ABOUT DR. SILAS NORMAN:
Dr. Norman is a native Detroiter, Clinical Professor of Medicine and the Co-Medical Director of Kidney and Pancreas transplantation at the University of Michigan. Dr. Norman is also the incoming Chair of the MOTTEP Detroit Foundation.
Dr. Norman received his medical training at Wayne State University in Detroit, Michigan and Residency at Baylor College of Medicine prior to returning to the University of Michigan for his nephrology fellowship and master’s degree in Public Health
Dr. Norman’s research is focused on reducing health disparities in kidney transplantation.
RESOURCES:
Kidney Disease Deaths and Death Rates: Washtenaw County Health Department
TRANSCRIPTION:
David Fair: This is 89 one WEMU, and welcome to our weekly exploration of equity and opportunity in our community. We call it Washtenaw United. And today, the focus is going to be on increasing the health opportunities for African American males that suffer disproportionately from excess chronic kidney disease. I'm David Fair, and I'd like to welcome you to this week's addition of Washtenaw United. Our guest today has witnessed the impacts in the community and in his practice. Dr. Silas Norman is co-medical director of kidney and pancreas transplant at University of Michigan Health, and he is the incoming chair of the Detroit MOTTEP Foundation. MOTTEP is the acronym for Multicultural Organ Tissue Transplant Education Program. Dr. Norman, thank you so much for making time today.
Dr. Silas Norman: Thank you. I'm happy to be here.
David Fair: Well, in general, health outcomes for African American males are worse than for white men. There are systemic issues at play, and, as such, there is sometimes mistrust of the medical community. In a broad sense, what are the pathways to changing that?
Dr. Silas Norman: Thank you so much. That's a great question. One of the ways we think we can best optimize care for African American men is to make sure that we have what we would consider culturally congruent care, which is to say, engage African American men with health providers and health educators who are also African American.
David Fair: When it comes to discussing kidney health more specifically, I keep coming across a phrase that seems rather straightforward, but I want to gain further clarity from you. And that phrase is "excess chronic kidney disease." What makes it excess?
Dr. Silas Norman: Oh, that's a great question. As you know, somewhere around 13 or 14% of the US population and about 14% of Michigan's population is African American. Despite that, we look at the individuals who have chronic kidney disease is far in excess of that 14%. And so, for one example, if we look at people on the kidney transplant waiting list, about a third of people on the kidney transplant waiting lists are African American. And so, that's where we see this excess of disease that we talk about.
David Fair: Now, you're a Detroit native. How prevalent was this where you grow up and in your family?
Dr. Silas Norman: You know, that's a terrific question. So very prevalent. Like a lot of people. I think chronic kidney disease is so prevalent, and the main causes of kidney disease--diabetes and high blood pressure--are so prevalent, I think almost all of us either experience or know someone with kidney disease. And I can say the same in my own family. I had three individuals with chronic kidney disease, one on dialysis, one who received a transplant. And I think that's pretty representative of what we see in the community. And one of the things I think is most important to think about and as we go forward thinking about our new project is that because it's so endemic in our communities, it's become normalized. And many of us. I think. Just expect that we or someone in our family is going to have high blood pressure or going to have diabetes or going to have chronic kidney disease, as if that's just part of being African American.
David Fair: Now, your dad was also a doctor and he, too, was dedicated to serving the community. And as you think about what you saw growing up and what you now experience as a doctor today, one would think that, as society evolves, things would improve. Has this situation improved at all over the decades since your childhood?
Dr. Silas Norman: That's a complicated question. We certainly have better technology and better care options than we did when I grew up. But one of the things that I think has remained true over the decades is that, despite the prevalence of high blood pressure, diabetes and chronic kidney disease in the community, there's a number of people who don't have awareness of the disease or don't have awareness of the treatment options. And so, despite the advances in medicine, many people who are unaware that they have high blood pressure or diabetes are not getting treated. And so, we're seeing diseases that potentially could have been prevented. And we're still seeing people have progression of their kidney disease, need for dialysis and the need for transplants, again, that could have potentially been prevented had people just been aware of their disease and what to do about treatment.
David Fair: We are meeting the moment with Dr. Silas Norman on 89 one WEMU's Washtenaw United. Dr. Norman is co-medical director of kidney and pancreas transplant at University of Michigan Health and is serving as incoming chair of the Detroit MOTTEP Foundation. Now, the stated mission of MOTTEP, or the Multicultural Organ Tissue Transplant Education Program, is to decrease the number and rate of ethnic minority Americans who need those organ and tissue transplants. Meeting The Moment is a new MOTTEP program, and, Dr. Norman, within the context of the greater mission, how will meeting the moment move the community forward?
Dr. Silas Norman: So, Meet The Moment is a novel program that's designed, as you said in your introduction, to recognize that we have a high-risk group of individuals in our community that is young African American men, and we're, specifically with this project, looking at individuals between 18 and 35 with the idea that we have a population at high-risk for chronic kidney disease, because these are young people. Like many young people, they'll believe that they're healthy, may not be accessing the health care system, may not find the ways that we currently can access the health care system inviting to them and so are untreated. And because they're such a high-risk population, if we can bend the curve with these individuals, we can prevent disease, get better treatment for disease, not only can we benefit these individuals, but in decreasing the rate of disease in these individuals is also helpful to their families. It's also broadly helpful to the community.
David Fair: To create awareness and to educate, I've heard the word "influencer" bandied about. What constitutes an influencer in the context of Meet the Moment?
Dr. Silas Norman: So, thank you. And this shows a little bit this novel approach. And the idea is that, in this day and time, particularly with all the social media we have, we know there's a number of social influencers out there who talk to people about all kinds of things, including health-related topics. And so we thought, wouldn't it be great to take individuals who are themselves in this 18 to 35 year range? And so, there are people that the people we want to serve and reach would see us peers and would see as people with a valid and trusted message about health, to reach out to these young African American men and talk about health and talk about prevention and talk about chronic kidney disease in a way that many of us who are either a little bit older or may not have that community connection that---
David Fair: That resonates.
Dr. Silas Norman: It resonates in a way that I still think that I'm young and cool, but it turns out that, you know, potentially to an 18 year-old--
David Fair: Yeah, you don't have to go far to find out otherwise, do you?
Dr. Silas Norman: Right, exactly. And so, this is an opportunity to say, "You know what? Let's find a a 25 year-old influencer who can bring this health message and the importance of health in being able to advocate for your health and be an active partner in your health to these young individuals that we think we can make great headway in reducing disease."
David Fair: Once again, this is Washtenaw United on 89 one WEMU. And we continue our conversation with the incoming chair of the Detroit MOTTEP Foundation, Dr. Silas Norman. And, you know, learning more about kidney disease and learning from trusted or admired people can certainly make an impact. And that is the goal of the program. However, knowing more doesn't necessarily mean there was greater access to quality health care and whether even access is affordable. How is MOTTEP going to work to change that part of the equation? Because it seems to me they have to work in companionship.
Dr. Silas Norman: Absolutely. Absolutely. So, one thing is that MOTTEP--for years, really--is a community-based organization. And so, I think one of the benefits we have going into this program is that we have a large, community-based network of individuals. And part of that network is to not only inform people about their potential risk of disease and how to monitor themselves, but also to provide resources both on the web and then to make individuals like myself available as people need care or recommendations of where do I get care or how do I get care, importantly, as you said, making sure that this is affordable care. What do we do in terms of people's different insurance and financial situations? And it turns out, particularly on the early end, when you're talking about preventative care, that doesn't necessarily need to be that expensive. And there's a lot of ways for people to, again, actively participate in improving their health. And we hope to provide those resources for folks.
David Fair: I think a lot of folks feel helpless in trying to effectively deal with the American health care industry. How might those of us hearing your message today, if they so desire, get involved and advance the aspirations of MOTTEP and the Meet the Moment program?
Dr. Silas Norman: Terrific. So, folks who go to MOTTEP men dot org, and that will take them to our web site. And that's a good way to both see some resources and to get involved either as a participant or if you just want to support motivate in this effort. That would be a terrific way.
David Fair: I would like to thank you for the time and information today. I am very grateful.
Dr. Silas Norman: Thank you so much for having us and giving me an opportunity to talk about this important Meet the Moment program.
David Fair: That is Dr. Silas Norman. Dr. Norman is co-medical director of kidney and pancreas transplant at University of Michigan Health and is incoming chair of the Detroit MOTTEP Foundation. For more information on the foundation and its new Meet the Moment program, visit our website at your convenience at WEMU dot org. We'll get you everywhere you need to go. Washtenaw United is produced in partnership with the United Way for Southeastern Michigan, and we bring it to you every Monday. I'm David Fair, and this is your community NPR station, 89 one WEMU FM, Ypsilanti.
UWSEM STATEMENT:
On July 1, 2020, the Washtenaw County Department of Health declared racism a public health crisis in our community. A declaration by the County’s Board of Commissioners followed.
What does this mean? It confirms that racism-- not genetics, not culture, not health behaviors-- is the root cause of disparities that “harms, kills and prevents individuals and communities from living healthy lives,” and commits the Health Department to sharing power, decision-making and resources with community members and communities of color who are most impacted by existing health disparities.
According to the NY Times 1619 Project, “racial health disparities are as foundational as democracy itself.” The negative and compounding impacts of socioeconomic status and institutional racism lead toshorter life spans and higher likelihood of adverse health outcomes for people living in poverty and people of color.
Importantly, a study published in the journal Nature illustrates that this is not a result of individual choices, but rather institutional racism. It found that millions of Black people have been affected by racial bias in health-care algorithms used by many U.S. hospitals, resulting in Black people being less likely than white people who were equally sick being referred to programs.
Because healthcare costs typically make up a significant portion of a household’s annual budget, this places additional stress on families with low to moderate incomes (ALICE). And just because you have healthcare does not guarantee that it is affordable or accessible.
WEMU has partnered with the United Way for Southeastern Michigan to explore the people, organizations, and institutions creating opportunity and equity in our area. And, as part of this ongoing series, you’ll also hear from the people benefiting and growing from the investments being made in the areas of our community where there are gaps in available services. It is a community voice. It is 'Washtenaw United.'
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