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back to Questions You Didn't Ask. I'm Nyesha
Frey, and this is episode two of No Health, No
Wealth. We're continuing our conversation with
Dr. Keisha Bentley -Edwards and Farhad Ali about
the ties between economics, justice, and health.
Let's get into it. Yeah. And I wanted to speak
on that a little bit and pull Farad in some more
in terms of the manufactured adversity, because
what you just talked about in regard to those
four grocery stores on one intersection, I have
definitely experienced that when I lived in North
Raleigh. Right. I'm from Raleigh and North Raleigh
has always been considered the more affluent
neighborhood or community. And there are several,
but it's definitely, you know, has always had
that reputation. And it wasn't because I was
affluent. I just found a nice apartment in a
nice place. So I was kind of, you know, the person
that was a little maybe out of place, you know.
But so there's the aspect of even city planning
in terms of the fact that what I found in Raleigh
was that you did have a mixture of rent. and
property values, right? So you could be a person
with a low to moderate middle income and still
live in North Raleigh. And so there's some of
that mixture. And with that, if you were able
to find that nice apartment and qualify for it
and maintain it, all that good stuff, then you
had access to more of these grocery stores and
shopping centers and free samples and really
good customer service, maybe. And I say maybe
because sometimes, depending on whether or not
I had my hair done or I had just come back from
a meeting, from work, where I was looking really
professional, or if I had just rolled out of
the bed on a Saturday morning to go grab something,
I might be treated differently in certain spaces,
right? Absolutely. And that's a part of, no matter
how much money you make, how much education you
get, you're still Black. Right. And the first
thing that people do is they they make a judgment
about you and how they're going to treat you
and what opportunities they're going to present
to you based on your physical appearance, not
based on your resume. And even then, sometimes
they don't care. So what I saw is that, you know,
OK, so this is able to happen right where you
can have these competing. Companies providing
the same service. Slightly different ways, just
slightly different ways in the same area. It's
not more populated in North Raleigh, I don't
think. Right? No. You see how much space there
is in between houses? No. Right. But I'm just
saying, like, in terms of even for those that
were like me, I was living in an apartment. You
know what I'm saying? There's apartments, there's
houses, there's condos, there's all types of
stuff in North Raleigh. They still have these
businesses. multiple businesses that offer the
same things they offer groceries they offer healthy
food options they offer coffee they offer restaurants
they offer workout they offer nature trails they
offer all types of things that could help make
your life easier as long as you can afford it
right you're not charged a convenience fee right
you're not so they have all these things to make
life more convenient but if you live in the hood
then you are charged it's a tax it's a convenient
fee that's added so going to the bodega going
to the the mini mart you know all those different
things you get you pay you pay for the convenience
you get that's that added tax you pay for the
surveillance and the harassment too so the other
part of it is You know, when they talk about
it's not a good investment in the black and brown
community and we're going to lose money and this
and that. But on the other hand, at least in
Texas, your example, right? They're handing out,
they're giving food away. They're giving food
away because someone said it wasn't good enough,
right? So I'm just trying to figure out how is
that math, math? And I'm going to throw that
to Farah. How does that work out? And there's
my other question. There was a Target and a Walmart
that was always empty. Have you ever been into
a Walmart where there is never at least 15 people
in line in front of you? The one last Kmart.
the one last i'm telling you that empty empty
parking lots like what like you could just dance
you could you know how you see that the tick
tocks where folks are dancing in walmart so is
the walmart stand because the one that was over
in the line it's club walmart it's all everybody
the line in the back of the store and they're
making money hand over fist clearly clearly everybody
mad up in there and they got a point yes they
got several police always always not the police
but the police the police we're gonna let you
talk we're gonna be we're gonna let you talk
we're gonna let you talk go ahead listen i enjoy
watching y 'all i mean i think it's important
i mean you know, this is an interesting conversation
because we're talking about culture as well,
right? And so we begin to believe that sometimes
when you're conditioned to be in that environment,
then it becomes normal, right? I mean, I'm listening
to you all talk. It's not like we all haven't
had that experience, right? We all have had it
because the environment conditions us to be space
in that. and we've also experienced differently
by being in different communities and so i think
there's this awareness of people are putting
culture on economic development decisions to
match that right so it's interesting if you you
look at well we're going to build this this big
box store right but then they put the stuff next
to it that they feel is going to help the culture
like the hair place the bar like they it's really
about sales it's really about the dollar and
the more those dollars you can get because of
the buying power you go hard at it and create
this economic environment again you know i don't
you know i remember they would boycott the stores
i'm like there's some stores we can't boycott
because those are the only stores in our community
absolutely so you we can't boycott some stores
but i do believe that when you start looking
at the return on an on dollar investment i mean
that's what i'm hearing from you right it's like
the developers are not thinking about the community
they think about getting a return for their dollar
and so the community becomes secondary because
really what you want out of the community is
financing so no one is talking around improving
the community they're asking how many people
are in the community what's the roof People make
these business decisions based on rooftops, people
in the community, incomes. All these things are
factors that are not necessarily additives. They're
just science. Is it science? It might be science.
I don't know. I mean, this is science. If you
have a lot of single moms in the community and
they may have children. They may or may not have
a partner. It's a science to put a child care
facility on the corner. I mean, that's the science.
The numbers work because if you get 5 % of that
community, you make money. You make money if
you get 5 % of that community to buy. I mean,
economics is all a social science. That's true.
It's like who's buying what and how much convenience,
as you would say, Keisha, to put in their community
for them to get access to it. And then they figured
if there's a thousand people there, if I can
get 10 percent of that thousand, they run those
in their performance, which is their balance
sheets or their financial statements. And they
say, if I get 10 percent of these people, I make
it, you know. And they get 20 percent. It's a
great day. 30 percent is a better day. Right.
But that 10 percent is the conservative number.
You know that, again, it may attract more people
in how they do it. So, you know, when you look
at communities, it's like when you have economic
planners or housing planners or business planners,
it's really this is what I'm saying. We want
we should really want communities to thrive.
I don't know why we try to put different communities
stations. I think we should want all communities
to thrive. And if that's the case, you build
in systems for them to thrive. It actually helps
the social fabric of bad things not happening.
I'm trying not to say things, create biases and
the people who may hear this may not understand.
But if you create jobs in my community, there's
less likely there's going to be. An underground
economy. Correct. I mean, I can do this all day,
right? If I know how to hire Ray Ray or Jamal,
because I know what their tendencies are, their
skill sets, because God blessed everybody the
same way. And so if you could sell, I'm of the
opinion, if you're gifted to rap and the way
they rap these days, because when I grew up,
rapping was like hotel. You know, now, you know,
then you take up, and now, Eminem. Yeah, it's
all that stuff. It's like, brrrr, you know. And
he old. Right. You know, it happens. Hey, you
said, I can't, like, what do you mean? Right?
Petey Pablo and all those guys, right? And I'm
still old. Enjoy your age. Right? But I say all
that. I know how old you are because I know how
old I am. So go ahead. Exactly. Exactly. I know
everybody and everything. Everything you just
said is all in my wheelhouse. Yeah. So you think
about that. So if a kid can memorize all that,
why can't they be a lawyer? Absolutely. It's
the same skill. It's just managing. You can remember
code and statutes the same way you can remember
rhymes. Oh, you bad. Right. So it's helping creating,
taking the talents in our community and crafting
them. If you can do graffiti, I'm convinced you
can be a creative artist and CAD and all these
other things. If you could sing, you can do voiceovers
in movies and theater. If you can do these things.
So I guess what I'm trying to say is when you
look at community economic development. As assets,
not just income, but I'm going to help this community
be better off by bringing this in. Think about
communal stuff. Think about if you make a candle.
I've got a couple of candles in my office. You
think about a candle may cost $5 or $10. To create
a candle may cost pennies. It's just whack. But
can you imagine teaching your kids how to do
that and to hustle that in the community and
other communities? You teach them entrepreneurial
skills. But if you were doing community economic
development, you would create a place for people
to be entrepreneurial, to build on your community
because it's a social benefit to your business.
So if I have a business, McDonald's, Hardee's,
Wendy's or whatever, and I'm putting it in the
community. I'm thinking in my mind, I want to
build a community center next door that will
support entrepreneurship because that would be
my workers. That will be my innovators. That
will be my customers. I mean, I go on and on.
She had workspaces. Right. You start thinking
like that, you build community. But we have stopped
thinking like that community act. We start thinking,
I got mine, you got yours. But it's a way to
have a collective. Because none of us have enough
by ourselves anyway. So the collective allows
for us to all thrive in a way that it's not competitive,
but it's more community. So that's kind of how
I think through this. It's not always. a economic
win for people to think like that, but I do think
it is a social economic win to do it. If you're
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so i'm gonna challenge you on that and i know
that you can meet the challenge because i i just
finished a series with dr paul fleming and i
asked him this question what you just described
in terms of community economic development the
difference between that and what we consider
now is economic development how you talked about
translating talents into careers entrepreneurs
so on and so forth you talked about social fabric
and all this stuff is it more cost effective
And you can talk about short versus long term.
To continue on this path of what we could now
consider transactional economic development as
it is to shift to a more community economic development
where we're having more of a transformational
systems change in terms of developing communities.
If you could talk about... The pros and cons,
maybe the cost and benefit, maybe the ROI. And
I know I asked like 10 questions. If you can
just lean into that a little bit more in terms
of, you know, as a business person, as an entrepreneur,
as a successful serial entrepreneur. Are you
are you missing out on money or are you playing
a long game? How do you see that working out?
So I believe that having a balanced approach
to helping people be better off pays dividends
in the long run. I believe that, like that's
a part of my DNA, right? That creating equitable
benefits for people to have affordable, inclusionary,
longstanding protections. Because I've been blessed
to see both sides. Talk about it. Lean in. Right?
So I know the skill sets that it takes to live
in a community, to keep your head on a swivel,
to make it paycheck to paycheck, to be able to
balance daycare, parents, and everything else
that's a part of that process. And I've also
seen people not have that, don't have those same
skills. because they never rode a school bus
and they never had to have a key, last key key
because they were dropped off at school. And
I've seen them need a computer, not a calculator,
a computer and get it the same day. I've seen
people get the resources they need quickly, which
may not have taught them the skill sets to be.
There's a difference between empathy and sympathy.
Right. One is really experiencing it. And one
is just like, you know, I can never be empathetic
to some things that maybe a woman may feel. Right.
I can be sympathetic, but I can never really
be empathetic. Right. But I can be sympathetic
enough to make sure that I provide inclusionary
stuff. Let me tell you what I learned. I was
on the board of the American Heart Association
and told them I really don't want to be on the
board. That's something I thought cancer killed
people more than any group. That was. heart diseases
killed more people than any other disease and
i learned heart disease kills more people of
color than any other disease and i learned heart
disease killed more black women of cup i mean
than any other disease right so then i started
thinking around and then we created this environment
where We had the sororities, the links, the mothers
at churches, and we created a social economic
group around educating these women around CPR
and all these things, because we knew that they
were also the backbone to their communities,
including Indian women, Hispanic women, Black
women around CPR and all these other things.
So then I'm thinking about economic development
on this. So if I know. And I'm not saying this
is always true, but if I know in a housing community
that has 400 homes or 400 apartments, that 300
of them are single women of color or single women
with children, right? Single parent women. And
I know that heart attacks kill Black women more
than... Why don't we have defibrillators in those
communities? Listen. I'm just asking. Be a part
of a community economic development tool that
I would think that should be provided because
it would help keep people alive. It would help
keep families stable. But are they a strain on
the economy? They're poor. They don't have a
husband. But guess what? Would it be a strain
on the economy if she dies and that child is
raised without a mother and then they have to
go into the system and they have to go through
the mental health strains of being moved out
and trying to bury a mother and having to go
through a system of what could happen? Is that
a strain? I think we need to start measuring
the economic and non -economic processes between
making decisions around recognizing if heart
disease kills. more people women of color particularly
black women than any other disease then i'm thinking
wherever they convene live party pick a name
we should have cpr training defibrillators and
an understanding of how to make this work because
if they are backbone of the community. And we
can agree to that because they're making more
money than we are making. They're in college
more. They are disciplined. They are nurturing.
And we know that women are, I mean, let's not
play this game, right? We know there's Black
girl magic. Why don't we want them to live longer
and do better and help our community? So when
I'm thinking about community economic development
is what I was saying to you. And you're like,
isn't that a cost to have a defibrillator? You're
damn right it's a cost. Yes, exactly. Yep. With
no life insurance. I was about to say, cheaper
than the GoFundMe. You know, and then we can
teach. But not only that, listen, Keisha, if
we do that, then we're training the kids how
to do CPR. And we train them how to do CPR, which
could be. You know, we don't want to talk around
that. We just want to put people in boxes in
community and say, I did it. That's the transactional
part of that bothers me. Because when I go back,
so these poor people have, oh, you know, they're
sick, but you're not providing a doctor. There's
no urgent care downstairs. Shouldn't there be
rotating doctors? You got a thousand people in
here. I mean, like that kind of mentality of
social. social engineering and community economic
development to get to the positive outcomes of
a labor force. Because remember, if you think
through it, people are good for economic development
because they provide labor. And what you're talking
about is that manufactured adversity, right?
So I shouldn't have to overcome that because
the It should already be there, right? The urgent
care should be there so things don't have to
literally fester. You know, not only do we need
to have a defibrillator, we also need to make
sure that it works and it's where it's supposed
to be, right? One of my colleagues, Monique Starks,
that's her line of work. She's a cardiologist,
is identifying where these are, these devices
are. And to make sure that we have more of them
in black communities and rural communities and
black and rural communities. Because for all
the reasons that you're talking about, the places
that have the lowest risk for heart disease is
where you find more of these devices. So I want
to even push it, push us a little bit further
back because we're talking about. economic, community
economic development. We're talking about the
intersections of economic justice and health
equity. And I'm so fortunate to be the host of
this show because I get to learn and talk to
all these amazing people. And I'm going to go
again to my conversation with Dr. Fleming, where
he talked about prevention thinking, root cause
analysis, where he talked about taking a few
steps back, right? So what would economic justice
and health equity look like in a community where
you didn't need defibrillators everywhere where
you didn't need people trained with cpr because
like you said for rod you're not just helping
people survive you're helping them thrive so
what would that look like in terms of you know
how you create these communities develop housing
And what other things, other things that are
around? Well, see, I'm glad you brought that
up. That's been my thing. You know, it's a two
pronged approach. The first prong. So a lot of
times when we talk about resiliency and especially
when we talk about resiliency with black people,
with children, it ends up being a stopgap measure.
What do we need to get them now? How can we make
them? more flexible or more hardy and resistant
to the poor outcomes of adversity, right? That
is the quick, let's do this because this is the
situation you're in now. Children are only children
for a short period of time. They don't have time
for long -term solutions. I get that, right?
But we saw oftentimes those systemic responses
stop there. They stop at that individual level,
that immediate band -aid, and they never actually
get to the root problems, right? They never actually
get to what is causing the issues. So I think
that we actually have to have that dual approach
or the two -pronged approach to let's make sure
people are taken care of now by having the defibrillators,
but also making sure that their communities have
what they need. So in the long term, they won't
need them or they won't need them as much. So
I don't think it's either or I think it's both
and like we need to help people where they are
right now, but also give them and not give them
but make sure the resources are readily available
and reachable so that they can be their healthiest
selves. Where, you know, people have agency,
right? So it's not that we're trying to make,
I say we need to make all the decisions for folks,
but people operate in the context that they live
in, right? So all the things that Farad is talking
about, if, you know, I'm in a housing community
where I got to walk, you know, a quarter of a
mile, half a mile just to get to the bus stop
compared to other folks. who have in that same
quarter mile, they have an urgent care. They
have an urgent care, a doctor's office, a hospital,
and specialty centers, specialty clinics. all
in that same distance, it's a very different
conversation we're talking about when we talk
about primary care providers. You know, you complain,
you hear people complain about folks going to
the ER when they should just go, like, why are
they doing any preventive care? And it's like,
well, where are the primary care doctors, right?
Who's going to watch these other kids while I
take me, myself? to the primary care. You know,
like these are things that we have to talk about.
How long is the wait, right? So in order for
me to get the test, it's six months. And these
are some systemic failures that are not being
addressed. That is a big issue across the board,
but it's even more intense if you live in an
area that does not have these things readily
available. And we see, you know, there's a lot.
that is talked about especially right now with
the medicaid cuts that are happening now about
closing hospitals and clinics in rural communities
but these hospitals and clinics have been getting
cut and broken down in predominantly black communities
you can look at chicago you can look at los angeles
for the last 50 years 60 years ever since ever
since we had a medicare That was when you started
seeing the hospitals and clinics in Black communities
start getting shut down and getting shuttered.
And we're still, we're dealing with those consequences.
And which is why you have those maternal health
deserts, while you have, we talk about food deserts,
but we don't talk about the health deserts that
are also in urban communities. Yeah, you know,
and Keisha, one of the things, too, that we sometimes
take for granted is the exposure of this. Like,
I didn't know what, I mean, I didn't know what
defibrillator was until I was in my 20s. And
I think it's important that that social capital
of understanding community stuff is important.
I was listening to you talk, and I just was sitting
there going, you know what? Some people don't
even know what a defibrillator is or maternal
health is and why that's important. So the more
we can expose people to this, I think the more
we can provide a greater understanding for the
next generation. Because the generation of wealth
is just not about income. Absolutely. You know,
it's social capital. it's economic capital and
it's physical capital and if you've got those
three you've got the ingredients for building
wealth because sometimes how many of us get jobs
because of who we know oh most definitely yes
exactly and so to know who you know sometimes
having the language is important Sometimes you
don't get the job because of who you know. Anyway,
I'm sorry. And so your ability to have a command
on, you know, my wife was telling me when she's
been an entrepreneur for like 35 years, she told
me like there's two pages that she reads in the
paper. It's the sports section and the business
section. She said two reasons. One, they're always
factual. and two that's what men talk about and
and she's as an entrepreneur she's trying to
build out understanding those things are important
to be in conversations and so being able to train
you know people say well those kids didn't learn
it at the dinner table or lunch table the breakfast
table let's let's start teaching them that right
so social capital does have its own baseline
that we could also be able to help people to
be better off. And so I'm thinking around all
the things that we take advantage of that we
don't recognize builds our credibility and our
ability to be fluid in community. And same skill
sets need to be taught in a community because
there's just a lack of awareness. Well, you know,
I would even say it's not just the lack of awareness.
but also the practical aspects of how to use
what when. And so even as we talk about health
literacy, financial literacy, it's not enough
like at your Sunday service and it's heart disease
awareness, right? And you get those fast facts,
right? That Black folks in their mid -40s. are
twice as likely to die from their first heart
disease or heart incidence. Black people in their
mid -40s are two to three times more likely to
die from a heart attack, their first heart attack,
than their white counterparts. It's one thing
to get that information in the Sunday service
or in the schedule. What do you call this? It's
one thing to get that information in the Sunday
program, but it's something else that when you
have, we're at a church where every third Sunday
they have blood pressure checks or they have
a, like you may know that you're supposed to.
watch your blood pressure, but you don't know
exactly what it is and I don't know how to do
it. So now all of a sudden I know how to check
my blood pressure and everyone else's. So it's
one thing to know that blood pressure is important,
but it's something very different to know how
to check your blood pressure, to know what is
high, what to do, where to go and when to go.
And the same thing can be said about economic
health as well. you know knowing what to use
when is important but have being able to have
that practical knowledge to actually have the
money so you can test it out and make some mistakes
and recover from it and know how to recover from
the mistakes. You know, that's really all part
of that social capital that is really important.
That is part of that generational wealth. Because
as you said, generational wealth isn't just about
the money you pass down. It's important. But
it's also about the social capital that you pass
down, the fact that you can call. like Uncle
Daddy, Judge Uncle Daddy, and say, can you, you
know, get my baby a job? I got a speeding ticket.
You tell me what I need to do, right? Exactly.
I got a speeding ticket. Or, you know, or I was
at a party I shouldn't have been at. Like all
those different things that can happen as a teenager.
Those are the social intergenerational knowledge
and social capital. that comes with it and it's
and i'm still not comfortable with my own social
capital you know i've been working at duke for
nine years i'm still uncomfortable calling a
physician that i know personally to say hey can
you uh take another look at this right so this
is something i have to get comfortable with because
i need my daughters to be very comfortable calling
on their network for favors right because that's
that's just part of of wealth and, and having
that access. Like that's really, that's why I
got the big dollar education so that I would
have access to these circles and I need to use
them better. That's episode two of No Health,
No Wealth. I'm Nyesha Frey. Thank you for listening.
Be sure to tune in for the next episode as we
build on this dialogue about money, equity, and
health. Follow or subscribe now so you don't
miss it.