MINORITY HEALTH special Issue 2025
The San Diego
By Dr. John E. Warren
This Seventh Annual Minority Health Special issue updates and expands upon what we have presented, during the past six years, on those ethnic groups that are our Minority Health communities. This issue is a compilation of information gathered from a number of sources such
About Our SEVENth Annual
MINORITY HEALTH special Issue
as the Office of Minority Health within the U.S. Department of Health and Human Services, the Centers for Disease Control and Prevention, the San Diego County Department of Health and Human Services and other data in the public domain.
Because of the importance of the information contained in this issue, we have published this year’s report in a pullout magazine format to increase its shelf life to indefinite use of the materials provided. This will also increase awareness of the groups identified in this issue: Black/ African American, Asian American, American Indian, Alaska Native, Native
Hawaiian and Pacific Islanders, all of whom have members here in San Diego County. This year we have allowed links to electronic ads that sponsors will run on our website connected to their ads in the magazine.
We extend our deep appreciation to those members of the healthcare industry who have made this issue possible with their generous support.
The Seventh Annual Minority Health Special Issue will be available through the Voice & Viewpoint as long as copies last following this publication date.
MAJOR 2025 POLICY SHIFTS IN U.S. HEALTH & SOCIAL PROGRAMS
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The Six Major Minority Groups VITAL SIGNS: AFRICAN AMERICAN HEAL H
Black people make up 14.4% of the population in the United States as of July 2024, according to the most recent US Census Bureau data. The Black population has grown by nearly 33% since 2000, with the increase in foreign born Black people playing a significant role in this growth. As the population has grown, it has become more diverse, with an increase in the share of Black people who identify as multiracial and/or Hispanic.
The share of the population who identified as people of color has been growing over time, with the largest growth occurring among those who identify as Hispanic or Asian. The racial diversity of the population is expected to continue to increase, with people of color projected to account for over half of the population by 2050.
Black/African Americans
Demographic Overview: In 2023, 39.6 million people in the United States were nonHispanic Black alone, or 14.4% of the total U.S. population of 340.1 million. Blacks/ African Americans are the second largest minority population in the United States, following the Hispanic/Latino population. In 2022, most of the US population lived in the South (56% of the total U.S. population) The Midwest and Northeast each had 17%, and the West had 10%, according to Pew Research center. The states with the largest Black populations overall between 2010 and 2022 were Texas, Florida, and Georgia.
Educational Attainment: As of 2023, about a quarter (27%) of all Black U.S. adults ages 25 and older have a bachelor’s degree or more education. More Black women than Black men had earned at least a bachelor’s degree (28.9% vs 22.8%). In 2023, 11% of Black U.S. adults earned an advanced
degree, according to a Pew Research Analysis of 2023 American Community Survey.
Economics: According to the U.S. Census Bureau 2023 Report, the average Black household income was $56,490 in comparison non-Hispanic white household income of $84,630. 21% of Black individuals lived in poverty in 2023, versus 10% of white individuals, based on KFF U.S. Health Facts. In 2023, the unemployment rate for non-Hispanic Blacks 25 years and over was 4.5%, higher than that of nonHispanic whites at 2.9%.
SOURCE: US CENSUS BUREAU Population Estimates, July 2024 (V2024)
insurance coverage: In 2023, 9.5% of Black people under the age of 65 were uninsured, compared to 6.5% of white individuals, according to a KFF analysis of the 20102023 American Community Survey. Also in 2023, 38.2% of Black people relied on Medicaid or other public health insurance.
health: According to Census Bureau projections, the 2022 life expectancies at birth for Blacks are 72.8 years, with 76.5 years for women, and 69.1 years for men. For nonHispanic whites, the projected life expectancies are 77.5 years, with 80.1 years for women, and 75.1 years for men.
American Indian/ Alaska Native (AI/AN)
Demographics/health Overview: This population includes people having origins in any of the original peoples of North, South America, and Central America, who maintain tribal affiliation or community attachment. Studies on urban American Indian and Alaska Native populations have documented a frequency of poor health and limited health care options. Leading diseases and causes of death among AI/ AN are heart disease, cancer, unintentional injuries (accidents), diabetes, and lower respiratory disease. Reports from Indian Health Services show AI/ANs also have disproportionately higher rates of mental health problems such as suicide, posttraumatic stress disorder, violence, and substance use disorders.
Asian Americans
Demographics/health Overview: This racial group is defined as people having origins in any of the original peoples of East Asia, Southeast Asia, or the Indian subcontinent. Some negative factors influencing Asian American health include infrequent medical visits, language and cultural barriers, and lack of health insurance. Asian Americans are most at risk for: cancer, heart disease, stroke, unintentional injuries (accidents), and diabetes, with a high prevalence and risk factors for chronic obstructive pulmonary disease, hepatitis B, HIV/AIDS, smoking, tuberculosis, and liver disease. In 2023, Asians accounted for 36.2% of all TB cases in the U.S., continuing to represent the largest proportion among racial/ethnic groups.
Continued on page 6
Social Determinants of Health in San Diego County
What are social determinants of health (SDOH)?
Social determinants of health (SDOH) are the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. SDOH can be grouped into five domains.
SDOH have a major impact on people’s health, well-being, and quality of life.
SDOH accounts for as much as 50% of county-level health outcomes, and within SDOH, socioeconomic factors contribute to wide health disparities and inequities. For example, people who don't have access to grocery stores with healthy foods are less likely to have good nutrition. That raises their risk of health conditions like heart disease, diabetes, and obesity — and even lowers life expectancy relative to people who do have access to healthy foods.
Just promoting healthy choices won't eliminate these and other health disparities. Instead, public health organizations and their partners in sectors like education, transportation, and housing need to take action to improve the conditions in people's environments.
SOURCES:County of San Diego Health and Human ServicesAgency Public Health Services Community Health Statistics Unit report,“Racial Equity:Framework & Outcomes Brief County of San Diego”,September 2024; Domestic Policy Council Office of Science andTechnology Policy,“Social Determinants of Health”; Healthy People 2030,U.S.Department of Health and Human Services,Office of Disease Prevention and Health Promotion. Retrieved [May 14,2025],from https://health.gov/healthypeople/objectives-and-data/social-determinants-health
The Six Major Minority Groups
Continued from page 5
Native Hawaiians/Pacific Islanders
Demographics/health Overview: This racial group refers to people having origins in any of the original peoples of Hawaii, Guam, Samoa or other Pacific Islands. Significantly, in comparison to other ethnic groups, Native Hawaiians/ Pacific Islanders have higher rates of smoking, alcohol consumption, and obesity. They also have less access to cancer prevention and control programs. Leading causes of death include: cancer, heart disease, unintentional injuries (accidents), stroke and diabetes. Other prevalent health conditions and risk factors among Native Hawaiians/ Pacific Islanders are hepatitis B, HIV/AIDS, and tuberculosis, with 2022 tuberculosis rates at 24.4 per 100,000 people.
Hispanic/Latino Americans
Demographics/health Overview: This ethnic group includes any person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or ori-
gin, regardless of race. In 2022, the CDC projected that the life expectancy at birth for Hispanics is 80.0 years, with 82.8 years for women and 77 years for men. Some negative health factors include language/ cultural barriers, lack of access to preventive care, and the lack of health insurance. Significant causes of mortality for Hispanics include chronic lower respiratory diseases (including asthma and chronic obstructive pulmonary disease), liver disease, influenza and pneumonia, suicide, and kidney disease. Hispanics have higher rates of obesity than non-Hispanic whites.
Middle Eastern North Africa (MENA)
Demographics/health Overview: 2020 marked the first time U.S. Census respondents could report MENA heritage. Between 2010 and 2019, around 342,000 individuals immigrated to the U.S from MENA countries, with Lebanese, Iranian, and Egyptian populations representing nearly half of the
3.5 million who reported MENA descent in the 2020 Census. MENA immigrants were less likely to be uninsured than the total foreign-born population (10 percent versus 18 percent) in 2022. Educational attainment among MENA residents aged 25 and over is notably higher than the general population, with 48.1 percent holding a college degree or higher. However, economic disparities persist, as almost 31 percent live in poverty, and lack of federal data hinders efforts to address these issues. Notably, health data for MENA Americans remains significantly understudied—largely because the U.S. Census and federal health surveys historically classify them as “White,” obscuring disparities in chronic disease, mental health, and access to care.
SOURCES: Martinez and Passel, Pew Research Center, “Facts About the U.S. Black Population”, January 23, 2025; Marrow and Batalova, Migration Policy Institute, “Middle Eastern and North African Immigrants in the United States”, June 12, 2024; Guzman, US Census Bureau, “Median Household Income Increased in 2023 for First Time Since 2019”; Hill, Artiga, and Damico, “Health Coverage by Race and Ethnicity, 2010-2023, Published: Feb 13, 2025
MENA Americans: The Fight for Data Visibility
Health data for Middle Eastern and North African (MENA) communities remains understudied due to their classification as "White" in federal surveys, masking disparities in chronic disease and healthcare access. Recent legislative efforts aim to correct this, but have yet to pass Congress:
• H.R.2730 (2023): Health Equity and MENA Community Inclusion Act of 2023
Seeks to classify MENA as a distinct racial/ethnic group under the Public Health Service Act.
• CA AB 2763 (2024): The California MENA Inclusion Act
Advocates for future collections of MENA demographic data requirements across California state agencies.
MENA includes:
• Middle Eastern: Afghan, Bahraini, Emirati,Iranian, Iraqi, Israeli, Jordanian, Kuwaiti,Lebanese, Omani, Palestinian, Qatari, Saudi Arabian, Syrian, Turkish, and Yemeni.
• North African: Algerian, Djiboutian, Egyptian, Libyan, Mauritanian, Moroccan, Sudanese, and Tunisian.
• Transnational Middle Eastern and North
• African: Amazigh or Berber, Armenian, Assyrian, Chaldean, Circassian, & Kurdish
Key Updates:
March 2024: The Office of Management and Budget added MENA as a federal reporting category (SPD 15). Federal agencies must adopt these changes by March 2029, ahead of the 2030 Census
Dec. 2024: The U.S. Department of Health and Human Services (HHS) announced plans to integrate MENA-specific race/ethnicity questions.
SOURCES:OMB SPD 15,HHS.gov,Congress.gov;ArabAmerican Civic Council, National Library of Medicine
Rebuilding Lives, Not Just Homes
Inside JIREH’s Grassroots Recovery Mission
By Macy Meinhardt V&V STAFF WRITER, CA LOCAL NEWS FELLOW
When floods devastated Southeastern San Diego in January 2024, displacing thousands, recovery became a community-driven initiative that continues to this day. Among those still showing up is JIREH Providers Inc.’s, delivering care and resources to survivors where systemic aid has fallen short.
“Disaster recovery is not straightforward; it is a step-by-step journey with ups and downs and periods of progress coupled by periods of setbacks,” said Samantha Williams, JIREH’s CEO.
More than 1,200 residents, many of whom are low-income, were displaced, and almost 5,000 businesses and homes were damaged from a historic atmospheric river that slammed into San Diego. More than a year and a half later, recovery efforts from the disaster are still underway, with up to 300 families still displaced. “Disaster recovery is much more than the city rebuilding streets and homes; it’s helping to rebuild lives,” Williams emphasized.
From the moment the storm hit, JIREH Clinic has worked side-by-side with survivors for the past 15 months. The storm altered JIREH’s trajectory for 2024 as they learned how to shift from just providing health services to broader disaster case management.
Going beyond just the quick fixes, JIREH’s service to the community addresses the multifaceted nature of disaster recovery, raising awareness of the interconnected social, physical, mental, financial, and spiritual dimensions of healing.
About JIREH PROVIDERS
Emerging from the pandemic, JIREH set out to make healthcare resources accessible to marginalized communities.
life and death for some folks, and they have been left with a very, very traumatic experience,” said Williams.
Looking back & reaching forward
Part of Williams’ vision for JIREH is to ease her community's distrust within the healthcare system, adapting many basic services provided by a standard brick-and-mortar clinic to instead fit an accessible and culturally representative mobile setting, one that looks like them. Services provided include education, vaccinations, testing, preventive care, minor treatment procedures, and referring patients to trusted healthcare options.
Boots on the ground healthcare
JIREH’s collaborative efforts helped deliver support, including crisis counseling, medical screenings, resource navigation, supply distributions and disaster case management to flood victims in their time of need.
JIREH’s contributions didn’t stop there. They hosted a series of community wellness events in the hardest hit neighborhoods, such as Shelltown and Southcrest. With three chefs on the team, JIREH was instrumental in distributing home-cooked meals, among other resources, to neighbors in need.
Mental health impacts of the storm
The storm’s mental and emotional toll was significant, Williams said. The loss of homes, possessions, and in some cases, the loss of loved ones, has resulted in prolonged psychological suffering for some.
“Sometimes, when folks look at the flood and they think about what people lost, we don’t often really acknowledge that it was
Recovery efforts today from JIREH largely entail showing up, checking in to assess changing needs, and ensuring no one impacted feels forgotten or left behind.
“One story that stays with me is visiting a woman who had been displaced with her grandchildren. She shared that for weeks, no one had come to check on her until JIREH knocked on her door. She said, “You made me feel like I wasn’t forgotten.”
“Moments like that remind me that our work is not just about services—it’s about restoring dignity and hope,” said Williams.
Today, Williams says the most urgently needed resources among flood victims are mental health support, housing referrals, and continued access to primary care.
Goals for 2025 entail upgrading their mobile health care vehicle, expanding partnerships with senior recreation centers and organizations like the Jackie Robinson YMCA, attending more youth health resource events in the community, and getting further involved in the maternal health space.
Team JIREH: (L to R) David Verdugo, Samantha Williams, and Detlef Williams in front of their mobile health clinic.
Photo Courtesy: Samantha Williams
JIREH Providers providing meals to impacted residents during one of their community pop-up events. Photo Courtesy: Samantha Williams
Team JIREH administering clinical services within the community. Photo Courtesy: Samantha Williams
PERSISTENT HEALTH DISPARITIES FOR BLACK AMERICANS
Heart Disease and High Blood Pressure:
Heart disease is the leading cause of death in the U.S., with coronary artery disease (CAD) being the most common type. CAD can lead to heart attacks. Risk can be reduced through lifestyle changes and, sometimes, medication.
How Does It Affect African Americans?
• In 2023, Black adults were 20% more likely than white adults to b e diagnosed with high blood pressure.
• Black women were nearly 50% more likely to have it.
How Does It Affect Black San Diegans?
• 2022 data shows that in Central San Diego, Black residents were 65% more likely to be hospitalized for heart disease than white residents (267 vs. 162 per 100,000 people).
• Black residents in the Central Region had the highest rates of death, hospitalization, and ED discharge from hypertensive diseases compared to those in other regions.
Lowering Risk:
• Nutrition: Eat a healthy diet (more fresh fruits and vegetables, lower salt intake)
• Weig ht: Maintain a healthy weight
• Exercise: Be physically active (seek advice from your doctor)
• Smoking: Do not smoke
• Alcohol: Limit alcohol intake
How Does It Affect African Americans?
Nationally:
SAN DIEGO COUNTY STATS BY ETHNICITY
Asthma:
SAN DIEGO COUNTY STATS BY ETHNICITY
• Between 2019 and 2021, about 4.2 million African Americans had asthma.
• By 2023, t hey were 30% more likely to have the condition.
• In 2021, African American adults were 2.5 times more likely to die from asthma than white non-Hispanic adults, and children nearly 8 times more likely. Secondhand smoke raises children's risk of respiratory issues, especially those in poverty who often have higher levels of cotinine, a nicotine byproduct.
In San Diego County:
• Black residents were hospitalized for asthma at a rate 375% higher than white residents (632 vs. 133 per 100,000), with the highest rates in the Central Region.
• While asthma’s exact causes are unclear, children exposed to secondhand tobacco smoke—especially those in poverty—face higher risks of acute respiratory infections and elevated blood cotinine levels.
SOURCES: CDC. High School Youth Risk Behavior Survey Data. High School Students Who Had Obesity, 2023; County of San Diego, Health and Human Services Agency, Public Health Services, Community Health Statistics Unit, September 2024; CDC, 2024. Deaths: Final Data for 2021. National Vital Statistics Report, Vol. 73, No. 8; SEER*Explorer: An interactive website for SEER cancer statistics. Surveillance Research Program, National Cancer Institute; 2024 Apr 17. [Accessed 10/16/2024]
Cancer:
WHAT IS CANCER?
Cancer refers to diseases where abnormal cells grow uncontrollably and can invade other tissues. These cells can spread through the blood and lymph systems. Cancer is not just one single disease, but many diseases.
Cancer and Black San Diegans:
• In 2019, Black residents in San Diego County had the highest cancer death rate—171 per 100,000—compared to 151.4 for white residents.
• Black San Diegans also faced higher mortality rates from breast, lung, prostate, and liver cancers.
Lowering Risk:
• Making healthy choices, keeping a healthy weight
• Avoiding tobacco
• L imiting alcohol intake
• Protecting your skin. Screening tests can find some cancers early, when treatment works best.
• Vaccines (shots) can help prevent or reduce your cancer risk (example: HPV, hepatitis)
Cancer and African American Men:
Diabetes and Obesity:
WHAT IS DIABETES?
Diabetes is a chronic condition that affects how your body turns the food you eat into energy. It involves problems with insulin, a hormone that helps sugar (glucose) enter your cells. Without proper insulin function, blood sugar levels rise. Over time, diabetes can lead to serious issues like heart disease, vision loss, and kidney damage. There is currently no cure.
What is Obesity?
Obesity poses serious health risks. Adults with a BMI of 30 or higher are considered obese. For children, overweight is defined as a BMI between the 85th and 95th percentiles, and obesity as at or above the 95th percentile. BMI is calculated from weight and height. Obesity is linked to major causes of death, including diabetes, heart disease, stroke, and certain cancers.
DIABETES and African Americans:
OBESITY and African Americans:
Adolescent Obesity and African Americans "
Mental and Behavioral Health:
What is mental and behavioral health?
According to the CDC, mental health includes our emotional, psychological, and social well-being, influencing how we think, feel, act, handle stress, relate to others, and make choices throughout life. Behavioral health focuses on the actions people take in response to situations and is often shaped by their mental health.
How Does It Affect Black San Diegans?
Black residents in San Diego County faced the highest rates of various mental health conditions, including ADD, anxiety, mood and personality disorders, PTSD, schizophrenia, and substance-related issues.
• In 2022, they had the highest inpatient treatment rate for mood disorders (280 per 100,000) and the highest
hospitalization rate for suicide among all racial and ethnic groups.
SAN DIEGO COUNTY STATS BY ETHNICITY
Stroke:
What is Stroke?
A stroke, or brain attack, happens when blood flow to the brain is blocked or a vessel bursts, damaging brain cells. It can lead to lasting brain damage, disability, or death.
How Does It Affect African Americans?
• In 2022, Black San Diegans in the central region were the highest ethnicity to be hospitalized for a stroke
• Black men are 70 percent more likely to die from a stroke.
• African American women are twice as likely to have a stroke.
Listening to Black Californians
California, home to the most culturally diverse population in the country and the fifth-largest Black population of any state, has a major opportunity to be a leader in health equity. But, again and again, research has shown that racism and structural barriers in the health care system prevent Black Californians from achieving the health they actively seek.
BLACK CALIFORNIANS HAVING THEIR SAY
Healthcare to Meet Our Needs
SOURCE: Listening to Black Californians: How the Healthcare System Undermines Their Pursuit of Good Health by Linda Cummings, PhD, California Care Foundation, October 4, 2022
Listening to Black MEN IN California
The study involved hour-long interviews with 49 Black men, four focus groups with 26 participants, and surveys from 1,235 Black men across California, representing a diverse and large sample.
RECOMMENDATIONS:
Create community forums
Build
Expand
Involve Black
Source: Listening to
“It Wasn’t Just a Typo”: The Doctor Visit That Went Viral
By Macy Meinhardt V&V STAFF WRITER, CA LOCAL NEWS FELLOW
When Kierra King, a 26-year-old Black woman, walked into Perlman Clinic for routine lab work, she expected standard medical care. What she received instead was a degrading reminder of how deeply racism persists in healthcare. A medical assistant labeled her test tube with the name “King Kong”—a blatantly racist slur historically used to dehumanize Black people by comparing them to primates.
“I felt so small,” said King, as she described the March incident during an interview with Voice & Viewpoint
The medical assistant in charge of creating the label claimed she was typing too fast and didn’t double-check the name. Despite being “filled with rage” on the inside, King said she remained calm when she confronted medical staff, documenting the exchange on her phone, which she later uploaded to TikTok. The video went viral. Her composure was out of necessity, King said. As a Black woman, had she reacted any differently, “Then I am ghetto, or have an attitude, or I’m the aggressor,” she said, in describing the ‘Angry Black Woman’ trope.
Within days, her video amassed millions of views, exposing ugly truths. While many believe racism is a thing of the past, Black patients still face dehumanization in places meant to heal and provide care. The level of disbelief—as evidenced in thousands of comments under her post— further layers the harm, proving how badly people misunderstand racism’s persistence.
“This is just one instance,” said King, “stuff like this is happening all the time. But it’s my story, and it’s an experience that I refuse to be silent about,” King said.
Systemic Failures & Institutional Response
Perlman Clinic declined to respond to Voice & Viewpoint for comment. For King, the clinic’s nonresponse only compounded the damage. The medical assistant claimed “King Kong” was a typing error.
“I felt she was trying to gaslight me into thinking that we went over the label when I know for a fact that we did not,” said King. King recounted that the medical assistant gave King her name and said she was welcome to report her.
After the video went viral, Perlman issued a social media apology but later deleted it and replaced it with a generic statement about diversity—a pattern King recognized as damage control. King said a representative from Perlman later reached out to her to apologize and requested a one-on-one conversation with her.
“I made the decision that I didn’t want to speak with them. I felt like all they were going to do was try to cover themselves and try to save their reputation,” said King.
Medical studies show that such incidents aren’t isolated. A 2023 KFF survey found that Black adults are more likely than their White peers to report unfair treatment or disrespect by a health care provider due to their race and ethnicity and to report certain negative experiences.
King’s advice to others is clear: protect your peace. She’s now set on finding representative healthcare, preferably a Black female primary care provider, a move she considers both healing and safe.
“Although the experience was terrible, it’s now a part of my story and I now get to advocate further for women and people of color,” said King.
Photo of San Diego resident Kierra King (left), along with screenshot of her viral TikTok video, labeling her test kit with “King Kong”. PHOTOS: Courtesy of Kierra King
OUR MOTHERS +
Infant
Mortality in the
African American Community
An Important Health Marker
Infant mortality, defined by the CDC as the death of an infant before their first birthday, is measured by the number of infant deaths per 1,000 live births. This rate not only reflects maternal and infant health but also serves as a key indicator of a society’s overall well-being.
How Does It Affect African American Populations?
• African Americans had the highest infant mortality rate among all racial and ethnic groups.
• Non-Hispanic Blacks/African Americans have 2.4 times the infant mortality rate as non-Hispanic Whites.
• Non-Hispanic Black/African American infants are almost four times as likely to die from complications related to low birthweight as compared to non-Hispanic White infants.
• In 2022, Non-Hispanic Black/African American infants had 3.2 times the sudden infant death syndrome mortality rate as non-Hispanic Whites in 2022.
• In 2022, non-Hispanic Black/African American mothers were twice as likely to receive late or no prenatal care compared to non-Hispanic White mothers.
Our State & Local Data
Did you know that compared to San Diego County infants overall, San Diego’s African-American infants are:
• Over 5 times more likely to die, about 50% more likely to be born premature, and twice as likely to be born with low birthweight than White infants
• Nearly three times more likely to die during their first year of life
• Nearly 60% more likely to be born premature
Black Infants In San Diego
CHILDREN
BLACK MATERNAL HEALTH
Women who give birth find it difficult to access treatment for perinatal mood and anxiety disorders. Lack of time for screenings due to work or childcare, transportation limitations, language barriers, unaffordable mental healthcare, and lack of access to quality mental healthcare in the community, along with other societal and structural barriers.
Several Risk Factors For U.S. Black Women
OF SOCIAL SUPPORT
SOCIOECONOMIC STATUS HISTORY OF SEXUAL/ PHYSICAL VIOLENCE POOR ACCESS TO HEALTHCARE POOR ACCESS TO EDUCATION
STRESS
HISTORY OF DEPRESSION
A LOOK AT THE NUMBERS
Mental health conditions are a leading cause of maternal mortality. Black women not only face a higher chance of developing perinatal mood disorders than white women, but they are also less likely to receive treatment due to factors such as fear of stigma, involvement of child welfare services and financial barriers.
3-5x BLACK WOMEN ARE MORE LIKELY TO DIE FROM PREGNANCYRELATED DEATHS COMPARED TO WHITE WOMEN
>50% MOST PREGNANCYRELATED DEATHS OCCUR IN THE POSTPARTUM PERIOD
# 1 PERINATAL MOOD DISORDERS ARE ONE OF THE LEADING COMPLICATIONS OF PREGNANCY AND CHILDBIRTH
BLACK MATERNAL MENTAL HEALTH
Mental health conditions are a leading cause of maternal mortality. Black women not only face a higher chance of developing perinatal mood disorders than white women, but they are also less likely to receive treatment due to factors such as fear of stigma, involvement of child welfare services and financial barriers.
The mental health of Black moms is in crisis. Weathered by a lifetime of systemic racism, discrimination, and structural inequities, black women experience high levels of trauma exposure that deteriorate their physical and mental health. This increases the risk of mental health disorders among Black birthing people.
40% BLACK WOMEN EXPERIENCE MATERNAL MENTAL HEALTH SYMPTOMS
"After birth, I cried for weeks. I felt so down I had no support from my OB doctor. I didn't get to see her after six weeks. It would be nice if there were more support for new mommies."
Dr. Carolle Jean-Murat: Healing Beyond the Hospital Walls
By Tihut Tamrat
VOICE & VIEWPOINT STAFF WRITER
For nearly two decades, Dr. Carolle JeanMurat stood as a singular force in San Diego County’s medical landscape—the only Black female OB/GYN in the region for 17 years. A native of Haiti and descendant of a long line of healers, shamans, herbalists, and midwives, Dr. Jean-Murat brought more than medical expertise to the exam room. “Healing is not just about medication or surgery,” she says. “It’s about connection—between doctor and patient, between mother and child, and most importantly, within yourself.”
ean,” continues Dr. Jean-Murat, “But some people [give labor] in 2 minutes or some might need 3 hours, every woman’s body is different and there was no leeway!” she exclaims. “I knew I had to step away in order to truly help women the way they deserved.”
Dr. Jean-Murat left conventional practice to pursue a more expansive vision of healing. One that she wholeheartedly believes in. “I’m an intuitive healer,” she explains, “ I connect with my patients in order to calm them.”
Embracing her intuitive and spiritual gifts as an energy and trauma release healer, her approach weaves together intuitive knowledge, energetic alignment, and active listening—elements often ignored in modern healthcare. A learned practice that was inspired by her late grandmother, Eugénie Jean, who influenced her to always listen to her intuition
Frustrated by the limitations of traditional Western medicine, Dr. Jean-Murat unfolds the truth about the medical system. “The protocols were rigid. It became more about procedures than people,” she says. One such protocol is the rules and regulations surrounding a cesarean (c-section), a surgical procedure where a baby is delivered through incisions made in the mother's abdomen and uterus.
“If a patient is in labor for over 2 hours then it is required by the hospital to do a cesar-
and her patient. “My grandmother was my spiritual back up. Whenever something would be off, I call my grandmother. Then she lights a candle and says, ‘You are going to listen. The Holy Spirit will guide you’, and it always got resolved.”
At the heart of her method is the belief that wellness is only possible when the mind, body, and spirit are in harmony.
The Mind-Body-Spirit Connection
Dr. Jean-Murat educates in her published books, (Strengthening Your Spiritual Foundation for Optimum Health: 18 Ways to Unleash Your Innate Powers and Mind, Body, Soul & Money: Putting Your Life in Balance) that the body is not just a vessel for medical intervention but a spiritual structure, which she likens to a “primitive house” model. In her model, the mind forms the windows, doors, and walls of the house; the body is the roof—but it all depends on a strong spiritual foundation. Without it, emotional wounds, especially unhealed trauma, can manifest physically.
Dr. Carolle Jean-Murat at her sacred healing garden sanctuary on Thursday, April 24, 2025. PHOTO: Tihut Tamrat
Dr. Jean-Murat’s paternal grandmother Eugénie Jean, herbalist. PHOTO: Courtesy of Dr. Carolle Jean-Murat
Dr. Carolle Jean-Murat helping a patient at the Hôspital St. Joseph in La Vallée de Jacmel in the southeastern region of Haiti. PHOTO: Courtesy of Dr. Carolle Jean-Murat
One of the first babies
Dr. Carolle Jean-Murat delivered.
PHOTO: Courtesy of Dr. Carolle Jean-Murat
Her insight is particularly significant when it comes to addressing the experiences of Black women. “Black women are more likely to be inappropriately touched, more likely to be raped, to be in intimate partner violence, and be therefore disconnected with their body—especially during childbirth,” she explains.
Dr. Jean-Murat says this systemic disregard and overexposure to trauma not only affects health outcomes but also the experience of motherhood itself. “Pregnancy is one of the most sensitive times,” she notes, “but too often, the mother is isolated and she finds herself by herself and vulnerable because she is going into a system where she doesn’t feel heard, instead of being in a beautiful moment.”
Rather than merely identifying these problems, Dr. Jean-Murat offers solutions—starting with a cultural and spiritual reclamation of birth. One of her proposed methods is Built Well for Birth, a pre and postnatal coaching program designed to empower women long before they arrive at the delivery room, founded by Andrew Martinez. The Built Well for Birth method helps women practice pushing, release fear and tension, and connect their minds to
“By the time you’re in the hospital, it’s often too late to reclaim control. We have to prepare our women ahead of time—to remedy and empower themselves.”
— DR. CAROLLE JEAN-MURAT
their baby’s movements—all with the aim of making birth a powerful, even transcendent, experience.
“It’s about building confidence,” she says. “By the time you’re in the hospital, it’s often too late to reclaim control. We have to prepare our women ahead of time—to remedy and empower themselves.”
Dr. Jean-Murat also strongly advocates for Black doulas, midwives, and birth advocates who provide culturally affirming support. These caregivers, she says, are key to creating safe spaces where expectant mothers can be seen, heard, and honored.
“Pregnancy is a natural thing,” she reminds us. “We need to leave the negative emotions behind. Birth is sacred.”
Though she no longer practices in a hospital setting in the U.S., Dr. Jean-Murat’s legacy reverberates throughout the lives she’s touched. Dr. Jean-Murat is currently a cancer remission specialist and emotional trauma release expert. She is also the coadministrator of a nonprofit organization called CODEVA-Coude-A-Coude pour le Développement de La Vallée (Elbow to Elbow to develop La Vallée) which built Hôspital St. Joseph in La Vallée de Jacmel in the southeastern region of Haiti of which she contributes regularly. Fluent in five languages, Dr. Jean-Murat also provides free medical care and preventive health education to women of diverse backgrounds and cultures.
“My work focuses on identifying and addressing the root cause of trauma, offering sustainable, culturally responsive care that avoids unnecessary testing and treatment, reduces suffering, and enhances quality of life. I’ve learned that healing often begins when we stop fighting and start listening to our bodies, pain, and voice within,” says Dr. Jean Murat, “My mission is to help you reconnect with your inner power and allow your body to heal naturally, gently, and profoundly.”
Resources From Our Local Maternal Care Experts
What Expectant Families Need to Know
Resources for Doula Service:
1. For The Village - (https://www.forthevillage.org/) info@forthevillage.org; (619) 657-3384
2. HappyMama Doula Services - (http://HappyMama.global); (619) 800-6443
3. Frontline Doula Services - (https://www.frontlinedoulas.com); Support Hotlines
Wellness Services for Women:
1. Movement Matters - (www.movementmatterscollective.com)
2. Thriving While Pregnant & Beyond(https://tobeboundless.com/about-boundless-womens-fitnesspilates/); thrivingwhiepregnant@gmail.com
Social Service & Counseling Programs:
1. Healthy Start - Global Communities(https://globalcommunities.org) - (858) 279-9690
2. Urban Restoration(https://urbanrestorationcounseling.org/#b1424)
Alternative Pregnancy and Postpartum Services:
1. San Diego Community Birthing Center(https://www.sdcommunitybirthcenter.com/)
2. Root & Soul - (https://www.rootandsoul.com/)
3. Radiant Family Chiropractic(https://radiantfamilychiropractic.com/About)
Additional Support Services:
1. Black Infant Health Program(www.neighborhoodhouse.org/blackinfanthealth/)
2. Postpartum Health Alliance(https://postpartumhealthalliance.org/)
Black Maternal Mental Health Resources:
1. Shades of Blue - (www.shadesofblueproject.org)
2. Postpartum Support International (PSI) - (www.postpartum.net/)
SOURCES: Iris Payne, Director of the Black Infant Health Program and Nikki Helms, Owner and Director of the San Diego Community Birthing Center
BLACK AND AFRICAN AMERICAN COMMUNITIES AND
MENTAL HEALTH GUARDING OUR MENTAL HEALTH
Demographics/Societal Issues:
African Americans are 20% more likely to experience serious mental health problems than the general population. Adult African Americans:
• Living below poverty are two to three times more likely to report serious psychological distress than those living above poverty.
• Are more likely to have feelings of sadness, hopelessness, and worthlessness than are adult whites.
• Though less likely than whites to die from suicide as teenagers, Black teenagers are more likely to attempt suicide than are white teenagers (8.2 percent v. 6.3 percent)
• Of a ll ages are more likely to be victims of serious violent crime than are non-Hispanic whites, making them more likely to meet the diagnostic criteria for post-traumatic stress disorder (PTSD).
Partnerships
And Resources
Organizations with a focus on outreach to Black and African American communities:
San Diego Black Nurses Association
National Black Nurses Association
National Medical Association
Lee Thompson Young Foundation
SOURCES: Census.gov/quickfacts, Mental Health America
Reluctance and Inability to Access Mental Health Services:
Only about one-quarter of African Americans seek mental health care, compared to 40% of whites. Here are some reasons why:
• Distrust and misdiagnosis
• So cioeconomic factors
• A la ck of African American mental health professionals
• Me dications
• Provider bias and inequality of care
According to SAMHSA’s 2023 National Survey on Drug Use:
• Suicidal thoughts among Black young adults (18–25) increased by 3% from 2018–2023, continuing the upward trend noted in prior surveys.
• White and Multiracial adults were more likely to receive mental health services than Black, Hispanic, or Asian adults in 2023.
• Bl ack adults with mental illness are 2x more likely to binge drink and 1.5x more likely to misuse prescription opioids compared to those without mental health conditions.
Treatment Issues - Black and African Americans are:
• Over-represented in jails and prisons , with nearly 40% in the prison population
• Il l-served - less than 4% of APA members are Black or African American.
• Subject to stigma and judgment , research indicates that Blacks and African Americans believe that mild depression or anxiety would be considered “crazy”.
Substance Abuse and Mental Health Services Administration (2024), Health and Human Services Office of Minority Health, “Key Substance Use and Mental Health Indicators in the United States: Results from the 2023 National Survey on Drug Use and Health” (SAMHSA 2023)
GUARDING OUR MENTAL HEALTH
Mental Health: EARLY WARNING SIGNS + SYMPTOMS
Not sure if you or someone you know is living with mental health problems? The following feelings or behaviors can be an early warning sign of a problem:
EXCESSIVE WORRYING OR FEAR
CONFUSED THINKING OR PROBLEMS CONCENTRATING AND LEARNING
EXTREME MOOD CHANGES, INCLUDING UNCONTROLLABLE “HIGHS” OR FEELINGS OF EUPHORIA
PROLONGED OR STRONG FEELINGS OF IRRITABILITY OR ANGER
AVOIDING FRIENDS AND SOCIAL ACTIVITIES
DIFFICULTIES UNDERSTANDING OR RELATING TO OTHER PEOPLE
CHANGES IN SLEEPING HABITS OR FEELING TIRED AND LOW ENERGY
CHANGES IN EATING HABITS, LIKE INCREASED HUNGER OR LACK OF APPETITE
SOURCE: NAMI
CHANGES IN SEX DRIVE
DIFFICULTY PERCEIVING REALITY (DELUSIONS OR HALLUCINATIONS)
LACK OF INSIGHT INTO CHANGES IN ONE’S OWN FEELINGS, BEHAVIOR OR PERSONALITY
OVERUSE OF SUBSTANCES LIKE ALCOHOL OR DRUGS
MULTIPLE PHYSICAL AILMENTS WITHOUT OBVIOUS CAUSES (HEADACHES, STOMACH ACHES, VAGUE “ACHES AND PAINS”)
THINKING ABOUT SUICIDE
INABILITY TO CARRY OUT DAILY ACTIVITIES OR HANDLE DAILY PROBLEMS AND STRESS
AN INTENSE FEAR OF WEIGHT GAIN OR CONCERN WITH APPEARANCE
LOCAL SNAPSHOT: Suicide—A Deadly Reality in San Diego County
The San Diego County Suicide Prevention Council’s Annual Report to the Community 2024 revealed a shocking statistic: Suicide is a leading cause of death in the United States and in San Diego County. It is a complex public health issue that requires a multifaceted approach to prevention and intervention. Although data can be a powerful tool in addressing suicide, we can never forget that this data represents real people – our family, friends, neighbors, and community members.
Quick Facts:
• From 2021 to 2023, the suicide rate for Black residents in San Diego County increased by 51%
• In 2022, suicide attempt /emergency department encounter rates were highest among residents who were female, aged 10-24, Black, or living in the Central Region.
Suicide is the second leading cause of death for youth ages 10 to 19 years old. For Black kids, the suicide death rate more than doubled from 2007 to 2017, jumping from 2.55 per 100,000 to 4.82 per 100,000, increasing at a faster rate than any other racial and ethnic group.
• The most common method of suicide death for NonHispanic Black and White residents is reported as firearm.
Local Resources:
• Dial 1-888-724-7240 to connect to the San Diego Access and Crisis Line for free and confidential behavioral health resources & referrals, available 24/7 in over 200 languages. Find more resources at the It’s Up to Us website www.up2sd.org.
SOURCES: “Ring the Alarm: The Crisis of Black Youth Suicide in America,” 2020 report commissioned by the Congressional Black Caucus, The San Diego County Suicide Prevention Council’s Annual Report to the Community 2024, SANDAG 2019-2022
AFRICAN AMERICANS IN SAN DIEGO COUNTY
San Diego County Public Health Is Addressing
Health Disparities
By Fernanda Lopez
Group Communications Officer at the County of SD HSSA
Recognizing that chronic and infectious diseases can affect communities differently, the County of San Diego Public Health Services is committed to promoting health, preventing disease, and protecting the public’s health throughout the region.
Tuberculosis
San Diego County has some of the highest rates of Tuberculosis in California and the nation. Last year, the rate was 7.5 cases per 100,000 people.
The highest numbers of TB diagnoses are found in the southern and central parts of the county. Hispanics make up the highest proportion of people diagnosed with TB at 58% followed by Asian/Pacific Islanders at 28%.
The TB rate among people born outside the U.S. was more than seven times higher than the rate of U.S.-born people and varied by birth country.
To address these disproportionately high rates of TB among diverse local communities, County Public Health offers:
• TB risk and testing training to organizations, healthcare providers, schools, and others.
• A TB C linic at 5055 Ruffin Road that serves uninsured individuals.
• TB testing is also available at regional public health centers.
Black Infant Health and Perinatal Equity Initiative
African-American infants in San Diego County are five times more likely to die than White babies. Gaps in access to health care and racism contribute to this problem.
The County’s Black Infant Health program offers:
Free support for pregnant and postpartum
African-American mothers (16+) through Black Infant Health.
Funds support bias training for providers and a fatherhood program.
Programs shaped by a community advisory board.
Controlling Blood Sugar to Prevent Diabetes
Nearly half of all adults may have untreated prediabetes. This is a condition where a person’s blood sugar is higher than normal, but not at the level of diabetes. And most of the time, people don’t know that they have it. If untreated, many people with prediabetes could develop diabetes within five years.
African-Americans are twice as likely as other racial groups to visit an emergency room or go into the hospital because of diabetes. Fortunately, there are ways to prevent the progression of prediabetes into diabetes. Talk to your doctor to learn more about your risk for diabetes by getting a blood test, lower your weight if you are overweight and include exercise into your daily routine.
People can find the closest program to help with lifestyle changes by calling 2-1-1. For free nutrition resources visit the County of San Diego CalFresh Healthy Living webpage and to learn more about prediabetes in general, visit The Surprising Truth About Prediabetes, on the CDC website.
HHSA Tuberculosis branch staff mark World TB Day, March 24, which raises awareness about the impact of TB around the world and highlights the efforts to eliminate TB
Jabrasia, Dorian, and Ahliyah of El Cajon pose for the Black Legacy Now campaign working to raise awareness about inequities experienced by Black women and babies.
AFRICAN AMERICANS IN SAN DIEGO COUNTY
Heart disease and stroke are among the top five leading causes of death in San Diego County, with high blood pressure a leading risk factor. Historically, A frican-American adults have been burdened with higher rates of high blood pressure, heart disease and stroke.
Smoking, poor diet and lack of exercise play a negative role in heart health and
The County leads initiatives to:
• R educe new HIV diagnoses.
• Support individuals living with HIV.
• Train contracted providers to offer accessible, stigma-free, and welcoming services.
County Public Health Services (PHS) conducts outreach in vulnerable communities to:
• E ducate about safer practices.
• Promote the use of PrEP (pre-exposure prophylaxis) and PEP (postexposure prophylaxis).
• Connect individuals to additional
Tijuana River Valley Pollution
Raw sewage contamination continues to affect South Bay communities near the Tijuana River Valley. In 2024, the County and CDC conducted two major assessments on community health impacts.
Full results available at sandiegocounty.gov/southregionhealth .
Steps to reduce exposure to sewage odors:
• Limit outdoor activity if odors are strong.
• Keep doors and windows closed.
• Air out your home once odors fade.
• Have rescue meds ready if you have a respiratory condition.
• S eek medical care if symptoms persist or worsen.
Mental health resources are available for anyone feeling emotionally affected by the Tijuana River Valley sewage crisis through the San Diego Access Crisis Line by calling 1-888724-7240 or 988.
Smoking and Heart Health
smoking is a big contributor. Chemicals in cigarette smoke cause the cells that line blood vessels to become swollen and inflamed. This can narrow the blood vessels and lead to many heart conditions as well as stroke and blockages in the arms, legs, hands, and feet.
Smokers who quit, lower their risk of heart attack and stroke dramatically.
HIV/AIDS
resources such as substance use, mental health, and housing support.
People recently diagnosed with HIV receive:
• Assistance in quickly linking to treatment.
• A goal of connecting at least 50% of newly diagnosed individuals to care within three days.
For people living with HIV:
• PHS ensures follow-up to maintain care connection.
• Services are provided regardless of
Over time, the risk for these conditions can drop to that of a nonsmoker.
Make heart health a priority by visiting Kick It California, a free counseling service that has helped more than 100,000 Californians quit smoking successfully. Services are offered over the phone, online, through text, and the Kick It mobile app.
insurance status or ability to pay.
Progress in addressing disparities:
• Significant improvement in viral suppression among Black residents in the Ryan White program.
• As of 2023, 91.8% of enrolled Black residents achieved viral suppression, up from 84% in 2017.
Additional resources:
• Information on testing and services is available through the County’s Getting to Zero app, downloadable from the App Store or Google Play.
Mental Health Resources
County of San Diego Behavioral Health Services is developing a mental health messaging campaign, set to launch in e arly 2026, which will highlight how chronic stress from broken systems contributes to many health issues facing the Black community. Community and stakeholder input will inform the design of campaign materials to reflect the lived experience of the Black community in San Diego.
The County also provides opportunities for partnership and ongoing engagement on mental health topics with community groups across San Diego County.
• In March, BHS welcomed Black Leadership Alliance Coalition (BLAC) as a Live Well San Diego Recognized Partner.
• The North County African American Women’s Association (NCAAWA) during their general board meeting and the Becoming a Global Citizen mentorship program, to share critical information on youth mental health, wellness, and other key behavioral health resources with middle school students, their families, and NCAAWA members, as well as the Black Leadership Alliance Coalition. Groups or organizations interested in receiving a presentation on mental health services visit the Connect with BHS page and complete a Community Request Form.
HHSA Behavioral Health staff at the annual NAMI Walk, a community event to raise support and awareness around mental health
AFRICAN AMERICANS IN SAN DIEGO COUNTY
Breaking the Cycle My Journey to Freedom from Nicotine Addiction
By Keenan Abercrombia
Courtesy of California Department of Public Health
Iwas 10 years old when I first snuck one of my mom’s cigarettes. By 15, I was smoking regularly. Where I grew up in Compton, smoking wasn’t just a habit—it was a way of life. My mom smoked. My family smoked. Everyone I saw hanging out around the neighborhood and at the corner stores smoked. It was normal. Cool, even.
Looking back, I realize how much I was shaped by the world around me. Nicotine was everywhere, woven into the fabric of my life, and before I even understood addiction, I was hooked.
After years of smoking, my addiction only worsened when I became a culinary chef. Kitchens are high-stress environments, and for a long time, smoking felt like the only way to take the edge off. The vast majority of chefs smoke—it’s part of the culture.
At one point, I was smoking two packs a day, often smoking back-to-back cigarettes during my breaks. I tried quitting a few times. I even started vaping thinking it would help me cut back, but the flavors didn’t do it for me, and the headaches only made it worse. Clearly, I wasn’t ready to quit because I went right back to smoking cigarettes.
Then life started hitting me in ways I couldn’t ignore. I started losing family members to illnesses caused by smoking. I had to face my addiction head-on.
When I finally quit, I did it cold turkey. No patches, no vapes, no crutches— just pure willpower and the realization that I wanted better for myself. I threw myself into my work as a private chef and focused on raising my kids.
I also immersed myself in my roots with the Compton Cowboys, caring for horses
and mentoring youth. Horses have a way of grounding you, teaching patience and discipline. Now, I use that platform to show young people there’s more to life than the streets. More than addiction. More than the habits we inherit.
Today, at 33, I am committed to choosing life. I share my story because I know the struggle firsthand. I don’t judge anyone still in the cycle—I’ve been there. I
know how easy it is to think you have time until you don’t. I tell my loved ones and friends who still smoke to start now. Get ahead of it before it gets ahead of you because breaking free from the cycle of addiction is worth it. You are worth it. Science-based quit programs like Kick It California provides trained Quit Coaches to help people break the deadly cycle of tobacco addiction – for free.
MORE LOCAL COUNTYSPONSORED RESOURCES
Wellness:
• S an Diego Family Care: sdfamilycare.org/
• Better Cuts Mental Health Alliance: Barberishop network www.bettercuts.org/
• It’s Up 2 Us San Diego: up2sd.org/information/bipoc/
Mental Health Training:
• The San Diego Mental Health First Aid program: 619-543-0412, mhasd.org.
• The San Diego Suicide Prevention Council: Free, 858-609-7960.
Need Immediate Help?
• S an Diego Access and Crisis Line: a 24/7 resource helpline. (888) 724-7240
• 211 S an Diego: A free 24/7 hotline: (800) 523-5933, 211sandiego.org
Services for Older Adults:
• (EMASS) program: upacSD.com
Services for Veterans:
• The Courage to Call Program: 24/7 helpline. 1-877-698-7838 or 2-1-1 Option 4.
Services for First Responders
• Fire Captain Ryan J. Mitchell's First Responders Behavioral Health Support Program: (1-833-983-4778), www.sdfirstrespondersprogram.org/
PHOTOS: Compton Cowboys
Empowering Southeastern San Diego: Project New
Village's People-Powered ‘Good Food District’
By Macy Meinhardt V&V Staff Writer and CA Local News Fellow
Across the nation and locally to Southeastern San Diego, access to nutritious food is not just a matter of convenience. It is a fundamental human right that is often compromised in communities of color due to deeply rooted systemic disparities. As a social determinant of health, community food environments affect health, and can create or perpetuate conditions that contribute to health disparities and inequities.
Equitable Food Environments
Community food environments are defined by the type of grocery stores, eateries, and corner stores that are in a local area and the community's proximity to them. Historically, Southeastern San Diego has had a high prevalence of food insecurity, lacking sufficient access to grocery stores and markets offering nutrientrich foods that help maintain a community's health. This is also known as a “food desert” - a designated title given by the USDA
for Southeastern San Diego. Food deserts and food insecurity contribute to high rates of diet-related illnesses such as diabetes and heart disease within the area, specifically among people of color.
Why are there fewer fresh food markets here compared to other parts of San Diego? Economic disparity. Building a grocery store in
Our healthcare is under attack! Cuts to Medicaid and care programs will hurt low-income, people of color, and immigrant families the most. UDW is fighting back to protect our healthcare and our future.
Project New Village’s GFD initiative, encompassing Southeastern San Diego, Barrio Logan, National City and Lemon Grove, IMAGE: Courtesy of Project New Village
See SOUTHEASTERN page 22
FOOD DISPARITIES AND OUR LOCAL COMMUNITIES
southeastern:
Continued from page 21
Southeastern San Diego costs the same as elsewhere, but lower profits dissuade developers from investing. Typically, because there is an overabundance of fast food chain restaurants, liquor stores, and ultra- processed food options. Low-income families lack access to vehicles and/or juggle multiple jobs while raising young children, so they often rely on these easily accessible yet unhealthy food choices as their main source of meals throughout the week.
Community food environments are defined by the type of grocery stores, eateries, and corner stores that are in a local area and the community's proximity to them. Historically, Southeastern San Diego has had a high prevalence of food insecurity, lacking sufficient access to grocery stores and markets offering nutrientrich foods that help maintain a community's health. This is also known as a “food desert” - a designated title given by the USDA for Southeastern San Diego. Food deserts and food insecurity con-
"It wasn't just about people not having food, but the way food was distributed in the food chain."
- Diane Moss, Project New Village Managing Director
tribute to high rates of diet-related illnesses such as diabetes and heart disease within the area, specifically among people of color. Why are there fewer fresh food markets here compared to other parts of San Diego? Economic disparity. Building a grocery store in Southeastern San Diego costs the same as elsewhere, but lower profits dissuade developers from investing. Typically, because there is an overabundance of fast food chain restaurants, liquor stores, and ultra- processed food options. Low-income families lack access to vehicles and/or juggle multiple jobs while raising young children, so they often rely on these easily accessible yet unhealthy food choices as their main source of meals throughout the week.
Redefining the Food Chain of Power
Founded in 1994, Project New Village is a community rooted organization focused on bridging the gap for residents in Southeastern San Diego to have access and education to healthy food options.
After securing the vision to build an alternative food ecosystem, neighbors in Southeastern San Diego expressed interest in starting a community garden and farmers market to grow and sell their own produce—an initiative to boost both community health and the economy. Eventually, the idea for a Mobile Food Truck became a reality. Securing a grant from the State of California, the traveling truck buys produce from local farmers in the area and sells to people all over the neighborhood six times a week.
“There's no other truck like this anywhere in San Diego County, and I've made the conscious decision to serve our [local] area. We call all of these areas together ‘The Good Food District’. So we want to see our impact in that area.” said Moss on the
Addressing food insecurity in San Diego demands a multifaceted approach, encompassing community-driven initiatives and broader systemic changes, including policies that incentivize the
development of grocery stores in underserved areas. Efforts like those of Project New Village highlight the importance of grassroots solutions. By combining community-led efforts with policy reforms, San Diego can move closer to ensuring equitable access to nutritious food for all.
Visit https://projectnewvillage.org/ to learn more.
Food Disparities in
San Diego: ‘Hunger Doesn’t Wait—Neither Can We’
The San Diego Hunger Coalition, a county-wide network of local social service and healthcare providers, government agencies, and school districts, estimates that, as of December 2024, 1 in 4 (25%) San Diegans experience nutrition insecurity, totalling 822,000 residents including 212,000 children, 176,000 older adults, and 133,000 people with disabilities. Local areas with the greatest need include Chula Vista, El Cajon, City Heights, Logan Heights, Encanto, and the College Grove Area.
"We’ve streamlined operations to protect core services, but we need urgent support to continue meeting rising needs. Hunger doesn’t wait—neither can we."
- Alondra Alvarado,
and
Nutrition Insecurity & Equity
Nutrition insecurity disproportionately impacts Black people, Indigenous people, and people of color. SOURCE:
President
CEO of San Diego Hunger Coalitio
Project New Village Managing Director, Diane Moss (back row, sixth from the left).
PHOTO: Project New Village
Black San Diegans and Alzheimer’s Risk
What the Data Shows
By Emily Kim Jenkins
CONTRIBUTING WRITER
Important conversations about mental health are becoming more common, an important step to protect internal wellbeing. But how much have you thought about your brain’s health recently?
The Alzheimer’s Association reports that nearly 1 in 3 seniors dies with Alzheimer’s or another form of dementia, with older Black Americans nearly twice as likely to be diagnosed with dementia than older white Americans. In 2015, “Alzheimer’s Disease and Related Dementias” (ADRD) was the third leading cause of death in San Diego County, and the sixth in the nation. In San Diego County, an estimated 84,405 people aged 55 and older were living with ADRD in 2018, and by 2030, that number is projected to increase to over 115,000.
According to the Alzheimer’s Association,
the disease is a combination of what are commonly known as “plaques” and “tangles” in the brain. These plaques and tangles prevent vital cell communication and function, slowing the brain’s ability to work within the body.
The numbers tell a grim story, but with diagnoses rising, research is also quickly advancing. UC San Diego Health is currently conducting 8 mild cognitive impairment clinical trials of Leqembi, a drug that may slow the progression of the disease, 6 of which are open to eligible people.
Despite the significantly higher risk that certain demographics run of being diagnosed with the disease, there are patterns of inequity in research and understanding what leads to these disparities. Groups like Black in Neuro are seeking to change that by con-
necting Black doctors and students, such as Dr. Kacie Deters, a Black in Neuro seminar series lead.
Dr. Kacie Deters is a UCLA professor and scientist researching the racial disparities in Alzheimer’s, specifically understanding why rates are higher among different populations.
“Understanding the intersection of risk factors that drive cognitive decline and dementia in the Black population is critical to accurately assess, predict, and develop interventions for cognitive health,” she wrote on the UCLA Deters Lab research page. “My goal is understanding the intersection and contributions of genetics and social/environmental factors to cognitive decline and AD [Alzheimer’s disease].”
A study from the National Institute on Aging found that, although Black adults are at higher risk of developing ADRD, they’re less likely to be formally diagnosed, especially early on.
“Many Black older adults tend to seek medical treatment when they encounter neuropsychiatric symptoms such as hallucinations, delusions, and personality changes, but delay help for memory problems, which are often viewed as a normal part of aging,” the study says.
While scientists aren’t completely sure what causes Alzheimer’s, there are certain lifestyle factors that influence its development—the CDC recommends keeping an eye on health factors including blood sugar, blood pressure, hearing loss, physical activity and sleep habits, among others.
A healthy body includes a healthy brain, and ensuring these habits are in order may be a factor in preventing a memory disease.
PHOTO: CDC.gov
Dr. Suzanne Afflalo Champions Southeastern San Diego Through Medicine
By Emily Kim Jenkins CONTRIBUTING WRITER
From research to volunteer clinics to event planning and organization, there’s no question that Afflalo loves the San Diego community. Whether it’s her work in research, volunteer clinics, decades of family medical care or community event planning, there is no questioning her dedication to the care of those around her— especially the Black and Brown families of southeastern San Diego.
Afflalo was born in Jamaica as the fourthborn of five children. Her mother immigrated with Afflalo and two of her siblings when Afflalo was six years old. Her mother took up several jobs to support the young children, and Afflalo credits this work ethic modeled in her mother as the reason she’s so dedicated to her own work.
”I never saw her yelling, screaming, crying, she didn’t beat us. She didn’t curse. She didn’t drink, she didn’t smoke. She was just a wonderful role model,” Afflalo said. “Hardworking, dedicated, loving—so our household was loving.”
When they arrived in the United States, the family settled in Los Angeles, w here Afflalo graduated from St. Mary’s Academy for high school. She knew she wanted to be a doctor at age ten, when her mother went back to school to become a nurse.
seemed like a very natural fit for me. I do feel like my personality probably is suited for it, meaning, the patience, the compassion, the empathy, the willingness to be selfless.”
After graduating, she returned to Jamaica for a brief period, initially applying to the University of the West Indies. The waitlist
“Going into medicine seemed like a very natural fit for me. I do feel like my personality probably is suited for it, meaning, the patience, the compassion, the empathy, the willingness to be selfless.”
— DR. SUZANNE
AFFLALO
was several years long, so Afflalo returned to Los Angeles and attended Loyola Marymount University before going to George Washington University for medical school. Her residency was completed at Kaiser Permanente in Los Angeles, which began a decades-long career at Kaiser as a primary care physician.
Afflalo knows the responsibility of the role she plays. “If I’m in a space, I’m going to represent the community that I serve and speak honestly,” she added.
venting chronic diseases,” especially those which African-Americans are at higher risk for.
“[Of] all the patients I had at Kaiser, the Black and Brown folks are always at the top of the list for blood pressure, diabetes, heart disease, heart attack, strokes, dialysis, all that stuff. And it’s like, we [the healthcare industry] gotta do better,” Afflalo said.
She also started the Community Health & Resource Fair, which takes place at the Jackie Robinson YMCA on the first Wednesday of every month. Attendees can get free screenings from Afflalo and her team for common chronic diseases, such as diabetes, high blood pressure, breast cancer and more.
“My only mentor in life was my mother,” she explained. “Going into medicine
In 2014, Afflalo founded A Healthier Me, an organization with a mission to “improve the overall health of underserved communities in San Diego by controlling or pre-
Speaking about her mother, Afflalo said, “I tell myself, if I was one-tenth of the woman she was, I’ve done my job.”
Read the full article online at www.sdvoice.info.
Dr. Suzanne Afflalo has been a doctor in the community for over three decades and continues to use her expertise in what she knows to be a divine assignment.
Photo credit: Suzanne Afflalo
Esmie Afflalo, Dr. Suzanne Afflalo’s mother, serves as her role model and inspiration for her medical career. Photo credit: Suzanne Afflalo
AFRICAN AMERICANS AND THE HEALTHCARE SYSTEM
AI Is Reshaping Black Healthcare
Leaders Pushing for Improved Results in California
Artificial intelligence (AI) is changing how Californians receive medical care - diagnosing diseases, predicting patient needs, streamlining treatments, and even generating medical notes for doctors.
Why AI Matters for Black Californians
Black Californians experience some of the worst health outcomes in the state due to systemic inequities, limited healthcare access, and exclusion from medical research.
AI can be a powerful tool to close racial health gaps—but only if it’s developed responsibly, tested for bias , and used transparently. Active legislation, oversight, and patient advocacy are essential to ensure AI works for Black communities rather than against them.
Promises of AI in Black Healthcare
• Faster, more accurate diagnoses through analysis of scans, lab results, and patient history.
• Improved personalization of treatment , especially in cancer care and diabetes management.
• Early detection of serious conditions like heart disease, sepsis, and stroke.
• Streamlined healthcare operations , reducing administrative burdens for doctors and improving patient interaction.
• Enhanced access to medical care in underserved communities.
Challenges and Risks
• Algorithmic bias: AI trained on nondiverse data may misdiagnose or overlook conditions in Black patients.
•For example, skin conditions like melanoma are often missed due to underrepresentation of darker skin in datasets.
• Automation bias: Healthcare providers may over-rely on flawed AI recommendations, risking patient safety.
• Discriminatory AI decisions: Insurance companies have used AI to wrongfully deny care or coverage.
• Historical data issues: AI systems may learn from and perpetuate past discriminatory medical practices.
• Environmental impact: High energy
and water consumption in AI infrastructure disproportionately affects communities of color already vulnerable to climate change.
• Undermined DEI efforts: Reduction in federal support for Diversity, Equity, and Inclusion threatens progress in fair AI development.
Legislative Solutions
• S B 503 (Sen. Akilah Weber Pierson): Requires AI in healthcare to be tested for racial bias before deployment.
• SB 1120 (S en. Josh Becker): Prohibits insurance companies from using AI alone to deny/delay care.
• AB 3030 (Asm. Lisa Calderon): Mandates patient notification when AI is used in their care.
• Attorney General Bonta’s Legal Advisory: Bars AI from unfairly denying care or falsifying medical records.
• G ov. Newsom’s Executive Order
See AI page 26
Only 3% of California Doctors are Black, Compared to about 5% Nationwide
THE STATS
First-year medical students 2024-2025
•American Indian or Alaska Native students - 15.4% decrease
•Hispanic, Latino or Spanish students of origin - 2.2% increase
•Black or African American students - 2.8% increase
•Native Hawaiian or Other Pacific Islander - 6.9% decrease
•Students of Hispanic, Latino, or Spanish origin comprised 12.3% of total students in medical school in 2024.
•Black and African American students comprise 10.3% of total students in medical school in 2024.
Percentages of Black Physicians Over the Decades
2025: 4.7% of physicians in the US are Black. 13.7% of the U.S. population is Black.
2024: 5.7% of physicians in the US are Black. 13.6% of the U.S. population is Black.
2021 : 5.7% of physicians in the US are Black. 12% of the U.S. population is Black.
2018: 5.4 % of physicians were Black. 12.8% of the U.S. population was Black.
1940: 2.8% of physicians were Black. 9.7% of the U.S. population was Black.
1900 : 1.3% of physicians were Black. 11.6% of the U.S. population was Black.
L to R: Dr. Timnit Gebru, DAIR’s founder and executive director; Dr. Akilah Weber Pierson, Judy Wawira Gichoya, MD, MS. PHOTO: CBM
Smart Strategies
for Navigating Tech-Enhanced Healthcare
1.Use Trusted Sources for Medical Information:
• Check the author, source, and date of online content.
• Ask your doctor for trusted patient educational resources.
2.Prep for Appointments:
• Read reliable material beforehand to make visits more effective.
• Be c autious of internet bias or misinformation.
3.Use Patient Portals Wisely:
• Access test results, notes, and history through secure portals.
• Wait to discuss results in follow-up visits rather than reacting right away.
4.Understand Provider Workload and Timelines:
• Give doctors time to review test results before following up.
• Understand that medical urgency , not speed, guides their responses.
5.Communicate Effectively:
• Use your doctor’s preferred method (email, phone, video, etc.).
• For complex concerns, schedule an appointment instead of sending multiple messages.
6.Be Thoughtful with Telehealth:
• Use video or phone visits for convenience.
• Send online messages sparingly, knowing doctors manage high volumes.
7.Build Strong Relationships:
• Match your communication style to your provider’s to improve understanding and rapport.
• Foster trust, respect, and openness for better care in the digital era.
Continued from page 25
(2023): Directs state agencies to assess and regulate AI’s healthcare impact, prioritizing consumer protection.
What You and Your Family Can Do:
• Ask healthcare providers if AI was involved in diagnoses or treatment.
• Request second opinions when AI-driven recommendations seem unclear or wrong.
• Advocate for inclusive AI legislation like SB 503 and AB 3030.
• Support and engage with organizations like the California Black Health Network (CBHN) that champion equitable AI in healthcare.
• Stay informed and vocal about AI’s use and its impact on healthcare decisions.
Finding the Right Doctor
Black Californians Weigh In Solutions
for Black Patients Seeking Culturally Competent Care
Ask for Patient Recommendations
• Seek referrals from other Black patients rather than relying solely on institutional listings or doctors.
Leverage Black Networks
• Us e trusted community resources like:
•The National Medical Association
•Local churches, fraternities/ sororities, and NAACP chapters
Use Specialized Platforms
• MyBlackTeleHealth.com – to access Black physicians virtually.
• AskTia.com – specifically for Black women’s health and wellness.
“At the end of the day, your physician has to be a professional that meets your needs. Somebody that's willing to listen to you. Somebody that's going to be available to see you. Somebody who works with you -- whatever your situation is.”
–Dr. Glenda Newell-Harris Oakland-based internal physician and medical advocate
• Use online platforms, such as social media groups focused on Black wellness in your region, for recommendations and reviews.
Be Prepared to Travel or Dig Deeper
In underserved areas with few Black doctors, finding culturally competent care may require:
• Traveling to nearby cities.
• Doing additional online research.
• Keeping and following up with personal contacts and referrals.
Consider Telehealth (Strategically)
• Use for consultations with distant Black specialists.
• But it is not a substitute for in-person primary care— important diagnoses should be handled face-to-face.
Build Long-Term Physician Relationships
Look for doctors who:
• Understand health disparities.
• Pr ioritize listening and trust-building.
• Ma ke you feel safe and culturally understood.
SOURCES: Joe W. Bowers Jr., “AI Is Reshaping Black Healthcare: Promise, Peril, and the Push for Improved Results in California,” California Black Media; Census.gov/quickfacts/fact/table/ US#; AAMC at aamc.org; Association of American Medical Colleges, “Medical School Enrollment Reaches A New High in 2024”; The California Black Health Network (CBHN); Edward Henderson,“Finding the Right Doctor: Black Californians Weigh the Burden and Benefits” California Black Media’s California Black Health Journalism Project
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Black Health Bill of Rights
We have the right to a culture of health that values our whole wellbeing and allows us to achieve optimal health.
This article calls attention to the concept of a “culture of health”—a term coined and widely disseminated by the Robert Wood Johnson Foundation—as a broad vision to characterize requirements for a society that enables and supports health and health equity.
2
We have the right to receive respectful and dignified healthcare .
Being a ‘patient’ is, by definition, a subordinate role. The rules of engagement are determined by policies in medical practices, hospitals, and large health care systems. However, these systems are also obliged to respect individual value as human beings, honor their basic rights, and deliver care that preserves dignity and does not discriminate based on personal or group characteristics.
3
We have the right to healthcare that is culturally sensitive and that incorporates cultural humility and structural equity. These terms reflect three important dimensions of the delivery of medical care and other health services.
Culturally sensitive health care.
Cultural humility raises the bar for health care provider behavior.
Stuctural equity calls for fairness in all aspects of health care systems—awareness of and removal of barriers that impinge on equity in health care.
4
We have the right to approach solutions to Black health from a strengths-based approach that incorporates a decolonized and intersectional lens to health equity.
Effects of slavery did not end with emancipation. These effects are “intersectional” in their differential impacts on gender-age groups in Black communities. For Black Americans “decolonized” approaches means countering these longstanding effects.
5
We have the right to transform our health by reclaiming our power and autonomy.
We must have opportunities to do more than remove health threats left over from slavery. In the spirit of selfdetermination, we must have the power, resources, and autonomy to create opportunities for optimal health and well-being.
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We have the right to honor and incorporate lessons from our past, present, and future as a Pathway to restoring our health.
Black Americans have shown historic resilience in the face of incredible challenges. This history should be acknowledged and applauded but not viewed as an excuse for perpetuating such challenges.
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We have the right to have our full humanity honored and valued .
The principle that health is a human right is fundamental. The principle that all people are valued equally and that, therefore, Black people have full human rights.
