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The Last Call

James Kyle



  • November 2, 2008
    9:30 AM

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him I have a wonderful pleasure of combining both my preaching ministry with the medical ministry is looking on in my topic I knew that on Sunday morning after breakfast before discharge that I needed something that would hold his attention so I decided to combine an apocalyptic portion in the middle portions of the last call we preachers always used things like the last hole it has an apocalyptic ring to it and this is was really talking about the really good about the health ministry and the social determinants of health I told him unsuccessful today to make you a little uncomfortable or one preacher told me once he said your rule is to go and bring comfort to the afflicted and intuitively comfortable some of your follicular comfortableness is what you doing better work with you I want to talk to you about why equally created die unequally since two thousand four abusive medicine has essentially acknowledged the existence of racial and ethnic health disparities in our society as physicians and where you've trained you seen the outcomes of these disparities in your residency training programs in your fellowships were patients in certain communities from certain ethnic groups will have different problems these disparities commit America's minorities having excess burdens from disease morbidity and mortality and easy this excess burden of disease is also commonly by shocking disparities how is so the major studies of the Dennis area scene in the know of in the two thousand four on equal help also the icy medicine report and essentially the model when adversity was somewhat controversial the Bush administration sequestered the book for about six months it was absolutely so most of it is to read and study were coming out called about the study and what it evolved out of the Regiment of minorities in this country Dai 's reporting numbers of almost every disease you can imagine hypertension diabetes heart disease cancer and reserve significantly higher than among limit their white counterparts and Higgins make is asked questions like what's going on communities and causes these high rates of disease and death we also found out even when those that is presented for treatment and treatment options are handled disparately by the medical profession which means that and after American movement was recently done that to the American and a Anglo man and negating the same biography these are speaking the same time while you take it to be the CDR and the women complaining of left sided chest pain crushing radiating to the neck down the arm the removal of your engineers trained that the same kind of fighting schools similar income similar insurance and he found that on average the white patient more than three or four times all appropriate theorist life the love as you have a honoring and or perhaps the cash and so it was a woman the spirit known as the health care disparities in the broader context health disparities are experienced in the context of broader profitable hotel practices fully addressed the excessive burden of disease that characterizes both black and Hispanic immigrant of minorities in particular maybe attribute of medical causation but disparities even understood as a mosaic enjoyment in health disparities among isolated phenomena but I created animals and complex interactions within the natural political social and economic environment I wish we could live outside of Volvo 's also suspect this was going on on Wall Street right now affected by the heavy look at your 401(k) plan recently about the value of your house who was going on the state of California versus budget for many other states we all live in the context of these significant progress in eliminating health disparities will not occur in a vacuum but will be accomplished only challenge the environmental determinants of health in this room were probably a collection of the best lifestyle positions and practitioners the world but what we need to do cannot be done in the context of the individual practicing one on one to deal with health disparities you have actually begin to coalesce and work with others in our discipline and outside purpose of the changes in the communities in which we serve a supplemental social terms of health we all know that the four is him for your health and wellness of our best not to be poor poor people have a higher burden of disease heartburn of buildings the worst housing have poor access to good nutrition and is only doing all of the side effects of the exposed to the summer factors are higher racism racism is a factor in this country for the Palos Verdes what I call educational misadventures was medication within the visibility try attending inner-city urban high school and apply to college is going to get into any color as the apostolic on your most numerous of your half all high schools probably only reads the sixth and seventh grade level upon graduation so what are their options and we totally local and education at your option was efficient as the option if you're in a school that is committed to your educational success in middle schools only is only committed to moving you through then you're not have much of an education high levels of incarceration on talk about that later but in my minority communities in large numbers of people were incarcerated and the these incarcerated individuals are not only remove up to me but also expose a homosexual disease while in incarceration enemy combatant community one of these we find in high levels of incarceration and poor communities is that this is also the spread of HIV AIDS to give you an example here the state of California you cannot pass out condoms and state penitentiaries to inmates the reason you can't because of the state of California passed a law that that has prohibited any form of sexual contact between men imprisoned men have met have settled are there other day this is convenience so the same dollars and you can have because we don't allow these men have sex so that we understand that you me you got a principle of people who were imprisoned because I have no respect the law and then you pass the law this is a cannot have sex while in prison and you expect those who are in prison will believe that law while invisibly all of a lot of government was the first place and so these men come out of prison invertebrates I but they are essentially heterosexual and take the disease back to communities and affect when good benefit to and so incarceration for minority members has a major impact upon the HIV spread in the same communities when these men do low self-esteem is another social tournament people don't feel good about themselves when the image of themselves as negative they'd have negative hats if you don't care about yourself when you don't care about others so why would I hesitate to shoot you in a drive-by when I don't think I will live past my sixteenth birthday anyway urban overcrowding Yancey seems that is about the impact of urban overcrowding physical status we went to many people into close proximity to each other you just begin to create a lot of stress and spread infectious diseases that are very beautiful malnutrition malnutrition and in poor communities is not the same as the malnutrition in other countries malnutrition in America for the most part is calorie caloric excess is a great of one millimeter from the masses is for food and someone who didn't sign most poor communities are always on McDonald's and unlock the liquor store on every corner is hard to find an actual supermarket that has rosaries and vegetables and fruit available in price so when you take the patient your office is your office that you are having is coming from poor communities even given a lifestyle prescription that included him good nutrition and diet with a little back to the communities where they came from the noncomplying union which is fine accessible at prices they can afford so that even this is an environment that some of these we are going to do with living teleportation and a dysfunctional school nurses these two from fatherless cool of a hundred miles Los Angeles Crenshaw high Crenshaw high has a dropout rate somewhere around fifty to sixty percent of the students who start as freshmen drop opportunity from seeing students who drop out or more likely delivery for students who drop out of school are more likely to become arrested because they had no education in the weaver living what you expect them to do and it was a low console I have is not so I slung drugs for living hypothetical extortion for living joined again poverty spawns malnutrition obesity isolation violence and overall poor health status of the race disparities in education what is also more likely than blacks and Hispanics adults have a cost reimbursable number thirty three percent of white handles at the lease them back to me in two thousand five only seven while only twelve dollars and degrees twenty ninth revision Americans had an even dressed me in two thousand five however my households have incomes of more than two thirds higher than black forty two thousand five his immediate income numbers White House holds meeting was to develop black thirty seven thirty six Asians sixty dollars to be adopted by Asian families of you know him who that is let me know the poverty rate this only eight three percent of whites were poor while twenty four nine percent of blacks one percent of Hispanics eleven provisions disparities in home ownership almost grew after World War II due largely to government programs G.I. Bill programs and made it affordable for reference file black and minority families were left out because of discrimination and the effects have still been developed today to support the Lance Freeman on his work look more semifinals and white households owned their homes older homes in two thousand five I began financial downturn the number may be lower at that time only forty six percent of blacks and forties of the Spanish owned their own councils these racial gaps have probably increased a little twenty five years and homeownership is the way that most people begin their pathway to financial wealth and financial independence by Orlando for many minorities is never how it's disparities of their house this is from the Seattle Post-Intelligencer in January two thousand seven exclusion from federal mortgage programs and intentional discrimination and the sighting of an assignment to public housing exclusionary zoning laws steering by real estate agents redlining by mortgage lenders and property insurers him recently by the appraisal practices are among the forces of account for segregated housing despite the great opportunities there's so much housing in this country still segregated and is secreted by the frost by these processes I wanted to get back to incarceration for in twelve states like MacArthur recently twelve to sixteen times greater than one now black farmers and what was in the population of incarcerated at sixteen times the rate of whites so letting the drive into one of several conclusions all black people are criminals that we should watch her purse before I leave the ruminant or the court systems do not meet about justice equally or their populations men especially had little and with opportunity options X role models and examples education a lot of work in other facets and therefore we see these numbers some of all the future to today's Latino men are positive receiving five tonight after those white and fifteen station letter sent to prison on drug charges at race fourteen fifty times you should know how professionals that includes one cocaine sold for use in this country powder cocaine which is snorted and crack cocaine rock cocaine which is smoked the laws because the crack epidemic was remembering communities our government passed laws in the penalties for crack cocaine was him by minorities much harsher than abilities that are for powder cocaine therefore for house photography to you may do for years three years for the same house of crack cocaine the three times the sentence so this is why you have people in jail for drug charges by the way is the decision to us that we had acknowledged this country that alcoholism is a disease and that a hollow addiction and a message right tools and buy your car we don't rest out hauling the possession of alcohol but that we take drug Xanax who are also a medical disease who are we at the two substances much more powerful than alcohol and we believe that our only recourse is imprisoned relevant treatment as we continue to warehouse our system imprisons and letting others of other religions over this from human rights watch so when you look at all these issues always and always there as I was on the board for minority communities have more morbidity or mortality and higher incidence of disease and always have the burden of disease knowledge there is higher one has to question is this simply a coincidence and where you can make it up as an argument than one oh two areas this may be simply coincidental it is hard to make that argument we look at all of these areas is only going to the halftime professor you want a story about the hypertension in African Americans you should know that if you look at all all sentence on planning Africans who are African-American in this country had a higher blood pressure than any African Diaspora online is a wise I like say economic this theory in his theory was if you look at the middle passage use the years in which slaves were brought from Africa United States launched shifts there was a environmental and biological advantage to being a high sodium retainer because the major reason people died apostleship was dehydration imagine being stuck laying in racks with the estimate from those in the top going down to those of the editing allows once a day to get air so that you clean the whole in these last seawater honestly any guy would drink is it you were a selenium retainer your opportunity not to become dehydrated and while you will go to Lowe's was later enhanced if you were not a silly retainer and you just pass you your own isotonic urine out of a faster rate UBC more dehydrated those can dehydrated die first the slaves and finally wound up longest on this country or highest selling retainers by the majority cling to survive the survival benefit those of you who when the metal is less for years which will when you treat African-Americans high blood pressure your first line of defense is what salt restriction and diuretics because most Latin Americans high blood pressure or high sodium retainers those biological survival advantage which means this also part of why only in this country him high blood pressure among black people on the planet as we have while MySpace am selected for the people who arrive to resume bypasses to the highest of everything that's when the background with reviewing with you in the community so I'm so planned obsolescence just for a moment believe that I was losing you seal the list of diseases I was the reason why this is these are allowed to have such a high burden of disease in our communities is because of planned obsolescence learning it usually excessive morbidity and mortality in racial and ethnic minorities in America you could not feel or injure more people live design than we do in this country by malignant neglect if you actually set out the purpose of killing a bunch of people who converge on we do this by later system run as it runs everyday neglect to rotate your tires on your car could be considered benign but neglect of whole populations to never be seen as benign and could suggest a song a malevolent intent and that Republicans as ministers health ministers of the gospel we look at populations as a hobby Minnesota decision earlier for my colleagues here were talking about the whole notion of our of our wellness and lifestyle centers associate with some some of you have been also one of the biggest criticisms that we all and in the wife felt ministry understand the most lifestyle ministry programs both residential and outpatient programs are only geared to those who could afford because most of myself supported so if you're poor on welfare her working in a plan the where the average American is in terms of economics the masses of people who are in this country could never afford our inpatient or outpatient residential livestock sold while we talk about lifestyle ministries we have to understand that you don't think outside the box on my salmon is the Holy Ghost one segment of the American population as a minority segment and ignores the rest of the population of those what is marginally educated marginally employed or even the average person the person who makes an average income of fifty thousand dollars is not a human five thousand dollars of college were residents of the bit is not as much a matter of premeditated intent as a matter video surveillance uncoordinated political processes lock public will and the lack of genuine concern demonstrated by current literature response if you want about a perfect example of this is our country but about our response to Hurricane Katrina and the fact that the only field surveillance on horny little process by public will lack genuine concern and many people in our country see when they look at the government 's response to the problems and enforcing the fall if you look at the church 's response is really the first and easily retrieve this continued neglect it we only focus on individual lifestyle change that will come in the work only Jesus and this is also done and not left the other undone yes we must be about lifestyle change but I wanted to begin to think about lifestyle change in the broader context of the society with people whose lives were trying to change lives everyday our early this dear is important the abolitionist movement and great temperance movement amazingly understood and that is really a single slave owning a single smoker or are into recovery just wasn't enough by itself but also entire institutions the laws and the societal norms this fondles evils of them anonymously so just helping one person 's cholesterol one person 's blood sugar one person 's hypertension as individuals is not the whole essence of its history and tradition of the Adventist health message if we go all way back to the early episodes will also begin to address the societal problem with tax smoking by not attacking smokers the tobacco industry and what the industry is doing to people and our greatest public health success the last fifty years has really been the work was then done in the wrong tobacco cessation and had very little to do with attacking smokers had everything to do with attacking the laws that Howell was used and sold marketed in this country allegedly the Ministry of human thought what the danger of complacency multitudes live in institutions and organizations that work of the door social worker will lead to message them up to the work of Nablus they excuse themselves from contact with the world in their hearts grow cold they become self absorbed and UNIX and expressed inexpressible because of an unenforceable support should be low but a man dies out Russell is impossible for us to become actually disconnected from the world my colleague here in emergency medicine can get disconnected world doorstep every day to this comment by the journals but I put in private practice I have gotten related if I wanted to choose an opportunity I need to work identify with category pages I want to see if I want to see Medi-Cal patients adolescent was a certain period class I'll see you soon last and I will be a little boutique medicine where doctors can now say look for files and also your puppy care of all your care of the make house calls but I wanted to private insurance and are able when the paper boutique medicine one recall twenty bars they wanted out because Ms. housecall window has a nice you know Starbucks located in his office wall humanities about any movie the edifice of the building and we measure viewing one ninety five real charity helps men to help themselves but Truman has these more than mere gifts beneath a genuine interest in the welfare of others we just seek to understand the needs of the poor and distressed hitting on the help that will benefit the multiview file time and personal effort cost far more than merely to give money and assiduous cherries helping people help themselves that is in power and our ministry be looking with Jesus about his ministry Luke the call to unloose the burdens and the heavy load to set the captives free and somewhat empowering people in our lifestyle ministry we empower the individual to take care of themselves what we have stopped doing or maybe have not started yet is in power communities and take better care of themselves I can drive a certain certain communities and ability to seventy degrees in LA will Delaware river Herman Miller this in the Los Angeles River Ridge community and the community while we were lots okay why thriving Bel-Air I would be hard-pressed to find any advertising signs on the streets advertising anything but certainly not advertising liquor or tobacco or other principal and interest in wireless however almost every other billboard advertising liquor and tobacco in Watts thirty two is the most polluting on every corner our churches and in the stores in Bel Air you're hard-pressed to find her severe Congress airport land to build one level when you do find that you will find a liquor store you might find some key but that also but was there right so fine wine some of them so two separate communities with two different messages of going to the reference entities as an individual position just working in your office if you happen to be in what you can't change was going on in the middle you look at how you now connect with other to create a ministry that helps people to help themselves and policy communities to cast off the impression of marketing and profiteering that happens on poor people all the time so what I'm really talking about is a change in paradigm articles but the linking of the gospel ministry and the health ministry will also utilize an ecological and environmental approach addressing the social determinants of health must become the mainstream strategy of public him or use of any ethnicity because these social determinants are responsible for the patient whose life value not quantity and I'm talking about a interdisciplinary collaboration between doctors ministers social workers law-enforcement educators all working together in communities trying to change in the social milieu the social determinants of those committees are facing neither was quite Christ's method alone will give true success in reaching the people the Savior mingled with men as one who desired to show their sympathy for the minister to their needs and won their confidence they need to following one of the problem we've had in our churches that's why we minister to the community 's needs as we understand them as we perceive them to be anonymous it's what their needs are I remember once we were running a 5K plan to stop smoking and I opened this program up and out walks center in LA we several families are very weak we want to have this program is going to Nickerson Gardens housing project without first talking about our new plan to stop smoking in one centimeters when you talk about stop smoking she said my son this morning was arrested he's in jail my daughter is pregnant and she's only fifteen and now you want to take myself my cigarette away from what her what she was thinking is stopping smoking is not my biggest issue session duration Eisenhower son is going to mice home and take care of this pregnant sixteen -year-old will happen to her so what we were seeing as organizations lifestyle in particular last element for life better she was saying I don't think so so what are we when long as we were irrelevant to what point the purpose of our health message and many people have this listed we make our health message is about is not about her health but this is not to give central minimum greater longevity don't get it confused by the self-study yes if you live a healthy lifestyle you will live longer by the way I know the kanji was a shock they didn't even bacon die someone what your lifestyle is as long as you are one of sin and born when you will die so the only bleeding the longevity manager for health messages merely a byproduct is a side show it's not purposefully help methods its real purpose is to improve the function of our minds and bodies of water that we can help souls that are within the mind and voice of God I get people healthy so they can better hear God speaking to them in these last days the three Angels messages the required minimum to have clear thinking so you can apprehend what God is saying so I want not to be inebriated or encumbered by by disease and illness is not able to think clearly we can't think clearly they can hear God is look at the political messes with your last few months if you are not really thinking clearly you recognize what you hear from both sides is a lot of garbage people stretching the truth and batting nuances that you can't even figure out easily with the Florida harvest in terms of having lung in CNBC and CNN doing what the call fact checking that checking the facts and if you listen to the facts as we get when you realize that have to want to hurt was source humans are humans on the store everything that comes only in the last thing that you can clearly know me saying this is a video to help people live longer by living miserably do I want to live longer it is not to bring God down to men who somehow think that because we are vegans or vegetarians of whatever we are that we are now God is not possible stress is not only low people only days or only most people don't eat meat but is not properly brought down by helping men and women reach up to God it doesn't remove any points in heaven and usually says to heaven by having a clear mind to understand Paul talks about her moments by having a renewed mind the last call contextual ministry our health ministry is not only be connected to our preaching but is preparing way into the lives of those suffering around us to only address disease without addressing the social determinants of health is a form of what I believe is malpractice and as he has a group e-mail we cannot be found guilty of forgetting the people that we serve social context I was I was impressed that social context what were doing more work it makes no sense to send the newly recovered back the cost of an unhealthy environment and expected with dry so if you take that woman I heard the example earlier today in the halfway I will run feeling us getting wrong drugs this makes your back in a halfway house the liver drug users in the wintertime would take someone try to enter lifestyle the living room back in my life communities but when you sort talent is not to choose one approach over the unlucky adapting one approach over the other our challenge is to see the salvation and restoration image of God in human flesh by running the chains that bind in the genes that destroy it is combining lifestyle medicine the gospel truth was empowered communities this ministry cannot be done by any of us as individual you busy pages and all my soul to your offices or small groups but we're going to change the social determines in the communities where we serve we must learn to link with people from other disciplines and workforce solutions that empower communities and do not hold solutions on UNIX with u but without slowly of course were not taught in medical school as a leader teachers in our churches the church should be the center of the societal change is the leader in networking the physicians and nurses and dentists work in the Congregational Ramos commendations so I'll change dietary hats will work together in communities and make sure that food is available to those communities that is helping wholesome and cost-effectively purchase and only banana the community can buy from the five and dime as for what he wanted at seventy five cents per banana than what is in the Bible of food at those prices one they only see a thousand fifteen hundred dollars a month total in that is our challenge the challenge of taking what we do for the individual and asking the hard questions where that person where they going back to when they leave my care one man said where a person stands is wholly dependent on where he was sitting before they stood where people are in your office is wholly dependent on where they came from before they found you in your office if we don't start thinking about these determines that the health of people and have accommodations and we will miss our major opportunity so now we can never do away with myself I was on at the to our lifestyle individual medicine we begin to think collaboratively in a community about changing and addressing the social determines thank you


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