Abdul dissects how Black Lives Matter in healthcare. He talks to Rep. Cori Bush, the former nurse turned Black Lives Matter Activist turned Congresswoman about her journey from the bedside to the bullhorn and what the fight for health justice should look like today.

Transcript

Dr. Abdul El-Sayed: The Biden administration announced its support for COVID-19 vaccine patent waivers as the World Trade Organization meets this week to discuss those waivers. Meanwhile, cases are surging in India and Brazil, sending single-day records almost every day. And in 2019, the U.S. birth rate fell for the 6th consecutive year, reaching a three-decade low. This is America Dissected. I’m your host. Dr. Abdul El-Sayed.

Dr. Abdul El-Sayed: Welcome back to Season 3 of America Dissected. Last week, I wanted to set some context for the season. Why, as we begin to emerge from this pandemic, we need to keep paying attention to what’s next on the horizon. But I tried to situate that in my own story because public health is all about the set up. This week, we step back into our regular format, talking through the most pressing issues and then interviewing the thought leaders, activists, and policymakers looking to solve them. Let’s get to it. 2020 was filled with tragic moments, like that first lockdown, the fear abounding, not knowing how long we’d be there, or what would come next. But there’s one moment from that year, I don’t think any of us will ever forget. That raw, painful moment when we saw, or just even heard, about the brutal murder of George Floyd. I won’t ever forget it. I could only watch the first few minutes, it was too brutal. It launched a reckoning about police brutality against Black folks that continues to reverberate today. Nearly 10% of Americans, that’s 35 million people, participated in a protest, making it the largest single movement in US history. And though that movement isn’t over—it’s far, far from over—we at least saw a rare moment of individual accountability.

[voice clip] State of Minnesota plaintiff versus Derek Michael Chauvin defendant. We the jury in the above entitled manner as to count one, find the defendant guilty.

Dr. Abdul El-Sayed: Derek Chauvin, the Minneapolis police officer who murdered George Floyd, is being brought to justice. But what about the system that killed and continues to kill so many other Black folks? And I’m not just talking about the criminal legal system, I’m talking about every aspect of American life. Racism shapes the houses people live in, the jobs they work, the schools they go to, even the air they breathe, and the water they drink. Dr. David Satcher, the former CDC Director under President Bill Clinton, he did a very simple study to try and quantify how all these things come together to form an all-out assault on Black lives. He asked a simple question: how many lives would be saved if we were to reduce the Black mortality rate so that it was the same as the white mortality rate? He found that we’d save 85,000 lives every single year. This week, I wanted to talk to someone who’s had a 360-degree view on the health inequities in our country. A little bit later in the show, we’ll hear from Representative Cori Busch, a nurse turned Black Lives Matter activist, who spent years without health insurance herself. She’s taking her fight for Black lives all the way to the hallowed halls of Congress. In a couple of weeks, we’ll be talking to Dr. Ibram Kendi, author of The New York Times best seller, How to Be an Antiracist, for perspective on what an anti-racist health care system might look like. But first, I want to dissect why it is that our health care system perpetuates racial inequities in the first place. In America, access to insurance is a function of your employment, which, of course is a function of your privilege. People with stable employment that comes with a good salary and strong benefits tend to be people who went to college, who tend to be people who went to good schools, who tend to be people whose families had means, who tend to be white. That’s not to say that only white people or all white people have insurance, but that is to say that the numbers break in that direction. For example, in 2018, 57% of black children and 54% of LatinX kids were covered by Medicaid, a federally-funded, state-operated health plan for low-income Americans. That compares to just 32% of white kids. But Medicaid reimburses at far lower rates than private insurance. Take your standard doctor’s visit, for example. Private insurance reimburses on average 3.7x as much as Medicaid. That literally translates this way: taking care of a privately-insured person is 3.7x as valuable as taking care of someone on Medicaid. The part I want you to take away is that our health care system renders richer people on average 3.7x as valuable as poor people. And because nearly 60% of Black folks are on Medicaid, while nearly 60%of white folks are on private insurance, it also means that we’re treating most white people as 3.7x as valuable as most Black people. This is just one way that systemic racism shows up in American health care, and it has profound knock-on implications for health inequities. Not only does it mean that many doctors just don’t see Medicaid patients at all, but when they do see them, they treat them as charity cases. They’re reimbursed only 27% as much. It also means that doctors’ offices just don’t open in predominantly Black urban communities, forcing Black folks to the hospital where, again, their insurance just doesn’t go as far, which renders them second-class citizens. But it also means that those hospitals just aren’t as well equipped. They’re only getting a fraction of what they would be if more of their patients were privately insured. You might think that one answer to this is just to get more people on private insurance. Well, so do the private insurers. But instead of actually trying to offer poor folks insurance that’s better than Medicaid, they’ve just made them plans with out of pocket costs in the thousands of dollars, and coverage that’s barely any better than Medicaid. So what’s the solution? How can we combat decades of inequity in health care, how do we ensure that Black lives matter in health care? Well, as you’ve heard me say a thousand times, that’s why I believe in Medicare for all. I wrote a whole book about it with my coauthor, Dr. Micah Johnson. Here’s why it would help solve the problem. So long as we have multiple different health insurers, we’ll always have a tiered system, stratified on wealth and income. So long as we have a tiered system, low-income people will have worse coverage. That is, of course, if they have coverage at all. And so long as structural racism shapes income and wealth, Black people will have lower income, and therefore worse coverage, and our health care system will continue to devalue Black bodies. The only way to solve this problem is to give every single person the same high-quality health insurance, regardless of their income, the color of their skin, who their mommy and daddy are, where they grew up, who they love, how they identify, and so on. After all, no matter who you are, your body is the most important resource you have. It’s about time we treated that equally. In a moment, we’ll hear from Representative Cori Bush on exactly how we reached this new reality, and how her experience is driving her work to fight for Medicare for all. Join us, after the break.

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Dr. Abdul El-Sayed: Ready to go?

Representative Cori Bush: Good.

Dr. Abdul El-Sayed: Great. Congresswoman, can you introduce yourself for the tape?

Representative Cori Bush: Sure. My name is Congresswoman Cori Bush, representing Missouri’s 1st District.

Dr. Abdul El-Sayed: I reached out to Cori Bush because there is simply no better person to talk to about the intersection between anti-Blackness, health care and public policy. She started her career as a nurse and after the murder of Michael Brown in Ferguson, Missouri, she became a leader in the Black Lives Matter movement. She spent time without insurance herself, and now she’s got the opportunity to do something about it, as congresswoman from Missouri’s 1st Congressional District. As I talked to Representative Bush, I really wanted to focus on her experience as a nurse and her time uninsured, which went right up to the beginning of her time in Congress. And I wanted to understand how they affected her perspective on the work she does every day as a lawmaker.

Dr. Abdul El-Sayed: I want to start with what you did before you became a congresswoman. You started your career in nursing. Can you tell me about why you became a nurse?

Representative Cori Bush: Sure. So both of my grandmothers, my maternal and paternal, were both in the nursing field. Their siblings, their sisters in the nursing field. I would always see my grandparents at my grandmother’s in white hat, white dress, white shoes, white stockings. But I never saw them working, so it just never clicked. But I was a candy striper for a hospital one year when I was about 14, no, 12, and I saw this Black nurse for the first time working, and it was so amazing. I just I could not take my eyes off of her. I was like, oh my gosh, the patients responded to her so well, she cared so much for them. And I just saw people healed right before my eyes with just the way that these women cared for them. And I knew immediately, I had to be a nurse.

Dr. Abdul El-Sayed: Wow. That’s beautiful. I have a grandmother who was also a nurse, and my mother also is a nurse, and I know that the people who do 95% of the healing in the hospital are nurses. So we’re grateful to you not only for your political service, but also for your nursing service. And how has your experience, your profession as a nurse, and the ethos that comes with that, the knowledge that comes with that, the skills that come with that, the attitude that comes with that. How has that informed your, in Congress in particular, but also your advocacy work?

Representative Cori Bush: You know, nurses are caretakers. You know, we love our patients, and we do any, we do everything that we do from the heart. We work to ensure that the health and stability of the whole person is maintained. Bringing a holistic lens to our profession, that will help us in pushing for these policies. And that’s why it’s always the first thing on my mind, is how will this affect each and every person? And not only that, how will it affect people in our communities who have the least? Because I saw so many of our patients, I saw patients die because they didn’t have access to health care. Or they had access, but not actual care, because they didn’t have all the money to be able to get their medications and have certain procedures. These are unprecedented times with record COVID-19 infections and deaths, the maternal mortality rate, infant maternal mortality crisis that we have right now—people, just millions of people die, uninsured, underinsured. I saw it every single day. And so that’s why I stand up in Congress the way that I do, fighting for what will change the lives of regular everyday people. And nurses do that. It’s critical that nurses have a seat at the table. We have to be there. We have to be there at the table where policies are made. And, you know, I’m just honored to be able to have, add that lens add that voice. Because the other thing is, I’ll say this, most of my work was in community nursing and just seeing the disparities and the trauma. It’s heartbreaking.

Dr. Abdul El-Sayed: Yeah, I really deeply appreciate that. I also ran for office, you know, people would ask, how does your profession influence your politics? And the point that I think people don’t appreciate often is that the first thing you do for someone you take care, of is you advocate for them. And that advocacy has to take into account not just what’s happening to them when they get in your clinic or your hospital. It has to take into account the 99.99% of the time that they are outside of that clinic or hospital, in the places that they live and work and pray and play. And that advocacy, if you’re curious about people’s lives and you’re serious about fighting for the means of their healing, that has to mean advocating for them in those communities. And I think the logical conclusion of that is in politics. And so the other side of it that I find so inspiring about your story is that, not only are you fighting for access to health care for people who don’t have it on the front lines as a congressperson and also as a nurse, but you’ve also experienced what it’s like to go without health care. Can you talk to us about that experience and what it taught you about the American health care system?

Representative Cori Bush: My goodness, yes, I did. Actually, I was an uninsured congresswoman. You know, so for the first month in Congress, I was still uninsured. I went through COVID-19 uninsured, and I have hospital bills from two hospitalizations while I was fighting. But I’ve been uninsured so many times in my life. For 10 years, I worked for a company, working in childcare—I couldn’t afford to send my own children to that preschool that I worked at, and I was uninsured. But I loved working with the children. And all they did was add it to, you know, it jack-up my credit, and just so many things, because I’m going to the hospital for a tooth ache! You know, I’m going to the emergency room for a sinus infection, that kind of thing. So being uninsured so often, just simply because I didn’t have the money. And then even once I was insured, let me say this, I worked as a nurse working in community health, and I was paying a $829 a month, you know, for my health care, for me and my children. Plus my deductible was $4,500. And just thinking about that, like, how do you survive? I pay, I was paying the same amount, you know, it was almost rent! It was almost rent, you know, every single month. So that affected me because health care is a human right simply because we all breathe. That’s a part of living on this planet. You breathe. And so because we breathe, you deserve to have health care to make sure that you can continue to survive. If it’s anything that we can do to help prevent harm, to prevent you from hurting or ending up in a position to where your life is at stake, then that’s what we should, we should be doing. So I always say: because you breathe, you deserve health care. And like I said, I’ve watched patients die. I remember seeing patients, they would come in and tell me: hey, nurse, my cousin and I were sharing my insulin, so I ran out early, you know. And I’m like: I know, but I can’t, we can’t get you anymore, you know, it’s not time yet, you can’t have it yet. And I had patients die that way, just sharing insulin with a family member, or just not, you know, trying not to use it. Patients who are using the same needle over and over again for months because the needles to put at the end of a pin to inject yourself with the insulin, the lifesaving insulin that you need, cost so much.

Dr. Abdul El-Sayed: You know, the point that you’re making here is a profound one, but it’s something that gets so baked into the obscene bureaucracy behind our health care system that we tend to ignore it or even worse, accept it as normal. And it’s the notion that your diabetes, my diabetes, some other person’s diabetes, is the same diabetes. But we don’t treat that diabetes the same way, depending upon something as arbitrary and capricious as how much money you have at your disposal. And one of the points I try to make to folks when I talk about this issue is that, imagine a legal system, right? To some degree, our legal system does this, so maybe it’s not the best metaphor. But imagine a legal system where the law said that the punishment for murder differed based on how much money you had in your pocket. So if you murdered a billionaire, you’d be spending years in jail. If you murdered somebody who is unhoused, you get out with a fine. And everybody when you bring that up, people are like: oh, that’s absurd, it’s crazy, that’d be immoral and wrong. Well, the sad thing, right, is that we treat people’s bodies differently based on how much money they have. And it’s even broader than that. Right? Because the number of people, unfortunately, who are victimized by murder is too high in this country, but it’s a far smaller number than the number of people who suffer with diabetes or suffer with cancer or suffer with asthma or suffer with any of these ailments that require treatment every day. They don’t get it because they just don’t have the money to be able to afford insurance, are not employed by an employer who pays for it, and our country does not want to do that thing in any real way. And so I want to ask you, now that you’re in a position of influence in Congress to talk about these things at a national level and have the platform that people who’ve had these experiences have deserved for a really long time, how does your experience shape your advocacy, and what are the barriers as you see them to being able to achieve real, lasting, high quality health insurance in our country for everyone, ala Medicare for all? What are the barriers there, and how are you thinking about making it happen?

Representative Cori Bush: Just thinking about the fact that no one asks for diabetes or cancer, migraines, cystic fibrosis. No one asked for if they’re dealing with something physically. And so it’s our job to make sure that our focus is people being well, and that someone making the decision between paying their bills, which they’re paying for things because they need them, and then their medical care. That shouldn’t even be a question. In Congress, you know, I’ve worked for so long just feeling like, you know, I wish I could do more. I wish someone would listen. I wish we, I wish we had someone who had the experience locally that I have speaking for us in Congress about these things. And so now that I’m in this position, I go back to that. I think about, like I said before, who in our community has the least? Because I’ve had the least. I’ve been one of those people. And so now I legislate that way. Everything that we do, we’re doing this from the lens of who has the least. So we think about the inequities. First of all, if we don’t highlight it, if we don’t tell the truth about it, we definitely can’t fix this, so I’m OK with telling the truth about what I’ve seen. But even just speaking about, like the Momnibus bill, if we are really going to deal with maternal health and infant mortality, I think about my own experience as someone who almost lost both of my children because a doctor felt like, oh, no your fi—I remember I went to the my regular doctor visit and I kept saying something is wrong, and the doctor was like: oh, no, you’re fine. And I said: no, no, no, something is wrong. You have a sign on your wall that says if you feel something is wrong, something is wrong, tell your provider. I’m telling you something is wrong. She said: oh, no, you’re fine. And she waved me off. And less than a week later, I had my child at one pound, three ounces. I was 5-months pregnant, and he had a 0% chance of life because our pain isn’t recognized as Black women and we know that in health care. So that’s why I speak up to it. So we legislate that way. We think about racism in that way. We look at racism, we look at xenophobia. We look at all of these ‘isms [laughs] that affect us in health care, but not only in health care, just across the board. And so that’s how we legislate.

Dr. Abdul El-Sayed: Yeah, well, I appreciate that because it requires that folks bring those experiences to the halls of power and force people to bear witness to what’s happening so often in communities that don’t get those voices. So we appreciate that. I want to ask about the pandemic, because the pandemic has devastated Black and brown communities, it has demonstrated the ways that structural racism shapes access to very basic resources, health care being one of them. But all the means of keeping yourself from getting sick in the first place, or so many others, whether it’s good housing or access to breathable air or drinkable water in my backyard, and here in Flint. How do you hope this moment is written about, talked about to be able to create change? Because I worry that it’s going to be easy for folks to talk about, quote unquote “going back to normal.” And I think we need to go forward to normal, a new normal that isn’t as broken as the normal we came out of. How do you think about this moment? How do you think about talking about what needs to be done and then getting it done? What will it take for us to build that new normal where we seek to uproot systemic racism and injustice that led to to so many unnecessary deaths to this pandemic?

Representative Cori Bush: Yes, yes. Yes. So looking at it and I like, exactly what you said, we don’t need to go back. We should not be aspiring to go back to the way things were. No, we should look at what was happening before, look at the disparities, look at the problems, and say we don’t want to go back there. You know, now we have, we have a different playing field. This is basically like a new start, because so many people that didn’t understand our plight before, you know, the plight of those who have been under-resourced, neglected, pushed aside, live at the very margins of our society—now, so many people see that didn’t see before, and now we’re doing things that we weren’t doing before. Look at the American Rescue Plan, look at how much funding went into our communities, especially our communities hit the hardest by this pandemic. So we have a place to start. So what we should be saying is: you know what, we don’t want to go back there, we had so much, there was so much violence and pain and destruction in our communities. There was so much racism and misogyny. You know, we lived in this white supremacist system. Most people in this country were oftentimes affected negatively because of that. And so when we talk about our Black, brown and our indigenous communities, our Asian communities, so now we start from here. Now we now we start. So this is how we should be looking at it. Like, OK, we knew that because we didn’t do health care right before, because people kept saying you need, health care should not be tied to employment, and we saw what happens when that does happen. We won’t do that again. So now we’re going to work and we’re going to bring home Medicare for all. We saw what happens when you don’t fund health and hospitals, when you don’t fund, when you don’t find your human services goose. Because what happened? All of a sudden, we have pandemic and we didn’t have what we needed to be able to make sure that people were safe and that people had shelter, our unhoused has shelter and that others had adequate housing. What happened as far as environmental justice? You know, we haven’t done enough to make sure that we have clean water and clean air. So what we should be doing now, we can’t go back because the pandemic showed us that people are already sick. And so when the pandemic hit, we did have enough to fight with and so we lost so many lives because of that. So we have to deal with making sure that we fix this climate crisis. And so because of that, now we’re going to flood resources into these areas that we didn’t do before. That’s what we should be doing. That’s what we should be looking at, because we saw we were not positioned as a country, as a world, we were not positioned to be able to handle that pandemic when it came, and the person who was leading when it came. That’s the other piece, we had someone there who was not—and so we don’t know who will be in position if something else happens. So we want to make sure that we set our country up the right way.

Dr. Abdul El-Sayed: We need we need real insurance. It’s the kind of society insurance that that we get only from investing in people and empowering them with the means of a dignified life that they’ve been denied. I really appreciate your time with us today. And I want to leave with just a final question. Your activism started before you were ever elected to Congress. What do organizers, activists and advocates need to get right about this moment, and need to understand about both their power and the opportunity ahead of us and the strategy that that folks should be following if they want to create change and build that that new normal that we’re talking about.

Representative Cori Bush: First of all, you know, we have so many, I’ve seen since the murder of Mike Brown and all of our activism and the 400 days we spent out there on the ground in Ferguson fighting for justice for him, and accountability for him, and for so many others. And since then, all the organizations and groups that have come about since then, all the movement work, all the organizing. And I’ll say this, all of the silos don’t help advance our agenda, you know. Breaking down those silos, the very silos that we thought we were fighting against, we’ve built up even more. So breaking those walls down. We have to work together. And we have to not just talk about being intersectional, we have to see how truly our issues interconnect, and even within our issues, how our work interconnects and do that, you know, instead of: who’s receiving what, how many times this person did this, you know. And I love the work that we’re doing. I absolutely do. But I’ve also seen how sometimes in Congress we get stopped by “who can we call about this?” Or this group won’t work with that group and all of that. Like, that’s such a barrier. We got to figure out how to do this thing together. And we can’t look at, you know, this organization is better than this organization. This one has more money than that one. And it is sometimes the one that doesn’t have the money is the one doing the most work, you know, because they are not paying administrative costs and all of that stuff. So that’s what I want to see. I would love to see as activists, us figure out how to just love each other as activists, and appreciate the work that we are all doing, regardless of who has a bigger title, regardless of who has more time on MSNBC or whatever it is. Like, let’s just do the work together. Look, if that’s soft pitch comes, I can hit it. But if you don’t throw me that soft pitch, I have nothing to hit. Now I got to go find somebody to pitch the ball. Please throw us the soft pitches, you know, so that’s what we need right now.

Dr. Abdul El-Sayed: And what’s your message to folks who aren’t out there advocating and organizing every day?

Representative Cori Bush: We need you. There is a place for every single person in this movement. Everybody has a place, every single person. You may not be the one that’ll get up with the bullhorn. You may not be the person that’ll get up in the policeman’s face or somebody else’s face. You may not be the person that’ll be out marching. That may not be you, but you might have access to a boardroom. You may have access to the media. You may have access to community members that we don’t have access to. That’s what we need. We need you to kick in there. Kick in wherever, whatever your network is, whatever that milieu is, whatever you have, whatever your environment is—we need you to kick in there. Because when we put all of that together because we can’t do everything, so when you put your piece with the next person’s piece with my piece, that’s how we see this real change. And the other thing is, we love what you do on social media. We all got to do that. But we also got to show up. We need your feet. We need your hands. We need your eyes. We need your body out there in some type of a way, whether it’s on the ground or like I said, in the boardroom, in the courtroom, wherever. We need you. And you got it. That’s the thing. You got it. There’s nobody coming around saying: oh, you’re an activist now, I’m going to anoint you because you serve 275 hours of community service. Nobody does that. Like you’re an activist because you’re active. So show up. We need you.

Dr. Abdul El-Sayed: Congresswoman Cori Bush, thank you so much for joining us today.

Representative Cori Bush: Thank you. Have a good one.

Dr. Abdul El-Sayed: As usual, here’s what I’m watching right now: teenagers aged 12 to 15 in America are on the cusp of being eligible for their COVID-19 vaccines. This is, of course, a good thing. Vaccinations and teens aren’t necessary to open schools back up, but they’ll go a long way to alleviating parents’ anxieties about it. And though rates of disease and death have been low, this pandemic has affected young people, too. That said, it raises a profound equity point. We’ll be vaccinating teenagers in America, while far more vulnerable elders in countries like Brazil and India go without vaccines in the midst of historic surges. That forces us to ask: what is America’s responsibility to the world? Thankfully, last week, the Biden administration put their support behind waiving intellectual property protections for COVID-19 vaccines.

[voice clip] President Biden siding with leaders across the globe to waive pharmaceutical giants’ patents on COVID-19 vaccines. The move could help save thousands of lives in countries like India and Brazil, where officials are grappling to contain new waves of the coronavirus.

Dr. Abdul El-Sayed: Let’s dissect a bit here. Vaccine patents give manufacturers a monopoly on the production of vaccines. If you’re a monopolist, you try to extract the highest price you can because you’re the only one selling. People have to pay or go without your product. If that’s some fancy virtual reality headset or some other technology, so be it. But if that’s the vaccine for a deadly virus in the middle of a pandemic, that’s a bit of a different story. Their monopoly means that people simply don’t get vaccinated. These waivers would break the patent monopoly to allow foreign companies to produce vaccine for the rest of the world without having to negotiate with the manufacturers. They’d still get paid, of course, but a set price without being able to control the supply. Right now, manufacturers Pfizer, Moderna, Johnson & Johnson, they don’t want to lose their patent monopolies because it means they’d lose some money. And they’ve been lobbying the Biden administration and virtually anyone else who will listen to keep them. So the fact that the administration is supporting the waiver is a big deal. As you’ve heard me say before, it would be a profound moral failure on our part to fail the world at this time. There were basically three options the US had when taking up this responsibility: either directly manufacture enough for everyone, buy enough for everyone, or get behind waiving patent rights for US-based manufacturers to allow them to manufacture enough for everyone. Personally, I think we should do all three. They’re not mutually exclusive after all. And by getting behind this waiver, the Biden administration is signaling their intentions to do just that. Good-faith detractors against the waivers argued that it would dry up supply lines, that international manufacturers don’t have the necessary equipment to manufacture mRNA vaccines and that they just don’t meet standards. It’s true, mRNA vaccines are harder to manufacture at scale than traditional vaccines, but it’s also true that a tremendous amount of the world’s vaccines already are produced in facilities in lower and middle-income countries. They can do it if we support them. And while supplies are limited, that’s in part because demand has been low because only a few manufacturers have a lock on the vaccines. If manufacturing was open to new companies, demand for these supplies will grow, resulting in more production capacity of the various supplies and reagents coming online. Now, the bad-faith detractors argue that this waiver will kill the incentive for innovation in the future. And you know what? That’s hot garbage. These manufacturers took zero risk on these drugs. They were bought and paid for by the US government even before they knew they would work. The US government, you and I, as taxpayers, took the risk to innovate and now they want to protect their profits while folks suffer around the world. In fact, Pfizer reported that they’ve already made 3.5 billion with a ‘B’ dollars on the COVID-19 vaccine in the first quarter of 2021 alone. How much more do they think they deserve?

Dr. Abdul El-Sayed: That’s it for today. Next week, we’re tackling science and health communication. I’ll speak with none other than Dr. Sanjay Gupta, CNN’s chief medical correspondent, about how new science, misinformation and politicization changed his job as a medical journalist in the context of the pandemic. If you like our pod, tell everyone about it! Rate and review today, and make sure you tell your friends. It’s not just a vanity thing, it changes the way that algorithms serve up our content. So please, do your part.

Dr. Abdul El-Sayed: America Dissected is a product of Crooked Media. Our producer is Austin Fisher. Our associate producer is Olivier Martinez. Veronica Simonetti mixes and masters the show. Production support from Tara Terpstra and Lyra Smith. The theme song is by Taka Asuzawa and Alex Sigiura. Our Executive producers are Sara Geismer, Sandy Girard and me: Dr. Abdul El-Sayed, your host. Thanks for listening.