?

Dr. Smith: Sure. At Acclinate, our focus is on accessing and engaging communities of color so they can make informed health decisions. At the center of that is education and empowerment. So, as Mona talks about healthcare and access to healthcare, and these things are extremely important, the way we approach it is by meeting people where they are and understanding that we really need to start with people’s understanding and awareness and being at a point where you feel like you’re not just a cog in a system, but you also have the opportunity to be proactive in your health. I was just in rural Alabama this Saturday, actually in Fort Deposit, and there’s discussions about…people don’t know what questions to ask when they get to the doctor. So, how do we better inform people and empower them so that when they do get to the doctor, which is really important, they know the right questions to ask? That’s really what we do as a company. Just excited to also work with UAB and Mona on initiatives to do just that.

Ms. Fry: Dr. Schmidt, Blue Cross Blue Shield of Alabama is our largest health insurer in the state. Can you speak to the ways that you all are working to address health equity?

Dr. Schmidt: Absolutely. One of the ways that we historically have addressed health equity, and I’ll kind of go through it historically and where we’re going as we move forward. Historically, what we’ve done a lot is partner with community organizations, with nonprofits especially, who are really working in their communities to address health and health inequities. And that’s been through The Caring Foundation, which is our nonprofit arm. But what we’ve really tried to do deliberately over the last several years is look individually at, as Dr. Smith and Dr. Fouad have both mentioned, social determinants of health for our individuals at a member level and also at a block level or a community level to really individualize those interventions. Because, as they both mentioned, health disparities have been around for a lot longer than we’ve been talking about them. We’ve been trying to deliberately move to developing those interventions for specific communities because what’s needed in a rural county in southwest Alabama is not necessarily the same needs that are needed in maybe downtown Birmingham or downtown Huntsville. So, what we really need to start with is collecting that data, looking not just at social determinant data, at race, ethnicity and language data, at member levels and at the zip code level to try to focus those interventions more.

Ms. Fry: Dr. Fouad, I believe you have some slides prepared. You and your team won the UAB Grand Challenge a few years ago. Congratulations. Please tell us about your project and how it has developed since winning the Grand Challenge.

Dr. Fouad: I prepared a few slides to talk about the Grand Challenge. I think this was one of the most unique projects I’ve ever done in my whole career. I have a big team here from UAB, and Dr. Ed Partridge too, who are part of this initiative. As you know, UAB put out a call for a concept for a Grand Challenge for UAB to address an issue in the community. We won this Grand Challenge out of 77 applications, so we’re very proud of that. It’s really related to health equity and what we call social determinants or other determinants of health. As we all know, unfortunately, Alabama is ranking at the bottom in all health indicators from heart disease to stroke to cancer to also some behaviors like eating healthy and exercising. We propose that in ten years, maybe we can improve our populations and hopefully we can move this ranking up and we are going to do our best to do that. This is our challenge. Our ten-year’s goal is if we can just make a very slight reduction in some of our indicators like blood pressure or diabetes or obesity, we can really improve the ranking of our state. And this is very important, not only to improve the quality of life of our Alabamians, but also for our economic development and bringing in more businesses because we need a healthy workforce.

We do that through the determinants of health, which is not only the social determinants, but the policies that we make that can impact health systems and the environment that can facilitate people to eat healthy, exercise and also prevention and wellness. We usually talk about individual behavior. We want them to stop smoking, eat healthy, but we need to facilitate this for them because, for some people, where they live and their lifestyles and the stress around their life may not allow them to do that. So, we decided to select four demonstration areas in Birmingham, four communities, two in the west and two in the east in addition to our campus. As you can see here, we’re looking into Kingston, Eastlake, Bush Hills and North Titusville to prove the concept. And then we’ll develop the model that we can expand it to the rest of the state and hopefully the nation.

In the health environment, as I mentioned, it all takes partnerships. We couldn’t believe how much, when we reached out to businesses, you can see here, from industries, construction companies, Alabama Power, Rotaries, Coco-Cola…everybody, when we talked to them, they wanted to help because their workforce and the families of their employees live in these communities. So they partnered with us because we wanted to fix the physical environment of where people live and play and then we can say, “Now you can eat healthy or exercise.” They have to see something physical that changed. So, what we did, we worked with the School of Engineering and they talked with the community: “What are your priorities?” They needed to fix their sidewalks so they can go on walks. They needed crosswalks so their kids can cross safely to school. They need lights so they can have safety and go out and walk. They need green spaces and to improve their parks. The School of Engineering team, with the City of Birmingham team, worked with the industries.

You can see before and after here of some of the parks in Kingston. We completed work in three communities, but this is just one. You see how the park looked before and after. Murals were painted. Residents came out with UAB students and also employees of these companies. They painted murals, they fixed the parks. Then you can see we fixed sidewalks, you can see before and after. From the homes to walk to the park, there were no sidewalks. Or the sidewalks for kids to go to school, they were broken and kids had to go down in the street and in the traffic. Also, improving for disability for people to be able to access their parks. The community, when they saw these improvements, they were thrilled. We also planted more than 100 trees, daffodils. The communities looked good and they were encouraged and felt that they matter, that we care about them, we want to improve where they live. We put bus shelters, we put crosswalks, and this happened in more than one neighborhood. Now we are going out to more neighborhoods in Birmingham. You can even see here we did drawn surveys to see where the dark areas are and Alabama Power donated and put more lights out there. We had good celebrations in Kingston. You can see Mayor Woodfin, President Ray Watts, CEOs of companies like Coco-Cola, Brasfield & Gorrie, they all come together to celebrate with the community this great improvement.

Once we did that, we started what we call the Live HealthSmart Keys and these are different partners. The keys are good nutrition, physical activity and prevention and wellness. One of the highlights is we have now a mobile market. You can see it here. You go inside and it’s exactly like a grocery store that has fresh fruits and vegetables and dairy products. We are now in 18 neighborhoods. Also, we reached out to Chris Hastings and he said, “I’ve been wanting to do something in the communities, but I didn’t know how to do that, how to enter.” We have coalitions in every community, we have relationships, so he said “I want to do something.” So, he’s been coming with the mobile market, demonstrating very healthy recipes using the fruits and vegetables that we are carrying in the mobile market and giving those out to the community. He’s also reached out to the network of other chefs in Birmingham to participate. You can see, the idea of Live HealthSmart Alabama is just contagious. Everybody we talk to wants to partner and wants to take part in this initiative. You can see we have also teaching farms in Kingston so kids can learn to plant vegetables and take them home with healthy recipes. We also just rolled out a mobile wellness van that is going out in the neighborhoods to get people screened and link them to primary care which gets them to access health equity. So, you can it’s all about partnership. We are having great momentum and I hope that anyone here that has an organization or likes to volunteer or be part of this, I welcome you to join us. Thank you.

Ms. Fry: Thank you, and we would be remiss if we didn’t mention Rotarian Teresa Shufflebarger, who helps drive this program for Live HealthSmart Alabama, thank you. We’re going to shift gears a little bit. Dr. Schmidt, Covid has changed a lot of things—for the world, obviously, understatement of the century, right? How has it changed Blue Cross’ focus on health equity? And do you think that access to telehealth during the pandemic has changed at all, and will you see that as a way to address health equity?

Dr. Schmidt: That’s a really great point—and that is the understatement of the century—especially in the payer field, it just upended our lives almost overnight, literally. One of the stats that really hit me, I think it was at the end of 2020 or early 2021, was the reduction in life expectancy in the United States just because of Covid. We know that life expectancy overall in the U.S. decreased by right about a year. That’s the first time we’ve seen a decline in life expectancy since World War I, so that was really tremendous. But when you break those numbers down and when you look at that across racial and ethnic lines…for white Americans, people who identify as white or Caucasian, that reduction in life expectancy was a little less than a year. When you look at people who identify as Black or African American, that reduction was three years. And for African American men, it was over three years. So, that difference right there just brings to mind in one stat the difference in the health disparities of how Covid affected not just the Blue Cross population, not just the Alabama population, but nation-wide.

I think, as we mentioned earlier, the disparities have been there, but Covid really brought to light the differences that different communities have, not only in their health care, but in their access. So, their access to vaccinations, their access to transportation to an appointment, their access to care that’s close by, that’s convenient, that’s available. And to your question on telehealth, I think that was one of the ways we tried to level some of those differences at Blue Cross. Early on, in March of 2020, which seems like decades ago, we opened up telehealth access and coverage to all of our in-network providers. We’ve always allowed telehealth coverage for behavioral health specifically and for primary care, but we opened it up to all specialties. Anybody who could provide care reasonably through the telephone or with a video component, we opened up that coverage. And we saw a spike in April and in May to about twice what we were seeing previously. And that declined in a lot of the specialties, especially the surgical subspecialities and some of the ancillary care, chiropractic for example. We saw that continue to increase and level off at a really high level for both primary care and especially for behavioral healthcare. That is one of the areas where disparities are the highest, not only in uptake, but in access. We have counties in the state that don’t have a single adolescent and pediatric behavioral health provider. Telehealth was really a way, especially on the behavioral health side, to open up that access. Now, it’s not ideal because we know that we still have disparities, especially in rural areas of our state when it comes to broadband access, so if you need a video component for your telehealth, a lot of areas don’t have reliable broadband access to this day. And we also have areas without cell service and certainly we have members and other Alabamians who don’t have consistent, reliable cell service. But it was a way to try to narrow those disparities, and I will say that our intent is to continue to offer that coverage to all the specialties where it’s reasonable, especially for behavioral healthcare.

Ms. Fry: That’s fantastic, thank you. Switching again, Dr. Smith, Acclinate made news recently because you all decided to move your headquarters here to Birmingham from Huntsville. Can you talk to us a little bit about what went into that decision and how you hope to grow here?

Dr. Smith: Well, Brantley, as you mentioned, I was the Dean of the Business School at Alabama A&M University for six years when the seed for Acclinate was planted. We started it in HudsonAlpha Institute for Biotechnology in Huntsville. There are probably many people here that have seen that facility. This was pre-Covid and pre-civil-social unrest and we were trying to get a spark on our business model. And, of course, when Covid came and we had the unrest in our country, this issue of health inequality and health equity really, as Mona said, there was a spotlight put on it. So, our phone started ringing. And we had to make a decision at that point in time. We knew we were going to grow and scale a company, but the question was where were we going to do that? We, of course, looked at Huntsville and thought about Huntsville as being a government contracting and NASA type of city. And we had all these people from Boston and New Jersey and Houston saying, “You need to come here.” And, matter of fact, I got on a plane and visited all those cities for a period of time to look at the ecosystem there. It was Victor Brown, with the Birmingham Business Alliance who said, “Why are you sleeping on Birmingham?” And I said, “Birmingham? Y’all are like right down the street an hour and fifteen minutes.” And he said, “Why don’t you come here. We’ve got some things to talk to you about.” And he brought me to Birmingham and he showed me the focus on health tech, he showed me the focus that UAB was doing with some of the initiatives that Mona talked about. He talked about this focus on health tech, this focus on growing minority-based businesses. And I remember specifically, Mona early on took me in to see Dr. Vickers, to let him know about what we were trying to do, early on in the process. We had many people in the community reach out and say, “We want you to come here.” And I think the thing that did it for us, then we had people willing to write checks. We had some fantastic investors from Birmingham and I mentioned a few of those. Timberline, Charles Goodrich, Shegun, Sanjay, these are all names of folks that said, “We want you here. We want to invest in your company because we want to see you be successful and grow.” That’s what it was. I would encourage Birmingham to think about that model, about attracting and retaining high-growth companies, particularly around this issue of health and to really look at putting Birmingham even more on the map when it comes to this issue of health equity. We’re happy to be here and we want to continue to grow in Birmingham.

Ms. Fry: And we’re thrilled that you’re here. And, being at Southern Research, we’re very excited that you’re here and we’re looking for ways to partner with you. I know that you and Abi have been in conversation and Josh as well. We’re looking forward to those types of partnerships as well to help grow the biotech ecosystem here in Birmingham, so that you’re going to continue to build on your current success. You talked a little bit about the economic impacts of health equity, Dr. Fouad, and then obviously the economic impacts of starting businesses here in Birmingham. Tell us, we’ve got a room full of business and community leaders. Tell us why this group needs to care about health equity in particular and are there actions that we, as business leaders, can take to start making some of the changes that need to be made to address these issues?

Dr. Fouad: We need to look at healthcare that is not just the job of the healthcare providers. I think prevention, quality of life, healthy people, we all care about. We have to take care of our children, to get them to eat healthy and be healthy. Obesity is just like a pandemic now, or an endemic…everybody’s obese, Alabama has one of the highest rates of that. We need to think about, if we have healthy communities, this can be a win-win for everybody. I don’t think there are any businesses that can say, “I don’t care.” Because the people that work for you, that make up your team, they are going to be more productive if they are healthy. They are going to be happier, with less absenteeism in work. The economy, as in health insurance, you don’t only insure the employee, you insure the family. So, you’re going to care about also the members of that family. If we have any company or businesses that comes to open a business in a community, they’re going to look at their workforce. Are they healthy? Am I going to have a good, healthy workforce or not? I think economic development is tied with health. We need also to think about not just providing care, but the social determinants of health. People that make policies, our legislators. It really matters where people live, because if they’re going to live in areas where they don’t have access to transportation or access to healthy grocery stores or services or recreation centers. President Watts is leading the effort now with Live HealthSmart Alabama on blight. How are we going to take care of those blights in our neighborhoods and turn them into either good homes that people can pay taxes to the city for or maybe green spaces or something that can be safer and raise everybody up? It is important, it’s all of us, it’s not just the healthcare system.

Ms. Fry: Dr. Smith?

Dr. Smith: Obviously, Mona hit the nail on the head about the economic impact, especially when it comes to the employers and the employee base. I would encourage anyone who’s interested to go to a site called B-included, and that is an initiative that Acclinate and Prosper Birmingham have entered into, which is to assist and be another resource to help individuals be educated, engaged and empowered about their health. That’s B-included.com. We encourage everyone to go to that site. We encourage, if you have family members that are trying to get answers and trying to connect with people that share some of their concerns or their issues as they relate to health, to go to that site. And what we hope to do is, again, educate and empower. It’s all these resources working together in order for us to move the needle. Because, as Mona has mentioned, if we look at the stats, it’s difficult for us to sit here and believe that there’s not significant work for us to do. And data and stats are one thing, people’s lives are another thing. So, there are people who aren’t living their full life and their full potential because they are not where they need to be from a health standpoint. We all need to have a role in that.

Ms. Fry: Thank you. Dr. Schmidt?

Dr. Schmidt: Absolutely, I couldn’t really have said it any better. It takes partnerships, it takes the provider community, the education community, the business community, and it takes policy and our legislative community as well. There’s a lot that individuals can do, but the policy makers really have a role to play in this as well. I will say that, as a physician and now as a part of Blue Cross, it’s really heartening to me to see this conversation happening. When I was in practice for a lot of years, we would see patients come in who had needs well beyond what the healthcare system specifically could help them with. We can help with medications and we can help with education and help manage diseases, but we weren’t in a position to help necessarily with someone who wasn’t able to pay their rent, who didn’t have safe housing, who might not have had running water at home or safe sewer. Those things impact health to such a greater degree than the healthcare system per se. When we talk about partnerships, it really does take all of us. I know Dr. Fouad and Dr. Smith both alluded to that. I just want to reiterate, as a payer we’re part of that, as a physician we’re part of that, and the community as well. It really does take everybody. And a healthy workforce is a better workforce. It’s not just about absenteeism, it’s about presenteeism as well—people who are at work but aren’t performing up to their optimal abilities because they aren’t well. I would just reiterate the fact that it takes a partnership of everybody.

Ms. Fry: Thank you all. I believe we have some time for questions. Thank you all so much for being here. This is a great conversation.

Brenda Hackney: Let me add my thanks to each of you for joining us today and for engaging in this enlightening discussion.

Mr. Rediker: Has anyone computed the cost to the state in terms of any economic metric you can think of, of our poor health as compared with our neighboring states that also have rural communities.

Dr. Fouad: There are some statistics on that. I don’t have it right now, but there are some statistics that show how obesity or diabetes impacts our economy in this state. I don’t have it, but we can bring it to you.

Dr. Watts: It’s billions.

Dr. Fouad: Probably, I’m glad that you have the answer, Dr.Watts.

Ms. Royal: First of all, UAB, this is amazing, what you’ve done. I’ve been able to see Mona and her work for decades, but this is a huge new launch and we thank you. Now, you can’t do it alone, so my question is, with all these rural hospitals and health systems being shut down, you talked about transportation and resources. What about the distances people have to go? Is it the mobile units that are now going to step up where the hospitals once were?

Dr. Fouad: Thank you so much, Barbara. We’re going to have to think out of the box. We can’t just say there’s no access to care, there’s no hospitals, we have to think about different models. Mobile wellness is one of them. But what we need, again, is partnerships. For example, Tiffany Osbourne is our community engagement lead. She’s working in Selma. There is a small community called Orrville next to Selma and they have nothing. They don’t have any healthcare providers, they don’t have any services. What she did is work with UAB Selma and now she’s taking a group of family medicine residents. We call it Doc on the Spot and they go monthly to provide care. So, what I’m saying, is there are many models and we have to think out of the box because if we waited for a hospital to open or stay open, it’s not going to happen. And that’s actually part of Live HealthSmart Alabama. We’re working with partners—whoever has a resource, whoever has an idea, we’re connecting the dots and supporting them to do that.

Dr. Partridge: I just want to thank the panel. An example of policy and its impact on this state. I’ll give you two examples. One, we do not in the state of Alabama have a statewide clean indoor air act. And we have a very low tobacco tax. The impact of that is huge in terms of the number of people that continue to use tobacco. And then the other thing that this state has failed to do, policy-wise, is expand Medicaid. So, that hurts access tremendously and that’s part of the reason some of the rural hospitals are closing. This is a powerful group, the Downtown Rotary Club, and, that we can be sitting here 60 years after the surgeon general’s report on tobacco and not have a clean indoor air act and not have a significant tax is really amazing. The other thing that Mona and I learned many years ago that I think is important and, again, impacts the people in this room, is you do not have to have a healthcare degree to address social determinants of health. We proved 30 years ago that you could take men and women from the community, lay people, and impact healthcare delivery. And we continue to do that. In fact, it’s much more cost efficient to have non-nurses, non-social workers, non-physicians deal with the social determinants of health because you don’t have to have that medical education to do that. And so those tasks to deal with social determinants actually need to be pushed out to non-medical providers. Because we don’t have enough medical providers to deliver the medicine that’s needed inside the walls of the hospital or the clinic. So, we’ve got to, as Mona said, think outside the box in terms of dealing with the social determinants. Which really accounts for about 70% of disease and lack of wellness inside the United States today. What happens inside the walls and clinics of the hospital accounts for about 20% at most. So, the rest of it is really outside the walls.

Dr. Fouad: Thank you, Ed. You said it well.

Mr. Boettcher: Thank you all for your remarks today. I think we’ve all seen in recent years the types of health services available to the public at pharmacies dramatically increase, especially during the pandemic. It used to be you couldn’t get a vaccination at the pharmacy. What sort of impact would it have to give pharmacists even greater power to treat patients, with proper training of course, especially in rural areas. How would that impact health equity?

Dr. Schmidt: I think that’s a great question and that’s something that we’ve really worked hard on as well. We know, especially in the population who’s over the age of 65, so for us that’s our Blue Advantage population primarily, those folks have contact with their pharmacists about three times as much as they have contact with a primary care provider or any other physician or nurse practitioner. So, we know that pharmacists are providing care already. Some of it is a matter of formalizing that care, so can we bring them more wholly into some sort of network or some sort of provider-based reimbursement system? Can we also remind people…can we make sure that we are supporting those pharmacists and supporting our members, and all Alabamians really, to remind them that they have this access in their communities? All pharmacists, but especially private pharmacies, those who aren’t operating under a CVS or a Walgreen’s or a Walmart, they are providing a lot of education for members and they’re also providing those vaccinations. I’ll speak for myself. In the last three months, I’ve gotten three different vaccinations at pharmacies and I haven’t been to a primary care provider or another medical professional other than a pharmacist. So, it definitely is an underutilized resource.

Dr. Irwin: Much of it is up to the individual, how they choose to live their life: whether they exercise, whether they smoke, whether they drink excessively, whether they know what their blood sugar is, whether they know what their cholesterol is. It comes down to the individual. The second thing is education in this country and healthcare go hand-in-hand. In many countries, children, before they leave grade school or high school, they undergo a health exam, Switzerland, for example. And they leave school knowing if they have a blood pressure problem or a cholesterol problem and it’s enacted at that level. And it seems to me, as a physician and dealing with people for years, that we very often catch people with problems that could have been addressed decades before when they were children. So, my question, with that bit of a preamble, is what are we doing at the school level? I sometimes refer to our generation as the throw-away generation. We spend a fortune keeping people like me alive. I believe that we should be spending more of that money preventing people from going into their 50s and 60s and 70s with chronic disease that could have been prevented. So, what are we doing about that in our schools?

Dr. Smith: I’ve been quiet for a little bit, so I’m going to take a stab at that first part of the question when you’re talking about personal choice. And it sounds like you’re a physician if I’m understanding correctly, so you’ve seen a lot of people come in under different circumstances. One of the things that I think we do as a company is we really try to understand people’s lived experience. It’s one thing, I think, to be in a situation where you’ve got great healthcare, you’ve got physicians that are on our speed dial or a family member. But in many people’s lived experience, it looks less like a choice. If you can’t go walk around your neighborhood without the fear of getting shot, that makes it more difficult to make a personal choice to go walk two miles every day after work. If the only thing you have within walking distance is fast food, it kind of makes it difficult to go to Publix and get that broccoli that costs a whole lot more than what that hamburger would be. So, a lot of times the lived experience seems like it’s not as much of a choice. Now, we still have an opportunity to educate, and engage and use these principles that we’ve talked about to bring the healthy food to the neighborhoods. But I do want to be careful about assuming that it’s an individual choice and they’re just choosing not to do those things. I can’t speak so much to the schools, but I’ll be more than happy to let Mona.

Dr. Fouad: I want to follow up on what Del said. Yes, it is an individual choice, but we want to facilitate that choice. We want to help them to make that choice. And that’s why we focus with Live HealthSmart Alabama on policy, system and environment. We work in the environment not just to make it pretty and beautiful. We did the sidewalks, we put in the lights so people can go out and walk, we fixed the green space, we did the crosswalks, we did bus shelters because if someone is standing to pick up the bus to go to Cooper Green or anywhere and it’s raining or hot, they’re not going to go to their appointment. So, we can talk about social determinants in health, but also we have to work in policies. Like, for example, as I mentioned, our team is working with a wellness taskforce for the schools because we need to put in the schools physical activity. We need to work on the cafeterias and the food options that the kids eat. We need to educate the kids about nutrition and physical activity. We’re partnering with a nonprofit called HEALS Alabama and it’s in many schools in the state. They are in the schools of our demonstration zones. I agree with you, focusing on the children is very, very important. We’re also adding another pilar to Live HealthSmart, which is education. If kids read and write at even a third-grade level, they are going to do better as they’re growing up. So, it is more wholistic. It’s not just “don’t smoke,” “don’t eat French fries,” or “take your blood pressure pills.” It’s more complex than that and that’s why we need to think about it as more comprehensive. The healthcare system providers need to work with the educators, need to work with the business groups, need to work with community organizations, need to work with faith-based. We all have to work together to do that. But if we focus on one thing, we’re going to stay as we are, as we’ve been for the last decades. Thank you for the question.

Ms. Hackney: I want to thank each of you for joining us today and engaging us in this very enlightening discussion, so let’s give this panel a great round of applause.

PanelisT bios

Mona Fouad, MD, MPH is Professor of Medicine, Director of the Division of Preventive Medicine, Edward E. Partridge, M.D., Endowed Chair for Cancer Disparity Research, and Senior Associate Dean for Diversity and Inclusion in the Heersink School of Medicine at the University of Alabama at Birmingham.  Dr. Fouad is a member of the National Academy of Medicine and is recognized nationally as a leader in health disparities research.  She served as a member of the National Institutes of Health (NIH) National Advisory Council on Minority Health and Health Disparities from 2008-2012. Also. Dr. Fouad was selected as the UAB 2018 Distinguished Faculty Lecturer for advancing the frontiers of science and outstanding contributions to education, research and public service. Dr. Fouad obtained her MD from Alexandria University School of Medicine in Alexandria, Egypt, and her MPH from the University of Alabama at Birmingham School of Public Health.

Dr. Fouad has contributed to the science of health disparities through major studies to identify variability in cancer care and outcomes based on race, gender, and age.  She has developed nationally emulated models in recruitment and retention of minorities in clinical trials and innovative community-based approaches to reducing racial disparities in breast and cervical cancer.  She has been the driving force behind interdisciplinary research efforts for understanding problems related to cancer screening and cancer risk factors in the Deep South.  Her work in translating science into practice has improved health outcomes in minority and other vulnerable populations.  As a direct result of her research projects, racial disparities in breast cancer screening in Alabama Black Belt counties were virtually eliminated, as were disparities in access to cancer care.

Dr. Del Smith is a serial entrepreneur passionate about using business to impact society positively. He is the CEO and co-founder of Acclinate, a Birmingham-based digital health startup focusing on health equity through inclusive research. Del has extensive experience in healthcare, IT, and higher education. Before founding Acclinate, Del served as dean of the business school at Alabama A&M University. His research on high-growth, minority-owned firms has appeared in leading journals. Del earned his Ph.D. in Management from the University of Alabama.

Dr. Anne Schmidt is a graduate of Clemson University and received her doctorate of medicine from the Medical College of Georgia.  She completed residency training at the University of Tennessee in Memphis and is board certified in Family Medicine. Dr. Schmidt has practiced primary care in both rural and urban settings and served as Medical Director at United Cerebral Palsy of Greater Birmingham, developing a medical home model of care for people with disabilities. 

In 2015, Dr. Schmidt joined Blue Cross and Blue Shield of Alabama and currently serves as Senior Medical Director. In her current role, Dr. Schmidt is responsible for development and implementation of clinical programs that focus on improving the overall health and wellness of Blue Cross members and all Alabamians. She also serves as a liaison facilitating a strong collaboration between Blue Cross and other leading health organizations across the state, and she currently serves on the Boards of Directors of the Bell Center for Early Intervention Programs and the Alabama Humanities Alliance.

Brantley Fry is Vice President of People and Community at Southern Research. In this role, she guides employee recruitment and retention, employee safety, communications, STEM programs and other community engagement initiatives.

Ms. Fry has twenty years of experience providing leadership, management, and legal counsel to individuals, corporations, local governments, and Federal agencies. She formerly served as State Director for U.S. Senator Doug Jones. This breadth of experience provides a unique perspective in serving stakeholders and effectively communicating and advocating for their interests. Ms. Fry is a proven leader in her profession and in the community.

Admitted to law practice in Alabama and North Carolina, Ms. Fry is a native of Birmingham. She received her law degree from Vermont Law School in 2000 – the nation’s top environmental law program – and her bachelor's degree from Hollins College in 1995. She joined Rotary in 2017 and is an active member. She currently serves as Chair of The Women’s Foundation of Alabama. Ms. Fry is a member of Leadership Birmingham Class of 2019 and served as Past Chair of the Board of Trustees for The Altamont School. In addition, she is active in the parish at St. Mary’s-on-the-Highlands Episcopal Church.