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LISTEN: Reginald Tucker-Seeley on how racism is a threat to public health
Dr. Reginald Tucker-Seeley joins the Agents of Change in Environmental Justice podcast to discuss what impacts our health beyond lifestyle choices, and how racism remains a significant threat to public health.
Tucker-Seeley, an Assistant Professor of Gerontology and the Edward L. Schneider Chair in Gerontology at USC, also talks about his time in Washington DC as a Robert Wood Johnson Health Policy Fellow completely reshaping how he thinks about incorporating science into policy.
The Agents of Change in Environmental Justice podcast is a biweekly podcast featuring the stories and big ideas from past and present fellows. You can see all of the past episodes here.
Listen below to our discussion with Tucker-Seeley, and subscribe to the podcast at iTunes, Spotify, or Stitcher.
Transcript
Brian Bienkowski
I'm talking to Dr. Reginald Tucker Seeley, an assistant professor of gerontology and the Edward L. Schneider chair in gerontology at USC. Reginald spoke to our Agents of Change fellows about science and policy, he is a giant in his field and I just had to have him on the podcast. We talk about his work on teasing out what impacts our health beyond lifestyle choices, how racism is a threat to public health and how his time in DC as a Robert Wood Johnson Health Policy Fellow completely reshaped how he thinks about incorporating science into policy. Enjoy.
Now I am very excited to be joined by Dr. Reginald Tucker Seeley. Reggie, how are you.
Dr. Reginald Tucker Seeley
I'm doing great. How about you?
Brian Bienkowski
I'm doing excellent and where are you today, where are you coming at us from?
Dr. Reginald Tucker Seeley
I'm in Los Angeles, California.
Brian Bienkowski
Awesome, awesome. So Reggie, I really appreciate you being here today and before we get into some of your current work I wanted to just take a step back a little bit. And I saw that your undergraduate training was in accounting, which kind of threw me for a loop. So I was wondering what got you interested in public health.
Dr. Reginald Tucker Seeley
Yeah, so actually, in between accounting and public health. I got a Master's in Counseling and family therapy. Another detour. Actually, when I was in my master's program, I was working on a master's thesis, and for that project. I was reading papers on Social Determinants of Health, and the biopsychosocial approach to health. And I realized these were terms that I had never heard. But, but were so clearly articulating what I was interested in. And one of the articles was written by Dr. Norman Anderson, who was at the Harvard School of Public Health at the time, and I was a first generation college student first generation grad student, so I had no idea that schools of public health existed and that social and behavioral departments within schools of public health existed. So when I read the papers on Social Determinants of Health and the bio psychosocial approaches to health, I found Dr. Anderson, and then explored graduate programs at schools of public health. And then, just applied to the programs that had social and behavioral sciences in them, and I got into Harvard and Columbia and I chose Harvard and, then I stayed at the Harvard School of Public Health from Masters student to Assistant Professor.
Brian Bienkowski
You mentioned social determinants of health and another, another term there that I missed, I think it was bio—…
Dr. Reginald Tucker Seeley
Biopsychosocial approach to approaches to health. So this notion that our health is not only influenced by our biology, but also by our psychology and our social environment, and the integration of all of those together to explore, explore our health outcomes. Also during that period, I was doing my clinical internship at Washington University, and their Student Health and Counseling Service and this was in the early 2000s, and they had such a great approach to the mental health of their students. Sso they had their physicians, the psychiatrist, and the mental health counselors, we were all in one location. And I thought that was such a great approach and then it sort of helped to facilitate my thinking around approaches to health that not only thought about our physical health but our mental health and our social environments.
Brian Bienkowski
You mentioned when you saw these terms that this was what you wanted to do even if you didn't know what the terms meant, and I'm wondering if that passion grew from…was just kind of an interest you had, innate, or was this something that something from childhood or upbringing?
Dr. Reginald Tucker Seeley
Well, yeah, so I think in...mental health, and that process consisted of pulling out my undergraduate transcript, and making two lists: courses I loved and courses I hated. And in the courses I hated column tax accounting, cost accounting, all of my accounting courses, and the cost in the classes that I loved were all of my social and behavioral science courses. But I recall at the time as a first gen college student, I had no idea what someone who liked those kinds of courses did for work. And so, I attended the University of Tulsa and Oklahoma for undergrad and it's a small liberal arts college with a really great business school, and we had great, you know, job placements, I knew what I was going to do after college, and actually I landed a great job after college in accounting. I worked in the field for about five years, and great jobs, but they were just not things I wanted to do and I really wasn't passionate about them.
Brian Bienkowski
So perhaps there's a little overlap this question with what you've gone over so far but I've been asking all the fellows in our program, what's a defining moment that shaped your identity.
Dr. Reginald Tucker Seeley
Hmm, identity as a, an individual as a scholar?
Brian Bienkowski
Personal or professional.
Dr. Reginald Tucker Seeley
Um, that's a really good question. I think, I think there, there have been several moments that have been, you know, defining moments for me. I think making the decision to leave accounting was a really big decision. Deciding to enter mental health, realizing that, you know, that wasn't the thing. And then, at 30, I was embarking on a third career so I think that that defining. Yeah, I think I've had so many moments I think that the thing that's been helpful across those moments is just you know not being scared to make those big leaps.
Brian Bienkowski
Was there any mentors, coming up through?
Dr. Reginald Tucker Seeley
Oh, of course, of course. You know, professional and personal. I had a great mentor when I was at, or several great mentors, when I was at the Harvard School of Public Health, that really introduced me to this notion of a team based approach to mentoring. Sort of this notion that, like you might have a mentor that helps you with your actual work, you might have a mentor that helps you navigate your career, you may have a mentor that helps you with work-life balance. You know, trying to think about the various roles in which you need mentorship, and then finding individuals to fulfill those roles and not expecting one person, you know, to fulfill all the other mentoring needs that you might have.
Brian Bienkowski
So we've mentioned a couple times the social determinants of health, and I know this plays a big part in your current work. Can you give us some examples? Maybe some neighborhood level environmental impacts that impact people's health first, then the individual level and social and economic factors.
Dr. Reginald Tucker Seeley
Yeah, so, in some of my earlier work regarding the neighborhood level, one of the things I was really interested in is, how do people perceive their neighborhood environment? And so we explored the association between perceived neighborhood safety and physical activity behavior among older adults. And what we found was that their perception of their safety was associated with their level of physical activity, and that didn't matter if they were high socioeconomic status or low socioeconomic status. Because socioeconomic status is a really good predictor of the type of neighborhood you live in. So, if you have more socioeconomic resources, meaning more financial resources, higher education, you're going to likely be in a neighborhood that provides a lot more resources. The perception is that it's going to be safer, it's going to be free from things like litter, graffiti ,and those kinds of things. And so what we found is that, regardless of socioeconomic status, the perceived safety was important in predicting whether or not older adults engaged in physical activity. And so it's important to think about not only the resources that you have but how you perceive the environment around you. I've also done some work looking at neighborhood resources. So what do people have available to them in their neighborhoods. And one of the things we found in some of that work is that in neighborhoods that are predominantly racial and ethnic minorities, those neighborhoods have more have a higher density of fast food restaurants, and so then that impacts the kinds of food choices that people can make based on the kinds of things that they have around them.
Brian Bienkowski
That leads me into my next question: You pretty recently had a conversation with a colleague, it was called "how racism is a threat to public health." Can you talk a little bit about, you know, especially right now where we're at in the US, hate seems de rigueur right now. And I wonder if you could talk about how this translates into poor health outcomes for black and brown people when there's racism and hate kind of out in the open or even if it's insidious.
Dr. Reginald Tucker Seeley
One thing I often use when I give talks about racial and ethnic disparities is from Sir Geoffrey Vickers, where he talks about this notion that public health is really guided by redefining things from things that are a given to the intolerable. And I think for too long we see these health disparities sort of a given, and we need to move them to this point to where they are intolerable. We no longer tolerate these differences, these large differences in health and healthcare related outcomes by race. I think the challenge to that is racism. The different experiences the different levels of socioeconomic resources. And how racial and ethnic groups have been sorted is really based on a history of social policy that has sorted racial and ethnic minorities into certain neighborhoods, into certain into specific jobs that then lead to these difference in health outcomes that we see.
Brian Bienkowski
So this spider webs into all kinds of different systems and cultural institutions, this goes pretty deep. But I'm wondering if you have kind of specific suggestions or prescriptions that you think kind of the public health field could do to, to address some of these in the more immediate.
Dr. Reginald Tucker Seeley
Yeah so, I think, given the events of last summer. The deaths of George Ford and Breonna Taylor really galvanized people to start to talk more about systemic racism. And I think, since I've been in public health, this feels like the longest sustained conversation that's been…I mean I think we've continued to talk about it in public health, but it seems like we are sort of engaging with larger communities. And so, during this period, we're seeing so many organizations come out with statements, which is which is great, but I think we have to move past the statements, and to the action. And so it's great to be against racism, but how are the behaviors of your organization anti-racist? What are you doing to tear down the barriers to systemic racism, the things that have, as I mentioned earlier, sorted groups into, respective places and positions in the social hierarchy. So what can organizations do, what can individuals do? The first step is introspection. So thinking about what have you done as an individual, what has the organization done, that has perpetuated systemic racism within your respective context. And then making an effort to be anti-racist, to no longer engage in either those behaviors or those practices from your organization. And to ensure that, as decisions are being made from an organizational perspective, that racial and ethnic minority folks are at the decision-making table. There's a saying—I spent some time in Washington DC as a Health Policy Fellow, and there's a saying there that, if you aren't at the table then you're on the menu. And so I think it's important for the people who have been historically marginalized to be at the decision making table as those structures around systems are being dismantled.
Brian Bienkowski
You mentioned your work as a policy fellow in this. Before we get into that, I'm wondering if your work now—so if you if you do some research on a neighborhood and you notice the research you mentioned before, maybe there are not mental health resources, maybe there aren't green spaces, whatever that is. Do you or colleagues, is there kind of the next step of like, well we need to engage city planners, we need to engage community leaders. Is that something you're trying to actively do?
Dr. Reginald Tucker Seeley
To be honest that's not something that we have been historically trained to do in public health programs which I think is something that we need to do a better job of. So I will say that the best part of that process should be not that we engage with those policymakers at the end of our study, but that we've been having conversations with those policymakers all along. So that we are not just introducing them to our findings and assuming that our findings are going to be priorities for them. And so if we have included folks in the community and policymakers in the conversation from the beginning of the research projects, I think that facilitates change much better than saying, "hey we had these research results, are you interested in them, here's a copy of our paper."
Brian Bienkowski
So your work as a health policy fellow with the Robert Wood Johnson Foundation. What was that experience like, what did you learn? Did it give you different insight on science and research in the policymaking arena?
Dr. Reginald Tucker Seeley
Things that I quickly realized when I got there was, I thought I knew something about health policy. I knew like so little about how big this enterprise really is, of health policy. And so that was one of the first things I learned. And then after those three months you're placed in either an executive branch or a congressional branch office. My cohort has six fellows and we all were placed, we all chose, congressional placements in the 2017-2018 academic year, and my placement was in Senator Dianne Feinstein's office working with her health policy team. And so one of the many, many, many things that I learned was that policymakers, primarily members of Congress have so many issues that they're juggling. I would sit in on staff meetings and I would just watched Senator Feinstein go from issue to issue to issue. From issues related to defense, related to health care, related to housing and education. For those of us that are researchers, we have our area, and we take our area to the policymaker, assuming that they're going to care about that issue when they're juggling all of those other things. And so, I think I realized that we as academics have to do a better job at figuring out how to get policymaker attention when they have so many other things that they're paying attention to.
Brian Bienkowski
And what are some of those tools or tips that you brought home.
Dr. Reginald Tucker Seeley
Yeah, so, first thinking about what are the priorities of the policymaker? They list those priorities on their websites, they tell you what they're interested in. And so trying to align what you do with policymakers that are interested is one of the first things to do. The other is establishing a relationship with the staff member. Many of the listeners may be familiar with Capitol Hill days if you're a member of a professional organization—you go to the Hill, you talk about, what your organization does and what your issues are. And many people may think that Hill visit is the end. And actually that Hill visit should be the beginning. It's the beginning of establishing a relationship with that staff member so that they know who you are, they know what your organization does, and they're familiar with that work. So that in the event that something comes up that they're working on, your organization is one of the first that they think about to reach out to. The third thing is, your organization might be the one that they reach out to, but they're going to reach out to you and they're going to need something really quickly. So the pace of Washington was something else that was unlike anything I've ever seen. Because issues just keep coming, they come up so fast and you have to sort of get up to speed on that topic and be ready to write talking points for the policymaker that day, or the next day. And it might be something you know a lot about, or it might be something you know very little about initially. So just being prepared for that pace, both from the staff member side, and from the side of the researcher if you're asked to provide information.
Brian Bienkowski
It's funny you mentioned the pace, because when I go to journalism conferences and talk to my DC friends who work there, I always tell them, we do not have the same profession. What you do and what I do—I'm up here in the in the sticks, it is just a radically different world. Were there any specific bills, or pieces of legislation that you worked on?
Dr. Reginald Tucker Seeley
So when I was there, the Democrats were in the minority. So, you know, the other thing is, you learn about how Congress works and the Republicans were in the majority so it was really difficult for any Democrats to put any bills forward. So I worked on a lot of priority areas for Senator Feinstein, but not on any specific legislation—not on any specific legislation that actually made it to the floor. But we did actually work on sending letters to executive branch folks. So one of the things I was really proud of is that we worked on a letter to NIH focused on increasing diversity in clinical trials, that Senator Feinstein was really interested in, ensuring that NIH did a much better job of focusing on that.
Brian Bienkowski
Would you have recommendations for up and coming scholars who want to see their research turned into change, they want to see it turn into policy change and good. But you know a lot of, let's be honest, at a lot of universities that's still not something that's incentivized. You know, you have to publish in research journals. Any advice for someone who wants to really do research, but also have it turned into action.
Dr. Reginald Tucker Seeley
I think sort of thinking about at what level you're interested in turning it into policy. I think it's really hard to get it, you know, into federal level policy. But maybe local policy is a place where you could have a bigger impact and those people are closer to you. But you're right, in the academic environment, those things are not necessarily incentivized. And so I think the academy is going to have to change in terms of, what are we encouraging scholars to do in terms of dissemination. Because I think the other challenge is that the pace of policy moves both quickly and slowly, so sometimes things move really fast but to actually get legislation over the line can take years. And so, again, maybe looking locally to where change can probably be a bit quicker, and getting your research in the hands of local policymakers who might be interested in what you're working on, and then making sure that you try to keep some of those connections with legislators at the state and federal level as well.
Brian Bienkowski
You mentioned a broader recognition of racial disparities and public health, I'm wondering if there's other things that are giving you hope and optimism that you're seeing in the field right now.
Dr. Reginald Tucker Seeley
I think that's the big, that's the big one, the attention to racial and ethnic disparities we saw with the pandemic. I think for many of us who work in this space, the stark disparities that we saw from exposure, to access to treatment, to access to the vaccine, and sort of that whole trajectory was less surprising to those of us who who've worked in this space. But the fact that we're seeing more people talk about it is encouraging. And to see funders talking about, not only describing these differences, but how do we address the systems that created these differences. So I'm starting to see a lot of funding announcements related to addressing structural racism, the structure that led to the differences that we see. So not only are we just describing these differences across groups, but we're actually hopefully now looking for solutions.
Brian Bienkowski
When COVID hit, we had a couple of the Agents of Change essays ready to go, and we were scared that they were going to get buried in this COVID news. And then they came out and they were speaking to the topics you're talking about: representation in research, one was about food access and farming in black communities. And these are some of the most widely read stories I've seen since I've been editor, and I think it was this recognition among people that there's just this intertwining of all these issues. And COVID kind of brought that to the surface, so to speak. Is there anything you're not working on, but you hope to work on either soon or down the road.
Dr. Reginald Tucker Seeley
Yeah, so one of the things, back to my Washington DC experience, is that I learned so much about the legislative process. How things go from an idea that a policymaker just has, how that idea moves through the office, how that idea moves through the congressional body to legislation to law. And I'm really interested in, what are the facilitators and barriers to legislation to address health disparities. There's been a couple of pieces of legislation introduced related to this, but they've just been introduced and they haven't really moved forward. And so I'm really interested in gaining a better understanding of that process, of what are some of the barriers to moving that kind of legislation forward. And specifically legislation that is explicit about its attention to those differences. I think one of the things that's sometimes said in policy circles is that, a rising tide lifts all boats. But I don't necessarily think that, in a rising tide, that all boats are as prepared to be lifted. So there's all these sayings about how, we're in the same storm but not in the same boat—all of those kinds of sayings. So I think, recognizing that we need general population policies to improve the health and well being of our general population, but we also need very targeted policies that address the historical and the systemic racism that again has sorted people by race into certain neighborhoods, certain places, certain jobs and certain positions within our social hierarchy.
Brian Bienkowski
On the communication front you mentioned, one page kind of distilled down research. Are there any other tools, I know Dr Ami Zota, my colleague here is doing a lot of Twitter. She's having the agents use a lot of social media platforms to try to get their message out, get their voice heard a little bit. I was wondering if you use social media, or other kind of mediums to get your message out.
Dr. Reginald Tucker Seeley
I do. So I have a Twitter account that I use and also I'm engaging with undergrad students on my campus. So I'm not the best at things like Instagram, and all of those other types of tools, and so I have an undergrad student in the lab that's helping me with communication. So he created an Instagram account for our lab and created some infographics that introduces the staff. And we're starting to work on ways in which we can summarize the findings from our studies that are in these single page documents, to where people can just get either the basic ideas from our papers and then maybe go read the full paper if they're interested. So I'm still learning how best to navigate social media and hopefully the undergrads can help me do that.
Brian Bienkowski
Yeah, it's hard to keep up, eh?
Dr. Reginald Tucker Seeley
It is. It's so many of them. I'm still on Facebook and I hear that's just for folks, you know, my age and older so yeah.
Brian Bienkowski
So Reggie, this has been a lot of fun for me and I have one last question that I've been asking everybody and that is the last book that you read for fun.
Dr. Reginald Tucker Seeley
Oh, for fun. That's an interesting one. I just bought a book called The Sum of Us. I think that it's by Heather McGhee, so correct me if the title of it is incorrect, I'm sorry Heather McGhee for getting the title wrong. But, I've just read the introduction, and she was writing it during Trump's movement into office and that was actually when I was a Health Policy Fellow and she does work on economic policy. And it perfectly described my experience in Washington, so I'm loving that book right now. It's interesting, I think that as an academic our fun and work books kind of blend together. So yeah, that's the book I'm currently reading right now.
Brian Bienkowski
Well, excellent, Reggie. Thank you so much for taking time today, I really appreciate it.
Dr. Reginald Tucker Seeley
You're welcome, glad, happy to chat.
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