Former Surgeon General Jerome Adams discusses health disparities with Mizzou audience

The value of knowing your audience and tailoring your message to get the results you want is a skill Jerome Adams learned to use as a public health official working in government.

Adams, the surgeon general during the Donald Trump administration, on Monday was the keynote speaker to conclude Black History Month at the University of Missouri, with its theme of "Black Health and Wellness."

He spoke to an audience of around 75 people in Stotler Lounge at Memorial Union on the topic "Why Health Inequities Are a Social Justice Issue."

He was labeled as possibly "the nicest guy in the Trump administration" in a Washington Post headline.

"You have to be realistic about the audience you're working with," Adams said. "The real challenge is how do you find a middle ground."

Infant mortality is much higher among Black children than white children, he said.

It wouldn't be good to lead with claims of institutional racism as health commissioner of Indiana in trying to get funding from a super-majority of white, Republican lawmakers.

"Instead of leading with race, I talked with them about how infant mortality is higher in rural communities," he said. Many of them were from rural areas and he worked in information about Black infant mortality when it fit.

"That resonated with them," he said, resulting in $18 million to lower infant mortality in the state.

People are more likely to compromise when race isn't part of the equation, he said.

He talked about a heart patient with swastika tattoos on his chest and their mutual interest in their own kids. The patient initially was reluctant to expose his chest to Adams to attach electrodes.

"I'm not Pollyannish here," Adams said. "I don't know if I changed his mind. But maybe that planted a seed."

A similar approach is needed for those who are vaccine-hesitant.

"There's still lots of barriers out there," Adams said. "When we blame and shame people, we push them away."

The infamous Tuskegee Study, during which Black men with syphilis were given placebos and allowed to die instead of being treated, went on for 40 years and isn't easily forgotten, Adams said.

He convinces people every day to get vaccinated, he said. He does it by explaining why he got vaccinated and by telling them he cares about them.

Questioned by MU law professor David Mitchell, Adams was asked about admitting this year that he was wrong about telling people to stop buying masks at the beginning of the COVID-19 pandemic in February 2020.

Up until then, if you had a respiratory infection, you knew it, he said. China wasn't being forthcoming with information about asymptomatic transmissions, he added.

"We also knew that health care workers couldn't get masked and they were being harmed," Adams said of the mask shortage early on. "(Masks) have not been shown to protect the general public against infection."

But learning about asymptomatic transmission changed his advice and that of Anthony Fauci.

"That's how science is supposed to work," Adams said.

The problem is people are penalized when they say they're wrong, he said.

"I went to D.C. to be America's doctor, not America's politician," he said.

Speaking with reporters before the event, he said he's very troubled about how politicized health information has become. The solution may be found in delivering the information somewhere other than the major news organizations and more outreach at the local level, to church groups and in languages other than English.

The pandemic was superimposed over a divisive presidential election, he said.

Most people believe that racism exists, but most people don't believe they have any responsibility for it, he said. That's where data collection comes in.

"The pandemic has shone a light on the importance of data collection," Adams said, adding that after gearing up, the Centers for Disease Control and Prevention was able to show high rates of COVID-19 infection among Blacks.

Blacks and Native Americans suffer higher rates of obesity and diabetes, are more frequently front-line workers, and often live in multigenerational households, putting them at greater risk, he told reporters before the event.

While acknowledging "bad actors" on both sides, the only examples he used were Democrats.

He called Joe Biden's vaccine mandates for workplaces "heavy-handed and political."

He said he was hurt by Vice President Kamala Harris' comment during the campaign that she wouldn't trust a vaccine produced by the Trump administration.

That's not the message people heard, he said.

"What people hear is don't trust the vaccine," Adams said.

Here's what Harris said on Oct. 7, 2020: "If the public health professionals, if Dr. Fauci, if the doctors tell us that we should take it, I’ll be the first in line to take it. Absolutely. But if Donald Trump tells us that we should take it, I’m not taking it."

Speaking with reporters before the public talk, Adams talked about the importance of mental health screenings and making them routine with physical exams.

"We can't be healthy physically if we aren't healthy mentally," he said.

His own brother was incarcerated with substance abuse issues when he was surgeon general, he said.

"My brother is home now," Adams said. "He's struggling."

Recovery-friendly communities are needed, with good-paying jobs.

"I really believe we need to engage with the business community," he said.

The U.S. spends the most money on health care and gets some of the worst results, Adams said.

"Health care alone won't make you healthy," Adams said.

It also requires a job with a living wage, access to fresh fruits and vegetables, and walkable communities, he said.

He ended with a quote from Missourian Mark Twain, encouraging the audience to see the world through others' eyes.

"Travel is fatal to prejudice, bigotry and narrow-mindedness," he said.

rmckinney@columbiatribune.com

573-815-1719

This article originally appeared on Columbia Daily Tribune: Blaming and shaming isn't a good strategy, said former surgeon general