>>> TONIGHT, NEW YORK BOSHS PROVIDERS BRACE FOR AN OUT OF STATE SURGE.

AND HOW THE SUPREME COURT'S DECISION COULD FURTHER HURT BLACK MOTHERS AND BABIES ALREADY FACING A LIFE OR DEATH CRISIS.

"METROFOCUS" STARTS RIGHT NOW.

♪ >>> THIS IS "METROFOCUS," WITH RAFAEL PI ROMAN, JACK FORD AND JENNA FLANAGAN.

>>> "METROFOCUS" IS MADE POSSIBLE BY -- SUE AND EDGAR WACHENHEIM III, THE PETER G. PETERSON AND JOAN GANZ COONEY FUND, BERNARD AND DENISE SCHWARTZ, BARBARA HOPE ZUCKERBERG, THE AMBROSE MONELL FOUNDATION.

AND BY -- >>> GOOD EVENING, AND WELCOME TO "METROFOCUS."

I'M JENNA FLANAGAN.

IN THE MONTHS SINCE THE SUPREME COURT'S MONUMENTAL DECISION STRIKING DOWN THE CONSTITUTIONAL RIGHT TO AN ABORTION, NEW YORK PROVIDERS HAVE BEEN BRACING FOR A POSSIBLE SURGE OF PATIENTS FROM OUT OF STATE.

AS THOSE IN NEED OF AN ABORTION START ARRIVING, PLANNED PARENTHOOD OF GREATER NEW YORK IS RESPONDING BY INCREASING APPOINTMENT AVAILABILITY BY AS MUCH AS 20% AT ITS NETWORK OF HEALTH CENTERS.

AND FOR A CLOSER LOOK AT THE IMPACT OF THE COURT'S DECISIONS ON LOCAL CLINICS, WHERE OUT OF STATE PATIENTS MIGHT BE ARRIVING, AND WHETHER NEW YORKERS COULD HAVE TROUBLE ACCESSING THOSE SERVICES, WE'D LIKE TO WELCOME DR. JILLIAN DEAN, CHIEF MEDICAL OFFICER AT PLANNED PARENTHOOD OF GREATER NEW YORK.

DR. DEAN, WELCOME TO "METROFOCUS."

>> THANK YOU.

THANK YOU FOR HAVING ME ON.

>> DR. DEAN IS JOINING US AS PART OF OUR SERIES ON THE RULINGS AND THEIR IMPACT ON THE TRISTATE.

I WANT TO START WITH JUST THE DAY-TO-DAY WORKINGS AT PLANNED PARENTHOOD, AND WHAT IT MEANS TO INCREASE APPOINTMENT AVAILABILITY BY 20%.

>> I FIRST OF ALL WANT TO MAKE IT CLEAR THAT THIS SUPREME COURT DECISION, THIS DISGRACEFUL, WRONGFUL DECISION, HAS PROVOKED A HEALTH-CARE CRISIS, AND IN ONLY FOUR SHORT WEEKS.

SO OUR DAY-TO-DAY WORKINGS LOOK DIFFERENT THAN THEY DID PREVIOUSLY.

THIS ISN'T THEORETICAL.

WE ARE SEEING PATIENTS EVERY DAY IN OUR HEALTH CENTERS WHO ARE COMING TO US FROM OUT OF STATE.

THEY ARE COMING FROM GEORGIA, FLORIDA, TEXAS, ARIZONA, OHIO, OKLAHOMA, TO JUST NAME A HANDFUL OF THE MANY, MANY STATES WHERE WE HAVE SEEN PATIENTS.

AND I WILL TELL YOU THAT PEOPLE ARE TRAUMATIZED.

THEY ARE TRAUMATIZED NOT ONLY BY THE HURDLES THAT THEY HAVE TO OVERCOME TO GET TO OUR HEALTH CENTERS, INCLUDING RAISING THE MONEY FOR TRAVEL, LODGING, ARRANGING CHILD CARE, TIME OFF FROM WORK OR SCHOOL.

THEY ARE TRAUMATIZED BY THE FEAR THAT SOMEONE IN THEIR HOME COMMUNITIES COULD FIND OUT THAT THEY HAD HAD AN ABORTION AND THAT THEY OR SOMEONE THEY LOVE COULD BE AT RISK OF CRIMINAL LIABILITY.

I WANT TO BE CLEAR -- ABORTION IS HEALTH CARE.

IT IS IN FACT ESSENTIAL HEALTH CARE.

AND IT IS -- I CANNOT DOWNPLAY THE STRESS THAT WE ARE SEEING IN PATIENTS.

THE TEARS, THE SELEVATED BLOOD PRESSURES.

THE FOLKS COMING INTO THE HEALTH-CARE CENTERS ARE THE LUCKY ONCE.

OTHERS ARE NOT ABLE TO MAKE THE JOURNEY TO AN ABORTION ACCESS STATE.

>> THAT'S INTERESTING THAT YOU MENTION AS A -- I GUESS A SIDE EFFECT OF THE STRESS OF THE WHOLE SITUATION IS THE ELEVATED BLOOD PRESSURES.

ARE YOU ALSO FINDING THAT PEOPLE, BECAUSE OF THE NECESSITY TO TRAVEL, MIGHT BE WAITING LATER INTO A PREGNANCY TO RECEIVE HEALTH CARE THAN THEY MIGHT HAVE IF THEY WERE ABLE TO ACCESS IN THEIR OWN COMMUNITIES?

>> ABSOLUTELY.

WE ARE PREPARED FOR THIS TO HAPPEN.

AND WE ARE SEEN IT HAPPEN ALREADY.

SOME OF THOSE FOLKS HAVEN'T MADE IT TO US YET BECAUSE THE SUPREME COURT DECISION, AS I SAID, WAS ONLY A MONTH AGO, AND THESE PEOPLE ARE WORKING ON THE FUNDS AND WAITING TO COME TO PLACES LIKE NEW YORK CITY.

RIGHT AFTER OKLAHOMA PASSED ITS TOTAL ABORTION BAN, STYLED AFTER THE ONE IN TEXAS, AND THIS WAS BEFORE THE SUPREME COURT'S HORRIFIC DECISION A MONTH AGO.

WE HAD A PATIENT WHOSE HOME STATE WAS OKLAHOMA.

SHE WAS A STUDENT IN ANOTHER STATE WITH VERY, VERY POOR ABORTION ACCESS, SO SHE WAS ARRANGING TO GO BACK TO OKLAHOMA AS SOON AS SHE FOUND OUT SHE WAS PREGNANT, AND BOOM, THE BAN HAPPENED AND WAS UNABLE TO GET AN APPOINTMENT.

THIS STUDENT, LIKE MANY STUDENTS, WAS ON A BUDGET, AND IT TOOK HER THREE MONTHS TO RAISE THE MONEY TO MAKE IT UP TO NEW YORK.

SO SHE STARTED HER JOURNEY AT TEN WEEKS OF PREGNANCY.

SHE ARRIVED IN NEW YORK STATE AT 22 WEEKS.

AND SO THAT'S WHY I'M SAYING THAT WE DON'T EVEN KNOW THE FULL IMPACT ON HOW MANY PEOPLE ARE BEING PUSHED LATER.

WHEN PEOPLE ARE PUSHED LATER IN ABORTION, THE PROCEDURE IS -- IT TAKES LONGER, IT DOES CARRY MORE RISK, AND IT IS MORE COSTLY.

THIS PARTICULAR INDIVIDUAL WHO CAME TO US AFTER NOT BEING ABLE TO OBTAIN AN ABORTION IN HER HOME STATE, TO ON SBTAIN HEALTH CARE IN HER STATE WAS FORTUNATE BECAUSE WE WERE ABLE TO PROVIDE HER WITH A SAFE LEGAL PROCEDURE IN NEW YORK, AND I WANT TO REMIND VIEWERS THAT ABORTION REMAINS LEGAL AND PROTECT IN THE NEW YORK STATE, SO SHE WAS ONE OF THE ONES TO MAKE IT UP AND SHE WAS TEARFUL AND SO GRATEFUL.

>> I ALSO DO WANT TO -- WITH PEOPLE WHO MIGHT BE FINDING THEMSELVES HAVING TO WAIT LONGER INTO A PREGNANCY TO RECEIVE CARE, THE DIFFERENCES, AGAIN, IN LAWS BETWEEN STATES.

THERE ARE SOME STATES WHERE ABORTION IS LEGAL THROUGHOUT THE ENTIRE PREGNANCY AND OTHER STATES, LIKE IN NEW YORK, WHERE IT'S UP TO THE POINT OF LIABILITY.

IS THAT SOMETHING THAT PLANNED PARENTHOOD IS HAVING TO FACTOR?

THAT IF SOMEONE -- IS IT POSSIBLE, PERHAPS, TO FIND YOURSELF HAVING WAITED TOO LONG?

>> THAT IS ALWAYS THE CASE.

THERE ARE -- IN STATES THAT HAVE MAINTAINED ABORTION ACCESS, THERE ARE DIFFERENT GESTATIONAL LIMITS UP TO WHICH ABORTION CAN BE PROVIDED.

IN NEW YORK WE ARE FORTUNATE TO PROVIDE ABORTION UP TO LIABILITY.

WE HOPE PATIENTS ARE ABLE TO COME TO US ALONE BEFORE THEN, BECAUSE IT'S CRITICAL TO GET THE CARE EARLY IN PREGNANCY, IF POSSIBLE, WHEN THE PROCEDURE IS MUCH MORE SIMPLE, MUCH MORE STRAIGHT FORWARD, WHERE THERE'S THE OPTION OF MEDICATION ABORTION OR PROCEDURAL ABORTION, OTHERWISE KNOWN AS SURGICAL ABORTION, WHERE THE RISKS AND COSTS ARE LOWER.

BUT THERE WILL ALWAYS BE PATIENTS WHO NEED TO OBTAIN THIS CARE LATER IN PREGNANCY.

EITHER BECAUSE, LIKE THE ONE I DESCRIBED TO YOU, IT HAS TAKEN MONTHS TO ANYONE TO RAISE THE FUNDS AND THEN THERE ARE ALSO PATIENTS WHO DON'T IDENTIFY THAT THEIR PREGNANT UNTIL LATER IN PREGNANCY.

WE JUST HAD A PATIENT WHO, A NEW YORKER, PLANNING A MOVE TO A NO-ACCESS STATE WHO HAS IRREGULAR PERIODS BECAUSE OF A MEDICAL CONDITION AND SOMETIMES GOES FOR MONTHS WITHOUT HAVING A PERIOD.

SO JUST IDENTIFIED THAT SHE WAS 17 WEEKS PREGNANT AND HAD BEEN PLANNING A MOVE TO A STATE WHERE SHE WAS GOING TO BE STARTING A NEW JOB.

SHE'S A SINGLE MOM OF A SCHOOL-AGE KID.

SOLE PROVIDER FOR HERSELF AND HER CHILD, FOR HER FAMILY.

AND THIS MOVE WAS CRITICAL IN TERM OF EMPLOYMENT.

SHE HAD TO PUT OFF HER MOVE TO THE NO ACCESS STATE, PUT OFF THE START OF HER NEW JOB BECAUSE SHE WAS UNL ABLE TO OBTAIN THE HEALTH CARE SHE WOULD NEED IN THAT STATE AND FORTUNATELY WE WERE TABLE HELP HER IN NEW YORK.

SO WE SEE FOLKS WHO DO NOT PRESENT UNTIL LATER IN PREGNANCY BECAUSE THEY WERE NOT ABLE TO IDENTIFY THEY WERE PREGNANT UNTIL LATER ON, AND THEN OF COURSE THERE ARE ALWAYS FOLKS WHO LEARN LATER IN THE PREGNANCY THERE IS A SERIOUS MEDICAL CONDITION, SOMETIMES NOT COMPATIBLE WITH LIFE OUTSIDE THE WOMB FOR THE FETUS, AND THAT OFTEN -- THAT DIAGNOSE, THAT INFORMATION OFTEN IS NOT OB OBTAINED UNTIL LATER IN PREGNANCY.

>> OF COURSE.

I ALSO WANT TO TOUCH ON, AS YOU WERE MENTIONING, EVEN FOR SOME NEW YORKERS WHO ARE FINDING TH THEMSELVES IN NEED OF ABORTION SERVICES, IS IT FIRST COME, FIRST SERVE?

HOW IS PLANNED PARENTHOOD OF GREATER NEW YORK HANDLING NATIVE NEW YORKERS?

I HATE TO USE THE WORD NATIVE, INSTATE.

IS THERE ANY DIFFERENCE?

>> YOU MENTIONED AT THE TOP OF THE SHOW WE ARE INCREASING OUR ABORTION ACCESS 20% ACROSS OUR SERVICES, BUT IT MEDICATION THROUGH MEDICATIONS OR PROCEDURAL.

WE ARE GOING TO NOT ONLY TO SERVE THOSE OUT OF STATE BUT TO SERVE NEW YORKERS BETTER.

BECAUSE WE NEED TO PROVIDE ABORTION CARE TO THE FOLKS WHO NEED US.

WE ARE HERE FIRST AND FOREMOST TO SERVE THE PEOPLE OF NEW YORK STATE, BUT WE ARE ALSO UNDERSTANDING THIS IS THE TIME TO STEP UP AND SERVE THE PEOPLE OF THE NATION.

I RECENTLY HAD A PATIENT WHO CAME TO ME, LIVES FROM NEW JERSEY, WORKS IN CONNECTICUT AND CAME TO ME FOR AN ABORTION IN NEW YORK.

THERE'S THREE ABORTION ACCESS STATES I SAID, HOW IS IT THAT YOU CAME TO US?

SHE SAID, YOU HAD THE SOONEST APPOINTMENT.

THAT REALLY FELT GOOD FOR ME TO BE ABLE TO STEP IN AND PROVIDE THAT CARE.

BECAUSE ABORTION IS A TIME SENSITIVE MEDICAL PROCEDURE AS I TALKED ABOUT THERE.

>> IN ADDITION TO ABORTION ACCESS, THERE ARE ALSO QUITE A FEW PREGNANCY CRISIS CENTERS IN ALL THREE ABORTION ACCESS STATES THAT YOU JUST MENTIONED.

AND AT LEAST IN NEW YORK STATE, WE KNOW THE ATTORNEY GENERAL'S OFFICE IS SAYING THAT QUITE OFTEN THESE PLACES WILL MISREPRESENT REPRODUCTIVE SERVICES THEY CAN PROVIDE.

AND VARIOUS OTHER MISLEADING TA TACTICS.

WHAT IS YOUR CONCERN ABOUT PREGNANCY CRISIS CENTERS POPPING UP AND PERHAPS CONFUSING PEOPLE AT A POINT OF CRISIS IN THEIR LIFE?

>> WELL, I -- WE REFER TO THESE AS FAKE HEALTH CLINICS, BECAUSE IN FACT THESE ARE NOT HEALTH-CARE PROVIDERS.

THESE ARE BUSINESSES THAT THESE HARMFUL TACTICS TO LURE PEOPLE IN UNDER THE GUISE OF PROVIDING THEM HEALTH CARE.

THEY PROVIDE MISINFORMATION MISINFORMATION NOT ONLY ABOUT ABORTION AND SEXUAL REPRODUCTIVE HEALTH CARE IN GENERAL, BECAUSE MISINFORMATION DIRECTLY RELEVANT TO THE PERSON PRESENTING TO THEM, INCLUDING HOW FAR ALONG THEY ARE IN PREGNANCY AND SOMETIMES WHETHER OR NOT THEY ARE PREGNANT.

THEY DO THIS TO TRY TO TRICK PEOPLE SO THAT THEY EITHER BECOME TOO LATE IN PREGNANCY OR DO NOT KNOW THAT THEY ARE PREGNANT AND THEREFORE CAN'T ACCESS TRUE HEALTH CARE FROM A TRUE HEALTH-CARE PROVIDER.

THEY'RE BASICALLY CAUSING THEM TO MISS A WINDOW FOR WHEN ABORTION WOULD BE AN OPTION FOR THEM.

WHAT WE NEED ARE PUBLIC CAMPAIGNS TO TELL PEOPLE WHAT TRUE COMPREHENSIVE SEXUAL REPRODUCTIVE HEALTH CARE WOULD LOOK LIKE TO PREVENT THEM FROM FALLING VICTIM TO THE FAKE CLINICS SO THEY CAN IDENTIFY WHAT SEXUAL AND REPRODUCTIVE HEALTH CARE LOOK LIKE AND HAVE ALL OF THEIR OPTIONS OPEN TO THEM, INCLUDING THE OPTION FOR ABORTION.

>> ONE FINAL QUESTION, AND THAT IS A HEADLINE THAT'S MADE NATIONAL NEWS, AN ABORTION ON A 10-YEAR-OLD RAPE VICTIM.

-- COULD FACE CHARGES FROM OUT OF STATE ATTORNIES GENERAL?

>> THAT -- THAT WHOLE -- THAT WHOLE SITUATION WAS SHOCKING TO ME.

AND I WANT TO MAKE IT CLEAR.

I WAS NOT SHOCKED THAT MY COLLEAGUE PROVIDED CARE TO A 10-YEAR-OLD RAPE VICTIM.

BECAUSE UNFORTUNATELY, THAT IS SOMETHING THAT THOSE OF US WHO ARE IN THE FIELD HAVE SEEN.

I MYSELF HAVE PROVIDED CARE TO 10-YEAR-OLDS, A 9-YEAR-OLD, IN FACT, 11-YEAR-OLDS, TO VERY, VERY YOUNG CHILDREN IN THAT AGE RANGE WHO HAVE FALLEN -- WHO HAVE BECOME PREGNANT AND USUALLY IT'S THE RESULT OF AN ASSAULT.

SO WHAT WAS SHOCKING WAS NOT THAT THIS PATIENT NEEDED THE CARE.

WHAT WAS SHOCKING WAS THE ATTACK MADE ON THIS HIGHLY REPUTABLE DOCTOR, ON HER INTEGRITY, ON THE TRUTHFULNESS OF THIS WHOLE SITUATION.

THAT WAS COMPLETELY APPALLING AND COMPLETELY SHOCKING.

I'M SO GLAD THAT I -- I'M FORTUNATE TO PROVIDE CARE IN NEW YORK STATE WHERE I DO NOT ANTICIPATE ANY ATTACK LIKE THAT.

IN FACT, WE HAVE HAD SO MUCH SUPPORT AS ABORTION PROVIDEDRS FROM OUR ELECTED OFFICIALS.

THERE HAVE BEEN LAWS PASSED TO PROTECT ABORTION PROVIDERS IN NEW YORK STATE FROM LAWSUITS FROM OTHER STATES WHERE, WHEN WE PROVIDE CARE TO PATIENTS TRAVELING FROM THOSE STATES, THERE HAVE BEEN THERE HAVE BEEN LAWS PASSED TO SECURE ACCESS TO ABORTION FOR NEW YORKERS AND THOSE TRAVELING FROM OUT OF STATE.

WE'RE FORTUNATE TO HAVE THE SUPPORT OF OUR GOVERNMENT AND GOVERNOR AND ELECTED OFFICIALS.

>> UNFORTUNATELY, WE ARE GOING TO HAVE TO LEAVE IT THERE, BUT DR. JILLIAN DEAN, CHIEF MEDICAL OFFICER AT PLANNED PARENTHOOD OF GREATER NEW YORK.

THANK YOU SO MUCH FOR TAKING THE TIME.

>> THANK YOU FOR HAVING ME.

>> ABSOLUTELY.

>>> WHEN THE SUPREME COURT OVERTURNED IT 1973 LANDMARK DECISION ROE VS. WADE, THUS REMOVING A FEDERALLY PROTECTED RIGHT TO AN ABORTION AND RETURNING THE ISSUE TO STATE LEGISLATURES, MANY AMERICANS FELT IT WAS AN ASSAULT ON HEALTH CARE.

WHILE ANY PERSON OF CHILD BEARING AGE WILL FEEL THIS DECISION, SOME HEALTH-CARE EXPERTS ARE WARNING IT WILL FURTHER THE DISPARITIES THAT ALREADY EXIST IN AMERICA ALONG RACE LINES.

FORMER ESSENCE MAGAZINE EDITOR LAYS OUT THE CASE FOR HOW AND WHY RACISM IS A PUBLIC HEALTH RISK IN HER NEW BOOK "UNDER THE SKIN, THE HIDDEN TOLL OF RACISM ON AMERICAN LIVES AND ON THE HEALTH OF OUR NATION", AND SHE JOINS US NOW.

LINDA, WELCOME TO "METROFOCUS."

>> THANK YOU.

GOOD TO BE HERE.

>> I JUST WANT TO STARLET OFF SAYING YOU HAVE BEEN SOUNDING THIS ALARM FOR QUITE SOME TIME.

IN 2018 YOU WROTE AN ARTICLE FOR THE "TIMES," WHY AMERICA'S BLACK MOTHERS AND BABIES ARE IN A LIFE OR DEATH CRISIS.

SO, CAN YOU JUST EXPLAIN FOR THE VIEWERS, WHAT IS THE UNIQUE CRISIS THAT'S FACING BLACK MATERNAL HEALTH?

>> FIRST, IT'S A CRISIS FACING AMERICA SOME WE ARE THE ONLY WEALTHY COUNTRY WHERE THE NUMBER OF WOMEN WHO DIE OR ALMOST DIE RELATED TO PREGNANCY AND CHILDBIRTH CONTINUES TO RISE.

THE ONLY WEALTHY NATION.

BLACK WOMEN ARE THREE TO FOUR TIMES MORE LIKELY TO FACE THE CRISIS OF DEATH OR NEAR DEATH ON WHAT SHOULD BE THE BEST TIME OF THEIR LYES, AND EDUCATION DOESN'T PROTECT US.

IN OTHER WORDS, EVEN IF YOU'RE AN ELK KATED BLACK WOMAN WITH A MASTERS DEGREE OR MORE, YOU'RE STILL MORE LIKELY TO DIE OR ALMOST DIE THAN A WHITE WOMAN WITH AN EIGHTH GRADE EDUCATION.

SO CLEARLY THIS IS A CRISIS.

AND WHAT I TRY TO LAY OUT IS AMERICA'S BLACK MOTHERS AND BABIES WITH A FOCUS ON AMERICA, BECAUSE THIS IS A CRISIS THAT AFFECTS ALL OF US.

>> WELL, WHAT IS AT THE ROOT OF THIS CRISIS, THEN?

I FEEL SO MANY PEOPLE MIGHT WONDER, HOW IS IT THAT WE GOT TO THIS PLACE?

>> I THINK THAT THE KNEE JERK REACTION IS IS IT'S SOMETHING WRONG WITH WOMEN'S BODIES OR WE'RE DOING SOMETHING WRONG CULTURALLY OR EDUCATIONALLY.

I THINK WE PRETTY MUCH -- THAT'S BEEN DISPROVEN.

AND WHAT I LAY OUT IN MY BOOK AND IN THAT ARTICLE IS THREEFOLD.

ONE IS THAT THERE'S THE EXPERIENCE OF RACISM AND DISCRIMINATION AND BIAS IN THE HEALTH-CARE SYSTEM ITSELF, WHICH HAS BEEN WELL DOCUMENTED FOR DECADES.

THE SECOND IS SOMETHING ABOUT THE LIVED EXPERIENCE OF BEING BLACK AND A WOMAN, A BIRTHING PERSON IN AMERICA, IS BAD FOR THE BODY AND THE BABY.

I DID NOT COME UP WITH THAT.

I'M A JOURNALIST, BUT THERE ARE SCIENTISTS WHO HAVE SAID THOSE WORDS VERBATIM.

FINALLY THERE'S SOMETHING ABOUT OUR COMMUNITIES THAT ARE LESS HEALTHFUL.

BLACK COMMUNITIES AND OTHER COMMUNITIES OF COLOR ARE SUBJECT TO MORE POLLUTION.

AIR AND WATER POLLUTION.

LESS GOOD HEALTH-CARE FACILITIES.

IT'S HARDER TO ACCESS HEALTHY FOOD.

IT'S SOMETIMES UNSAFE.

THE HOUSING ISN'T SAFE, THE EDUCATIONAL SYSTEM.

SO THOSE THREE THINGS ARE REALLY WHAT IS AT THE HEART OF THIS, NOT SOMETHING THAT WE ARE DOING WRONG OR SOMETHING WRONG WITH US.

>> I WAS WONDERING IF YOU COULD UNPACK FURTHER THE HEALTH DISPARITIES AND THE EXPERIENCE OF BLOCK MOTHERS AND BABIES.

AND I ASK THAT QUESTION BECAUSE, AS PEOPLE WERE REVIEWING YOUR BOOK, A LOT OF PEOPLE DIRECTLY TIED OUR CURRENT MATERNAL -- THE WAY THAT AMERICA VIEWS MATERNAL HEALTH THE OUR PAST AND SLAVERY.

>> I THINK THAT IS FAIR, AND I WAS PART OF THE 1619 PROJECT, WHICH WENT BACK IN TIME TO LOOK AT -- BECAUSE THERE'S NEVER BEEN A TIME IN AMERICA WHERE BLACK PEOPLE AND WHITE PEOPLE HAVE HAD EQUAL HEALTH OUTCOMES.

SO IT'S ALWAYS BEEN A PROBLEM.

AND IF YOU LOOK BACK AT WHAT WAS HAPPENING FOR US DURING ENSLAVEMENT, ESPECIALLY WITH REPRODUCTION DID, AND SOMEONE SAID IT TO ME RECENTLY.

IT WAS LIKE WORK DEALT WITH FORCED LABOR S, AND A DOUBLE MEANING.

ONE IS WE WERE FORCED TO WORK, RAISE THE ECONOMY, RAISE THE FORTUNES OF THE SOUTH AND CEMENT THEM BY PROVIDING FREE LABOR, BUT WE ALSO CREATED MORE FREE LABOR BY BEING FORCED TO REPRODUCE.

SO, IF WE HAVE HAD INJUSTICE IN REPRODUCTION FOR 400 YEARS, IT'S NOT SURPRISING THAT NOW THAT ROE VS. WADE HAS FALLEN THAT WE WOULD BE HIT HARDEST AND LONGEST.

>> AND SO WHEN YOU ALSO TALK ABOUT BLACK -- BIRTHING PEOPLE OF BEING HIT HARD INTEREST LONGEST, I WAS ALSO WONDERING IF YOU COULD EXPAND ON A CONCEPT I CALLED WEATHERING, WHICH I FOUND TO BE VERY INTERESTING AND SOMETHING THAT I DON'T THINK GETS ADDRESSED ENOUGH WHEN TALK ABOUT HOW RACISM AFFECTS THE BODY.

>> WEATHERING IS A VERY INTERESTING CONCEPT, COINED BY ARLENE JERONIMUS.

IT'S THE IDEA THAT SOMETHING ABOUT HAVING TO, SORT OF, HARD COPING AGAINST DAILY DISCRIMINATION AND HARD CORE DISCRIMINATION WEATHERS THE BODY.

IN OTHER WORDS, EVERY TIME YOU HAVE TO DEAL WITH SOME KIND OF STRESS, BUT EXTREME STRESS ESPECIALLY, THE SYSTEMS OF THE BODY KICK INTO GEAR.

SO YOUR HEART RATE GOES UP, YOUR BLOOD PRESSURE, YOUR STRESS HORMONE LEVELS.

AND CERTAINLY THIS IS A SURVIVAL MECHANISM, BUT IT ONLY TURNS DANGEROUS WHEN IT HAPPENS OVER AND OVER AGAIN, AND WHAT SHE FOUND IS IT RAISES SOMETHING CALLED THE ALISTATIC LOAD, AND THAT MEANS YOUR BODY IS WORKING OVERTIME.

IF THAT HAPPENS OVER AND OVER AGAIN, WHICH IS WHAT HAPPENS TO PEOPLE WHO ARE DISCRIMINATED AGAINST, WHICH HAS HAPPENED LONGEST AND WORSE FOR BLACK PEOPLE, IT CAUSES THE BODY TO PREMATURELY AGE, AND THAT IS CALLED WEATHERING, THE SAME WAY A HOUSE WOULD WEATHER A STORM.

IT KNOCKS THE PAINT OFF, PUTS THE SHINGLES -- MAKES THE SHINGLES FLY OFF, THE WINDOWS BREAK, BUT SHE ALSO -- SHE'S A VERY POETIC SCIENTIST, AND SHE ALSO NOTED THAT BLACK PEOPLE AND OTHER PEOPLE OF COLOR ALSO WE THINKER THE STORM.

WE HAVE COMMUNITY, KINSHIP, NEIGHBORHOOD COHESION, WE HAVE LOVE.

AND I REALLY LIKE THAT CONCEPT, WHICH IS -- YOU KNOW, I'M SAYING CONCEPT, BUT IT'S VERY WELL PROVEN, AND SHE AND OTHERS HAVE BEEN TALKING ABOUT IT FOR DECADES.

BUT IT CAUGHT ON MORE RECENTLY BECAUSE OF COVID.

AND YOU SAW RIGHT AWAY THAT PEOPLE WHO WERE OLDER HAD WORSE HEALTH OUTCOMES.

BUT THEN ALSO PEOPLE -- BLACK PEOPLE HAD WORSE HEALTH OUTCOMES AT YOUNGER AGES, AND YOU KNOW, IT WAS DIFFERENT.

IT WAS LIKE A TEN-YEAR AGE DIFFERENCE IN WORST HEALTH OUTCOME, AND EVERYONE INSTANTLY WENT TO THE DOCTOR AND SAID, OH, YOUR WEATHERING HYPOTHESIS EXPLAINS THE DISPARITY.

>> NOW TO BACK UP TO A SORT OF HIGHER VIEW, HOW DOES THIS CONSTANT EFFECT OF WEATHERING, BROUGHT ON MY CHRONIC AND PERSISTENT RACISM IN THE COUNTRY, HOW IS THIS AFFECTING ALL OF AMERICA?

HOW IS IT COSTING EVERYONE?

>> WELL, AMERICA HAS THE WEALTHIEST -- WE'RE VERY WEALTHY, AMONG THE WEALTHIEST NATIONS.

WE ALSO HAVE THE BEST HEALTH CARE.

IT'S HIGH TECH.

WE SPEND THE MOST OF ANY COUNTRY IN THE WORLD ON HEALTH CARE.

YET OUR HEALTH-CARE STATUS COUNTRY ISN'T GREAT.

SO IN OTHER WORDS WE HAVE EXTREMELY HIGH LEVEL OF INFANT MORTALITY COMPARED TO OTHER COUNTRIES, THOUGH WE SPEND MORE.

THEN AT THE OTHER END OF THE SPECTRUM, WE HAVE A LOW LIFE EXPECT EXPECTANCY COMPARE ODD OTHER COUNTRIES AND OTHER DISPARITIES IN BETWEEN.

WHY WOULD THE RICH COUNTRY WITH THE BEST HEALTH CARE -- WE SPEND SO MUCH ON HEALTH CARE, HAVE WORSE HEALTH OUTCOMES?

YOU LOOK AT THE INEQUALITY IN THE SYSTEM, THE EXPERIENCE OF BLACK PEOPLE ACROSS CLASS LINES, AND THEN IT KIND OF MAKES SENSE.

IT'S A TERRIBLE MAKING SENSE.

BUT IT DOES AFFECT ALL OF US, BECAUSE IT'S NOT JUST THE BLACK HEALTH STATUS.

IT'S THE HEALTH STATUS FOR THE COUNTRY AS A WHOLE.

>> YOU MENTIONED EARLIER THAT THE HEALTH OUTCOMES OF A WELL EDUCATED, PERHAPS, HIGH EARNING BLACK PERSON COULD ACTUALLY OR AT LEAST EXPECT A PARENT COULD BE WORSE THAN A WHITE PERSON WHO IS LESS EDUCATED AND EARNING LESS MONEY.

I WONDER, WHAT ROLE DOES THE MEDICAL COMMUNITY PLAY IN THIS, AND HOW CAN IT BEGIN TO ADDRESS?

BECAUSE IF WE SPEND SO MUCH MONEY ON HEALTH CARE, IS NOT ACKNOWLEDGING OR ADDRESS TEACHING OUR HEALTH CARE PROFESSIONALS ABOUT THE PHYSICAL EFFECT OF RACISM PART OF THAT?

>> I HAVE BEEN THINKING A LOT ABOUT THIS BECAUSE I TALKED TO A LOT OF MEDICAL STUDENT GROUPS AND PHYSICIANS, AND I WANT TO MAKE CLEAR I DON'T THINK THIS IS A PROBLEM OF INDIVIDUAL DOCTORS WHO GO INTO MEDICINE BECAUSE THEY'RE TRYING TO DO HARM TO PEOPLE.

BUT IT'S SYSTEMIC.

AND I GOT A NOTE FROM A FRIEND OF MINE, AND SHE WAS TALKING AT THIS TERRIBLE THING THAT HAPPENED TO HER WHEN SHE WAS PREGNANT.

AND I SAID, DID I HAPPEN BY A DOCTOR?

SHE SAID, NO, IT WAS AN EMS PERSON -- THIS WOMAN IS SO SOPHISTICATED, AND SHE WAS ACCUSED OF DRUG SEEKING.

THE FIRST THING THEY ASK IS, WHAT DRUGS ARE YOU ON?

WHEN SHE WAS HAVING A SEVERE MISCARRIAGE.

THAT KIND OF THING, I HEAR IT EVERY DAY FROM BLACK WOMEN, AND THESE ARE IN MY FRIEND GROUP.

SO PART OF THIS -- IT'S BEEN WELL DOCUMENTED THAT BLACK PEOPLE AND OTHER PEOPLE OF COLOR HAVE A WORSE TIME IN THE MEDICAL SYSTEM, AND IT'S NOT JUST ANECDOTAL.

WHAT I LOOK AT IS A 2002 REPORT OF 480 OTHER STUDIES THAT TALKED ABOUT THIS DISCRIMINATION THAT BLACK PEOPLE EXPERIENCE MORE OFTEN IN THE HEALTH-CARE SYSTEM AND THERE WAS ONE STUDY I REMEMBER THAT REALLY HIT ME, AND IT WAS ABOUT AMPUTATION.

IT LOOKED AT PEOPLE WHO HAD DIABETES, AND EVERYTHING WAS LEVEL AT THE SEVERITY OF THE DIABETES.

IT LOOKED AT THEIR HEALTH INSURANCE.

EVERYTHING WAS LEVEL.

IT LOOKED AT BLACK PATIENTS AND WHITE PATIENTS.

BLACK PATIENT WERE MORE LIKELY, EVEN WHEN OTHER THINGS WERE EQUAL, TO HAVE A LEG AMPUTATED.

SO I DON'T THINK INDIVIDUAL EVIL DOCTORS OR HEALTH-CARE PROVIDERS ARE GOING IN TO DO HARM, BUT SOMEBODY IS MAKING A DECISION BASED ON, PERHAPS AND PROBABLY, IMPLICIT BIAS TO CUT OFF SOMEONE'S LEG MORE OFTEN IF THEY'RE BLACK.

>> HOW DOES THIS COUNTRY AND ESPECIALLY THE MEDICAL INDUSTRY BEGIN TO ADDRESS THIS?

>> WELL, I AM A VERY GLASS HALF FULL PERSON, AND I'M SEEING CHANGES.

I AM SEEING MEDICAL STUDENTS WHO ARE POLITICIZED DURING THE HEAT OF THE BLACK LIVES MATTER MOVEMENT.

THEY WERE IN HIGH SCHOOL.

THEY WERE IN UNDERGRADUATE COLLEGE, AND NOW THEY'RE IN MEDICAL SCHOOL.

THEY'RE SAYING, WAIT A MINUTE, WE DON'T WANT TO GO INTO A SYSTEM THAT IS UNFAIR.

I SEE MEDICAL SCHOOLS THEMSELVES, YOU KNOW, THE ADMINISTRATIONS SOMETIMES GRAPPLING WITH THIS.

MEDICAL SOCIETY.

CERTAINLY GROUPS OF NURSES AND MID WIVES GLARAPPLING WITH THISO TRY TO DO BETTER.

I REALLY APPRECIATE THAT.

I APPRECIATE THERE'S AN ENERGY AND WILLINGNESS TO APPRECIATE THIS PROBLEM AND NOT SHY AWAY FROM IT, BECAUSE IT REALLY IS HARMING PEOPLE AND HARMING OUR COUNTRY AS A WHOLE.

>> ALL RIGHT, WELL, I'D LIKE TO THANK OUR GUEST, AGAIN, A "THE NEW YORK TIMES" MAGAZINE CONTRIBUTING WRITER AND FORMER ESSENCE MAG SEEN EXECUTIVE EDITOR AUTHOR OF "UNDER THE SKIN, THE HIDDEN TOLL OF RACISM ON OUR LIVES AND THE HEALTH OF THE NATION".

THANK YOU SO MUCH FOR JOINING US ON "METROFOCUS."

>> THANK YOU, I REALLY APPRECIATE YOU AND ALL THAT YOU DO.

>>> "METROFOCUS" IS MADE POSSIBLE BY -- SUE AND EDGAR WACHENHEIM III, THE PETER G. PETERSON AND JOAN GANZ COONEY FUND, BERNARD AND DENISE SCHWARTZ, BARBARA HOPE ZUCKERBERG, THE AMBROSE MONELL FOUNDATION.

AND BY --