WEBVTT - Brown on Racial Disparity Amidst the COVID-19 Crisis 0:00:00.160 --> 0:00:03.760 This is Bloomberg Business Week with Carol Messer and Jason 0:00:03.840 --> 0:00:07.280 Kelly on Bloomberg Radio. Let's get to our next guest, 0:00:07.520 --> 0:00:11.920 Absolutely Tracy Brown, President and CEO of the American Diabetes Association, 0:00:12.360 --> 0:00:15.360 joining us on the phone from Arlington, Virginia. And Tracy, 0:00:15.400 --> 0:00:18.280 first of all, thank you so much for joining us. Yes, 0:00:18.360 --> 0:00:21.000 Jason and Carol, thank you for having me. Well, we 0:00:21.200 --> 0:00:23.840 are excited to talk to you, in part because you 0:00:23.840 --> 0:00:25.880 know you are very much on the front lines of 0:00:25.920 --> 0:00:29.240 this and you are dealing with an issue that Carol 0:00:29.240 --> 0:00:31.360 and I have been talking about a lot, which is 0:00:32.040 --> 0:00:37.440 the disproportionate effect this disease is having on folks with 0:00:37.680 --> 0:00:45.440 underlying conditions, with folks in communities of color, economically disadvantaged people. 0:00:45.720 --> 0:00:47.720 Tell us what you are seeing, What do we need 0:00:47.800 --> 0:00:50.440 to know that maybe we're missing beyond those sort of 0:00:50.440 --> 0:00:55.560 broad strokes. So, uh, Jason, I mean, I think you 0:00:55.880 --> 0:00:59.840 have hit the nail on the head here. This uh 0:01:00.040 --> 0:01:07.480 bit nineteen pandemic has really shined a light on some 0:01:07.640 --> 0:01:11.880 existing problems in a very large way. You talk about 0:01:12.720 --> 0:01:16.080 people with underlying conditions, that's a hundred and thirty three 0:01:16.280 --> 0:01:21.479 million Americans um living with some kind of underlying condition. 0:01:22.400 --> 0:01:27.759 When you think about diabetes specifically, you are talking about 0:01:28.080 --> 0:01:32.360 thirty four million people who are diagnosed with diabetes, eight 0:01:32.520 --> 0:01:36.399 millions who are diagnosed with pre diabetes. I'm one of 0:01:36.440 --> 0:01:39.960 these people living with diabetes and has have been thriving 0:01:39.959 --> 0:01:42.400 while living with this disease for sixteen years. But here's 0:01:42.440 --> 0:01:47.640 the issue. I think you've heard that for anyone who 0:01:47.680 --> 0:01:54.280 contracts COVID teen that has an underlying condition, the higher 0:01:54.560 --> 0:01:59.040 rate of having a poor outcome is what's happening. This 0:01:59.080 --> 0:02:04.520 is demonstrate by data that is coming out across the 0:02:04.600 --> 0:02:09.000 state that out of the death that have occurred with 0:02:09.080 --> 0:02:12.720 COVID nineteen right now, there are the upwards of um 0:02:12.760 --> 0:02:18.560 in many states or more Jason, those people have had diabetes. 0:02:19.480 --> 0:02:23.080 When you double down on that and then you start 0:02:23.160 --> 0:02:26.880 to look at the UH numbers as it relates to 0:02:27.160 --> 0:02:31.880 people of color, you're talking to the upwards of seventy 0:02:32.000 --> 0:02:36.120 to seventy in some of these states that the depth 0:02:36.600 --> 0:02:41.120 of coronavirus are people of color. This is a real 0:02:41.600 --> 0:02:47.200 issue that is affecting all of America right now in 0:02:47.240 --> 0:02:50.560 this CRISI. And this goes to a bigger conversation too, 0:02:50.639 --> 0:02:55.000 that we had earlier in the week that talked about Tracy. 0:02:55.160 --> 0:02:57.880 You know, unfortunately, the level of health care that you 0:02:57.960 --> 0:03:01.880 get is often contingent on the job you get, and 0:03:01.960 --> 0:03:04.959 the job you get is contingent on the education you get, 0:03:05.320 --> 0:03:08.720 and the educational access that you have is often, you know, 0:03:08.880 --> 0:03:12.520 courtesy of the world that you are born into. And 0:03:12.560 --> 0:03:16.520 we know that minority groups are often left behind when 0:03:16.600 --> 0:03:20.000 it comes to that initial kind of gayway into a 0:03:20.120 --> 0:03:24.120 much better life. And so this is a big problem. 0:03:24.160 --> 0:03:28.760 How do we get at the core of it? So, uh, Carol, 0:03:29.400 --> 0:03:34.880 what you adjust articulate it is the social determinants of health, 0:03:34.960 --> 0:03:40.000 right like, these are all of the environmental UH factors 0:03:40.120 --> 0:03:48.080 that affect um people and uh particularly diabetes and again 0:03:48.280 --> 0:03:53.000 other underlying conditions. And if you think about these social 0:03:53.040 --> 0:03:56.560 determinants of health, there's data out there that says that 0:03:57.120 --> 0:04:02.760 equates about eighty percent of poor health outcomes. Now, let's overlay, 0:04:02.840 --> 0:04:05.640 like we already had an issue pre COVID and you 0:04:05.680 --> 0:04:08.920 have just outlined, let us add on top of this 0:04:09.160 --> 0:04:14.320 the COVID nineteen crisis, with more than twenty six million 0:04:14.600 --> 0:04:20.080 people or more now filing for unemployment. The majority of 0:04:20.120 --> 0:04:22.840 those people when you lose your job, you lose your 0:04:22.880 --> 0:04:26.880 insurance when you lose your job. Not only did you 0:04:26.920 --> 0:04:30.679 lose your insurance, you lose your income. Let me put 0:04:30.960 --> 0:04:34.000 the spotlight on this as it relates to someone who 0:04:34.080 --> 0:04:38.400 is living with diabetes. The person living with diabetes already 0:04:38.440 --> 0:04:42.640 has medical expenses that are two point three times more 0:04:42.720 --> 0:04:47.560 than a person who does not have diabetes. We already 0:04:47.600 --> 0:04:51.000 know that the lots of data out there that says 0:04:51.080 --> 0:04:56.000 people who don't have insurance have horror health outcomes. And 0:04:56.040 --> 0:04:59.320 then now we have that if you have diabetes or 0:04:59.360 --> 0:05:05.240 an underlying condition, the likelihood of COVID nineteen leading to 0:05:05.640 --> 0:05:09.760 bad worth outcomes and or death. All of this now 0:05:09.920 --> 0:05:15.440 has just gotten um, you know, exponential. And so what 0:05:15.720 --> 0:05:20.719 you have, Carol, now is the people who need help 0:05:21.040 --> 0:05:24.960 the most are not getting the help. And if you 0:05:25.120 --> 0:05:28.240 don't have health insurance and you don't have income, you 0:05:28.279 --> 0:05:31.039 can't get the medical medication that you need. If you 0:05:31.200 --> 0:05:35.440 don't have health insurance, you will not go to the 0:05:35.480 --> 0:05:38.960 doctor to care for your your body, which means you 0:05:39.000 --> 0:05:42.000 can get sick and sick er and then end up 0:05:42.480 --> 0:05:47.440 in the very hospital system that is already exploding right now. 0:05:47.680 --> 0:05:51.520 It's a bad, bad scenario, right It's a cycle that 0:05:51.880 --> 0:05:54.960 just continues going down. So Tracy, talk to us about 0:05:55.000 --> 0:06:00.520 what you are pitching lawmakers regulators onto a aviate some 0:06:00.560 --> 0:06:03.039 of these problems in the short term, and then maybe 0:06:03.080 --> 0:06:05.840 we can talk about some of the more structural issues, 0:06:05.920 --> 0:06:10.240 because I know the cost of insulin and the ability 0:06:10.279 --> 0:06:13.359 to get insulin is a hugely important issue for folks 0:06:13.440 --> 0:06:17.640 with diabetes exactly. So Jason, there there are you know, 0:06:18.040 --> 0:06:21.560 three things that right now we are beating the drum 0:06:21.720 --> 0:06:25.200 very hard on during this COVID nineteen pandemic. The first 0:06:25.600 --> 0:06:27.920 is as you talk about, but the last thing that 0:06:27.960 --> 0:06:33.280 we want is for people not to take their diabetes medication, 0:06:33.400 --> 0:06:36.440 whether that's insulin or the prescription drugs. And so what 0:06:36.560 --> 0:06:40.719 we're asking um both at the federal and the state level, 0:06:41.240 --> 0:06:45.560 is an elimination of all copais for insulin and other 0:06:45.720 --> 0:06:49.840 diabetes prescription drugs. So that's not the end all, be all, Jason, 0:06:50.200 --> 0:06:54.680 but removing as much of the financial burden as we 0:06:54.839 --> 0:07:01.120 can so that people do not skip or rations their 0:07:01.160 --> 0:07:06.040 medication right now is what we're going for. So that's one. Two, 0:07:06.520 --> 0:07:10.400 we've talked about the need for continuity of health insurance coverage. 0:07:10.600 --> 0:07:14.600 It's a huge so we are actually uh speaking and 0:07:14.680 --> 0:07:19.200 advocating very hard to say, Look, if Americans with diabetes 0:07:19.520 --> 0:07:23.320 lose their jobs during the wake of this pandemic, we 0:07:23.480 --> 0:07:26.520 want to make sure that they don't lose their health 0:07:26.560 --> 0:07:29.760 insurance coverage and so that there is continuity of coverage 0:07:29.960 --> 0:07:32.560 so that they can still get the care that they need. 0:07:33.400 --> 0:07:38.640 And then the third thing, Jason, as look the numbers 0:07:38.640 --> 0:07:43.640 with COVID nineteen cases still continue to rise. We know 0:07:44.080 --> 0:07:48.440 the economic pressures and that states are looking at reopening. 0:07:49.720 --> 0:07:54.200 We have to have not only more testing, Jason, but 0:07:54.280 --> 0:07:58.080 the testing has to get to the communities and the 0:07:58.160 --> 0:08:01.280 people who are most at it and need it. So 0:08:01.320 --> 0:08:06.200 we we are advocating very hard not just more tests 0:08:06.200 --> 0:08:09.280 any or everywhere. Well, let's get the test to the 0:08:09.320 --> 0:08:15.240 community that now that's not happening, Tracy, and I will 0:08:15.280 --> 0:08:17.080 stay within my family, like I know a couple of 0:08:17.080 --> 0:08:21.040 people who have diabetes. I will say also, I think 0:08:21.560 --> 0:08:23.400 once we get through this, and you're right, we need 0:08:23.480 --> 0:08:25.520 to make sure that those who have diabetes are getting 0:08:25.560 --> 0:08:29.880 their treatments. It's crucial. But I do also wonder take 0:08:29.960 --> 0:08:32.360 several steps back. We've got to figure out how to 0:08:32.400 --> 0:08:35.800 get diabetes under control and I'm a big proponent, Jason. 0:08:35.880 --> 0:08:37.720 I talked about it a lot with guests on our show. 0:08:38.040 --> 0:08:40.560 You know, doctors and you know people from the medical 0:08:40.559 --> 0:08:44.320 community about really focusing and this is a shift for healthcare, 0:08:44.440 --> 0:08:47.320 is focusing on wellness. And maybe this is something where 0:08:47.320 --> 0:08:50.280 telemedicine can help us in the future because it makes 0:08:50.280 --> 0:08:52.960 it easier for everybody to reach out potentially to the 0:08:52.960 --> 0:08:56.240 medical community. But you know that we have such high 0:08:56.360 --> 0:09:00.480 numbers in the United States globally when it comes to diabetes. 0:09:00.559 --> 0:09:03.439 We've got to figure out how to roll back those numbers, 0:09:03.480 --> 0:09:06.559 I mean, and so I'm curious about your efforts along 0:09:06.600 --> 0:09:13.800 those lines, Carol, like you equiitness said that better than myself. Listen, Um, 0:09:13.840 --> 0:09:17.080 this was a The diabetes is an epidemic that existed 0:09:17.120 --> 0:09:21.960 before this pandemic existed. And here's what we know. Eight 0:09:22.160 --> 0:09:27.360 five of people are walking around this country and they 0:09:27.400 --> 0:09:30.480 don't even know that they actually have pre diabetes. And 0:09:30.520 --> 0:09:32.600 I told you one out of two people have pre 0:09:32.679 --> 0:09:36.120 diabetes or diabetes. What we have to start with is 0:09:36.240 --> 0:09:39.640 driving awareness and so we we we are trying to 0:09:39.760 --> 0:09:46.120 drive home a simple notion, Uh, Carol, every time people 0:09:46.200 --> 0:09:49.920 go to the doctors, you get your blood pressure checked. 0:09:50.000 --> 0:09:52.960 It's just like clothwork. That is not the same for 0:09:53.000 --> 0:09:55.959 your A one C. So I don't you know. I 0:09:55.960 --> 0:09:57.800 didn't even ask you. Do you even know what your 0:09:57.840 --> 0:09:59.960 A one C is? Right? This should be a stand 0:10:00.000 --> 0:10:04.880 your eyes, very standardized check that happens every single time 0:10:05.320 --> 0:10:10.840 that someone goes to a doctor, a planic, healthfare or whatever. 0:10:11.280 --> 0:10:16.440 Because it starts with knowing. Then once you know where 0:10:16.520 --> 0:10:20.280 you are with diabetes or free diabetes. This is the 0:10:20.400 --> 0:10:24.199 thing that unnerves me. There is a lot of things 0:10:24.200 --> 0:10:28.559 that you can do to help manage your diabetes, and 0:10:28.640 --> 0:10:32.280 here here are the four things Carol one. You have 0:10:32.400 --> 0:10:35.000 to be mindful of what you're eating. You have to 0:10:35.040 --> 0:10:38.920 be mindful of how you're moving your exercise, you must 0:10:39.040 --> 0:10:42.280 manage how you're sweeping, and you must manage your stress. 0:10:42.320 --> 0:10:46.360 All of these things cause havoc to your blood bluecoatter, 0:10:46.440 --> 0:10:50.840 your blood sugar if not managed. So that's type you 0:10:50.840 --> 0:10:53.560 know for a type to someone living with type two diabetes. 0:10:54.440 --> 0:10:57.000 If you can do those things, you can start to 0:10:57.040 --> 0:11:01.040 get your diabetes under control. Those who live with type one, 0:11:01.679 --> 0:11:07.400 which is an autoimmune disease, listen, this is where insulent 0:11:07.440 --> 0:11:12.480 affordability becomes a musk, because we don't want people who 0:11:12.520 --> 0:11:16.640 need influence to live choosing do I pay my rent 0:11:16.720 --> 0:11:19.080 or do I get my influence? Do I put food 0:11:19.080 --> 0:11:21.400 on my table or do I get my influence? So 0:11:21.840 --> 0:11:25.240 that's the other thing that we're fighting for to uh, Carol. 0:11:25.280 --> 0:11:28.200 But you're right, like we need to control the things 0:11:28.240 --> 0:11:33.040 that we can control, but it all starts with knowing, right, So, Tracy, 0:11:33.160 --> 0:11:35.600 I do wonder given your background, you've had some big 0:11:35.640 --> 0:11:39.440 corporate positions. You were the senior vice president operations and 0:11:39.480 --> 0:11:43.600 the chief experience officer at Sam's Club part of Walmart. 0:11:43.720 --> 0:11:46.800 Is our listeners very well known being the savvy business 0:11:46.840 --> 0:11:51.880 audience they are, Where does the responsibility lie and where 0:11:51.880 --> 0:11:54.360 do you see the most effort on that side, on 0:11:54.400 --> 0:11:59.240 the wellness side, especially between the government and companies. I mean, 0:11:59.320 --> 0:12:01.079 I know, you know, we're very fortunate to work for 0:12:01.120 --> 0:12:03.800 a company that puts that front and center, but I 0:12:03.840 --> 0:12:06.600 know we can't say that for all companies. What do 0:12:06.679 --> 0:12:10.080 you hear from the corporate side, especially at this time 0:12:10.200 --> 0:12:11.720 when people are going to have to start to be 0:12:12.080 --> 0:12:17.280 much more worried about the self health and safety of employees. Yeah, 0:12:17.320 --> 0:12:22.559 I mean, Jason, I think the responsibility all of us 0:12:22.640 --> 0:12:28.559 bear some responsibility in this entire eco ecosystem, from federal 0:12:29.160 --> 0:12:34.560 UH government, to corporate government, to state, local community to 0:12:35.679 --> 0:12:41.000 uh you know, even the insulin manufacturers, the drug manufacturers, 0:12:41.040 --> 0:12:47.000 the retailers, pharmacies, everyone including the individual we all own 0:12:47.400 --> 0:12:50.760 a piece of this responsibility. And just to view, as 0:12:50.800 --> 0:12:54.560 you said, when I am talking to corporations and and 0:12:54.559 --> 0:13:01.400 and again someone who spent a lot of time at Walmart, Um, 0:13:01.440 --> 0:13:05.800 these corporations care about their employees. At least I know 0:13:05.960 --> 0:13:11.760 for our fact Walmart does, and they want healthy employees. 0:13:11.800 --> 0:13:15.640 But if you didn't care just about the human side 0:13:15.640 --> 0:13:19.400 of this, there's an economic side of it as well. Jason, 0:13:19.920 --> 0:13:24.920 diabetes cost this country three twenty seven billion dollars a year. 0:13:25.640 --> 0:13:30.959 So there's both a human piece of this and an 0:13:31.080 --> 0:13:35.760 economic piece of this. And I think right now, all 0:13:35.800 --> 0:13:39.880 of these corporations they not only have the employees their 0:13:39.960 --> 0:13:45.320 own employees, but the communities in which they're located, right 0:13:45.360 --> 0:13:47.319 and and I and I will, and we're running out 0:13:47.320 --> 0:13:49.160 of time, but I will say to Tracy, I mean, 0:13:49.200 --> 0:13:52.240 you're right, it's economic. I mean in terms of healthier 0:13:52.280 --> 0:13:56.040 food and having access to it, it can be more 0:13:56.040 --> 0:13:57.960 expensive or you have to have the time to prepare it. 0:13:58.000 --> 0:14:00.720 So there are so many things that go into this, 0:14:00.800 --> 0:14:02.560 but I'm so glad we got some time with you. 0:14:02.600 --> 0:14:05.520 Good luck with your efforts. Tracy Brown, President and chief 0:14:05.520 --> 0:14:09.280 executive officer at the American Diabetes Association, joining us on 0:14:09.320 --> 0:14:11.600 the phone from Arlington, Virginia. I have to say when 0:14:11.600 --> 0:14:14.240 we talk about health crisis, and of course nothing compares 0:14:14.280 --> 0:14:15.880 to I think what we're going through, but I do 0:14:16.000 --> 0:14:18.880 feel like diabetes is another one, Jason, that we've got 0:14:18.880 --> 0:14:21.840 to figure out absolutely, Oh yeah, for sure. And I 0:14:21.840 --> 0:14:24.600 mean and the numbers that Tracy laid out are staggering 0:14:24.720 --> 0:14:28.400 and a good reminder not just about people, um you know, 0:14:28.440 --> 0:14:31.840 living with diabetes, but people living with pre diabetes, which 0:14:31.880 --> 0:14:34.840 obviously gets into a lot of those sort of underlying 0:14:34.880 --> 0:14:37.920 health issues which that you mentioned. Yeah, it's a big deal.