Imagine an under-resourced place in East San Jose where Vietnamese immigrants live with significant health and social disparities. The community is painfully aware that due to legacy of war, political persecution, and mass displacement, they have been through significant multigenerational trauma. They prioritized and advocated for the building of a trusted place where they can receive mental health services in their own language or through an interpreter that they trust.

The City of Compton, California and community of North Long Beach, California continue to experience extraordinary barriers to lifesaving medical care. With the highest rates of maternal mortality, infant mortality, and homicide in Los Angeles County, these areas lack essential lifesaving medical services including, a high-risk hospital-based birthing center, a neonatal intensive care unit, and a level-one trauma center.

The White Coats For Change (WCC) project is a transformative initiative aimed at equipping and empowering health care providers to actively engage in civic activities and drive systemic change.

Los Angeles County (along with California and the remaining United States) is in the worse overdose crisis in our history, driven by fentanyl and methamphetamine. No community is unimpacted by overdose, which spares no racial, ethnic, socioeconomic status, or age group. The historic response to substance-related crisis – to encourage people who use drugs to seek substance use treatment – is a necessary but insufficient response with when not paired with robust prevention and harm reduction initiatives that reach the people most in need.

Permanent vision loss is prevalent among the aging and will continue to rise. There are gaps and barriers resulting from fragmented care locally and globally. The health inequity among the aging, visually impaired population is also a public health issue with an economic burden on state and federal resources. The CDC reports that 4.5M over age 40 report that they are blind. This number is expected double to 9M by 2050. There are 21M more who reports having “vision problems” not correctable with conventional glasses, contact lenses, or refractive laser surgery.

We face an escalating addiction epidemic, with more than 100,000 people dying of drug-related overdoses in the US in 2021—the highest number of deaths ever recorded. San Francisco has the highest overdose death rate in California. At SFGH, more than 1/3 of hospitalized patients have a substance use disorder (SUD). Our patients with SUD have longer lengths of stay (3 v 5 days), 1.5x higher 30-day readmission rates, and 5x higher self-discharges than those without SUD.

Yousef "Dr. Yo-Yo" Turshani, witnessed the protests of summer 2020 and sensed an opportunity. He leveraged his role on the Pediatrics Exam committee of the American Board of Pediatrics to make a change that could have national implications. What is on the Board exam directly influences what residencies believe matters; what is taught or valued. That influences the students who learn from the docs and thereby all who work with pediatricians.

Governor Gavin Newson issued an Executive order (N-01-19) in 2019 to transition the pharmacy services from Managed Care Plans (MCPs) and Fee for Service to Medi-Cal Rx. It is to be administered by Magellan Medicaid Administration under Department of Health Care Services (DHCS) guidance. MCPs like Central California Alliance for Health (CCAH) provided our historical claims and prior authorization data to facilitate continuation of care for Medi-Cal members.

The politicization and circulating misinformation on the COVID-19 pandemic and vaccine has led to increased vaccine hesitancy. In particular, Black and Latino communities have suffered the burden of infections and death, yet lag in their vaccination rates. Based on experience, and research done on these local communities, we know that if information is scientifically accurate, but not adapted to the local contexts, people are less likely to trust the information and may look elsewhere for answers.

Marginalized communities were disproportionately affected by the COVID-19 pandemic with increased cases, hospitalizations, and deaths. As the County COVID-19 testing lead, I worked to ensure equitable access to COVID-19 testing in marginalized communities across Los Angeles County.