Are people going to keep doing the work that needs to be done after everyone’s vaccinated? with Dr. Mattie Castiel
Today, we’re talking with the Commissioner of Health and Human Services for the City of Worcester, Dr. Mattie Castiel and asking the question: “Are people going to keep doing the work that needs to be done after everyone's vaccinated?"
Listen to Public Hearing wherever you get your podcasts and on WICN 90.5FM, Worcester’s NPR affiliate station. And, while we celebrate women all year round, our guests for the month of March are all women who live, influence, and/or impact the City of Worcester, MA. Learn more about our show at PublicHearing.co
Transcript for this episode
Joshua Croke (00:07):
Hello, Worcester and the world. This is your host, Joshua Croke, and you are listening to the Public Hearing podcast and radio show. Our show is about exploring compelling futures for our cities and communities. By taking a close look at the city of Worcester, Massachusetts, the second largest city in New England, we talk with members of the community residents, artists, public servants, small business owners, local activists, and politicians about inclusive, equitable, and prosperous growth. Today, we're talking with the Commissioner of Health and Human Services for the city of Worcester, Dr. Mattie Castiel and asking the question, are people going to keep doing the work that needs to be done after everyone's vaccinated? This is the Public Hearing podcast and radio show
Joshua Croke (00:50):
Public Hearing is available wherever you listen to podcasts and on WICN 90.5 FM on Wednesdays at 6:00 PM. Worcester's only NPR affiliate station as Commissioner of Health and Human Services. Our guest today, Dr. Mattie Castiel is responsible for overseeing the Divisions of Public Health, Youth Services, Human Rights, and Disabilities, Veterans Affairs, and Elder Affairs along with advancing initiatives that fall under the scope of youth violence, homelessness, and the opioid crisis. Mattie has an extensive background in public health and addressing the social determinants of health, which for listeners who might not know the term are the economic and social conditions that influence individual and group differences in health status. She has been a champion at supporting the needs of those who have been put into vulnerable situations by poor and unjust systems and as a tireless advocate for equity in our community. So Mattie first outside of your work as Commissioner of Health and Human Services for our city of Worcester, I'd love for listeners to learn a little bit more about you. And I always start the show, asking our guests to share some of their social location or social characteristics of one's identity that have been deemed to be important by society to bring additional context to our conversation today. Some of those may include social class, gender, race, and ethnicity, educational achievement, et cetera. Please share whatever you would like to bring into this space today. And thank you so much for joining me on Public Hearing.
Dr. Mattie Castiel (02:16):
Thank you. Thank you so much. So I guess what I'm going to start telling you is that I'm originally from Cuba. I came to the United States on what was called a Peter Pan Expeditions, which were when thousands of kids left Cuba to the United States. Thinking at some point that we would be sent to Russia sort of to be indoctrinated was, was the thought process. And so my brother who was eight and I was seven left Cuba alone and stayed in a foster home in Florida. And interestingly enough my mom actually wrote letters to Catholic charities and Jewish highest to be able to say that I was allergic to the cold, allergic to anything that had to do with down. And so that, because they were thinking of sending us to Boston.
Dr. Mattie Castiel (03:11):
And so ultimately they didn't send us to Boston and we ended up in LA a little bit warmer area there. And so you know, I grew up in LA and went to medical school in San Francisco, which was always a challenge because I come from a Latino background, that my parents are, in particular my mom thought, that going to med school was a men's profession and not a women's profession and really was not comfortable with me going into med school. But ultimately I moved forward and I went to med school and I guess the compromise was that I wasn't going to move too far away from home. I went to San Francisco for medical school and subsequently then after that did residency in St. Louis where I met my husband who told me he would come to a New England area.
Dr. Mattie Castiel (04:09):
He wanted to do that for two years. That was 34 years or 33 years later. And here we are in the place that originally came to, originally was told to me that that's where I should go, which was Boston. I'm not in Boston and I'm in Holden actually. But close enough to Worcester which is where I've spent the majority of my life really now. I have two kids who I am encouraged to try something different and look at, see what's out in the world. And then I thought they would come back, but instead they are, one's in New York and one's in Michigan and they have not come back. So they found something else out in the world. So that's pretty much a quick story.
Joshua Croke (05:00):
Great. Well, thank you so much for sharing and what a powerful, you know, origin story. And is there something kind of specific that inspired you to get into medicine and go to med school, even at the objection of your mom?
Dr. Mattie Castiel (05:16):
I think I've always, I like doing things and helping people. I did a lot of that with my dad. My dad was a salesman from the back of his car who, you know, came to this country with a third grade education. And he used to try as much as he could to help people. And I would go a lot of times with him to do, to help him with his job. It was usually in the neighborhoods or Latino neighborhoods. And so, we did a lot of that. I also did a lot of interpreting for my parents when they went to the doctor and really saw a need in the community. And I guess from then on it sort of had been my mission, I got a job when I was in high school working in a hospital.
Dr. Mattie Castiel (06:03):
And actually my first experience was that I worked as a pharmacist tech and I met some of the doctors that were there and met a cardiologist who actually was going to be doing surgery. And I asked him if I could see it. And he agreed and I ended up meeting the patient before the surgery and talking to him and then actually got to see open heart surgery that day. And then came back to visit him afterwards and thought it was incredibly amazing to meet you know, sort of as I put it from, you know, from both the outside and the inside. And I think what better way to get to know people. And so from then on, it sort of was my mission to do this. I've never had the, quite the background, but certainly persevered to be able to do it. It's been my passion since you know, since I was young to go ahead and do it. And so I worked hard and I think I had the support of my dad who was very positive about it and helped me through the process.
Joshua Croke (07:19):
That's really powerful to hear and to explore. And now in your role as Commissioner of Health and Human Services here in the city, there's also the intersection of the logistics and the operations and the politics of health and medicine. And so, I want to explore kind of the question of, are people going to keep doing the important work that needs to be done after everyone takes a vaccine, but first talk about vaccine equity and kind of the current state of where we are, and hoping you can share a little bit with our listeners, you know, where are we and what still needs to happen to make the vaccine access more equitable in our communities?
Dr. Mattie Castiel (08:01):
So I think you, you know, that in our community, both the black and Latino communities are two times more likely to get infected with COVID and more likely to be hospitalized. Certainly our youth have been more likely to again, to be exposed to COVID because of our community being certainly low income, a good portion who are also our essential workers who are living in multi-generational housing and just not having the ability to isolate. And so, and because of working and trying to provide for family, sort of, not really in a lot of ways that doesn't come as a priority in a lot of ways. And bringing that educational piece into the community has been an important piece to try and to get people tested, trying to get people to understand what COVID is and how they can protect themselves.
Dr. Mattie Castiel (09:08):
But we've been the highest numbers of people getting COVID for the same token, we've been the lowest people getting vaccinated. So the majority of people who have been vaccinated have been the white community. Latinos and blacks have been the lowest who have been vaccinated. And so even though the state had really try to roll out the you know, how they were going to do the vaccinations you know, starting with hospitals, for example, that everybody in the hospital, not just docs and nurses would get the vaccine, but that the person who comes into the room to clean the room or to change the person all of those folx would get vaccinated so that you're looking at the entire hospital to be able to to get vaccinated, or we did home health aids, which the, you know, that was next in line which was the, you know, majority of home health aids are, are people of color.
Dr. Mattie Castiel (10:14):
You know, we did a lot of group homes shelters and all of those were first in line so that we could get communities of color. But there was still hesitancy with some folx getting the vaccine. And then it's still rolled out that we were able to you know, to bring out the vaccine into the community and that's been our goal. I think we look at you know, when we talk about reaching out into communities of color, we're looking at doing something that is different, is going out into the communities where people feel comfortable accessing care, as you probably know, there's been a long history of you know of distrust in our community, both in government and both in health. And people just aren't comfortable in that sense. And those are part of the reasons why there are inequities in healthcare.
Dr. Mattie Castiel (11:19):
And so how do we change that? How do we bring that access into the community? How do we build trust into the community to be able to one receive vaccinations and, and get treatment? And what's the best way? And I think one of your questions was, you know, how do we extend this into the, you know, into the longer future after COVID, because right now it is working, it is helping that we go out into the community that we go into churches for people feel comfortable or entities in their neighborhood that they access so that they feel comfortable. And some of the ways that we've done it is actually just even walking down main street and, and sort of going into the businesses and you know, when essential businesses came into the rollout and just talking to people in the community and being able to vaccinate those people. So it's, it's been a process, but I think it's the process that we need to figure out how we change in order to provide the changes that are needed so that we have equitable access to the communities and maybe being able to change the inequities that do exist in healthcare.
Joshua Croke (12:45):
And trust-building, you mentioned, which is so crucial and important. And this echoes into a lot of the conversations that we have on the show, whether it's educational access, whether it's healthcare, a variety of different community factors that are influenced by often a lack of trust. And I used to ask the question, how do we rebuild trust? And someone called me out not so long ago on saying, well, I don't feel like I've ever had trust with some of these systems. So how do we build trust from the ground up with, with folx in community? And so what are some of the tactics or strategies that you've been seeing as successful, in building relationships and nurturing trust with folx in the community?
Dr. Mattie Castiel (13:32):
So I think it's being part of the community. I think it's engaging with the community. It's listening to people in the community, listening through the thought processes, listening to what, what they feel are the issues that are keeping them from accessing care or from thinking differently about certain care. But, somehow I guess it's also that having that empathy, that you care, you want to be able to help that it's genuine, and it's not just I need numbers or but then you are truly engaged in helping the community. And I think part of what happens is that we don't change our system, right? So, we believe that everybody's going to go to whether it's St V's or UMass that they're going to go to the hospital. We don't go and outreach into the community.
Dr. Mattie Castiel (14:34):
We're not seeing how people live in the communities. I always talk about that, we tell people that, you know, here's your treatment for diabetes. Here's what you should be, you know, eating for diabetes, but we never look and see where people live and do they have access to food and are they able to buy the food? So, really being a part of the community and getting to know each of your patients and understanding what, what their issues are that may prevent them, whether it's finances, whether it's issues with housing, whether it's issues with transportation or jobs or anything like that, that may be a priority in their lives. And everything else may be secondary. So how do we help them with the priorities and then deal with the next stuff. And so it's a different way of looking at it. And I guess we have to be willing to change how we do business as usual.
Joshua Croke (15:33):
Yeah. I was fortunate to receive my first dose of the vaccine recently, and I really reflected on and sat and considered some of the layers of privilege that were what enabled me to be able to get that dose. You know, I follow Mass COVID Vaccines or on Twitter, which sent me a notification that things became available. So I had to have the device and to have access to the internet. I had to have all of my information to get registered, was fortunately able to do it at Worcester State and the same fees and UMass site, which was run incredibly well. But I was talking to the woman who administered my dose and she was like, yeah, it's amazing. We have people who drove here from Cape Cod this morning because they found the opportunity to, you know, come and get that.
Joshua Croke (16:29):
So there's vehicle access and ability to transport oneself, and also the ability to kind of on a drop of a dime to be able to reorganize your schedule so that you could go at the time that was available. And so those different layers of privilege and access are so present. And one of the things that I think has been more exposed, and this has been so much of your work even prior to COVID and to this pandemic is exposing the inequities in health care and access. And so what are some of the things that you feel are what that need to happen in order to keep people engaged in this work? Now that more people have felt the effects of what a pandemic can do related to equity and accessibility to healthcare? How do we keep championing this work and not go back to what was quote unquote normal, but really change the way in which we're engaging with our community and providing accessible and equitable care?
Dr. Mattie Castiel (17:39):
I think that part of the issue is, again, looking at, I'm watching my husband go, so I'm getting distracted. Tell me the question again, I got distracted there.
Joshua Croke (17:57):
How do we not go back to what was normal and continue to push the need for accessibility?
Dr. Mattie Castiel (18:05):
And that's the question. And that's what I worry about. I think that, you know, we talk about the inequities that exist in healthcare and those inequities have been around for a long time. They've been around for decades, if not centuries, right. They've been around for a long time, we've watched them and we haven't done the pieces that need to happen. So we need to look at healthcare differently. This we say, Oh, COVID brought it out. But for those of us who've been working for our whole time to know that these things actually have existed. So I think it takes a real effort to be able to do that. You know, we started the COVID-19 Equity Task Force and it was great. We have community members that were part of it and you know, UMass and, and the city.
Dr. Mattie Castiel (18:54):
And, you know, I remember like the community members who were part of the task force saying, you know, I've done this before. I've you know, are you sure this is going to create some change? People are tired too. I'm looking at, you know, sort of being a part of a constant struggle to create change and not being able to create change. So they're, they're weary about the situation. And ultimately, I think people go back to what they're comfortable with. So I do worry about that. I think we’ve been having lots of conversations in the community regarding a lot of these issues and hopefully those will continue to improve. I know some of the conversations and we started this a couple of years ago, was looking at anchoring institutions and sort of that idea that, you know, in Worcester, for example, that the large nonprofits, that the large corporations can actually start investing locally, that we can buy housing.
Dr. Mattie Castiel (19:55):
And that's where we put our money to that. Everything we do is locally. That we support mom and pop shops that we give people jobs that we use that money for housing that we improve neighborhoods, their whole idea of having that green neighborhood, that people will feel comfortable with, that they feel safe walking through that area, being able to exercise. We can actually do that in our community if that's, if we can get everybody to have that mindset, I don't think anybody will lose out in money. I don't think that that's the piece, but we will see an incredible difference in our patients and what goes into the hospital, the health of our community, which overall is going to save. It's going to save the community money. But what most of it does is that we've given access to all our community that they're able to live in an equitable way
Dr. Mattie Castiel (20:48):
like everyone else, that they have the same abilities to have a job, to maintain a job, to access to food, access, to transportation that we provide these things. And that would be wonderful. I mean, I think that I could see that happening, you know, we're beginning to see it in some ways in our homeless communities, you know, when we started doing shelters, when, when COVID first hit and looking at you know, we, the city took over some of the shelters and divided people so that they can you know, have some space between them. So we started you know, we went to the high schools and, you know, 25 people per high school, but then we brought healthcare. Then we brought addiction care. Then we brought mental health care. And then we, you know, we watch people change and we watch people stabilize.
Dr. Mattie Castiel (21:40):
And we say, well, there's housing first. We just put people into housing and we'll bring them services. Well, we don't even have the housing to be able to do that. But if we were able to stabilize people, people are actually looking then for treatment, they're looking for the ability for housing and for jobs. And we were able to house like 44 people during that time. And those are people who that it hasn't been something that we've done, but bringing all the right pieces to those who are suffering with homelessness was able to stabilize people. You know, it's a thought process, nobody desires to be homeless. That's not somebody’s thought process. That's what I wanna do. And so being able to bring the right services to people really changes who they are and what they want to do.
Joshua Croke (22:30):
And there's also the element that I think about a lot in various conversations that I have with folx in the community around like the de-stigmatization of some of these experiences, you know, I've been in Worcester now over 10 years, went to WPI and then stayed here as a recent graduate. And initially started an organization called Action Worcester. That was all excited about getting more students off campus and connected to each other. And because of my background in human centered design, I was like, well, we're just getting involved in the community. Who are we to say what the community needs? Let's host think tanks and bring folx across the city, whether they're long-term residents, whether they recently moved here, whether they're college students, whether they work for the city or they're part of the nonprofit community. Let's bring these folx in and have them engage in conversations around various topics and different areas about things from public transportation to health, to an entrepreneurial and innovation ecosystem in Worcester.
Joshua Croke (23:35):
And so many of the things that were exposed during those conversations were eye-opening to me, as someone kind of really just starting to get to know the city and recognizing that some of the reasons and challenges that students aren't getting off of their campuses is because of similar challenges or things that other people in the community are facing as well as a layer of like stigmatization on safety or the, you know, these other issues. And there are so many people like yourself who champion the work of, you know, addressing and prioritizing the actual needs of members of our community. And I think one of the challenges that I've seen in some different, like different philosophies of how to develop and grow a city is around how to address challenges, right? And there are people who say, I want to solve the quote unquote homelessness problem, which is really just a frame for, I just don't want to see homelessness as opposed to addressing the need for identifying the root cause of this, your point,
Joshua Croke (24:49):
like nobody wants to be homeless, right? Like that security and housing is a fundamental, you know, in my opinion, human right for access. And there are other folx who say, you know, people in those situations, why don't they just get a job? Why don't they just do this? And, you know, I've learned and grown so much over the past handful of years through our mutual friend, Nikki Bell, and her work at LIFT and addressing, like, if you don't have housing, you don't have an address. You can't get a license. You can't, there are so many challenges that people face in addition to health challenges related to homelessness that we're not looking at as a community more broadly, to address us. So what do we need, or what can community members who are listening do to help support this more equitable approach to development, as opposed to the, I just don't want to see this, you know, these issues in the community, how do we kind of glaze over them? What do we need to really advocate for funding, for resourcing, for priority in our community?
Dr. Mattie Castiel (26:02):
So there's a lot of things. So first I just want to say, cause I've there is a piece, like you said, a stigmatizing and I'm thinking about when I started doing some population clerkships and which is a clerkship that they spent two weeks, medical students spends two weeks with me and we get to know Worcester, we get to know the community. And I had mentioned that we were gonna walk down Main Street and, you know, look at the businesses and we talk about, you know, what goes on there? And one of the guys one of the students said to me, well, you know, when I first got to the school, they told me that these are areas I should not go visit. And now I understand why, or I mean I don't understand why. Yeah. I'm one of them, the same people that are here.
Dr. Mattie Castiel (26:55):
This was, these are Latino, I'm Latino. So why is this one of the areas that we should not visit? And it's the same thing to what you were saying that, you know let's figure out the homeless piece because I don't want to see them, but if you actually see them as people, no different than you that hopefully, maybe you will think differently that they just haven't had the same exposure as you've had. They haven't had the same privileges as you have. You know, it's one of the things that I think I worked with to put the Cafe Rayes is the restaurant which is a job training program for Latino men with addiction. Part of that whole process was that, you know, why are you having this problem? You shouldn't be having this problem.
Dr. Mattie Castiel (27:44):
You can pick yourself up by the bootstraps and you can get rid of this problem. And for people to understand that there are certainly talented people that addiction is a disease like no other disease, but then to bring them out into a restaurant and have them do their job and do a great job like they do to be able to say, wow, I didn't think that this was addiction. And for the same token, for the people who are dealing with addiction to say, I didn't think that I could be part of the community. So how do we bring people from the outside? People who have not dealt with addiction, people who have not dealt with homelessness to really try to understand, or mental health issues. I mean, that's, you know, we've changed our whole system of mental health.
Dr. Mattie Castiel (28:30):
We, you know, people who are living on the streets, a lot of them are at the combination of addiction and mental health issues. And how do we say that we need to be able to treat people, those people are no different than anybody else that, you know, they could be your kids. They could be your parents, they can be your grandparents because we still see an older generation of people who are living in shelters, because for whatever reason, whether it's mental health or addiction, or whether just a tough time in life that we see people in shelters and how do we, as a community say that this is an important piece in our lives that we can't move forward until the rest of the people are part of our society, part of who we care about.
Dr. Mattie Castiel (29:16):
And I think that that's, I hope, and I'm sure it's been tried before and you know, we haven't moved, but I think we gotta continue to talk to people that this is no different than anybody else and that we can't move forward until we do that. You know, I make that conversation about that. You know, this country cares about GD, you know, our growth, our gross national product, you know, how much our business doing, you know, how much money are we putting together for our country. And that's what everybody, that's the stock market. That's all of that. But in reality, if we based what the gross national product, what, what we do or what's, our GDP would be providing housing, making sure that people have all the things that they need.
Dr. Mattie Castiel (30:06):
That's what would make our country great. We think about all the other, you know, European countries who spend their money on the social services. We don't spend money on social services. We spend money on healthcare and only 20% of our health is based on healthcare, not on everything else. We need to be able to help people who don't understand how to take their meds or who don't understand what diabetes is. Being able to really take people by the hand and show people how to do whatever that issue is so that people understand and that we care about people. That's hopefully the goal that we can change in our community is that we can't live in a you know, in a bubble that there are people around us who are suffering and we need to be able to help them. That's what should be our goal in life.
Joshua Croke (30:58):
And America generally has always had a more reactionary approach to healthcare and providing health once those needs arise, as opposed to the preventative care that really intersect with the things that, you know, we're talking about of, you know, how do we break cycles of generational poverty, and how do we address food deserts so that people have access to healthy food. We had Grace Sliwoski on the show the other day from the Regional Environmental Council talking about the program that is supported on EBT cards to allow folx to use like up to $40 in locally farmed produce as part of the resource that they're able to get through their through their EBT cards. And the challenge of making more people aware of that, as well as getting it into communities. And, you know, Worcester has a decent amount of what are considered food deserts related to getting access to healthy foods and like looking at that preventative health care.
Joshua Croke (32:05):
And so I'm interested in your thoughts on how do we also hold the city and our partners and our institutions accountable to really prioritizing those types of needs. I feel like there's a lot of, and for folx who are regular listeners of the show, know that I challenged some of the city at larges approach to economic development, because I think it looks a little too far outside the city for dollars and resources to come in, as opposed to really looking at economic gardening, which is cultivating the resident base here. So how do we help encourage and connect people to resources and education that are residents here to advocate for their spaces and their needs.
Dr. Mattie Castiel (32:53):
And, you know, I think we have a lot of organizations that work in different levels in our community. I think that one of the things that came through the pandemic is that they were all sort of working in silos. And one of the things that we've done now is really like Worcester Together is really working together to solve a lot of the issues and to stop working in silos and stop wanting, you know who's going to get the grant and who's going to be able to do some of these pieces, but how do we work together? And I’ve seen a lot of that start to happen. I've seen those discussions. I’ve seen the groups getting things done. I'm hoping that, that is, and advocating, advocating has been a huge part of what we do.
Dr. Mattie Castiel (33:46):
And so I'm hoping that those, that part of us like Worcester Together, that we continue to get together, that it doesn't end, and we have to fight to make sure that it doesn't end, that we have to hold people accountable, that the end of COVID doesn't go back to normal. I don't think we can ever go back to normal. I think part of what's what's happened during COVID is that people who were not part of this process and who were not aware of what was happening in our community are now aware of what's happening. And I think for the same token as you and I cannot see the things that are happening in the community is now part of others. And, and that those groups are the ones that are going to be able to advocate for change in our community, that we can either go to a local level or to a state level, to advocate for our community.
Dr. Mattie Castiel (34:39):
So I am incredibly impressed that we, that these groups of people, these agencies who are now working together, whether it's for mental health, whether it's for homelessness, whether it's for addiction, that we can move forward. I'm going to try to be optimistic that this is going to continue and that it can work. We can move forward. I think we have to, there are lots of things in our community that we kind of are afraid to move forward. And it'll happen in government as it does in health, because people are weary of the repercussions that may happen. But I think that overall, when you see the outcomes and if you don't take that step to make the changes I think we're losing out. And so I think I see more people taking that plunge and making, asking the questions, or trying to figure out how to change something and how to get a group of people first together to say, how do we change this? And then that group of people together is the ones that's going to make the changes. So I think there is power in groups, and there is power in working together to be able to create the changes and hold people accountable to be able to make those changes.
Joshua Croke (35:57):
Yeah, I couldn't agree more from my handful of years now in and around the Worcester nonprofit scene, I've not seen as much collaboration that I see now, historically. And I think, you know, American society at large, I think is a very individualist and very scarcity based mindset. You know, communities thinking about, Oh, like if we give money to this, that means I'm losing money over here. Or if, you know, I have to look out for myself before I can look out for others in the community. And that mindset, I think it really limits the potential that we actually have and the vibrancy and the access to resources, and being able to accurately distribute those resources in the ways that we need to. I reflect on when I was in Atlanta, Georgia, a couple of years ago, I went to a Smart Cities Expo, and met the founder of a company called Gooder Co a black woman entrepreneur who started this essentially a technology business to redistribute food resources in the community based on food surplus, you know, say the airport always had plans to have X number of meals.
Joshua Croke (37:19):
But if for whatever reason, they don't sell all those meals, the food isn't gone bad, but they aren't going to use it. And so they have to throw it out so that food surplus, how can we redistribute it to community? And that takes intentional collaborations. And I know that from my work and coalition building and supporting root cause analysis to identify things that are broken and wrong with systems is really looking at how do we come together to collaboratively solve specific issues while also allowing each other to address the challenges that we're more specialized in and how do we not compete? You know, Worcester, I think one of the common points of discussion is always like we have a finite amount of foundations and grant making agencies to distribute money. So it's like, you don't want to get too close to that organization down the street, cause you might be competing with, you know, for grant dollars at some point. And I still don't have the answer to how we solve that piece specifically, but I think the collaborative nature that we're starting to see is something that I hope continues as well.
Dr. Mattie Castiel (38:33):
I mean, I'm looking at, for example we've talked about for a long time having a day resource center where, you know, people who are homeless can access different agencies, different things that they may be in need of for the same token people who are housed can also come and be part of it and sort of guide people into, Hey, I'm housed here is what I'm doing. Plus it also gives people who are housed. The ability to engage. If you talk to somebody who's recently been housed, they say that they feel like they're in jail because they're in a room with four walls, which they never were before, prior to being homeless. But all of those conversations, the ability to have healthcare for the homeless, the ability to have a safe place, or like we have an overflow shelter, how do we continue that piece?
Dr. Mattie Castiel (39:28):
How do we bring all these organizations into one area where instead of people going across all over the city to have one place talking about preventative stuff that people are, if they're thinking that they may, you know, can't pay their rent and worried about becoming homelessness, where can they go? Where's one stop shopping that they can access all of this information. And that's something that looks like it may be coming to fruition and that's only coming to fruition because all these agencies collaborated together. And I think that's the piece that I'm seeing. I'm seeing that in the sense with nonprofits being able to do some of that I'm worried about the piece about healthcare and how is healthcare going to be different than if healthcare doesn't change how we do business? That's the piece
Dr. Mattie Castiel (40:30):
that's not gonna change the inequities in health care, but if we can start changing neighborhoods in the sense of bringing better affordable housing neighborhoods and being able to provide free transportation for people, more access to jobs, I think that in itself is going to improve healthcare. So if we focus on those things and I think, you know, we always talk about that, you know, making sure that, you know, the social determinants of health have a component or the roots are part of racism and how do we acknowledge racism and how do we say that that's a part of what's happening? How do we change our thought process? And you see people moving, it's a slow process, but you see people moving into that direction. I don't think a year ago we would have been able to talk about racism. We talked about the social determinants of health. It didn't mean a whole lot. Oh yeah. We have to do housing. We have to do these things, but it didn't mean no we've created that system. We've created the inequities and housing and housing and jobs and economics for people and education for people we need to figure that piece out and we need to change that. And I see more movement in that direction.
Joshua Croke (41:52):
Well, and I appreciate you naming, you know, systemic and structural racism as someone who works for the municipality, because not everybody who does will. And I think, you know, naming things is an important part of change because we need to be able to address root again, root causes. And if people are scared to use the R word of racism, we're not actually getting to some of the root structural, oppressive marginalization within these systems. And you know, I reflect on, it was recently Black Maternal Health Awareness Week, you know, and looking at how black women have a higher mortality rate significantly than white women in this country. At alarming rates globally, even in developed countries like the U.S. and people still challenge the notion that systemic and structural racism exists, because it somehow offends their perception of the American portrait. And so, how do you work in and alongside the space, knowing that you will be challenged by some, possibly some of your peers, some organizations, and, you know, other systems and structures in the community to really do the work that needs to be done while managing that kind of the politic side of the conversation.
Dr. Mattie Castiel (43:26):
I mean, I think it's having those conversations. I think people need to understand the cause of stress, what we call weathering, in a lot of ways of what happens to people in our communities you know, factors are that whether of myself and others, and we'll talk about the Latino community and the black community have experienced that. I remember just in my realm of having med students of color say to me that their time in medical school, for example, is like a constant sitting, somebody sitting on your shoulders, watching you, watching what you're going to do, watching how good you're going to be or not be. And that is an incredible amount of stress that we leave medical school with that then continue in our jobs. So which that constant stress and whether it's the stress of, you know, black families having to tell their kids, this is what you do when you see police, or is what you do when you're confronted by somebody, whether it be police that you have to be able to tell your kids that there's a possibility that, you know, you put your hands up, you do all the things that you're supposed to, because I think people need to understand that the amount of stress, the amount of trauma that goes through people, people of color, immigrant communities, Latino communities has had a detrimental effect on their health.
Dr. Mattie Castiel (45:03):
And that is truly a key to being able to help. And in particular to change the inequities that exist, if we are aware of what has happened and aware of what continues to happen and to be able to create spaces for people to be able to talk about these issues. I think it's important. I don't think people talk, I don't think that these issues are brought up. I don't think anybody has an idea of what different communities go through and to be able to understand it would certainly be a useful piece. But I think that that's part of what happens in our community and those things, that's what creates the fear of people you know, getting vaccinated or getting tested or you know, t's all of that. And that this distrust that exists is all part of that process.
Dr. Mattie Castiel (46:07):
And I think being able to talk about it is important. I think we have not been able to. I feel that we are getting to a point where we're able to talk about it, get people to understand white supremacy. And what does that mean that, you know, if we look at everywhere, every business, every place whether it's, you know, wherever CEOs are, you're not going to see somebody of color in those positions very, very rarely. And to be able to acknowledge that you have people of color working with you and to value who they are and to have their voices being heard is extremely important and to understand what they've gone through and to value them, I think I think will create a lot of changes but that's a position that we have to get to. And,I truly I guess for me it's being able to talk about it, being able to say that it exists is, or at least giving people that space to hear it is hopefully what slowly but surely maybe it will create some changes. Definitely. So in our last
Joshua Croke (47:30):
Few minutes, what do you feel is the next most elegant step to move Worcester forward in a transformative way?
Dr. Mattie Castiel (47:40):
I think continuing to work together, I think to acknowledge the issues that exist. And in particular, what is happening in communities of color? I think working together how we have, not to end that process, not to be afraid to move forward, not to be afraid to make changes. We may make some mistakes, but I think in the long run we will be able to change things. Some people may not like some of the changes, but I think we have to do it for the good of our community so that we are all living in a space that we can all survive. I look forward to that. I'm encouraged. I’m hopefully in this position to create and be able to talk about some of these changes and to be able to work together to support that.
Dr. Mattie Castiel (48:39):
So, and making that a priority in what we do, to be able to name that racism is a public health crisis are things that we would have never done before, but then let's talk about how we change these issues and what do we need to do differently. And you've seen that there has been changes in some of that. There's been changes coming out of our city manager to talk about some of these issues and he's taken steps to be able to change some of this stuff. And so I look forward to being able to work in that realm and be able to create some changes.
Joshua Croke (49:23):
Thank you. I appreciate all that you do for the community and the role modeling that you also do. I know it was very public when you got your vaccine and did the Pfizer trial and everything like that. And I think, again, people seeing examples of folx in our community kind of stepping forward to do this on behalf of everybody is a very powerful thing. So in our last minute here are there, is there anything that you want to make people aware of either how they can continue to advocate for the changes that we've been talking about and not falling into complacency of kind of back to how things were, how do we keep pushing forward as a community. And is there anything other than get your vaccines you want to let people know about?
Dr. Mattie Castiel (50:21):
I think not only get your vaccine, but encourage others to get your vaccine. I think to sort of I don't want people to become complacent. I want people to continue to work together. And I talk about that, you know, the feelings that you get when you're able to make you know, improve somebody's life or add to a community, I don't think that there's any other reward than being able to do that and to enjoy that process because that's what our community should be. It's about helping one another. It's about understanding all the different communities that exist and cherishing that and enjoying that process because that diversity is what makes us who we are and value that. And so I think continuing to talk and continuing to work together to make changes is what's going to do with, and I actually do value. If organizations can work on anchoring institutions and to be able to provide you know, for our community by investing their money in our community would make dramatic changes for us.
Joshua Croke (51:44):
Absolutely. Well, thank you so much, Mattie, for listeners, we're talking to Dr. Mattie Castiel the Commissioner of Health and Human Services for the city of Worcester, and I really value and appreciate your time and all you're doing for our community.
Dr. Mattie Castiel (51:58):
Thank you. It was a pleasure
Joshua Croke (52:03):
Since we talked so much about the vaccine and equitable access to it. I thought we could end the show today with a little bit of information for listeners about where to get your vaccine. So the city of Worcester receives and distributes about 975 vaccines per week at the city's emergency distribution center, which is currently operating out of the Worcester Senior Center. But this is in addition to other agencies across the city, administering vaccines, including Worcester State University, and a variety of pharmacies and health centers. You can learn more about specifically Worcester based access at Worcesterma.gov/coronavirus/vaccination. And just also please remember that no insurance, no identification is not a problem. You do have to make an appointment to get a vaccine, but the vaccine is free. You will never be asked for a credit card number to make an appointment.
Joshua Croke (52:58):
You can get the vaccine, even if you do not have insurance, a driver's license or a social security number you will not need copies of medical records or a note from your doctor to prove that you are eligible. And because the vaccine supply is limited, it may take a while to schedule an appointment, which is one of the equity issues that we talked about today, but there are opportunities to preregister. There's also a great resource of volunteers called MACOVIDvacshelp.com, which is a group of volunteers in Massachusetts who have successfully secured COVID vaccine appointments for thousands of eligible individuals with a focus on underserved communities. They're working around the clock to book hundreds of appointments every day. So that is MACOVIDvacshelp.com. If you are on Twitter, I also recommend following vaccine time, that's just @vaccinetime, which connects folx in Massachusetts to appointments by notifying you via Twitter.
Joshua Croke (54:02):
When appointments become available. That's how me and my partner got our vaccine appointments. And we were able to get them here in our local community. So please again, spread the word, get vaccinated, encourage folx to look into the research about the importance of vaccination, and let's get through this together. Thank you for listening to Public Hearing our podcast and radio show that airs Wednesdays at 6:00 PM on WICN 90.5 FM Worcester's only NPR affiliate station. If you're not in the Central Mass radio range, you can tune in live via their website @wicn.org. And you can find us wherever you get your podcasts. Thank you again to Dr. Mattie Castiel for joining us today. I'm Joshua Croke, and this has been the Public Hearing podcast. Public hearing is created and produced by Action! by Design. We help organizations develop equity centered community engagement strategies, facilitate community workshops, tackling social issues and help build coalitions brands and stories that better the world learn more @actionbydesign.co.
Joshua Croke (55:05):
Our audio producer is Giuliano D'Orazio. Thank you to Eric Gratton, Molly Gammon, and Shawn Chung, who also support the production of Public Hearing. And we always love to hear from our listeners, what resonated with you on a past episode? What would you like to hear more about on a future episode? And if you enjoy the show and are learning from it, please share it with your friends. It's the best way to support our work in talking about equitable, sustainable, and prosperous growth strategies for Worcester, but also thinking about creating compelling futures that include everybody more broadly for cities and communities across the country. And as always, thanks for listening.
