Florida health agencies are run by black women. Can they create fairness?

TALLAHASSEE – Shamarial Roberson remembers the wait.

Her grandfather had suffered a stroke and needed a doctor immediately. Roberson, so just less than 10 years old in a town of about 800 people in North Florida, could do nothing but watch the time go by as paramedics made their way to a nearby town.

“I understand what it means when we read in textbooks that access (to medical care) is limited in rural areas,” Roberson said, 35-year-old Greenville native who is now a senior official in the Florida Department of Health.

In February, the govt. Ron DeSantis has appointed two black women to head the state’s main health agencies. Shevaun Harris now heads the Children and Families Department, and Simone Marstiller is the new secretary of the Health Care Administration Agency. Add Roberson, Assistant Secretary of Health for the Department of Health, to the list, and black women are at or near the top of the state’s three major health agencies.

DeSantis made the appointments as the pandemic forced a national count on inequalities in the U.S. healthcare system. Black Floridians face a myriad of challenges. While being infected and hospitalized with COVID-19 at disproportionately high rates, they are also under-represented among those who get vaccinated statewide.

The coronavirus pandemic has only exacerbated inequalities that span decades. Acute mental health issues, high death rates from cancer, and severe complications in childbirth all weigh disproportionately on black Floridians. Among the reasons given by the experts are: disparities in income and insurance; the racial prejudices inherent in the health care system; the stress that comes with going through decades of racism.

Experts and Florida officials say representation matters. Harris, Marsiller, and Roberson bring diverse perspectives that could leave the state better equipped to tackle these challenges, they say.

“I give (DeSantis) all the credit for making the appointments he’s made,” said Marstiller, the new secretary of the Agency for Health Care Administration, which administers the Medicaid program. state and regulates more than 48,000 health facilities. “It is important that people see the diversity among their heads of state. “

OCTAVIO JONES | Times Juvenile Justice Secretary Simone Marstiller speaks to students at the Hope for Healing Drug Addiction and Substance Abuse Initiative held at Roland Park K-8 School in Tampa, Fla. On Thursday, 16 May 2019. [ Times (2019) ]

DeSantis “recognizes talent,” said Haywood Brown, who until April 2 was vice president of institutional equities at the University of South Florida. In this capacity, Brown, an obstetrician-gynecologist by training, has led the university’s diversity and inclusion efforts on campus and in the community. In a state like Florida, “you need to have a talented and diverse group of individuals who can represent the people,” he said.

But experts say representation alone will not be enough. For leaders to overcome these inequalities, they must pursue policies that correct them and, ultimately, be supported by others. in power, said Katrinell Davis, associate professor of sociology and African American studies at Florida State University.

“We can’t assume that things will change overnight – or in any way – because these black women are appointed to these positions,” Davis said. “We have to see what kind of policies they will support. “

The women DeSantis has appointed will implement the policies set out by Republicans. For example, Joan Alker, executive director of the Georgetown Center for Children and Families, said one of the most effective The things Florida could do to improve health inequalities are to expand Medicaid under the Affordable Care Act. Yet Republicans like DeSantis are opposed to expanding the program. They argue that Medicaid is not worth the cost to the taxpayer.

Yet women hold positions that have considerable power.

Roberson, who joined the Department of Health in 2016 and whose current salary is $ 144,200, said she was proud of her track record in addressing health inequalities in Florida. At the center of it record, she says, is her mentoring work for students. She hopes young black professionals will notice her rise to the highest levels of government in Florida.

“This will give other minority populations and people who wish to enter fields such as public health hope that it is possible to have a career in public health and to be a valued member of the team. “said Roberson.

She helped her ministry define the state’s health priorities in a comprehensive health plan intended to cover the years 2017-2021. The document outlines nine broad goals, and health equity is at the top of the list.

But the pandemic has shown how deeply ingrained health inequalities are in Florida: State has been slow to ease high level of COVID-19 case rates and low vaccination rates in communities of color. (Since the fall, the per capita death gap among black and white Floridians has narrowed, according to the COVID Tracking Project.)

As Florida makes strides in reducing new cancer cases, recent statewide study finds health assessment, progress lags in other areas: black men remain more likely than white men to develop some forms of the disease, to be diagnosed at later stages, and to die from the disease. Blacks are more likely to be diagnosed with colon and prostate cancer than any other ethnic group.

And although black women are as likely as white women to be diagnosed with breast cancer, they are more likely to die.

DeSantis has appointed Shevaun Harris to head the Florida Department of Children and Families.
DeSantis has appointed Shevaun Harris to head the Florida Department of Children and Families. [ JOSEPH EDWARDS | Courtesy of Florida Department of Children and Families ]

Harris, a native of Brooklyn who moved to Florida to study at Florida State University, said she made equity a goal of her job. Prior to his most recent appointment to the Department of Children and Families, Harris worked on the state’s Medicaid program at the Agency for Health Care Administration. (Medicaid is a state and federal program that provides health insurance to hundreds of thousands of poor Floridians – mostly children.) Most recently, Harris was the agency’s acting secretary from October 2020 until February.

She has also taught as an assistant professor at FSU’s College of Social Work and was a case manager at Big Bend Cares, an organization that provides services to people living with HIV / AIDS.

As the new secretary of the Department of Children and Families, Harris, 41, will oversee an agency at the center of Florida’s fight for racial equality. Black children are disproportionately likely to be removed from their parents’ care: only 17% of Floridians are black, but black children understand 29 percent of all children which are deleted.

When asked what she would do to fight for equality, Harris initially replied that she needed to take a closer look at the issue.

“As long as these disparities are present, I will examine them,” said Harris, whose salary is $ 146,000. “We will absolutely address all of the disparities identified. “

Marstiller, 56, is the most seasoned of the three. As an agency secretary, his salary is $ 165,800. Florida State Government veteran Marstiller, born in Liberia, first worked in the Jeb Bush administration. from 2001, where she served as Deputy General Counsel – just the first of many titles she would have continue to stand in state government.

Most recently, Marstiller also served as a judge in the First District Court of Appeals and secretary of the Florida Department of Juvenile Justice.

At the Department of Juvenile Justice, Marstiller has witnessed how young black Floridians disproportionately interact with the criminal justice system. According to the ministry’s own data from 2017-18, black children included half of all juvenile arrests in Florida.

Marstiller said she is working to bring racial equality to the forefront by hosting a webinar with various state and local officials who work in the criminal justice space: judges, prosecutors, public defenders, etc.

“We brought them together and really talked about the importance of recognizing where at all decision points across the system, where and how those decisions can affect racial disparities,” Marstiller said.

As a juvenile justice secretary, Marstiller was criticized by criminal justice advocates earlier this summer. These advocates wanted Marsiller’s department to test more aggressively for the coronavirus in state juvenile detention centers. (At the time, Marsiller claimed his agency was “vigilant in our fight against COVID-19.”)

Experts say the new secretaries will have huge responsibilities as Florida recovers from the coronavirus pandemic – but also plenty of opportunities. Various choices could help convince Floridians of all walks of life that the state is fighting for their interests. But only if the policy reflects a commitment to reducing disparities.

“I applaud the diversity of these choices,” said Fentrice Driskell State Representative D-Tampa, but added: “We cannot afford to have purely performative dates”.

The Healthy St. Petersburg Foundation provides partial funding for The Times articles on equity. He does not select story subjects and is not involved in reporting or editing.

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