More Conversations from Aspen Ideas: Health

JOEL BERVELL: Hey, listeners, we're back with two more conversations from our very special miniseries of The Dose recorded live at the Aspen Ideas Festival. I spoke with some of this year's Aspen Global Innovators Healthy Communities Fellows, and I'm still thinking about everything we talked about. Today, we're sharing interviews with people reshaping how we think about and address community health. I hope you enjoy.

My first guest today is Mary Oxendine. She's a Lumbee and Tuscarora granddaughter of rural sharecroppers, and a cultivator of relationships and traditional Indigenous foodways. We could stop right there, and just launch into this conversation.

There's so much to talk about. But I also want to say Mary was until recently the inaugural Durham County, North Carolina, food security coordinator, where she helped support the growth of a Black femme-led community accountable grocer and launch initiatives to develop an incubator farm centering Black, Indigenous, and people of color.

She also works with beginning and established farmers to develop and grow their businesses using environmentally sustainable practices and building intergenerational community health, wealth, and healing.

What a huge pleasure to have you here with me in studio in Aspen. Thank you so much for joining me, Mary.

MARY OXENDINE: Thanks so much for having me, Joel. I really appreciate it.

JOEL BERVELL: Yes, of course. So your work on so-called food security issues isn't obviously about health outcomes to some, but it is. If you're hungry and don't have access to proper nutrition, that can create a whole range of issues for health, for children, for everyone, all the way up to elderly adults. Can you give us some insights on the most urgent food security issues among the populations you work with in North Carolina?

MARY OXENDINE: Absolutely. So as many people know, in the United States, we have a prevalence of diet-related diseases, and part of that is definitely eating behaviors, but actually, food insecurity contributes to potentially poor eating behaviors or disordered eating. So if you don't have enough money to purchase nourishing, nutritious food, you're going to try to get the biggest bang for your buck. So you might be buying maybe ramen noodles or hot dogs, things that maybe make you feel full, but don't necessarily give you the best nutritional benefits. So in that cycle, if you're eating those unhealthy foods, you start getting sicker, potentially having more health issues, and then you have to pay more for medical bills. So then you have even less money for food, for housing, for childcare, for all the things that have become even more expensive during COVID. And so that cycle ensues. And so just thinking about just heart disease, diabetes, high cholesterol, definitely are contributed to by folks that are facing food insecurity.

JOEL BERVELL: Absolutely. And like you're explaining, it's a cycle that self-fulfills itself as it continues to go.

Your own roots are Indigenous and, like so many of us, mixed. Can you talk a bit about your Indigenous, Black, Latina, and other communities and how they may share similar challenges or face very different challenges in access to good nutrition?

MARY OXENDINE: Absolutely. I would say, particularly, Indigenous and Black communities have been displaced, disconnected, removed from their traditional foodways, and even for the Latino community or Latina community, some of them have chosen to move to the United States. And I think that that really impacts these diet-related diseases and the new American diet that everyone is consuming. Also, just to add to that, the way our society is structured in historical racism, systemic racism, Black, Latino, Indigenous folks are more likely to be food insecure because some of the populations tend to have lower incomes, and so they're facing even more problems in addition to the disconnection.

JOEL BERVELL: I always think about the fact that in medical school, we never really have a nutrition course, or most schools don't. I think a few medical schools I've introduced it in, but having culturally competent ways of talking about nutrition too, because like you're saying, the access to different foods is very different, depending on communities or even culturally what is seen as the foods that are in an environment. So I think the work that you're doing is so important in that regard too.

MARY OXENDINE: Thank you. Yeah, I think having more nutrition courses in medical school would be extremely important, but also just noting that there are a lot of dieticians that could be part of that care team with physicians. I know physicians are tasked with learning a lot of things, and I don't think it's realistic for one person to hold all the knowledge. And so I think working with pharmacists or physical therapists, just making sure that dieticians are integrated deeply into that care team so that patients are really getting that nutritional advice that they need and physicians aren't necessarily tasked with learning a whole 'nother field of knowledge.

JOEL BERVELL: A whole 'nother discipline.

MARY OXENDINE: A whole 'nother discipline. Yeah.

JOEL BERVELL: Yeah. And is there a fundamental shift going on in the food security space away from traditional food assistance slash delivery systems? So things like meals on Wheels or food pantries, which often feature shelf-stable and less nutritious food to a focus, some more growing healthier foods at home, and if so, how is that supported?

MARY OXENDINE: Yeah, there's a twofold answer to that. So people do need food right now, so we absolutely need to support our food pantries, but part of the work with the pantries was helping them to be able to have refrigerators, freezers, to be able to actually source produce and frozen fruits, vegetables, meats, so that it's not just the canned and shelf-stable products all the time, that folks do have access to healthier foods. And then the other arm of that is really focusing on how do we create systemic change to create a more equitable food system so that people can actually be able to access the food that they need. And so creating things like the incubator farm or supporting local grassroots-led grocery stores and really thinking about how do we build up the organizations that are already working in this space and support the efforts that are already in place.

JOEL BERVELL: And you mentioned incubator farms. Could you explain a little bit about how they work, so listeners have an idea?

MARY OXENDINE: Yeah, so the idea is, let's just say, you have a large amount of land and each potential person that would like to farm gets a part of that land, and they have the access to education, to the tools, equipment, resources that they need to learn how to farm on a smaller piece of land that they then can build their business up to a place where they can potentially move and be able to purchase their own land and be able to scale their business. So it's really a place to foster learning growth, connect them to markets, and be able to launch new business owners.

JOEL BERVELL: That's such a beautiful model, and it's creating generational wealth in a way, right? Giving people the opportunity to have their own land, grow their own land, then pass it on for generations.

MARY OXENDINE: Absolutely.

JOEL BERVELL: Actually, one other question. How can we scale the work that you're doing right now on the ground and replicate it in other communities?

MARY OXENDINE: That's a great question. I think really listening to community is where I would start. These ideas and the work that I was doing, it didn't just come from me. It was things that folks had been talking about in the community for a long time. It was things that people wanted to get going, but they weren't sure how to get started. So I just got to be an instigator and an advocate. And so I think, in that way, it can be replicated in that the folks that are facing these problems already know what the solutions are, and they know what would be most helpful for their community.

JOEL BERVELL: Absolutely.

MARY OXENDINE: And so, just empowering, providing resources, to advocating for those solutions that are coming up from the community is how I would say you could replicate this work.

JOEL BERVELL: Well, truly, Mary, thank you for all the work that you're doing in your communities and beyond. All the best to you as you push the work forward. Thank you so much.

MARY OXENDINE: Thank you so much, Joel. And I will be founding a new Indigenous food sovereignty organization soon. So more to come on that.

JOEL BERVELL: I love that. Okay, last question then: So now I need to ask, how can people support you? What are your needs right now?

MARY OXENDINE: So I'm looking for partners and supporters to be able to launch my organization. I'm really focused on doing a feasibility assessment, as well as creating a strategic plan, thinking about how do I work with my elders that I'm already in community with and folks that I've already been in conversation with to move this work forward. So if you're interested in supporting financially and just in partnership, and if you are interested in Indigenous food sovereignty, about preserving foodways and medicine, definitely feel free to reach out.

JOEL BERVELL: Mary, thank you so much for the work you're doing in your communities and all the best to you as you push forward the work. I know you're here because your work is at the forefront of needed change, to ensure that everyone has access to everything they need to live in good health. Thank you so much, Mary.

MARY OXENDINE: Thank you.

JOEL BERVELL: My final guest on this Aspen edition of The Dose is Shameca Brown, a mental health advocate and provider in Tulsa, Oklahoma. She has founded two mental health care organizations, and for more than six years, she's served on the board of directors of the Mental Health Association of Oklahoma. The state of Oklahoma currently ranks 49th for health care in the country.

What that means is that health care access and health care quality in Oklahoma is about the worst in the nation. And I believe when people say health care, broadly, they're talking about physical well-being. I don't assume that most folks in the United States automatically even think of mental health as part of health care. So, for my guest, the assignment she has taken on is very clear.

Shameca Brown, it is my honor to have you here with me on The Dose.

SHAMECA BROWN: Thank you.

JOEL BERVELL: So your work as a mental health advocate for Black and brown people in Oklahoma takes a community healing approach. You're very intentional with a youth focus promoting SEL, social emotional learning, and young adult peer support. How did you land on those initiatives as foundational to your work?

SHAMECA BROWN: So for me, I had a family history of mental health and was not aware that mental health was embedded generationally in my family. So as I became older, I became a mom and I wanted to really apply myself and create a better life for my children. I decided to go into some psychology work, so I was just exploring. I was healing at the time. And so when I got in, I realized that there were many families like mine that struggled with the same issues that I did, and there was just this unawareness. And so I took it upon myself to put myself out there and share my story and walk others through my healing journey. And so I wanted to do that on a larger scale. And so I then founded my agencies and I just decided to just be the trailblazer for my community and the families that I'm connected to.

JOEL BERVELL: Absolutely. I love that you say I decided to be the trailblazer, because it's something that you have to take up the mantle, no one's forcing you to do it. You have to be willing to put yourself out there and do it. What are the strategies you use to encourage mental health care? Is there a significant stigma barrier that you've seen?

SHAMECA BROWN: So first strategies, I'm very transparent with my clientele and I also train my providers to be transparent. Ethically, yes, we do have boundaries, but I think people receive better if they can see them in you. So when you share your story and your walks to life with others, I believe it helps them feel empowered and encouraged and gives them hope to continue on whatever journey they're on.

JOEL BERVELL: And I want to circle back to the youth piece of it, because that's central to what you are doing. Why focus there and how are you focusing there?

SHAMECA BROWN: They are so abandoned. Youth are so abandoned. The teenagers are so abandoned, they're so left out on their own. I was a youth that was abandoned. I didn't have adults that stood up to continue to care for me after a certain age. And a lot of my young adults just need someone to walk through life with them. It's a very challenging time. If you think back when you were 16 to 20, you're like you didn't know what you were doing yet when you think back. And so I really just like to walk beside them. That's it. Not control them, not tell them what to do, but just walk with them through life. Help them make wise decisions for their selves and their families.

JOEL BERVELL: I really want to stick with this because youth mental health is one of my passions. When I was an undergrad, I ran a mentorship program at two schools in New Haven, Connecticut, and they were both really low-resourced. And it was really interesting just seeing the struggles that the kids had to go through, and how they were so different than things that maybe other students had experienced. So I'm curious if you can maybe share some stories of some of the youth that you've worked with, strategies you found that have worked for them, things that have sparked change in their lives.

SHAMECA BROWN: So this last past year, I worked in a middle school with Black and brown youth. And one of the things I noticed is that, of course social media is their life. But one of the things I noticed is that outside of social media, they really do desire personal connection. They really want adults to be involved in their lives and in tune in what they're doing and interested in them. And so some of the approaches I take one-on-one is just learning about them.

I don't want to tell you who you need to be or who you want to be. I want to know who you are and understand you from that perspective. And then if I need to give you tools, I will give you the tools and resources, but at the end of the day, I want to get to know who you are. And I do that with my own children. I have a 17-year-old and I'm just like . . . and that has worked out for us. She's able to make decisions for her personal life, and I'm able to just, when something happens, I'm able to be there and say, "Hey, what direction you want to go now? This is my experience with me making a decision at that age and you get to choose."

JOEL BERVELL: Absolutely. And at the top, I talked about social emotional learning and how you're implementing that. For some listeners who may not know what it is, can you explain what it is at a high level?

SHAMECA BROWN: Yeah. So social emotional learning, we use that a lot with our younger, younger kids. We utilize that to help individuals identify their behaviors, kind of helping these kids and young adults understand their emotions, put meaning to their emotions.

JOEL BERVELL: Yeah, I love that so much. Emotional intelligence. I took a class on that when I was an undergrad with Marc Brackett at the Yale Center of Emotional Intelligence. And we learned about SEL and specifically this called "the ruler method." Where you're able to recognize your emotions, understand them, label it, and once you're able to do all of that, you're actually able to regulate your emotions. And I think too often we don't learn that, but the earlier you teach kids about that, the better they're able to understand themselves, understand how they interact with their communities, with their families, and to positively regulate their emotions.

SHAMECA BROWN: Yeah, and I think they're more confident within their selves if they understand their emotions and able to make decisions based on them rather than them making decisions from their peers.

JOEL BERVELL: We're talking a lot about individuals. What do you think is the single most important lever that could be pushed to promote improving mental health care capacity in your state, in Oklahoma?

SHAMECA BROWN: Programs. Whenever you develop a peer-to-peer model, I don't care any age, if you can develop a peer-to-peer model, my most success as being, coming from the trauma that I came from to where I am now, is because I had people who understood me, not understood me because they could empathize with what I was going through, but they related. They were able to share their stories and their testimonies of how they became or overcame. Peer-to-peer I think is a really good model. Teach children at a young age how to hold their friends accountable, how to be good friends, but also hold their friends accountable.

JOEL BERVELL: Yeah. Oh, I love that so much. Well, Shameca, thank you so much for being here with me on The Dose.

SHAMECA BROWN: Of course. Thank you.

JOEL BERVELL: I'm wishing you all the best in your important work in continuing to establish quality mental health care in the communities that you're in. It's not an easy job, especially in Oklahoma. But thank you for these insights that you've given us and listeners, and to the very real health equity struggles that are going on right now. Thank you.

Thank you so much for checking out this set of conversations from the Aspen Ideas Festival. If you haven't heard last week's episode with Lola Adedokun and Elizabeth Lutz, I recommend you check those out too. We'll be back soon with more episodes of The Dose.

This episode of The Dose was produced by Jody Becker, Mickey Capper, and Naomi Leibowitz. Special thanks to Barry Scholl for editing, Jen Wilson and Rose Wong for art and design, and Paul Frame for web support. Also, thank you to the Aspen Ideas Festival for their support. Our theme music is "Arizona Moon" by Blue Dot Sessions. If you want to check us out online, visit thedose.show. There you'll be able to learn more about today's episode and explore other resources. That's it for The Dose. I'm Joel Bervell, and thank you for listening.

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