Dying with (Aspiring) Social Workers

The hosts of the podcast "Dying with Aspiring Social Workers" discuss the impact of redlining on mortality rates and the opioid epidemic, specifically in communities of color. They highlight the lack of resources, such as grocery stores and healthcare facilities, in these areas. They also discuss the historical and ongoing issue of medical mistrust among people of color. The hosts emphasize the intersectionality of identities and how discrimination further contributes to substance misuse. They mention an organization called Ecuador that is working to provide access to quality produce and healthcare in underserved communities. The hosts emphasize the importance of involving the community in addressing these issues. Welcome to Dying with Aspiring, in parentheses, Social Workers. We have our two hosts today, me, Stephanie, and Skylar, and then we have our technical professional, Devlin Casillas. She'll be handling all the behind-the-scenes things, with editing, music, cutting, all of that, and me and Skylar will be handling the major portion of the conversation. And if Skylar wants to go into what kind of topics we're covering today? Yeah. So for this podcast, we have decided to look at the ways that redlining has affected mortality and, in specifics, how redlining has contributed to the opioid epidemic and the way the opioid epidemic is affecting people of color, and to add some background information on the opioid epidemic in general. In one of the articles that I read, it was saying that the U.S. loses 800 people a week from opioid-related deaths. And this statistic is pulled from an article called The Effects of Opioid Addiction on the Black Community by Claremont Griffiths, which is just crazy to think, 800 people a week. And this was published in 2018, so I think a lot of times, and a lot of the research that I found was prior to 2018, because the opioid epidemic really kind of started happening, I guess, around 2016, 2017. And so in 2018, 800 people, it's crazy. And then in some of the articles that I read that were talking more about kind of current time, kind of around 2020, it was saying that in areas, like I said before, that haven't experienced opioid-related mortality, now there's more than before. Something that will come up in a lot of the conversations that Stephanie and I have is that the opioid epidemic has been something that is mostly framed around experiences of white people in suburban areas. You know, what we found in our research and in making this podcast is the effects of redlining have dramatically impacted communities of color in the realm of substance abuse disorders. And so, yeah, that is what we're talking about. Stephanie did a lot of work in understanding and looking at redlining in Austin, which is where we live, all three of us. And so I'm going to let her get into that. All right. So not that any part of this podcast is supposed to be super fun and cheering, because we're covering pretty hard topics. Yeah. But as we know, the city of Austin has been, I guess, commercialized or put out to the world to be a place of discovery and inclusivity, diversity, all of the above. I mean, that's something even the University of Texas here advertises to people. But back in 1928, during the first phases of the Comprehensive Plan, that they were like planning the city of Austin with zoning and everything. I mean, it was called the Master Plan. And it's something that's talked about a lot in social work classes, because it is the root of a lot of the problems that Austin has with redlining, homelessness, gentrification, segregation. And basically, the plan contained a recommendation to locate African Americans and basically any other person of color into the eastern part of Austin, which actually the Supreme Court had ruled unconstitutional in 1917. But they went along with the whole segregate and separate the white race from the black race kind of idea, which, you know, isn't the best. And obviously now, the Master Plan still affects the southeast and eastern crescent of Austin with there being high densities of illness reported in that area, higher rates of socioeconomic distress in those areas, especially in specific cities that we can name or parts of the city that we can name. Creedmoor, Del Valle, and Colony Park are three cities that I've done a lot of research on just in this past semester because of other required courses. But those communities and a lot of the rest of the eastern crescent of Austin don't have access or accessible access to grocery stores, clinics, or full service hospitals. The closest HEB is probably two bus rides away from some of these cities. Something that this made me think about is Evelyn and I, we both volunteer with the homeless communities in Austin. And just from what Stephanie's talking about, there is a lot of needs in east Austin that are just not being met. And most of the time, in order to get those needs, you have to travel. And so a lot of people that are experiencing economic distress and all these things have to end up going downtown to receive the needs that they are not getting met. And so, like Stephanie was saying, I feel like Evelyn and I have seen this in our own experiences outside of making this podcast. It's really crazy to see the reality of how this happened years ago and it's still affecting people. Yeah. And so basically, that's what we're looking into for the most part. That's what most of the conversation is going to be about. And for context, the most diverse areas in the region, like in our little region, include Pflugerville and Taylor for people of color, Austin and Travis County for foreign-born residents, and Georgetown and Williamson County are the least diverse. And near us, Round Rock and Travis County best represent diversity in the region overall. But I think it's kind of counterintuitive for not just like, I guess, Austinites, like that's what they're called when they're born here. Austinites or the university or people who are advertising for Austin and trying to convince people to move here. I don't think it's fair or a productive conversation to paint it out to be like this really inclusive, this really diverse, really accessible city when in reality, there are a lot of issues that less accessibility is causing, especially to the black and brown community in Austin. And we're going to further that conversation with Skylar's portion. Yeah. Like Stephanie said, none of these talks are going to be fun and easy, especially hearing the way that this has affected people here in our home and just seeing the effects of redlining is crazy. It's like looking at the map. I think we talked about it and just seeing that feels such a big and real thing that I mean, we even see today years after. For reference, one of my other classes had presentations and one group had actual maps showing how distinct the lack of accessibility is. And it showed I-35, which is what separates the Eastern Crescent from the rest of Austin. And there was a line of HEBs right on the edge of I-35. And there's three or four, and they literally formed a perfect little seal between the black and brown community and the rest of Austin. You mentioned hospitals. And when I think about it, I lived on the east side for almost three years. And yeah, if you needed to go to a hospital, you had to cross I-35, or at least in my experience, most hospitals are located in central Austin. And that's so wild. People are having emergencies. Yeah. There's a clinic. I live in east Riverside, so it's kind of near that area. Do you live in Ballpark? No, I live in, yeah. I used to live there. But there is an HEB nearby. But that's, like, the only one. And that's the only one. And that also applies to the emergency clinic that's right down the road. That's still, like, a studio. Yeah, oh, really? That, yeah, are you talking about the one by Starbucks? Yeah. Yeah, that's newer. Like, I lived there two or three years ago, and they were building that, I'm pretty sure. Like, that hasn't always been there. And now that there's that little, like, shopping center, there's, like, another emergency clinic. But, like, it's still, like, two bus rides away. Yeah, and they're still not accessible. They're expensive. Oh, yeah. Even, like, with health insurance, if you're going to one of these clinics, like, it's still so expensive. And then I know they're, like, they just made an ARC off of, like, East 12th or East 6th Street. And, yeah, I never even thought about how difficult it has to be, like, even living further east than, like, where we, me, I was, and you are. Yeah. Like, how far it is to get to a grocery store. So it's not only, like, the social determinants of health, you know. It doesn't just end with, like, oh, like, lack of health care. There's also lack of nutritious food, lack of a social environment to accumulate a community feeling. Like, you know, there's them, and then there's, like, us, you know, like, that kind of feeling in these neighborhoods. Like, people don't really look out for each other anymore. But, yeah, I mean, this just leads to a whole array of different health issues. I mean, I feel like what you, like, have brought up, I read an article by Amaro. It's called the Social Vulnerabilities for Substance Use. And it talks a lot about how residential segregation, which that's what we're looking at, is a cause for substance abuse, substance misuse. And they kind of, like, link it back to the psychological aspect of this. And Stephanie was kind of getting into it, of this feeling of othering, that these folks aren't living in spaces where they get their needs met. And, you know, because of that, it creates this psychological distress. The authors explain this as, like, a residential isolation. And, you know, this manifests in so many different ways. You know, like Stephanie was saying, like, food deserts and not being able to go to the hospital. And then, you know, also the psychological aspect of, like, I'm so separated from everything that I need. And, yeah, it just, yeah, it shows that, like, the effects of redlining just continue to feed into this cycle of just inadequate resources. Yeah. And one of the resources that I have found was titled Social Vulnerabilities for Substance Use, Stressors, Socially Toxic Environments, Discrimination, and Racism. And there are a couple of authors that will name them all. But basically, they propose that socially-based stressors play a critical role in creating vulnerability to substance use. And they wanted to put greater, like, scientific research, like, attention towards furthering the understanding of, like, what gets under the skin to, like, attribute to that. So it's basically just, like, agreeing with what you said, that exposure to socially toxic, like, childhood environments, racism, discrimination, are one of the major, like, leading factors as to why people turn to drug misuse or substance misuse. Yeah, yeah. But, okay. Kind of what I wanted to continue on with this conversation is that these, this residential segregation or, you know, as Amara claims, like, is residential isolation, also kind of correlates with the unequal amounts of policing and arrests that happen in communities of color. And this can be attributed to the effects of redlining, that certain areas, you know, were reserved for certain people and vice versa. And, you know, therefore, police were targeting other areas more. And so they were targeting people of color even more. And then kind of like another topic that we kind of talked about, but I think it's important to kind of bring it back up, is that communities of color, people of color, have a harder time getting prescribed the medications that they need than their white counterparts do. And this came up a lot in, like, the articles I was reading. They were talking about, you know, like, most of the time we think of the opioid epidemic and we think of how it's affected white suburban people that are being prescribed painkillers. And then they, you know, build up a need for these that, you know, creates, you know, like an addiction. And, you know, that's like a whole other topic of, you know, terribleness is, you know, how these people were prescribed medications that they were told were safe to take. And now, years later, we're realizing that that was not the case. But kind of like tying into what we've been talking about is people of color, like, haven't been able to get the resources that they need. And so they weren't able to be prescribed pain medicine if they needed it. And in the last chunk of the podcast that we had recorded, I talked about, like, whenever I can remember, I was in pain. And I really, I had to get a root canal. And, you know, I can't imagine not being able to, like, get the care that I needed. And this ties back into the fact that, you know, these people are isolated. They aren't near a hospital. They aren't near, probably, a dentist. And not only that, not just, like, being near the resources, but being able to afford them. No, for sure. Yeah. Obviously, the school districts and the schools in these areas aren't of the highest quality, don't have as much funding, don't have as many people, like, advocating for them as they should. They don't have programs that can help them get into school. They don't have a lot of, like, SAT help or, and not only that, but a lot of these kids are first gen. So they don't have access to people who know how to do FAFSA and all these things. So along the lines of that, their educational pathways aren't the same, just even in that small part of Austin, as it is for everyone else in Austin, like, on the other side of I-35. And, of course, as we know, doing things, getting a high-paying job, whatever, like, all of those things is a lot harder when you don't have a college degree. And it's a lot harder to get a college degree when you don't have, again, the resources that you need to be able to pursue that. And so that leads down this road that we're talking about, you know. Yeah. And, yeah, and, like, what I was kind of, like, trying to tie into about not being able to get prescribed the medications that they need is that these people are going to find ways to, like, relieve the pain that they're in. And this, you know, leads people to seek out, like, illicit substances in order to treat the pain that they're in if they're not being prescribed pain medication. I read an article by NPR that talked about a woman that passed away shortly after childbirth because, you know, her doctors weren't believing her. She, like, had developed a cyst where her C-section was, had been feeling really ill. And, yeah, in turn, her doctors weren't listening to her, and then she passed away. And, you know, these stories, while, you know, they're awful and terrible, they happen. And so, you know, not being believed by your primary care physicians, not being believed by people in general creates even more psychological distress on top of the physical pain or, you know, things that they're going through. You know, this also kind of ties into how this is affecting urban areas, that it's not just happening in suburban areas. Like, most places that used to not have rates of opioid overdoses and stuff like that, mortality rates tied to opioids, have been seeing an increase in opioid-related deaths ever, you know, as years go by. And so, you know, it's showing that, like, this problem is continuing to persist. And in many of the articles I read, it talks about how not only is this problem persisting, but it's starting to grow even more for communities of color. And so, in places where there weren't mortality rates related to opioids, there have been even more. And so, you know, relating this back to a comment you had made earlier, it's not a problem that we're just seeing now with the trust within the medical industry as well for people of color. Medical mistrust has been a big issue since the medicines have been created. Well, we talked about gynecology in the last class. Gynecology. In the last... Before this very official professional recording happened. We had a little... We had a little... Yeah. And we had mentioned that medical mistrust has been a problem for as long as medicine has been a thing. As medicine practitioners were using enslaved black women, enslaved black men to perform and practice surgeries without any painkillers, without anything, before going on to provide the services for white people. And it just... I don't know. It's just... It's a historical problem that has been going on. Not even just in the city of Austin. I mean, it's a worldwide issue. So, obviously, we told Professor Cortez this the other day, but he did manage to put three social work majors into one group for this project, which was just a coincidence. It's kind of iconic. Yeah, he put all of us together. Like, okay. And so, you know, part of being a social worker is being able to identify intersectionality within people's identities, whether that be race, gender, sexual orientation, socioeconomic class. And I think it's important to highlight that, you know, on top of people being in the Eastern Crescent and being isolated with all the lack of resources, with low income, with all of this, there are intersectional identities that are still suffering on top of all of that. And I read a little article that stated that 26.3% of people who were transgender or gender nonconforming reported misusing drugs or alcohol to cope with transgender-related discrimination. And obviously, that's been a hot topic this entire year with 428 laws targeted against transgender and LGBTQ people being passed in the United States. And it's anywhere from 120 to 140 of those being in Texas alone. God. And that's just this year? And that's just this year. Oh, my God. That's just this year by itself. And so, we come into view with income disadvantage, education disadvantage, employment disadvantage, and then we have on top of that discrimination based on a person's gender identity and sexual orientation. And one of the main things in an article that I had mentioned before was that discrimination had a major, major role in someone's vulnerability to substance misuse. Yeah. And there's this other article named Substance Use Disparities at the Intersection of Sexual Identity and Race and Ethnicity. And this data is from 2015 to 2018, so it's a little older, but I thought it was recent enough. It was in early 2000s, 1990s, so I thought it was recent enough to be able to include it. But basically, what they concluded was that the disparities were most pronounced among racial and ethnic minority LGBTQ women, which could reflect their unique experiences of discrimination at multiple minority identities. So, you know, being a person of color, being a queer woman, being a woman. So I think it's just very important to, especially as social workers, not to wear out the word, but... No, you're a social worker with that intersection now. Yeah, right. Are you taking social justice? Yes, I took that class on justice. Yeah. But I just think it's really important that we, while we focus on redlining and its effects and everything, we also take the lens and focus in on the different communities and different identities that suffer within just that racial group. And so now that we've been talking for a really long time about all the really crappy things going on in Austin, I want to switch it over to looking at possible solutions, possible things, or things that are already being done here in Austin. And I have one major organization that has been doing a lot of work within these communities, particularly the ones that I named. So Creedmoor, Del Valle, and Colony Park. The organization is called Ecuador, and their program, Live Well, Viva Bien, basically what they've organized is a mobile grocery store. That goes at specific times to very specific spots to these locations that don't have access to quality produce and things. And they're also working on doing mobile clinics, other things like that. And basically, aside from my burp, they're doing a lot of work within these communities. And I think one of the most important things that they're doing is involving the community in their program. So they specifically hire and pay people from the community to serve as ambassadors. So these people will get feedback from the community, talk to people who live in the community, and then basically report back to them and be like, this is the overall, this is the overwhelming feeling I'm getting. This is what they think they need. This is what they want. This is what they need. I feel like that's been a topic that we've been focusing a lot, especially in this class. If you want to know about dying, let's listen to people that are dying. Yeah, exactly. If you want to know how to help people who don't have access to resources, listen to them and let them talk. So I think that's one of the most vital parts of their organization, is having that community ambassador, or they call it champion. And obviously, these people go through training to know how to defuse situations, talk to people. But I actually did an interview with the founder of the organization. Aren't they sweet and kind? She's out there. She's working. I am working. I'm a working woman. Period. I'm a working woman. And then... What was I saying? Oh, I had an interview with the founder. It's a fairly new project. It started in 2018, like before COVID happened. But he was very sweet. And he was... Live well? Live well, we love you. And they're paired with Equilab. Yeah, I think they do stuff with... Harm reduction as well. Yeah, yeah. The Black Men's Health Plan. Yeah, one of my friends, her field placement is there, and so she was talking about it to us one day. But yeah. But Ashton... Ashton Cumberbatch is his name. He focuses on including the community in fixing their community. But he does it in a way that doesn't make it feel like it's their job. It feels like it's being done for them, as it should have been, but they have a say in it, which is very important. And then you can talk about the Black Men's Health Clinic, if you know about it. I was going to talk about... I actually don't know a ton about the Black Men's Health Clinic. I know that it's relatively new, but I was going to talk about something that I do know a lot about, is the NICE Project. This is a harm reduction alliance here in Austin, and something that they've done recently is they've set up Narcan vending machines, which is just revolutionary. I mean, I know now that you can go to your pharmacy and get Narcan if you need it. What is Narcan? Oh my goodness. I don't know what Narcan is. Narcan reverses the effects of an opioid-related overdose, and so it's a nasal spray. It looks just like an allergy spray. If somebody is suffering from an overdose, you administer one spray into their nose, and it reverses the effects of an opioid overdose. I didn't know that. It's crazy, amazing, just phenomenal. I'm like a big Narcan advocate. Everybody needs to know about it, because it saves lives, especially right now. Narcan has to be in everything. Yeah, with fentanyl being in everything, and just in general, it's really cool, because if somebody, from my understanding, if somebody has stimulants in their system, which from a lot of the articles that I've read, most of the time when people are suffering an opioid overdose, they also have stimulants in their bloodstream. And so a big kind of fear whenever people are using Narcan is they're like, oh my gosh, is this going to be terrible if they have stimulants in their system? And it's not. It actually will just work to reverse the effects of the opioids. And so it's so easy to use. We did it in stocks, didn't we have, like we showed the video of how to use it. We have Narcan. But yes, they have a Narcan vending machine. And something else that I think is really cool that kind of goes along with just harm reduction, that's something I'm really passionate about, is the NICE Project actually goes to coffee shops. And they primarily go to Epoch, which is like my favorite coffee shop ever. They actually donated coffee to the social work protest. Icon, because they're icons. Because Epoch is just iconic. I was there this morning. All right, we're going to do a little commentary for Epoch. Go to Epoch. Yeah, for real. But they go to Epoch and they host Narcan training sessions. And so I think this is like another like really big solution that we're seeing. It's kind of like the right now. You know, if people are suffering with opioid misuse or opioid overdoses, you know, just like all of the things that are happening, especially with fentanyl being just everywhere. It's just like having these, you know, organizations reach out and go places and educate the community is just so important. Going off of one of the points that you made, one of my friends is in active recovery right now. And we were having a conversation about opioid, narcotic use, like just drug misuse in general. And they were telling me that if you've had anything that isn't weed or mushrooms in the last two years, then you've done heroin, you've done meth, you've done fent. Because she was saying that drugs like cocaine or pills or other things like that, they're being cut with those other illicit drugs, with the opioids. Oh, I thought you were saying it's people that haven't done drugs. No, no, no. No, no, no. She was saying like if you haven't done anything that is like naturally occurring in like major kind of situations. Oh yeah, so like huge problems. You know, like weed or like mushrooms, those naturally occurring in nature, whatever. But even, you know, people are starting to lease marijuana. That's why it's so important to understand what harm reduction is. And, you know, like I think there's like coffee shops here that I've, I'm pretty sure it's a coffee shop. Having like clean needle disposable places, you know, things like that are just like so important because like there's a huge problem that needs to be addressed and needs to be fixed. But like harm reduction is doing a phenomenal job of making sure that these people aren't dying. And I, you know, I think that the NICE Project is doing an amazing job with that. Another thing that we tackled, since we're like coming towards the end of the conversation, is housing and how, you know, it's not affordable. It's not accessible. I'm having to move out of my apartment because they raised the rent by $600. I live in a studio apartment and they raised the rent $600. So I know that Ecuador is actually working to create, I think they, I think I want to say it's 502 acres of land. And I want to say it was in Creedmoor. It could be in Colony Park, but I'm pretty sure it was in Creedmoor. But they're actually working, they've been working on it for a while. They used to be a dumping ground because, again, people don't have access to large dumpsters or a dumping ground or whatever, all that stuff. They have to like clean it out and do all this. So the creation of affordable housing is crucial to like fight against the effects of rent lining and gentrification. And it provides an outlet for those in low socioeconomic standing for, it provides, what is it called, an outlet for those to have, to be able to afford rent. There we go. And do all those things. If you can afford your rent, you can better afford your groceries. You can better afford all these things. You can survive. If you can't afford your rent, I mean, that is just, I mean, one of my favorite things that Ashton said is that they, his project, his group of people want to take people from surviving to thriving, which I thought was a very, very, very, very sweet sentiment. Yeah. Oh, wait. Black men's health clinic. If I, I have a little bit of information. They're located in the Eastern Crescent. And they, obviously they don't only service black men, but that's who it's kind of tailored for. But they have financial support. So help with insurance applications and coordination, gaps in coverage or to cover like co-pay in times of need. They give you access to healthcare facilitators, like, with no additional cost, including like scheduling your appointments and tracking your follow-ups. And they do a lot for physical health, mental health, and like lifestyle and education with veteran program, exercise classes, nutritional workshops, health fairs, heart health, diabetes health, blood pressure health, mental health, behavioral, all of these. They do a lot. So basically, to sum up our conversation, redlining and gentrification and racial segregation has been a problem in Austin for as long as Austin has been constructed. And across the state. Yeah. Has been an issue for as long as this country has been running, which leads to lots of disparities in health, income, which can lead to very sad outcomes, very sad endings to a person's life. And, you know, we talked a lot about the good death in our class with Professor Cortez. And I can't imagine how someone is supposed to have a good death like surrounded by these things. But, I mean, obviously we did cover a lot of organizations that are putting in the effort. And with more classes teaching people about how people are dying and how starting that conversation and making that conversation more comfortable to have, I think is also drastically important. Yeah. And then, you know, what we've gone over in this podcast is the effects of redlining don't stop with just where you live. You know, it has just been this long line of harm that has just been put onto people of color. And just, you know, the way the opioid epidemic and just opioid crisis has harmed these people as well. It's just one small piece of this terrible puzzle, I guess. And, yeah, like in order to, you know, mitigate these problems, there are the things that, you know, Bethany and I mentioned. And, yeah. I just wanted to close out by saying thank you for listening and for, I don't know, Mr. Cortez is listening. So I just wanted to say thank you for providing us the opportunity to look into these topics and to share what we learned. I think we should end on a happier note. Like, I think, let's do a little trivia. What is the fifth zodiac sign? The fifth? The fifth. Oh, they are in order. I saw it on TikTok. You saw it on TikTok? This is how we have to end the podcast. I'm a November and I'm a Scorpio. January, February, March, April, May, June. That's the end. Aquarius? No. Do you want me to give you the month? Yeah. Okay, the month is May and April. Oh, baby. Oh, actually, no. I don't even know what you said. Okay, I lied. I lied. It's July. Sorry. Cancer? No, Leo. Yeah. The fifth zodiac sign is Leo. I don't know why that was a trivia question. I googled it and I was like, what's a good trivia question? And that showed up. I hope you answered and I hope you had a great time listening to our podcast. We had a great time in your class. And good-bye. Good-bye. Three in your house. Three in your house.