- Welcome to "Mutually Inclusive."

I'm your host, Kylie Ambu.

The city of Grand Rapids recently declared racism a public health crisis.

And the urban league of West Michigan is taking proactive measures to create health equity in our neighborhoods.

That's something they say it starts with addressing the tobacco industry, specifically menthol cigarettes and the disproportionate outcomes they have on black neighbors.

(-_-_-_-_ music) - [Announcer] Support for "Mutually Inclusive" comes from the WK Kellogg Foundation, a partner with communities where children come first.

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Use the hashtag, #mutuallyinclusive.

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- Tobacco products are the only products that when used correctly, kill its user.

An industry that profits from addiction and death should be more regulated.

- [Narrator] Across the many streets that make up the diverse community of West Michigan, signs hanging on the windows of storefronts.

But while some areas show ads for candles and baked goods, others show a much constantly -_-_-_-_ or purchase.

- I've been in again, Grand Rapids, all my life, Boston Square, Oakdale Neighbors, all of my life.

We see on pretty much every other corner literally.

There's a -_-_-_-_ mom and pop store that has tobacco, -_-_-_-_ that They have the alcohol and things of that nature.

You can go five minutes away from there in East Grand Rapids.

-_-_-_-_ And you don't see that type of thing.

- [Narrator] Smoking is the leading cause of preventable deaths in the United States.

And Kent county sees about 5,000 deaths related to tobacco every year.

In fact, when we compare it to causes like eight suicide, cocaine, heroin, alcohol, and auto accidents, more people die from tobacco than those factors combined.

For some groups, these numbers go even deeper.

- The tobacco industry and its approach with mental products is an openly racist marketing strategy.

They have targeted black owned media for their products.

We have them documented saying that they're targeting black communities.

And in fact, back in the seventies, there were issues of them going and doing giveaways into black communities.

- Despite black individuals smoking less than their white counterparts, black smokers are more likely to die from smoking related illnesses like heart disease, lung cancer, and diabetes.

- My paternal grandfather passed of lung cancer and it was attributed to the many years of smoking.

You know, when this is going to say, it's people of color, you know, African-Americans Latinos, individuals nature.

And we see the disparities, even in the healthcare, the jobs has a lot to do with it, lack of education.

And of course you don't have access to a better healthcare because you don't have the funds or the jobs, the means to be able to pay for those healthcare issues.

- That's why the urban league of west Michigan launched it to west Michigan health equity coalition.

Last October, it's a partnership with the Michigan department of health and human services, the center for black health inequity, along with the Robert Wood Johnson foundation, as a way to address the many health disparities facing communities of color in west Michigan.

First thing on the docket proposing a menthol and flavored tobacco sales ban for the city of Grand Rapids.

- The overall mission of the west Michigan health equity coalition is to create cessation services, but also make it clear that a sales ban of menthol products does not include the prohibition of use or possession.

We're not looking for individuals to be policed because of the type of tobacco products they use.

We just really want retailers to not benefit from a product like mentholated tobacco.

- The coalition has created committees within it to work alongside its community, offering robust cessation services that are culturally sensitive and informed.

- I have a name recognition, people know us, you know, and so they're not the persons aren't so apprehensive or people approaching them.

So we're going right to those individuals, going door to door, going to business leaders and, and seeking out ways to be able to get the word out.

- The proposal follows national action by the FDA, which filed for a menthol ban.

This April Greg Hampshire director for the center of health, wellness and youth at the urban league of west Michigan says it's a way to put health equity on the forefront and elevate communities who are internally helping themselves succeed.

- Right where we're sitting right now, one in three adults smoke.

So we're talking a huge number of our neighbors needing help.

Quitting tobacco.

- Support for mutually inclusive comes from the WK Kellogg foundation, a partner with communities where children come first.

- If you want to join the conversation, follow WGU on Facebook, on Twitter at WGU public media and at Kylie ambush use the hashtag mutually inclusive past episodes.

And the mutual inclusive newsfeed can be found at wgu.org/mutually inclusive.

- And joining me now are leaders in the west Michigan health equity coalition.

We have Elaine Lyon, the public health consultant for the Michigan department of health and human services, tobacco section, Kenneth Lee program coordinator for tobacco control and prevention at the urban league of west Michigan and Greg Hampshire director of center for health, wellness, and youth at the urban league of west Michigan.

Thank you all so much for being here today.

Greg, I'm going to throw it right out to you first.

Where are we right now in really the coalition's work and what you're hoping to achieve?

- Well, the west Michigan health equity coalition is a multiethnic multicultural group of individuals that have come together to address significant health disparities in west Michigan with the partner ship with Michigan department of health and human services and the center for black health inequity, we've been able to connect with nearly 50 organizations in the west Michigan area with about 25 that have firmly committed to our mission.

This champions include everything from American lung association, American heart association, American cancer society campaign for tobacco free kids.

And tobacco-free Michigan community partners, such as neighborhood organizations like Baxter neighborhood and the Baxter community center, professional networking groups, for-profits that you would recognize if you're from the west Michigan area, healthcare providers and of course, nonprofit partners and faith-based organizations.

- Absolutely.

And I know Kenneth you're working hard with really a new proposal and that is to ban menthol cigarettes as well as flavored tobacco.

Where I guess, is this something new?

Is this something that I guess is coming off of the national decision with the FDA?

- Well, Keller is actually the first country that has an activist fan.

And right now there are only a few states in the United States that have banned menthol, but we already know is that by Robert can expect by enacting the span is that there'll be a reduced tobacco use initiation, be current tobacco users to quit improve health and save lives.

- Absolutely.

Now, Elaine, as Greg had mentioned, this is a partnership with quite a few different organizations.

Can you talk to me really about how the state department got involved and what your role is here?

- Sure, absolutely.

So we are and have been funded by the centers for disease control at the national level for many, many years.

And we also receive a little bit of funding from the state of Michigan through what's called the health and wellness fund.

So these funds together help us give funding to several agencies with whom we work, including the urban league of west Michigan.

And we've had a longstanding partnership with the urban league.

It goes back many, many years.

So we've known each other.

We've worked together on tobacco related issues for quite some time.

So the funding that comes from the centers for disease control is what gets passed along to our agencies, including the urban league and the department itself, the Michigan department of health and human services is really focused right now on making sure that we address a health inequity.

So when it comes to tobacco use, for instance, there are a number of communities who are very negatively affected by tobacco, certainly everybody's negatively affected, but there are some communities that are profoundly negatively affected.

And one of these groups is the African-American community, which is a group of community group that the urban league works with.

So our goal is to try to get to community members and let them know of the dangers of menthol and flavored tobacco products.

And we do this through the urban league, who has those trusted community partnerships.

They know who the leaders in the community are.

So we're really using what I would call a community-driven approach to try to address these health disparities or inequities using the urban league as the lead agency to reach out to community members and organizations that understand the needs of the black community and get folks together in the coalition, which you've heard about to address the menthol related targeting that has gone on, in big in the community, as well as trying to help people quit.

- Absolutely.

And let's talk about just how far back some of these, I guess, disproportionate outcomes for certain communities go back, Greg.

I know you're a, you're a big numbers guy and you recently, we're taking a look at the Kent county community needs assessment.

Before we talk about the past, let's talk about the present right now and where I guess our black and African-American neighbors sit when it comes to tobacco related deaths.

- Well, yeah, Pilate.

So the bad news is about 45,000.

African-Americans die from tobacco related diseases in the United States.

When we take a look at the amount of tobacco used in our black and brown communities here in Grand Rapids in Michigan, about 19% of adults.

But if you, with the, how tobacco works, there's some intersectionality when it comes to socioeconomic status and, and tobacco use, that was one of the key findings in that Kent county community health needs assessment.

And so if we look at communities and Grand Rapids, particularly in that 4, 9, 5 0 3 and 4 9, 5 0 7 in the areas that are the lowest income, you start to discover that one in three adults are using tobacco products.

And when we in a partnership again with Michigan department of health and human services, they did a wonderful survey that really broke down the tobacco use and a lot of these areas.

And one of the things that they uncovered was that preference for mentholated products that at 80 plus, I think it's 86% use mental, mental aided tobacco products in conjunction with other tobacco products, but one and two exclusively.

And we know with menthol that due to its ease of use, it's actually easier to inhale and retain the nicotine from the product.

And that is tied directly in the same Grand Rapids.

If you are a tobacco user and using that Kent county community health needs assessment, you'll see that our black communities are more likely to have cardiovascular disease and debt higher rates of lung cancer caught later and thus a higher mortality rate.

And then other comorbid comorbidities like diabetes are worse as well.

And so this tobacco use and particularly menthol has been destructive to our black and brown communities in the grand rapids area.

- And specifically destructive to those communities.

It's also been marketed to those communities for years.

Do you want to talk with me about some of the target marketing strategies that have really hit brown and black communities?

- Yeah, absolutely.

So tobacco has targeted black American communities through celebrating their culture, but also addicting them.

You know, you don't have to go that far back to look through a jet or an Ebony magazine that has full menthol ads just showing black people enjoying their lives.

They were one of the first markets that identified, oh, this is a growing economic market.

And in post segregation area, sorry, PO post segregation era and CA is pretty insidious.

You know, everything from hosting the cool jazz festival to just really tying their menthol products to black identity, but all the while addicting individuals and killing them.

I, Kenny array from center for black health and equity says this frequently.

And I think it's a very poignant is that tobacco is the only product when used properly kills the user.

And so regardless of tobaccos suppose had a history of supporting black culture and identity it's really was just using it, the prophet and, and her a significant portion of people are already marginalized group in the United States.

- And this next question, it can be for anyone, but I know when talking with members of the coalition previously, there's this common theme of how everything is interconnected when it comes to education opportunities, when it comes to jobs, it playing into, I guess, having a higher risk for addiction when things are being marketed towards these marginalized communities, how do you feel like that plays into really the, the health crisis we're seeing right now with racism?

- Well, I'll try and take a stab at that.

You know, there have been policies that have been enacted over the years, which have certainly given some groups opportunities that are better than others.

So for instance, we know about red lining that occurred in the African-American communities where, you know, certain folks were allowed to live in certain places, mostly whites, for instance, and blacks were not allowed to live in those areas, geographic areas.

So, you know, some of the policies that have occurred at the national level have really trickled down to the state and local level and it give given rise to those lower levels of educational attainment, poverty stricken communities, stress that, you know, when people are stressed out, they often turn to substances to, to try to help with that.

So unfortunately there have been policies that have been linked to the disparities that certain communities face.

So those who are of low, lower economic status, lower educational attainment and, and other groups as well.

But those in particular are often the marginalized communities that we see in.

And sadly that encompasses some of the African-American community as well.

So they are very directly tied and are some of the roots of what we see in terms of our health disparities today.

- Absolutely.

And that was, that was kind of the common theme when I was talking with folks from the coalition who said, you know, if we're not afforded the same opportunity for jobs and education, we certainly won't be afforded the same opportunities for healthcare and resources.

Kenneth, I know that a big part of the coalition, isn't just, you know, proposing this sales ban, but it's also coming alongside smokers who might want to quit and being aids in resources with that.

Can you talk to me a bit about that.

- In terms of eating individual sleeping?

Well, yeah, there's a lot of cessation resources that are out there and oftentimes individuals who, you know, there there's a microsecond people who want to quit, but sometimes they just don't understand and know about the resources that are out there for session methods.

And so if they can, if the coalition can connect with these individuals and educate them more on not only the detrimental effects that tobacco has like in Austin, but resources that are available, then obviously that can help to help us individuals quit.

- Absolutely.

And I know Greg, it was a big, I guess, point that you wanted to drive home.

You're not trying to criminalize anybody for tobacco use.

You're not trying to police individuals in the community and you want to come alongside them.

Do you want to talk with me about the overarching goal here of the coalition's proposal?

- Yeah.

So the main thing that we're trying to do here is to discontinue the retail sales of mental aid and flavored tobacco products.

We are not looking to connect and prosecute individuals because they have menthol cigarettes on their person.

This is an, an opportunity for civil rights abuse.

This is purely, we're trying to take a product that is dangerous and specifically dangerous to it's the community that the industry targeted and discontinue that practice.

There's also, isn't a prohibition of all tobacco products.

You know, we frequently, when we're looking at critiques of this model policy, a lot of people compare it to previous alcohol and marijuana prohibitions.

But the fact is that if individuals wanted to still use tobacco products, they still can, but menthol is an extraordinarily dangerous and pervasive product.

- And I know that a heavy part of some of the, I guess, video elements that you've rolled out to the community have been really led by children or by teens.

What focus do you have on the younger generation with this, a question for anyone.

- I'll, I'll, I'll jump into this.

So we have a youth tobacco task force.

That's through our mentorship program here at the urban league called urban fellows.

And our girls rock tobacco is just one piece, you know, our department's health, wellness and youth.

So we're trying to teach them healthy lifestyles.

And obviously as most of our, all of our youth, our black and brown youth, they all have been impacted by tobacco.

So helping educate them and educate their peers on the dangers has been incredibly persuasive when they've engaged their aunts, uncles, maybe parents or grandparents who are still daily users of combustibles.

- And I know a common thread has been almost dubbed, a generational curse that forms of addiction can have on families as they carry on.

What I guess are some of the things that we might see with this plan rolling out and how it will affect future generations to come?

- Well, one thing our data shows is that in particular black and brown households have a much higher rate, especially the kids in those households have much higher rates of exposure to secondhand smoke than in other households.

And so if we can get people to lay down the menthol products, which they're so accustomed to using, it's very possible that we can get them out of the house is out of the vehicles, therefore not affecting the health and wellbeing of kids.

And really by putting, getting rid of the products and the community, it leads forward.

I would say what's called a social norm, which helps kids to understand that it really is an issue that we don't need to deal with.

Like most people don't use tobacco.

And so it becomes a normal part of life.

They don't see it being used.

They don't see their family using it.

They're not being exposed to it.

And so it really will help to protect future generations of young people.

In particular.

Also, when you're talking about banning the retail sale of menthol and flavored tobacco products, we know that these are flavors that kids gravitate to.

So it's, it's pretty much the reason the kids will start using tobacco for the most part.

And so we can get rid of flavors.

We have really just assisted young people and not finding it to be that attractive.

There's a lot of data out there that shows kids, you know, gravitate to these products because of flavors.

So getting rid of flavors is really a large, far reaching policy that will help kids, many kids from ever initiating these products.

- Greg, it looked like, yeah, it looked like you wanted to say something.

- And just to piggyback off of a lane, I mean, as part of that, African-American smoke smokers survey that the Michigan department of health and human services, we deducted two thirds of black smokers in Cape colony initiated before the age of 18.

And when CDs, CDC did a study about daily smokers.

So not somebody who just enjoys a cigarette from time to time, but rather is, has a crippling addiction and uses tobacco every single day, nine out of 10 of them initiated before the age of 18.

So there's a high correlation with significant addiction being tied to underage initiation.

- Absolutely.

And as much as I'd love to continue the conversation on and on, we are running out of time.

So I'm going to, I'm going to go out to you Greg.

One last time with just where the coalition is right now and what steps is it's going to be taking within the next few months.

- So we are still gathering leaders, particularly in our faith community and building policy with the help of organizations like Michigan department of health and human services, the public law, public health law center center for black health inequity, as well as the champions that I mentioned earlier.

So we're meeting every third, Thursday from 11 to 1230 virtually at this time and working together with our several committees to really call this movement together.

And we're hoping to be more and more visible as we entered 2022.

- Wonderful.

Well, thank you all so much for your time today.

And for more information about the west Michigan health equity coalition or addiction resources, head online to wgu.org/mutually inclusive.

That's all the time we have, we'll see a soon.

- Support for mutually inclusive comes from the WK Kellogg foundation, a partner with communities where children come first.

- If you want to join the conversation, follow WGU on Facebook, on Twitter at WGU public media and at Kylie ambush use the hashtag mutually inclusive past episodes.

And the mutual inclusive newsfeed can be found at wgu.org/mutually inclusive.