177: Federal policies, health equity, and the legacy of John Lewis: an interview with Congresswoman Terri Sewell
Congresswoman Terri Sewell says she’s honored to have called John Lewis a colleague, friend and mentor. Lewis, one of the most important civil rights leaders in American history, died in 2020. But his legacy is carried on by health equity champions like Sewell, who has taken up the mantle on legislation that aims to address health disparities in our nation.
“The John Lewis Equity in Medicare and Medicaid Treatment Act — it really is an opportunity to reduce health disparities and to evaluate payment models of Medicare and Medicaid that will take social determinants of health into account,” Sewell says. “I really do believe that health disparities is a civil rights issue, and the opportunity to carry on a bill that [John Lewis] championed, now that he's gone, is a real highlight of my career.”
Now in her seventh term representing Alabama’s 7th Congressional District, Rep. Terri Sewell is one of the first women elected to Congress from Alabama — and the first Black woman to ever serve in the Alabama Congressional delegation.
She speaks with Health Disparities podcast host Bill Finerfrock about how her personal experiences have led her to the work she’s doing today in Congress and also shares these words of encouragement to those working to advance health equity in their communities:
“Stay in the trenches, continue to mobilize and organize around these issues and continue to fight… and advocate for what we know is a civil rights issue. It is a human rights issue, health care, and so we can be frustrated, we can be downright mad, but what we can't do is give up.”
A note to our listeners: Movement Is Life’s upcoming annual summit brings together stakeholders from diverse backgrounds to discuss healthy equity challenges and actionable solutions.
This year’s theme is: "Health Equity: Solutions from Healthcare Leaders.” The summit will take place in Atlanta, Georgia, from November 14 to 15. Registration is now open – find all the details at our website, and get signed up today!
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The transcript from today’s episode has been lightly edited for clarity.
Rep. Terri Sewell: I understand the importance of closing the gap, the health disparity gap that exists between African Americans and whites in my district, where we are three to four times likely to die in childbirth than our white counterparts, where the rate of obesity and chronic chronic illnesses, whether that's hypertension or diabetes, is so much higher in my district, where we have food deserts, where people really don't have access to fresh foods, fruits and vegetables, and yet, those are really critically important.
Bill Finerfrock: You're listening to the Health Disparities podcast from Movement Is Life. I'm Bill Finerfrock, a member of the Board of Directors of Movement Is Life, and I'm also the cofounder and former executive director of the National Association of Rural Health Clinics. I'm really excited to introduce to our listeners, our guest today, Congresswoman Terri Sewell. Congresswoman Sewell is in her seventh term representing Alabama's seventh congressional district. She is one of the first women elected to Congress from Alabama and the first Black woman to ever serve in the Alabama congressional delegation. She's been a champion for health equity at the national level, and we're honored to have her here with us today. Welcome, Congresswoman, to the Health Disparities podcast. Thanks for being here.
Sewell: Thank you so much for the invitation, Bill.
Finerfrock: I'd like to start off giving you an opportunity to introduce yourself to our audience. You're from Selma, Alabama, originally, and you were actually born right at around the time of Bloody Sunday. And so could you talk a little bit about your background and also how those events may have helped impact your life?
Sewell: Absolutely. Well, first, let me just say thank you so much for inviting me to be a part of this podcast. And health disparities is one of the top issues that I deal with in Congress, one of my top priorities for my district. I grew up in my district, grew up in Selma, Alabama, as you said, at just a stone's throw away from the bridge. In fact, my, the church that I grew up in is the historic Brown Chapel AME Church, which is the church where the marchers marched from, and retreated to during Bloody Sunday. I actually was born four months before Bloody Sunday, so I, my parents did not participate in it.
But let me just say, growing up in Selma, and attending Brown Chapel as a child, you had a healthy respect for the Civil Rights movement and the Voting Rights Movement. John Lewis and those foot soldiers would come back year after year after year to reenact Bloody Sunday, and to just remind the world to never forget what happened on that bridge. And you know, it was the blood, sweat and tears of those foot soldiers like John Lewis that really paved the way for access to voting rights for all Americans. And you know, it's an honor. I know that the shoulders I stand on are John's shoulders. I would have never thought as a child growing up and meeting Coretta Scott King and meeting Ralph Abernathy and all of them, they would come back year after year after year, just to remind us all of what took place in Selma and its importance in the world, and to think that I would grow up, daughter of Selma and become a member of Congress, the first Black woman member of Congress from Alabama, you know, years later, is just such a high honor.
And to be able to call John colleague, friend, mentor, was, is a high honor as well. It was just one of the most important mentors that I had here in Congress was definitely John, and the opportunity to join him on those pilgrimages, he also started something with faith and politics, where members of Congress, Republicans and Democrats, had an opportunity to walk in his footsteps, through my district, through Birmingham, Montgomery and Selma, it was just a high honor. And I think that carrying on his legacy and the legacy of those foot soldiers is something that's very personal to me. I'm honored to represent the wonderful people of my district that live there now, but I know that part of that is also preserving and advancing the amazing legacy of my district of civil rights and voting rights, and I really do believe that that health disparities is a civil rights issue, and the opportunity to carry on a bill that he championed now that he's gone, is a real highlight of my career and my time at on Ways and Means.
So this is just a great opportunity for me to pay it forward, to give me an opportunity to honor someone who meant so much to me and who fought so hard for all humanity. He believed in the beloved community and that beloved community was a community where health disparities did not exist, where white citizens and Black citizens, and irrespective of your race, or where you grew up, you had equal access to health care, quality, affordable health care was definitely something that John believed in and fought for on the House Ways and Means. And to follow in his footsteps, to have a seat on Ways and Means as an African American woman, and the longest serving African American woman on Ways and Means, and only the second Black woman to ever sit on that committee who's a Democrat. So you know, it is an opportunity for me to definitely pay it forward.
Finerfrock: Well, along those lines, we had worked with Congressman Lewis on the Equality in Medicare and Medicaid Treatment Act, and then subsequent to his passing, you've taken up the mantle on that legislation, and we've actually it's been renamed the John Lewis Equality in Medicare and Medicaid Treatment Act, which is intended to address that and reduce health disparities through the Medicare and the Medicaid programs. Can you talk a little bit about being on the Ways and Means committee, health disparities and the legislation and what you hope to accomplish?
Sewell: Absolutely, you know, one of the the things that I knew I wanted to do when I first got into Congress, was have an opportunity to sit on the House Ways and Means Committee, and only one African American woman had had an opportunity to do that, and that was Stephanie Tubb Jones, and she only served a year. And so it was a goal of mine, both because of my district and because of my professional interest. As you know, I was a public finance lawyer, tax and securities lawyer, both in New York City and in Birmingham, Alabama. So the opportunity to sit on Ways and Means whose jurisdiction is very broad, it includes all of Medicare. It includes social security, it includes trade, it includes tax and, of course, healthcare. And so the opportunity to sit on a committee that broad, that has jurisdiction over so much, so many of the things that I want to effectuate, was just an honor, and John was very helpful in convincing Nancy Pelosi and the steering committee to put me on that committee 10 years ago.
Finerfrock: You represent a district that's kind of interesting in its geographical makeup. I mean, you have some of the larger cities, portions of Birmingham, Montgomery, all of Selma, but you also have a significant part of what is generally referred to as the Black Belt, more rural, some of those rural areas.
Sewell: Selma is the Queen City, in fact, people think of Selma as this big town, and it's really a town of 19,000 surrounded by smaller counties and towns that come to Selma for our Super Walmart. I grew up in this district, Bill. I know what's possible from this district with resources and opportunities, and my task as its member of Congress is to provide those resources and opportunity. I think about my life's trajectory, and it was only made possible because of the sacrifices of those foot soldiers, those drum majors like John Lewis and so many, so many known and unknown foot soldiers. So you know, the opportunity to carry on his legacy was something that I don't take lightly.
I understand the importance of closing the gap, the health disparity gap that exists between African Americans and whites in my district, where we are, you know, three to four times likely to die in childbirth in our white counterparts, where the rate of obesity and chronic chronic illnesses, whether that's hypertension or diabetes, is so much higher in my district, where we have food deserts, where people really don't have access to fresh foods, fruits and vegetables, and yet, those are really critically important, and so, access to care, dearling with the social determinants of health, things like transportation and lack thereof, poverty and just having internal medicine doctors within reach, within a drive, for my constituents, is an issue. And so you know the John Lewis Equity in Medicare and Medicaid Treatment Act, it really is an opportunity to reduce health disparities and to evaluate payment models of Medicare and and Medicaid that will take a social determinants of of health into account, I think, is really the crux of that bill, and what we believe will help to address the access issue.
Finerfrock: Yeah, I think that's exactly right. And you know, what we've tried to focus some attention on is the interconnectedness of these issues, and people sometimes are shocked to hear that there are food deserts in rural communities where they grow the food that supplies grocery stores but isn't necessarily available in the communities adjacent to where that food is grown. It's one of the oddities that sometimes people don't really...
Sewell: And it's something that, how do I, something that has really been, you know, a driver for me is the fact that, how do I access the assets of this district, the poorest district in the state of Alabama for the people of the seventh Congressional district? I mean when you think about the fact that my district includes Mercedes Benz and Hyundai, it includes University of Alabama, Roll Tide. It includes UAB, which is a regional hub, and yet I have hospital, rural hospital after rural hospital that are closing in my district. You know, Alabama is one of the last 10 states that have not expanded Medicaid, and that's a real problem. It's unfortunate that our state legislators are looking at politics over people. The fact that it was called Obamacare was a big reason why my Republican colleagues in Congress and my Republican elected officials in Alabama, have not expanded Medicaid. And you know, it is not unlike, you know, given the fact that rural America is shrinking with every high school graduation, it's shrinking. And the reality is that there are, that their zip code, your zip code in America, sometimes determines your ability to get quality, affordable health care is just ...
Finerfrock: And life expectancy.
Sewell: Health outcomes. Yeah, you know, I think that health care is a basic human right, and should not be for the privileged few, but should be for every American to have access to. And so that, of course, has been a fight in Congress for a very long time, but having access to the Affordable Care Act for my constituents has been a lifeline for so many.
Finerfrock: You kind of touched on a little bit, but you know, there does seem to be kind of this political divide, if you will, on this. Do you have thoughts on what we can do to try and make some of this a little bit more bipartisan? Have you had success reaching out to some of your Republican colleagues to bring them to the table, to kind of try and address these things?
Sewell: You know, I have several colleagues in my Alabama delegation that represent rural America like I do, and working with them to try to increase the number of doctors, both to try to expand telehealth, so that, you know, and to provide broadband for some of my rural communities so that they could have telehealth, have been things that I've worked on. You know, I I don't look at the R and the D, I look at the people and the similarities in our our districts, has made it possible for us to at least sit at the table. We may not call it Obamacare, but to talk about access to to healthcare for all Americans, you know, and access to insurance so that all Americans can pay for quality healthcare is something that when we take away the labels: Obamacare, Republican, Democrat, and we just focus on people. My rural communities are no less, you know, in need of closing that health gap than theirs. Mine may be an African American rural communities, theirs may be a white rural community, but the with the crux of it is the fact that we both represent underserved communities, and those underserved communities, whether that's urban or rural, often have the worst health outcomes. Often are the ones that lack access to quality care.
Finerfrock: No, that's absolutely right, and. And we've we include geography, you know, health disparities based on race, ethnicity, gender and geography, because even though the underlying cause may be slightly different as to why people aren't getting health care, the reality is, you're not getting it, and these are the underlying factors at play, right? I want to be respectful of your time, so I'd like to kind of get your thoughts for our listeners. They've been out there in the trenches fighting for health equity and racial justice. What's your call to action for us as we continue to advocate for a fair, more equitable environment, whether it's healthcare or in general, and what can we do to help support champions like you in Congress and throughout the country?
Sewell: I think that John Lewis said it right, said it best on that very, his very last visit to Selma, which happened to be on a Reenactment Day of Bloody Sunday three years ago. And John said, Never give up. Never give in. Keep your eyes on the prize. And I say to all of my fellow folks in the trenches dealing with health disparities, with equity issues across the board, dealing with social injustices, to not give up. Just think where we would be if John Lewis and those foot soldiers had given up on Bloody Sunday and didn't try again and again to complete that march from Selma to Montgomery. Think where we'd be without the Fair Housing Act that came right after the Voting Rights Act. And so, you know, I think, I think that change rarely happens in the halls of Congress without bubbling up from grassroots activism. So stay in the trenches, continue to mobilize and organize around these issues and continue to fight for what we know and advocate for what we know is a civil rights issue, it is a human right issue, health care. And so we can be frustrated, we can be downright mad, but what we can't do is give up.
Finerfrock: That's a great sentiment, and I think that's an excellent closing point for our conversation today. I'd like to thank our guest Congresswoman Terri Sewell, for being with us here today. Before we sign off, I'd like to put in a plug for upcoming Movement Is Life's annual health equity summit. This year, the theme is health equity solutions for healthcare leaders. It will be in held in Atlanta from November 14th through the 15th. It's an incredible event, bringing together stakeholders from diverse backgrounds to discuss health equity challenges and actionable solutions. We hope you can join us. Visit our website at movementislifecommunity.org, for all the details.
That brings an end to our episode of the Health Disparities podcast, from Movement Is Life. I'm Bill finnerfrock. Until next time, be safe and be well and only be negative as it relates to COVID.