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Posted on October 20, 2020 at 12:39 PM

As part of the Fordham University Center for Ethics Education’s Advancing Health and Social Justice Web Series, Dr. Anthony Estreet, Dr. Gabriel Maldonado, and Dr. Kimberly Nelson led a panel on Wednesday, October 8th titled, “COVID-19 and Justice for Racial & LGBTQ Communities.” moderated by Dr. Steven Swartzer, Associate Director for Academic Programs and Strategic Initiatives in the Center for Ethics Education. Both Drs. Estreet and Nelson are alumni of Fordham’s HIV and Drug Abuse Prevention Research Ethics Training Institute, which is directed by Dr. Celia Fisher.

Part 1: Dr. Anthony Estreet

Anthony Estreet, PhD, LCSW-CC,LCADC, is an associate professor in the School of Social Work at Morgan State University. Dr. Estreet is also the director of Morgan State’s University Heart and Addiction Research (HART) Lab. The training lab is an interdisciplinary program dedicated to improving health and heart addiction related outcomes among diverse, at-risk urban populations. Dr. Estreet has also authored numerous articles and book chapters on substance use and mental health, youth development, social work, and social work in urban developments. He has also co-authored the forthcoming book, Trauma and Mental Health Social Work with Urban Populations: African-Centered Clinical Interventions.

Dr. Anthony Estreet began the panel with a discussion of Covid-19 and the social and racial justice issues affecting the Black community. The effects of Covid-19 on this community has exposed the deficits of government systems and highlighted the disparities within urban environments. The pandemic has affected the health care system and access to health care including nonexistent or limited access to the technology required to attain telemedicine services for many people. Dr. Estreet explained that although telemedicine was made available and medical facilities began accepting more insurance providers, the majority of people in minority communities did not have access to the internet or the technology needed for these services. However, the increase in accessible online services provided did demonstrate a positive impact on those able to access it. 

Dr. Estreet also described how the pandemic initiated a rise in community advocacy for social justice issues in light of cases of police brutality and violence. He further explained how the health disparities of Covid-19 and racial injustice are connected because they are both issues where the Black community is at a disadvantage. The lack of accessible and affordable healthcare provided to African Americans and the fact that they are on the frontlines protesting against social and racial injustices demonstrate both the deficits and disparities caused by the government’s systemic racism. 

According to Cigna Health Care, the underlying causes of the health disparities in the Black community including disparities in chronic conditions, preventative screenings and exams, and mental health have been linked to genetics, lack of economic resources, limited access to health care, delay in treatment, cultural beliefs, low literacy and health literacy rates, and certain environmental factors. 

Part 2. Dr. Gabriel Maldonado 

Gabriel Maldonado, PhD, MBA, is the founder and CEO of Tru Evolution, a California community-based non-profit organization that advocates for the community to address health disparities and social inequalities. The organization fights for health equity and racial justice to advance the quality of life and human dignity of LGBTQ+ people. Tru Evolution engages in advocacy for the LGBTQ+ community and communities of color and includes HIV prevention and care services, a mental health and behavioral health clinic, and emergency supportive housing. In addition to his work, Dr. Maldonado was a former member of President Obama’s Presidential Advisory Council on HIV/AIDS. He currently serves on numerous regional boards including the Burrito Community Health Foundation and global organizations such as the AIDS Healthcare Foundation. 

Dr. Maldonado described the impacts of racism and social justice in the context of environment and environmental justice, and how they intersect with the health disparities experienced in Black and Brown communities. He also discussed the lack of resources and support for the LGBTQ+ community, specifically Black and Brown youths, and how this limitation affects their overall mental health and perception of identity, which is what led to the creation of Tru Evolution. Tru Evolution began as an advocacy organization that evolved into a direct support provider, offering healthcare services including HIV services, a mental health clinic, and emergency housing. Dr. Maldonado highlighted the positive impact of the pandemic with the award of $4.2 million for Tru Evolution by California State to implement and create facilities for those that are in need of basic pillar necessities. Dr. Maldonado believes that the only way to achieve true equity and a better world is by looking at the key social determinants of health care that are impacting communities including housing, mental health, and access to basic health care.

3. Dr. Kimberly Nelson

Kimberly Nelson, PhD, MPH, is an assistant professor of Community Health Services at Boston University. Dr. Nelson earned her MPH in epidemiology and her PhD in clinical psychology from the University of Washington. Dr. Nelson’s work focuses on community and population level health implications while conducting individual level behavioral research. Dr. Nelson’s research concentrates on psychological and structural factors associated with the transmission or acquisition of HIV among sexual and racial ethnic minority adolescents and adults. She has authored numerous peer reviewed articles on adolescent sexual health and has completed a fellowship at the Fordham University HIV and Drug Abuse Prevention Research Ethics Training Institute.

During the panel, Dr. Nelson discussed her research on the sexual health of adolescents. Her research underscores LGBTQ+ youth and racial and ethnic minorities who are affected disproportionately by sexual, mental health, and housing disparities. She emphasized the lack of services and resources for LGBTQ+ and minority adolescents who are affected by Covid-19. Recently, Dr. Nelson conducted a study that focused on the impact of the pandemic on the sexual and daily lives of minority sexually active males who were between the ages 14-17. The qualitative data that was collected were based on questions regarding isolation, support, stress, depression, and anxiety. In her findings, Dr. Nelson reported devastating results including the increase in depression and anxiety, the lack of support due to virtual learning, and the loss of access that made them feel seen and safe. She also discussed the disparities and disadvantages seen between minorities and the privileges of white sexually active youth. The increase of police brutality and violence against Black individuals is affecting the mental health of the adolescents in these communities. Dr. Nelson stated that Black youth are not only struggling with the effects of the pandemic, but also with individual disparities from being at the center of recent events involving the killing of Black people.   

The panel ended with recommendations for starting anti-racist and anti-oppression work including (1) thinking about your own biases and privileges and how they affect your daily life, (2) developing ideas for affecting the structures and systems you reside in (work or community), and (3) addressing the inequities minorities are facing by bringing it to the forefront of your work to create change.

To register for the next panel of the Fordham University Center for Ethics Education‘s Advancing Health and Social Justice Web Series on the Ethical Implications of Stigma and Mistrust in Healthcare and Research, please use this Google Doc or visit: https://docs.google.com/forms/d/e/1FAIpQLSd3YeAUwmHqVuJXR74PL0kP-xu42_K88XvEYKhtKzgzkT6dmg/viewform.

For questions on the series, please email Steven Swartzer, Associate Director of Academic Programs at sswartzer@fordham.edu.

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