Kenyatta W. Stephens, Ph.D., is an infectious disease epidemiologist with years of advanced training and professional experience in diverse public health areas including disease surveillance, bioterrorism preparedness, epidemic/outbreak management, and HIV/AIDS research. She has extensive experience dealing with the COVID-19 pandemic. She sat down to talk with rolling out publisher Munson Steed, and here’s how the conversation went.
Munson Steed: We are on health, IQ annd we are talking about public health. I’ve got one of the best true public health innovators. HBCU graduate. Ph.D. Put a big D at the end. My dear favorite, saved my life ande verybody’s life during the pandemic, Kenyatta Stephens.
Kenyatta Stephens: Oh. hi! Everyone! Great to be here! It’s been a while. How are you? Yeah. Well, we’ve been at it.
MS: No question for those people who are out there. They got COVID shots. They were on that trajectory, and now they came out of the pandemic, and they’re questioning. Should I still get another COVID shot? How should they think about their COVID regimen? And why should they stop? Or should they stop?
KS: So, I will say this. I mean, personally, I’ve stopped. And the reason being is that I think I’ve said on some previous shows that vaccine isn’t really effective until you have a stable form of the virus and COVID is still mutating. So, we know that there’s so many different strains out there and we definitely can’t forget when Delta came through. And then just all of every year, every 6 months it was just like a different strain. And so, the strain right now. That’s dominant in the Us. You know. Doctors aren’t sure our researchers aren’t sure how effective. How effective it is against this current strain, even though you know the pharmaceutical companies are saying like, “Hey, you know, go ahead and get vaccinated,” but as quiet as it’s kept there are so many emergency rooms full of COVID patients. Hospitals are still full of COVID patients, and COVID is still the No. 1 killer in the U.S. So, most of the deaths in the U.S. right now, even still, are caused by COVID.
MS: But a little pushback on that, if you are over 60, if you have some preexisting conditions, should you get not just COVID, but flu shots too?
KS: Yeah, so in that regard. If you have preexisting conditions like, if you have, like, the heart disease, high cholesterol, like diabetes, like any type of chronic issues, I would definitely say, if you are more prone or susceptible to getting flu, or some of these respiratory viruses cause it’s not just COVID, it’s not just flu. RSV, which is respiratory central virus which we typically only saw in children pre-COVID and then the summer of 2021, when people started emerging from their home. Basically, we started saying, RSV and adults, which was rare. And so, RSV has run so rampant now in the US. That we are actually recommending that adults older adults, 16 over get an RSV vaccine which is unheard of because so many so COVID, essentially like just unleashed, like a herd of respiratory viruses that we had not really seen in the past, and some that we saw in smaller proportions in children that basically jumped to adults. So, if you have that lingering cough that you haven’t been able to get rid of 9 times out of 10, it’s RSV. And the crazy thing is, most doctors’ offices don’t test for RSV in adults. You will have to go to the emergency room to get an RSV test. And so, while some people thought that they were just battling this a cold or flu. It was actually RSV, so those are like the top 3. We’re seeing a lot of flu infections, a lot of COVID infections, and a lot of RSV infections. And I will say, if you are experiencing any type of respiratory distress or disorder. For more than a week and a half for more than 2 weeks definitely. Go to your doctor, because what we’re also seeing with trends in respiratory issues is that it’s progressing to pneumonia, and that’s what you don’t want. because that puts you at a greater risk. So
MS: It’s Black History Month. In my mind, it’s Black History Month every day, 365. Why should we understand the history of our family and our personal health?
KS: I always tell black people to know your history a lot of times. And especially a lot of black communities. We only know our maternal history. We do know, like the epidemic of the lack of black fathers and a lot of black families, and so a lot of people, myself included, don’t know our paternal history. And so, I have a friend. Some years ago, that was experiencing some health issues. And I was like, we’ll just tell them I always tell my doctor to test for everything, because when they give you that sheet of paper most of the time people are completing it, based on what they know from their maternal side they’re not including the paternal side. And so that’s why it’s important to know both sides of your medical history, and if you don’t know both sides of the medical history. Then just tell the doctors to test for everything. And as a result of that, that friend actually found out that he was in early stages of prostate cancer and it saved his life because the doctors weren’t really checking for that, because on the maternal side of his family there was no history of any type of cancer. And he was young. So that is definitely important.
MS: I want to get back into drilling in what we know. And so, if you know that there’s a history of diabetes. what should our behavior from a and I’m just saying, from a public health. We know these things. These are things that we know. We know our area. And I do. I don’t want people to think public health is. Yes, where you can buy food, those things become part of it. What should we know about that aspect of our health and our environment? And in our history, how it all works together.
KS: Yeah. So public health is very [important]. And I have to explain this a lot because a lot of people think public health is health. But public health is a precursor to health. Public health is prevention. Public health is intervention. We want to help you do those things and have those habits that prevent you from getting sick, and then, when you get sick, as a result of diabetes or some other chronic illness, you go to the clinical side or medical side, for quote, unquote treatment. but with public health, we look at every aspect of the community. We look at the social determinants of health, where people live, where people work. where people quote unquote play, where they spend most of their time. And so, when you look at a community that is facing and we do look like an infectious disease epidemiologist. We do look at those factors like. We see an uptick of diabetes in a specific area code or a particular city. And so, we can use mapping data to say, Okay, there aren’t any grocery stores here. This is a food desert or it could be a food swamp which I just me and my mentee had a after composer where we presented, where we talking about food desert and food swamps and people like, what’s a food swamp and a food swamp is where you have an overabundance of non-healthy options, such as the corner stores or the dollar stores, and I learned that in the beginning of the pandemic.
A very good friend of mine is a pastor [at a] church in Detroit, and I have been keeping him abreast of everything that was going on with COVID, and he was like, “Well, my congregation doesn’t know anything about it.” So, my very first COVID talk was at a church in Detroit. He called me from the pulpit on his phone and put me on speaker to talk to his congregation, and at that time liquor stores were being closed and people were in an uproar. And we’re like, well, what’s the big deal about a liquor store? Well, I learned that in Detroit, a lot of the people in the community dependent on liquor stores not just for alcohol, but for milk, for bread, for the food staples that they needed in their homes. And so that’s something that we would consider a food swamp, because, you know, those are on every corner. The food is typically overpriced. and a lot of the food tends to be unhealthy. So, from a public health perspective, if you’re a diabetic, you want to avoid those food swamp areas. And you definitely want to find the grocery stores. You want to be able to have access to clinics into that information. And also, green space parks.
We’re finding out that you know a lot of the parks in the recreational areas in the community, black communities and neighborhoods are either closed or not kept up, or they’re unsafe. So, these are all the aspects for the social determinants of health and public health that we look at to determine. Okay, where are we? How can we make a change? What are some interventions we can include in these communities? And what are some other ways to prevent the further development of these chronic issues in our community?
MS: Well, thanks for that. Yeah, let’s talk about the CDC. … One of the top 10 things that actually are leading to death in the African American community is heart disease with black women. Why is this public health crisis kind of not talked about? And then what is happening that black women are suffering from heart disease at such a high rate in our community?
KS: Well, it’s interesting. I was on a panel, and we were talking about black women are pretty much the No. 1 consumers of hysterectomies and other gynecological disorders. And what’s not being talked about is that the hysterectomies are being done, not just at older ages, but at younger ages, because black women are the main sufferers from fibroids and other gynecological issues. But what they don’t share is that those gynecological procedures, especially hysterectomies, increase your chances of heart disease.
So, even if it doesn’t run in your family, if you’ve had one of these procedures, you’re now at risk of developing heart disease, or you develop heart disease. And I have some friends. We’re in our early 40s, and they’ve had to have hysterectomies due to fibroids, and they’re now fighting high blood pressure, high cholesterol like heart disease. They run every day. They are running five miles a day. They’re active. they’re eating right, but their blood pressure is still high. and even if it’s not genetic. And so that prompted me to say, “Well, hey, let’s look at that. Let’s look at that data.” And that was one of the main things that I found out. That’s not talked about at all. They weren’t even aware. Because I’m like, why, now, are these 30-, 40-somethings are experiencing high blood pressure and other heart disease issues? And that was one of the main things that popped up, the gynecological procedure.
MS: When you think about thanks for that. When you think about the advent of on the top 10. We’ve got one more that we don’t think about it, and it’s just violence murder being a top 10 killer publicly. It’s a public health issue. How do we know? What should we be thinking about? Is our community conscious that one of the top 10 killers is this violence?
KS: So yeah, violence, yes. Violence against black women has definitely increased over the years. Prior, it used to be intimate partner violence. That was one of the top issues. But the CDC had to just put it in a broad category balance because we’re seeing the police brutality thinking about a you know, a Breonna Taylor, and violence doesn’t necessarily mean it’s from someone you know, or it’s community to community. It could be broader and a lot of times. It’s from people we know. But as the years have progressed, we’re seeing that it’s from other outside forces, unintentional injuries or unintentional violence. So yeah, black women unprotected, and you know I won’t get on that soapbox. But it’s definitely a public health issue at this point, because we’re seeing the numbers [are] staggering.
MS: Are young people aware of the reality, that where they are circumstances that you know, violence is one of the No. 1 causes that puts us in the top 10?
KS: No, and actually, Munson, we’re seeing an increase of violence in our young people in teenagers. Not only has the suicide rate increased, but also the intimate partner or the partner. Romantic violence. Has increased in addition to like the online and cyber bullying to which we grouped in that category of violence. And so there hasn’t been a lot of campaigns in our community to address that, especially in the young people, and I think it’s important. When I talked about before the interventions and the preventionary measures in public health, should it? We should definitely start at that. Those younger ages, because we’re seeing that those violence numbers as early as age 8, you have 8-year-olds who are “in relationships,” and they’re fighting, and they’re seeing they’re emulating the things that they see adults do in their household or in their families. And so, it’s definitely important to start that prevention early. So, as they progress into young adults and adults, we can kind of curve those numbers that we’re seeing in the adult population, especially violence against women.
MS: Lastly, did STD cities come out there. and several in the South. You know, New Orleans was one of the top 10 cities with STDs. it’s a public health obviously falls right in your area. With all the testing, what’s going on? What do? What do we not think about as a community. And how can we heal ourselves when we know that it’s really rampant right now? Philly was on one of the top New Orleans was on the top. For STDs. As it relates to cities.
KS: When the pandemic started and a lot of people were back at home … we started seeing the numbers increase. No. 1, people weren’t going to the doctor to get their STD checks. And then some of the behavioral health issues that we’re seeing in conjunction with STDs is that people, since COVID people that survive COVID feel like they don’t have to do those provisionary things like use condoms and other methods to prevent the spread of STDs because they were like, “Oh, I’ve survived COVID.” So, I mean, we have to bring in the mental health and behavioral health aspect of that to most mental health issues in the black communities have skyrocketed since the start of the pandemic in 2020. And so unfortunately, all these issues are gelling together, and it’s hard to tease out one from the other.
So, you definitely have to address it holistically from a behavior aspect. There’s a lot of we talked about the violence. So, the intimate partner violence and which we’re seeing is resulting in a higher spread of STDs. And then the behavioral health, like the depression and things like that where people are having more unprotected sex. because it’s a coping mechanism. It’s so. It’s like so many layers to it. But the important message that I want to share is that we have to. We have to start looking at our health. Holistic holistically. Are in, especially from a public health standpoint, because everything is somewhat interconnected and interrelated when it comes to the spread of the disease, preventing disease and even just getting testing and getting disease education.
We talk about health, literacy, Health IQ is perfect for that. So, there’s an issue with health literacy and a lot of people aren’t even getting the health care treatment that they need, because they don’t even understand the issues that they’re having. So, it’s important to be able to have help. People who are able to speak to these communities on their level. So much so. I attended a public health conference. And there’s a whole group that just trains individuals that go out into the black community, and even some Hispanic communities on health literacy like, how do you talk to people? What are the words like, how do you relate? And so, Health IQ is definitely on the forefront, because we’ve been doing that for a while? But it seems like people like other communities. Other people are catching on to that. But it’s definitely important to be able to speak to people in a way in a manner that they can comprehend, and on a level that they feel comfortable receiving that information from you.
