Okay, everybody. Next up is Camille Burnett. Camille is from the University of Kentucky School and nursing. We first got to know each other when you were at the School of Nursing at the University of Virginia. And you have been a growing, sustaining peace of National Cancer Prevention Day. And the National Cancer Prevention Workshop, which is now, helps to educate so many health care providers around the global. So we're glad you're here. Welcome. Camille, we have had some conversations this year about health disparities and disparities in general. Lots of conversations both on the phone over on Instagram Live. And I wanted to catch up with you today to find out what's on your mind, how you're doing. Tell us about what you care about. >> Right. Well, thank you, Bill. That such a generous introduction. And you know, I'm a big fan of less cancer. I'm always happy to have the opportunity to be a part of this incredible event year after year. And more importantly, to have the conversations about some of these really deep and important issues. That are at the forefront. And so for now, it's really thinking about, where do we go from here and re imagining what equitable and just healthcare could look like from different perspectives and from different actors? And so today I'm really reflective, I'm really wanting to think a little bit about where we are now so that we can appreciate a shift in terms of word is that we need to be. And so presently we put into the system health care system that its current configuration has has been unsustainable, and we know that it's spiraling out of control for a variety of factors. But right before our eyes, and so we kind of had a rude awakening, so what's not working and who is not working for particularly people who need it the most. Right? And so we know there's been challenges of accessibility, disparate outcomes, provider shortages and in the ongoing escalation of chronic diseases like cancer, etcetera and clearly there's no surge capacity with what's going on with covid. So I say all that to say that, yeah, there's weaknesses and vulnerabilities and inefficiency, but we have to do things definitely, and we have to look at the future of healthcare. That looks different from the reality that I've just talked about. And so in my heart of hearts, based on my experience, and my practice is, I believe that our health care has to start and has to end in the community. Let's use this for one second. There are two things I want to share with our audience. Can you explain your background a little bit for referencing it? Can you tell us a little bit about that? Absolutely. So, yes, I've had a long, deep history of as a nurse, particularly in public health, nursing on the front lines, as a researcher, as a consultant as an advocate, I do a lot of work in health policy. Particularly around desperate populations, have done really focus work with women who've been exposed to intimate partner violence and have shifted that focus to expand to other vulnerable groups and specifically around health equity and structural justice. And so I currently am at the University of Kentucky. I hold a position as an associate professor there. I'm also an administrator, so I also hold a position in the office of the Provost as the strategic advisor. Community engagement and academic partnerships. And so I've done a lot of deep working in communities, engaging communities and in ways to help overcome some of these structural inequities. And that tends to be one of my land skills to structures and systems, and ways in which we can rectify them to make them helpful for the people who need help the most. So that's a little bit about question Question. You've been an amazing powerhouse and amazing voice for for not just less cancer and the work that we do to serve populations. But, you know, in so many capacities, and I'm grateful for that, Camille, you talk about just health. Can you share with our listeners what exactly that means? And can we expand on that a little bit? Yeah. So when we think about structural justice, more so in creating systems that are just their systems that are created and works and created to work for the people who access those systems. And we start to think about the system not being created for itself but being created to meet the needs of the people who need those services. And so how do we construct and build and develop systems so that we're not trying to bend them towards being just but that they're inherently built in that way. And so we do a lot of talking about equity, and I think that's a great space for us to be in. But now we need to shift now to not just trying to sort of put it in some mediating items and factors that help to correct things. But we should be building them correctly in the first place, and so that's when, like, that's the area of justice that I'm speaking about. >> So when we see that it isn't just in so many places in our population. >> Yeah, that's right. >> Some people get an aspirin and some people don't [CROSSTALK] Sadly and to put it in super simplistic terms. I think one of the things that we do here, one of the things that you do is through sharing information [CROSSTALK] To care for themselves and to get the health care that they need. That's right, and we need systems that have to be. They can't be downstream right. They have to be extremely. >> Right. We have to have systems that are that are not reactive but systems that are proactive and and that's part of the system being just and they have to work across different groups and across populations and across different disciplines, they can't function with them within silence. It has to be available to where people are, where they live, where they work, where they play, and and definitely consider those drivers of health specifically the social determinants of health that has to be prioritized as well within just systems. >> This is complicated because there are many people in our everyday lives that we, you know, we travel in our everyday lives. We see lots of different people every day, and we're really not paying attention to our neighbors in the way that we need to. And I was just talking earlier that when we speak to prevention and we speak to developing policy, that not not every policy is foolproof. Often things look wonderful on paper that are just so darn hard to make a reality. And so we have to be aware that sometimes policies are not always full proof, but we have to follow and to meet people's needs as we can, and I think that's what what we work on. And certainly it's not just if if Children or adults or people that can't care for themselves cannot get health care. I mean, it makes no sense. So it is Certainly, you know, when we talk about leveling the playing field, that's certainly healthcare is certainly a piece of that. Absolutely. And you know, to echo what you're seeing, and it's not just if it's not a part of the solution, either. >> Right. >> Right, and I completely agree with exactly in that sense. >> So as we move forward, as we re imagine these things. >> Yeah. >> As we re imagine, health care as we re imagine the notion of prevention. It's really about seeing and understanding the needs of those people that aren't getting what they need. And so we may have an understanding. But now we have to reimagine meeting their needs. And so we've talked about getting word out, talking about policies, having these workshops, doing what we can to educate not only communities but healthcare providers. So they can better take care of their patients, and also help teach their patients to take better care of themselves in any way. So we now are seeing an evolving healthcare, worker or professional, that is able to advocate for communities in ways we haven't seen in the not too long past. You know, it's more recently, we're seeing more health care like Mona Hanna. Attisha, who was just on, you know, has really been an incredible advocate for her community in Flint, Michigan. We're seeing this more and more people like yourself, that are are not just dispensing band aids but dispensing systems, and other tools that help keep people well. So when we go and we re imagine this, what are things that we can do as a first step? And what can legislators do? What can community leaders do? How can we re imagine this? >> Well you know, there's different ways and spaces that the system has to be reimagined, right? And you've identified nicely some of the areas in the pockets that need to be touched. And so, I think one of the first areas we need to think about is, how it is that we can re envision and reimagined how we prepare our providers, to deliver this type of care within this sort of broader context of understanding, unjust root causes of disease and health and disparities. Right? And so there's something to be said about preparing and training. The next cohort in the existing cohort of health care providers to really understand the root causes, and the variations in human condition, and the social determinants of health. Because without this, it's like starting the story in the middle. And we're creating providers that are disconnected from the realities of people that they're serving, and they're disconnected in a substantive and often harmful ways. So we have to educate them in the truth, and engage them in education that cover topics that are relevant to health and outcomes of people like racism, and privilege, and white supremacy, and human rights, and justice. These have to be cornerstone pillars of knowledge that health care providers have. So then they can be more effective in how they touch and access people's lives. So that's one way, we can't suppress this discourse of these narratives that we're talking about today. And we can't concede your future, where we don't speak about these contextual drivers of health. Another area that I think is really important for us, is to understand this piece around advocacy that you just mentioned and it's important. I've always believed that we have a moral imperative as providers in an obligation, because of what we witnessed on a day to day basis in the community and people's homes. And when they come into tertiary centers, that we recognize and we see and we witness, the manifestations of health consequences in their lives. And so we have to really start to think. And we imagine ourselves not just as health providers, but as healers, as reconciler, as justice makers, as an act of caring, which is what one of my colleagues at Rafael would call it an act of caring. And really being health agitators and activists. It's really important. And in doing that, we have to recognize that health happens not just at the hospital, but more so it happens more importantly outside within the community. And we have to prepare providers across the spectrum of care, and in consortiums of healthcare providers that are interdisciplinary. And that includes social service providers to front first line responders to mental health practitioners, all of those types of areas. So that's one space. The other is within our system. And again, we have to think about where we're investing our resources. And again in public health, is where it's clear, it's always been clear that we needed to invest in that area. But more so, we need to expand that and really prioritize that as a space where the primary aspects of investments need to be made. And that decentralization of health happening in this one sacred building known as the hospital. We have to recognize that health happens across all of these spaces in the community, and schools, and churches, and community centers, in neighborhoods, and in people's homes. And then we get to the aspects of policies. There has been a movement for years to create health in all policies. And that means there shouldn't be policy that's tabled. That doesn't have a consideration around health or the impacts of health that's in it. And then we can think about again, who's covered right. Having a system of universal basic healthcare for all and how we're measuring, you know, successful health outcomes. You know, I could go on and on about all these ways in which we, in all the spaces that we can reimagine our system to be more effective and to be more equitable and to be more just super super import. >> I was talking earlier about one of the reasons I founded less cancer, and one of the reasons was to primary reason was to reduce suffering. >> Yeah. >> To lower suffering, and this is a year that I have put a lot of attention into how we can better lower the suffering for the world, for each other. For me, I'm not a very good listener. But for me, it's really been about listening and really understanding, that people have a lot of needs that aren't being met. And we need to listen better, because I think as humans, if we really tap into who we are as humans, we will want to do more. We have to see the people that aren't eating. We have to see the people, really see them. And I think for many of us, we lead our lives. We deal with all the 911s. You know, especially health care providers are under siege constantly. So, as we re imagine, what healthcare could look like as we re imagine what meeting needs could look like. It's key that we figure out how to slow down to really listen to people and see what they need. I think of the times that I've been sick or in the hospital, and I certainly have some resources. I'm not a rich person, but I certainly know a lot of people have a lot of friends. >> Yeah. >> And I think how hard it is for me to navigate that system. And I wonder what that means for somebody without health care, without resources, without money, somebody that can speak English or read. And, we were talking earlier about the work of prevention touches on many places like. Homelessness and hunger, which I don't know how many millions off the top of my head of Cchildren we have that our food challenged in this country, but millions. The literacy rate, all of these things, that are under the poverty umbrella, really [COUGH] work against people's health. It increases their risk for every chronic disease, including cancer, and that's our interest, we want to lower those risks, so how do we better meet their needs? How do we better care for them? How do we tune in and really listen to their needs and become as health care providers of which I'm not, how as healthcare providers can we be more enterprising and creative in helping to meet their needs and keeping them well? So, the conversation is right, but I'm eager to make it a reality for so many, and I know you are as well. And I think to our listeners out there today, the people that are [COUGH] watching and or getting. There are others like three places that we can go to that will help us get us closer to the goal, that are brothers and sisters that we love around the globe are getting the care they need. What are things that we can do today? >> Well again, one of the places and I agree, I think listening and all of those other filter are very, very important. But when we think about communities and trying to reach them where they are, part of all of that starts with what I like to call truth telling. And we have to work on building truth in order to rebuild trust, and we need to rebuild that trust. Especially with communities that have been historically marginalized and excluded and mistreated and abused by the systems that we're trying to get them to access. And so I think we have to start by changing our narrative, we have to start by acknowledging our history, and the role that we've played in helping to create and perpetuate the injustice. We also have to recognize that some of those harmful and alienating practices that are embedded in our structures in our systems, have to be unearthed and they have to be weeded out. And we have to face the truth that we are part of that problem, and we also are an important part of that solution. And so we need to be in those spaces where we are advocating and making those changes, and being in partnership with our community partners to be health activists and started to get us on those paths. We also need to go back to that notion that I talked about creating health in our policies, that is something that's very doable. That's something when we think about structures and systems, policies are part of those structures and systems. And we just have actors who re if I those policies that they've helped to create. And so what we need to do is start to focus in on where there needs to be health integrated in these policies, and we need to make that happen. And I think that's something that is an easier task of a place that we can start, and all of those things you mentioned that around poverty and all of those spaces, those are health concerns, those are health issues. And so another thing we need to start doing is leading, the narrative around what health is right? It's not just the absence of disease, if you don't have clean air if you don't have clean water, if you don't have access to economic growth and resources, we don't have shelter you're not healthy. And so part of that we need to own that dialogue, and put that front and center that all of these things are health, and that all of the policies about these things are health policies and insert that into those policies as well. And there's blue prints all over the world that we need to be reconnected to around the sustainable development goals. There's many UN declarations that move ratified, and we've agreed to as a country that we need to start practicing locally. And so a lot of these agendas that are already going on are things that we could be more involved with in a much more meaningful way. Because health and humanity are not mutually exclusive, right, and we have to really start to be clear about this intersectionality around the multiple identities and then make challenges that people face in our society. And we have to be honest about them and we have to start building health by building a health creating society. >> Some of those issues, are pretty painful to look at, pretty painful to look at and because I think in my world anyway, I'm making this assumption for many, probably a bad idea. But I don't feel their things in which the way we know our world in which the lens we see our world through. So, something that makes perfect sense to me may not even be on the radar of another. And so when I talk about listening, I really talk about trying to see the filter in which the world is transmitted through understanding what that filter looks like. And that response isn't a snap judgment or a sound bite, but is really unpacking something that will reach that person where they are. And, I mean, that's just in my experience, as a layman who has worked to educate global communities. And that's hard to do that it's hard to do because it's a different way of thinking, when we put on somebody else's glasses, we get in there shoes, and we see how their world operates. If Austin I said to a guy once who is in a very big surgery one time, and I said to this Doctor, have you ever been a patient in the hospital? And he's like, no I actually haven't, I was I just wish you would take five minutes to sit in this bed, because it' s the change very. So if we did that for how people live, if we really put ourselves in the shoes of a hungry child, or put ourselves in the shoes of a homeless family, maybe our response would be a little quicker, maybe we would figure out better, faster ideas. Maybe it wouldn't come down to little simple sound bites or air kiss solutions, to better serve all populations. >> And I think that's a really, really, really important point that you raise. And I'd like to build on that too, because I do think it's important. And I also think we in addition to understanding sort of people's condition and being in their shoes, we also have to go to the community and meet them where they are right? And that's what we speak about, I often about meeting the community where they are and being embedded in the community and not separate from what part of that community what does that look like. But we need to be in those places where people are experiencing these hardships and this abject poverty and lack of access. It's easy to other people when you're not engaging with those people. And you see them as apart from or different than yourself. And so part of that is to be merged in those experiences and you do need while you're being emerged. You're absolutely right. You do need to listen. Then you have to listen with an indifferent intentionality. But that has to be informed by understanding the truth of what the broader context of their experiences the full spectrum of that experience, because you won't know what you're listening for, right? And so part of that educational component is doing all those things critically listening, being embedded within those real situations within the community. And we also can be instrumental in helping to start, especially when we're starting to train our providers and our students and all of those people who are coming after us. And even now, in terms of starting to connect the dots, right from the community to the different sectors across the institution, so that we can find these common goals where we could build something really incredible together. But it does start a little spaces. It does start with that human connection, and it does start with a personal responsibility to have to be uncomfortable and knowing that that's okay, and it's necessary to grow. Nothing grows in comfort if you ever look at if you're a gardener at all, Bill, I don't know if you are, but you've been a little seed >> I'm a terrible gardener. >> Okay, well, maybe not. >> I do know things you can't believe. >> I'm going to use it anyways. But even when you plant a seed in the ground, it has to come through some discomfort to grow. >> Yeah. >> And we always benefit on the grill of that process in the end. And so I always look to the real world for inspiration of how to live your best life. And I do think that even something that small and that simple can teach us so much as people. And so, yeah, I'm okay with with uncomfort discomfort. And I think in the end, we'll all be rewarded because of it. >> I think so, too. And I think that we cannot give up hope on solutions. I think about when I spoke to Congresswoman Debbie Dingell about starting the caucus a House caucus on cancer prevention. All the things that have been introduced to their all the opportunities that we've had to introduce and educate legislators across the board on the issues that five years ago weren't on. The pfas issue that was one were active with very early on. And now Michigan is one of the states where they've discovered most of it where my home state where Congresswoman Debbie Dingell is from. And they may ban that this year, and because there were a group of us that cared enough about doing things differently. And if we can create more groups and more conversations around this, this is where policy can be incredibly impactful and can make change. Which we as a residing Dr Mona Hanna at least earlier, we were talking about how the tools of prevention are different and that it looks like education. It looks like continuing medical education. It looks like policy. They're not band aids. They're not stethoscopes. They're not in a big tower. There are none of those things that were dispensing or selling. But you systems creating systems, creating best practices and policies which sometimes get legislated and sometimes they're disastrous. Sometimes they did the intention is different than the reality and not all the time. But we have to be careful in the sense that we just keep going at it. Because one thing didn't work doesn't mean we don't go back and give it another try. And that's what we're doing here. That was the basis of this workshop. So we get better at caring for people, all people and people around the globe now that participate in this event. And I'm constantly seeking new ways that we can lower and reduce suffering among ourselves and around the world. And the solutions that you speak of today are all steps in that direction. And I would like to explore that more and work with you more to see how we might better be a stronger organization and helping people find their way, get health care, no matter who they are, what they look like. How are we going to do this? And those are issues that are critical to not only preventing chronic disease, but obviously cancer, which is our big focus. So is there anything else on your mind that you wanted to touch on today? >> No I just love the sense of community that you always bring to these discussions and recognizing that we're all on the same team here. You might have, we have might have different beliefs, different backgrounds, even different languages, different experiences, different social location but we are all on the same team. And I do think the more that we're able to have these conversations in an ongoing way, I think it's really effective. And one of these unfortunate outcomes of us really witnessing many of the challenges that the world is facing at the same time as is really galvanizing around this shared humanity and our willingness to come together to look for solutions irrespective of this diverse background. And instead we're really celebrating the difference in all of us and using that difference to come together to make something good. And so I'm always on board with that. >> Yeah I mean, we're all humans, we have need, and we all need to be cared for in ways where we connect, not disconnect. And I read something recently about listening, being kinder, connecting and working with people that aren't like us, diverse thinkers, and that becomes harder and harder to do. But we can't give up. We have to be persistent in working with people that are not like ourselves. Persistent in creating bonds and goals that where we share values, we may not share many things, but we should all feel the same about lowering the suffering that comes with cancer, lowering the suffering that comes with poverty, lowering the suffering that comes with homelessness and hunger. And I think when we get it down to that level, we can do this. We can work with people that are not like us to come up with something bigger and better. We can do this and and I'm committed to it. I know you're committed to it, and we're going to be in touch all year. We'll be in touch all year with ideas that are going to help make the world a better place. So I'm so grateful that you're a friend of mine and a friend of LessCancers and were able to connect today and be part of this form. It's amazing how each year gets bigger and bigger and bigger, right? >> Yeah, to all the work that as cancer has done, it's been wonderful just to watch. Watch it and I can see, I can't even imagine in the next few years where you possibly could go. But the sky is definitely not the limit for your work and all the wonderful things that you guys are doing. Right we know that we know the sky is not the limit as I saw something yesterday because we have foot steps on the moon, right. So we know this sky is not the limit. Keep going. >> There you go. And I love the fact that you do these have these conversations ways that make people really start to reflect even on themselves. I mean, we also have that personal space for accountability and reflection that we really need to start revisiting probably a little bit more frequently than we have. And I've written about that in a side book. Better how we can think about using personal tenents and inventorying ourselves every day. Just to be a little bit better than we were the day before. >> Right and we're going to do that. I'm committed to doing it. I sometimes slip, sometimes I slip. But I'm committing to giving a good old college try every single day. So >> We'll keep each other on, how is that? That will just keep each other. I said we'll keep each other. We'll keep each other honest. >> Absolutely right. >> The accountability partners. [LAUGH] >> Absolutely. I'm so grateful you're here today. Thank you so much. You're the best. >> Thank you. >> Thank you. Our honor. >> All right. Thank you.
