Like many African Americans, Alma Burrell’s father didn’t like going to the doctor, so he avoided treatment for his diabetes. Burrell recalls him saying, “If I'm sick, and I don't feel like my doctor understands me, I'll stay home, or else wait until it gets a lot worse before I go in.” Watching him succumb to the disease inspired Burrell to come out of retirement after only a month to co-direct San Jose’s first clinic geared toward black people.
“I’ve seen too many of my people suffer like this, and I felt like I still have some juice left,” Burrell says.
The San Jose outpost of Roots Community Health Center is scheduled to open May 8 on The Alameda to provide culturally competent care for Santa Clara County’s African-American population. About 200 potential patients have already set up appointments at the clinic, which will open initially for 30 hours a week.
A county-sponsored study in 2015 found that black people in the South Bay have disproportionately higher rates of HIV and AIDS, hypertension, Hepatitis C, diabetes, and cancer, and lower life expectancies than other groups. Inspired to take action, county supervisors worked with the Black Leadership Kitchen Cabinet to bring Roots, which has been operating in East Oakland for four years, to San Jose.
“What our community said was we need our own health facility, because they didn’t feel public health facilities were serving their needs,” says Walter Wilson, a longtime San Jose community activist and Roots board member.
“At first, to be honest, I said, ‘Is there a lot of need down there? I think of it as a wealthy area,’” says Dr. Noha Aboelata, chief executive officer of the nonprofit clinic. But upon seeing data from the study and hearing about the county’s financial support, Aboelata says she “was pretty moved by that.”
One of the key findings in the study is that health care disparities for black people often stem from unfair treatment and discrimination— factors that are preventable. One of the first ways to counter these biases is to hire African Americans in the community. “When you see people who look like you, when you encounter people who have been through what you’ve been through, that helps some of those barriers fall away,” Aboelata says.
Silicon Valley’s black population is small and shrinking, making up about 50,000 people, or 3 percent of county residents in 2012. That’s about the same size as the population of Gilroy. But African Americans face particular health challenges.
“Generally, as your income and education rate goes up, your health gets better, but it doesn’t happen like that in our community,” says the Rev. Reginald V. Swilley, a founding board member of the San Jose clinic.
The cumulative stress of bias and racism can take a toll on black people’s health. Negative experiences with the medical system compound the problem, the 2015 study found. “You have people who would see doctors who didn’t want to touch them,” Wilson says.
Burrell recalls a particularly awful trip to the doctor when her children were little. “I have two sons. One is chocolate and one is butterscotch, because our kids come in a rainbow of colors,” she says. “This doctor was determined that something was wrong with my son because he was a different color than his brother.” The doctor tested the lighter-skinned son for anemia, even though he’d come to the clinic for a sports injury.
Black patients “want to go to a place where they feel at home, where they feel welcome and people understand them and their culture, and they’re not getting that in San Jose or in the county overall,” Burrell says.
African Americans have experienced centuries of systemic racism and medical exploitation. Examples span from the infamous Tuskegee Institute experiments, where doctors injected black men with syphilis, to the unauthorized use of Henrietta Lacks’ cancer cells for decades of research, to medications that are never tested on black people before gaining FDA approval. These abuses and stories like those experienced by Burrell’s sons can create hesitancy to encounter the health care system.
“If there’s not a trusting relationship between you and your provider, you’re not going to follow their advice,” Aboelata says. “Then the patient comes back and didn’t take their meds, and the doctor labels them noncompliant.” This could lead to a doctor pulling away from the patient, which only fuels the cycle of mistrust.
Roots aims to break that cycle with “navigators,” or outreach workers who will connect patients with wraparound services beyond medical needs.
“If we say the No. 1 reason our patients are not well is poverty, that means we have to do something about poverty,” Aboelata says.
The county has offered support to Roots to the tune of $350,000, based on the clinic’s willingness to take on “high users of multiple systems,” including the 20 percent of county homeless residents who are black. “You know why they go [to the emergency room] if they break their toe or have a toothache, or get something in their eye? Because the emergency room will treat them,” says Wilson.
The county has an interest in getting those patients to less-costly regular primary care doctors, which Roots will oversee. However, Roots also expects to draw wealthier black professionals to the clinic as well. “I was going to take my Obamacare and transfer it to the community, but now I’ve got new insurance from my wife, so I’ve gotta figure out how I’m going to get in there,” Swilley says.
The clinic won’t be restricted to patients of African descent, so others looking for a change in health care are also welcome to join. “We'll never turn anyone away,” Burrell says. “But the services we offer are African-centered, and some people will be comfortable in that environment.” For Burrell, that means linking patients to a support system. “The focus is always about community. How can we connect you back to your people? You don’t have people? We’ll be your people.”
Silicon Valley’s challenge is the black community is less concentrated than at Roots’ clinic in the East Bay. “What’s great about Oakland is that most people of African descent are geographically in one area, and you can go and find a community of black folks in a particular radius,” Burrell says. “But here, we’re spread all through the county.”
To address the geographic sprawl, the clinic will be located on the heavily used 22 bus line right next to Ujima Adult and Family Services, which will partner with Roots to provide Afrocentric mental health care. Roots will also advertise on billboards, buses and radio while spreading the word at black churches and community events.
Burrell calls the clinic a labor of love.
“When you come to Roots, I want you to feel like you’ve just come home.”