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Didn't Ask. I'm Nyesha Frey, joined once again
by Dr. Paul Fleming. We're in the home stretch
of Beyond the Band -Aid, prevention, power, and
public health equity. And I can promise you,
this conversation keeps hitting new highs. Let's
dive right back in. So back to our hashtag. So
I think that it's really important that we do,
we are in a time where people are anxious for
action. And I appreciate the fact that you are
talking about how we need to free up our mind.
You know, the way that things have been is not
the way things are going to get better in the
future. We have to imagine something different
because the status quo has not served us, right?
It's not served the majority of us. And even
those who think that they are like living in
ease. There are certain aspects of this world
where you are not going to be able to escape
the impacts of your privilege. Yeah. And so I
think that we are definitely in a space where
we need to be about how. We need to be in the
how. How do we move forward? So your book encourages
a shift from tweaking systems, which has tended
to be the approach that has won. in a lot of
examples. You've said, let's shift from tweaking
systems to imagining entirely new ones. So how
would you say that that might look or play out
when we think about, you mentioned the criminal
justice system, we can relate to that, right?
We also talked a little bit about our educational
experiences. How do you think this prevention
thinking and kind of rehauling, if you will?
plays itself out in in any of those types of
yeah yeah so and and i also want to say you know
i think the tweaking of systems we've seen for
decades where we'll we'll make little policy
switches around the edges right even obamacare
which made some pretty big changes to our health
care system it was a tweak right we at the end
of the day we still had our patchwork system
that left a lot of people struggling. Right now
with Trump, what we're seeing is some smashing
of systems. And I think what I'd like to definitely
say is that's not what I'm advocating for either.
So tearing down systems, that may be a precursor
to building systems we need. So if I allow myself
to be hopeful, there is a way in which what we're
experiencing right now may be a precursor to
us being able to build the systems that we need
once they're torn down but of course it's being
done in such a reckless way that that that's
not what i would advocate for but the point being
is that we do need to dream up new systems right
there's a lot of things in our society that are
built over time right and if we were if you and
i got together, and this would actually be really
fun to do sometime, Naisha. We got together with
a whiteboard and we were like, all right, let's
start a new country. What do we want? How are
we going to make sure that people do share? What
are we going to do with people if they make a
mistake? If they do something that is somewhat
harmful to another person? What kind of system
do we want to put in place for that, right? The
first thing we're probably not going to say is,
oh, I have an idea. Let's put a bunch of people
with guns in our community. And make it so that
they can't really have any accountability. And
those people can lock people in cages. Or at
least start people in the process to that. That's
not what we're going to dream for our new country,
right? What we're going to think about. is what
systems are going to help everybody thrive? And
if you take that prevention thinking approach,
right, and you think about root causes, so why,
and I'll focus in this area of sort of criminal
justice, why are people stealing in the first
place? Why are people acting violently in the
first place? So if we dig into those root causes,
We're going to identify some different issues.
You know, if it's stealing, maybe it's connected
to poverty or not having resources or not having
opportunities. You know, there's a variety of
things that could be connected to. But but it's
not just that that the person who stole is a
bad person. Right. Which is what our criminal
justice system kind of imagines. And our news
media also imagines. Right. You're a felon. You're
labeled. you are not, it's not your behavior
was bad. It's that this person is bad. And so
anyways, so you're digging to the root causes
with violence that may have other root causes,
may have learned it from family growing up, whatever
it is, right? So we want to create systems that
prevent that from happening in the first place.
Right now, our systems, right, are set up that,
oh, This person committed an act of violence.
Now let's step in. Now let's channel all of our
expensive resources because the police are very
expensive and jail is very expensive. Now let's
channel all of our resources to addressing that.
Punishing them. Yeah. What if we marshaled all
of those resources to preventing it in the first
place? And that's that prevention thinking. And
so, you know, I can think of. I mean, first off,
if you're thinking about reorienting criminal
justice resources, I'm thinking a lot about how
do we put funding into schools to help social
emotional learning, help give young people the
tools that they need. Why aren't there widespread
free classes for parents on how to be better
parents? I certainly could use it. Okay. Or just
mental health around being a parent. Yes, exactly.
Widespread mental health resources, right? We
could channel so much of what we put into our
criminal legal system, policing, prisons. We
could channel it into improving mental health
in our communities, giving people the better
tools to deal with conflict, right? We, as a
society, we're pretty bad at dealing with conflict
in a nonviolent way. And conflict is natural
part of being in human relationships. Right.
And so anyways, that's that's that prevention
thinking. And that's that reorientation. And
to answer your question, I first went to the
place of like dreaming big. Right. There are
also some maybe less lofty, although I still
want to work towards that vision. Right. I'm
not losing that vision. But in the immediate
sort of shorter term, next couple of years. I
think about building systems like emergency response
systems that are disconnected from the police,
right? So if you have an emergency at your home
or you're out and about and you have an emergency,
in most of the US, the only resource you have
is you call 911 and a police officer with a gun
and the ability to arrest, detain, and send you
to court and jail. That is the person who responds.
If we were to build a system that had a more
care first approach that sent a social worker
to arrive on the scene who had conflict de -escalation
skills, right? Had the ability to refer you to
mental health services or housing services or
whatever services you might need, right? That
is the type of system that we need to be standing
up in our communities as an alternative to police.
And that creates alternative pathways, right?
Because if you think about the unhoused person
that, let's just say, is causing a mild disturbance
on a city street, right? There are any number
of ways that society could deal with that. But
right now, we mostly deal with it by calling
the police and the police show up. Now, there
are some officers that are very kind and they
try to help that person, right? But that is not
actually what police officers are trained to
do. And that's not what they're hired to do,
right? Our cities and our society is actually
asking police officers to take on this role that
sometimes leads to violence and arrests and imprisonment.
Right. So it's just it's set up for disaster
there. Right. Yes. In that case, when the police
show on the scene, you know, there's a decent
chance that a good outcome will come of it. Maybe
that person will get connected to the shelter.
But there's also a decent chance that that person.
ends up in jail for the night, that that person
ends up even worse, right? Getting harmed by
the police officer. And so a care first approach
would have us with somebody who is actually equipped
to help that person get the resources that they
need. And not just for that moment in time, but
how do we connect them with social services or
the health services they need so they can get
on a path to housing, to stability, et cetera.
And so so that's the type of systems that I think
prevention thinking allows us to think about,
dream up and then take action on. Right. Because
once we have a vision and a clear idea of it,
we can start advocating for it. We can start
talking to our city council people and saying,
why don't we have this? Why is it that my only
choice is police in this? Right. And there are
some wonderful examples across the country of
these programs sprouting up. I know Durham, North
Carolina has a program. Denver has a program.
There's other spots. So they are growing in frequency,
but they're still not widespread. And even the
ones that exist, some of them are going through
some growing pains. You know, they're new, so
they need to figure things out for how to operate.
But that's the kind of thinking, you know, the
book invites us to do together. If you're enjoying
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the conversation going. I love it so much. I
love it so much because everything that you were
sharing, you know, I either have a personal family
community example of, and I'll give two. One.
is a woman who has a business. She happens to
own some land. She lives there, right? She's
developing this amazing healing community, right?
And it's associated with land and nature and
all this other great stuff. And she had a disturbance
with a family member who was going through a
particular health crisis. And the response was
the police showing up. These two people are of
color, so it's concerning, right? You don't know
what you're going to get. Happened to get some
really nice police officers, but there were several
of them. Lights on, everything flashing and blaring.
Now she's talking to them. They deescalated the
situation. They understand what's going on. No
one's going to jail. We win, right? And so then
they start asking her questions, right? Because
they are human beings. They're curious about
the healing work that she's embarking on with
this land. She said, I would love to tell you
more and spend some time with you, but you're
going to have to come back when you don't have
that uniform on because my neighbors are watching.
And if I'm going to be a business, I can't be
having the police around here with their lights
on. Right. You're very nice people. I appreciate
you. And the good thing is that, you know, they
exchanged information and everything went smoothly.
That's not the story that we usually get in the
media. But the fact that there could have been
a better way, a better time for her to meet those
lovely people, or that there could have been
a different approach in which it was less jarring,
stressful, what have you, is pertinent to this
conversation. On the other hand, I'm aware of
a situation where a woman was with her child
who was having a mental health crisis. The woman
was living in the community that she had lived
in for a very long time. But, you know, like
you mentioned, being a parent does not come with
instruction manuals. And people who think that
they know how to parent your child, they're oftentimes
just as confused as you are. They're just arrogant
about it. and won't admit that they don't know.
It's just a stab in the dark, you know, and they
probably be a more nosy than not. Right. So she,
you know, it's like, okay, what do I do? Okay.
Well, I go to the emergency room. The fact that
people don't know what to do when they're in
an emergency or who to call when something happens
is a system that I think we should change. Right.
Yeah. Because we don't know when an emergency
is going to happen. Right. So there needs to
be some preventative action that happens early
so that when it shows up in your life, you know
where to go. Because when her and her child sat
in the ER for more than a day. In a city that
is known for having some of the most premier
hospitals and health care systems. Once they
got to see a provider. The provider was not equipped
to address the issue and ask the woman simply,
well, if that's what he's going through, why'd
you bring him here? I mean, I'm just saying,
you know, these are the systems that we have
to rethink. Right. Because we've been tweaking
them and changing this little thing and changing
that little thing. And yeah. OK, well, we hired
some nicer police officers. Well, guess what?
They're still showing up with guns and flashing
lights. OK, well, we've got this great health
care system and all these awesome hospitals,
but people in the community don't know how to
access it. Yep. Right. And the people working
in that. world class health care system, don't
know how to serve the people that show up in
crisis. Yep. Right. And so we have these world
class systems. We have these multimillion dollar,
trillion dollar investments in policing and this
and that. But when it comes time to talk about.
Well, what about if we were to partner with and
employ social workers or counselors or therapists
or psychiatrists and offload some of that money
that we've been blessed with from the federal
government or our state or local entity, right?
To have them partner, work alongside with, again,
coming out of our silos, coming out of our circles
and finding our center. Finding our collective
center and using those resources in such a way
that we're sharing so that we can care, right?
So that we can effectively serve the needs of
our people who are our brothers, our sisters,
our aunts, our uncles, our cousins, our friends.
Friends are good too. And not seeing people who
are going through a really hard time. as the
scum of the earth, something to be punished,
you know, this lifelong label of once a felon,
always a felon. Like who does that? Right. Oh,
you did this terrible thing when you were 22
years old, you've got to spend the next 30 years
of your life paying for it. Like what? I didn't
even live that long. Right. Yeah. I got to pay
for it for longer than I've been alive. Yeah.
Well, and it's, I, you know, I feel like a lot
of what we're talking about comes back to we
all are humans and we have a shared humanity
and some of these systems and our culture and
you know our media and other things are pushing
us to view other parts of society as less than
human that's not the way we always think about
it but in reality right when you're labeling
somebody a felon and you're kind of subconsciously
thinking of them as a bad guy that's what you're
dehumanizing that person right in in the case
of the healthcare system we see it they're sometimes
treating people not like they would treat their
own brother but they're thinking of them as this
person has made poor choices This person is not
doesn't have the same, you know, wherewithal
that I do. I'm thinking about. And so it's a
sort of dehumanizing of the person. Whereas if
we if we were more willing to give each other
grace, acknowledge that all of us are flawed.
All of us make mistakes. All of us make a series
of good choices and bad choices. But our environment
and our context shapes whether those choices
have dire consequences or not, right? Yes. That
is a big shift that I think we need to be cognizant
of the times ourselves, and I count myself definitely
including this, when we're dehumanizing other
people with our language or our viewpoints. And
so much of our systems could be better if we
actually saw every... Human in our society as
an actual human that deserves the same things
we deserve. Right. So we're getting into the
space of deserving. We're getting in this space
of resources, allocations, things like that.
And some people say helping others is too expensive.
You know, people say, you know, you have talked
about expanding your imagination, understanding.
that there is an abundance, having an abundant
mindset, but there is a lot of lack thinking.
There's a lot of thinking that's centered on,
there's a lack of resources, there are limited
number of resources and things like that. But
for us, Paul, the way that we were trained, right?
And the way that we are built is recognizing
that sickness, poverty, and early death is even
more expensive. for everyone. So tell us a little
bit more about what you say, what your book says,
what your research says about those types of
things. Yeah. And one other book I'd recommend
on this topic is The Sum of Us by Heather McGee.
And it really talks about how racism in US society
in particular, although I'm sure it's going to
be true across the globe, but It harms all people.
Sure, it has a disproportionate impact on Black
people and other people of color, but that it
harms the entire society. And part of the, some
of the examples, I mean, the prime example that
Heather McGee gives in that is the fact that
because of racism, there are so many communities
across the country that don't have public swimming
pools. Because rather than integrate public swimming
pools in the 60s, cities chose to just pave over
their swimming pools. So that means that white
people don't have swimming pools, right? Like,
yes, it also means that Black people don't have
swimming pools, but that is the racism in that
case, you know, caused that community as a whole
to have fewer resources. And there are... you
know a lot of other amazing examples in the book
some i also include in my book but you know you
can trace also like our lack of social services
including you know health care for all racism
in our society right part of it was a motivation
to keep black people and other people of color
from receiving those services so let's make it
so that nobody can have these services and so
it is you know it's true that racism harms black
people and people of color more but our society
as a whole is less resourced and less abundant
because of this disease we all have of yeah exactly
and you say it disease yeah and there's a um
there's a definition of racism by dr kamara phyllis
jones oh i love her yeah she's amazing one of
my heroes But in her definition of racism, she
really highlights it's at the end of the day,
it's the waste of human resources. Oh, gosh.
Right. And so to get back to your question directly,
what does it cost to help people? Oh, pennies
compared to the cost it has on society to keep
on harming people in the way that we do. Right.
Our policy choices are causing so much harm to
our communities. And it is wasting so much human
resources. Think about the millions of people
we imprison, right? I mean, some of those people
are brilliant. Some of those people are creative.
Some of those people bring happiness to others,
right? Like there is an abundance of talent and
resources in our prison population. And what
do we do? Keep it locked up. And we pay something
like I don't have the exact figure, but something
like forty thousand dollars per person per year
to do that. You could pay some that is in some
states an average annual salary. Right. And so
this argument of cost. On its surface, you know,
the cost of providing SNAP benefits, the cost
of providing Medicaid, the cost of providing
housing. Yeah, it does have a cost. That is true.
And there are finite resources within city budgets
and state budgets. All of that is true. But when
you think about what we waste harming people.
And then the money we spend cleaning up the mess,
right? So we are harming communities. I mean,
a prime example of this is Flint water crisis,
right? They tried to save a few million dollars,
ended up harming the whole community. It's costing
hundreds of millions of dollars. I mean, much
more than that, but in sort of direct costs,
right? That was, you know, just a direct policy
choice. Yeah. And instead of investing in the
community, right, because they were struggling
financially. Well, why were they struggling financially?
I'm going to get back to these root causes. Right.
They were struggling financially because of the
economic policies that caused divestment in the
city. It caused companies to have to leave. It
caused and then racism caused white flight. Yeah.
Investment. And then all of a sudden, Flint,
Michigan, as a town, as a municipality, was struggling.
And how did we as a society, in this case, the
state of Michigan, try to solve that? Like, oh,
let's give worse water. Let's make a decision,
right? No one will notice. Yeah. They could have
made an investment, right? They could have said,
oh, wow. Our past policies really made this city
struggle. We should fill in the gaps. Yeah. Right?
And we are seeing some of that now. There are
some good investments in the city of Flint now.
There's some amazing work being done. Is it enough?
Probably not, right? But the point being that
it can cost so much more to stick with this punitive
system, this... we're just wasting, you know,
I listened to economists and other policymakers
talking about the economy, how important the
economy is. Think about how gigantic our economy
would be is if everybody had the opportunity
to thrive and meet their full potential. How
about that? Think about all the stuff we would
be creating in our economy, how thriving we'd
be. But instead we, we hold back whole segments
of our population. We don't give them the opportunities
in school. We don't give them the opportunities.
We force them to be resilient. So some do break
through still, right? But many, the resilience
isn't enough, right? Because it's too, the weight
of the systems they're experiencing is too heavy
to bear. So yeah, you got me going, but you know,
it the cost the cost question it's just it's
a it's again a lack of imagination it's a lack
of being able to zoom out and actually think
about how like what are the ways in which we
are uh causing harm and and we're actually paying
money to cause that harm in a lot of cases yes
oh sorry one more thing police police Take up
30 to 40 % of city budgets, right? Yeah. We can
imagine other ways to use that money. Most definitely.
Other ways that also promote public safety. Other
ways that help people thrive. And so when we
have limited resources, we have to remember,
oh, we have plentiful resources. We are just
choosing to constrain them in certain ways. That's
another wrap on Questions You Didn't Ask. I'm
Nyasha Frey, and it's been an absolute pleasure
digging into these powerful conversations with
Dr. Paul Fleming. We've got one final episode
in this series, Beyond the Band -Aid. So don't
miss the grand finale. Subscribe, tell a friend,
and meet me here.