Minorities and heart health

Podcast transcript

INTRO
Welcome to Docs in a Pod presented by WellMed. Over the next half hour, Docs in a Pod will educate you about the health and wellness of adults everywhere. Co-host Dr. Tamika Perry and Carmenn Miles will share information to improve your health and well-being. And now here are Carmenn Miles and Dr. Tamika Perry.

CARMENN MILES
Thank you so much for joining us today. I'm Carmenn Miles, your co-host on the award winning Docs in a Pod podcast, brought to you today by WellMed. Each week alongside amazing co-host and guests, we'll bring you a wide range of health and wellness topics, especially those that impact our seniors 65 and over. Our goal weekly is to share practical tips, expert insights, and strategies to help everyone live healthier, happier lives and to better manage some of those chronic conditions. We're really excited to have you with us today. As a reminder, this podcast is available wherever you listen to your favorite podcast. Keep in mind you can also find us on the radio and several Texas cities as well as Florida. Our Docs in a Pod co-host today is none other than Dr. Tamika Perry. Dr. Perry, who I refer to as the People's Doctor is an associate medical director at WellMed, overseeing several large clinics in the Optum Care North Texas region. As an associate medical director, Dr. Perry supports providers of a number of clinics as they deliver quality care and a compassionate patient experience. For 11 years now, she's helped live out the WellMed mission of helping the sick become well and helping patients better understand and control their health. Dr. Perry is a proud alum of Prairie A&M University, where she earned her undergraduate degree. Go Panthers! She then went on to graduate from Philadelphia College of Osteopathic Medicine, where she was National Health Service Care Scholar. She completed her family medicine residency at Methodist Charlton Medical Center, where she served as Chief Resident. Dr. Perry is also diplomat of the American Board of Obesity Medicine. When she's not busy keeping people well, Dr. Perry is what I call a world traveler. Dr. Perry, when I last filled in for co-host, you mentioned that you had traveled to every continent with the exception of one. We just love hearing about your excursions, so tell us, do you have any travel ventures in the works for 2026?

DR. TAMIKA PERRY
ItÕs the exception of two. Antarctica and Australia. They are on my bucket list. My birthday is actually Saturday, which is going to be super cold here in Dallas. My plan was to go to Antarctica, but I found out that it is very, very pricey, so I wonÕt do that. However, next week is one of my fellow alumni from PCOMÕs birthday, and I'm going to Zimbabwe to celebrate her birthday, so I am excited about that. So, next week I'll be in Zimbabwe.

CARMENN MILES
How long is that flight?

DR. TAMIKA PERRY
Hours upon hours. We fly from here to Atlanta from Atlanta to South Africa, from South Africa to Zimbabwe. So, in all it's 14, 15, 16 hours, something of that sort. A long time.

CARMENN MILES
Well, we the rest of us will just live vicariously through you. We can't wait to hear the highlights of your trip when we chat next week. Happy birthday to you!

DR. TAMIKA PERRY
Thank you. I am so excited to hear from our guest today, one of my fellow PCOM alums, Dr. Mobley, because she always has such interesting, good nuggets of health to give us.

CARMENN MILES
Yes, she does. A little bit about Dr. Mobley. She graduated from Xavier University of Louisiana. She obtained her master's in business administration from Saint Joseph's Hobbs School of Business and Doctor of Osteopathic from Philadelphia College of Osteopathic Medicine. During medical school, she was active in the Student National Medical Association, and she completed her internal medicine residency and nephrology fellowship at Christiana Care Health Services in Delaware. Dr. Mobley began her nephrology career in Lake City, Florida, where she established a renal disease clinic and served as medical director of a dialysis clinic from DaVita Kidney Care. Later, she relocated to Tampa, Florida, where she started her hospitalist career with Optum. She later developed a skilled nursing facility program for the Tampa and Orlando areas, became lead physician and later associate medical director. But I understand, Dr. Mobley, that we have an update from you regarding your current role. Help us out with that.

DR. BROOKE MOBLEY
Yes, ma'am. I'm currently the medical director of all post-acute care for Optum and WellMed patients for the entire state of Florida.

CARMENN MILES
That is fantastic. Congratulations to you. That's a heavy load to lift, but we know that you can handle it. If she's not already doing enough, Dr. Mobley actively mentors medical students and founded a charitable organization called Purple Tears, contributing to the development of minority medical professionals while educating and trying to prevent further victims of domestic violence. She frequently speaks at conferences on topics such as cancer, medical disparities, domestic violence, and motivational subject matters, aiming to inspire future generations of medical and business professionals while educating the community around her about not easily discussed or resolved medical issues. Again, Dr. Mobley, what an impressive resume you have. How are you doing today? I'll just ask you one more time. I'm excited about our conversation today.

DR. BROOKE MOBLEY
I'm doing great. I'm excited for 2026 and looking forward to expanding my speaking engagements as well as my mentorship and relaunching my book.

CARMENN MILES
Your book? We're out of time today, but we're going to talk about that book on the next one. IÕll remember to note that. I want to hear more about that. I'm curious with your bio, especially with it being Black History Month, were there influences in your personal life when it comes to health care, or were there trailblazers or pioneers in medicine that led you to a career in health care? How did you get to this place?

DR. BROOKE MOBLEY
I'm told by my family that I said wanted to be a doctor starting at the age of five, and for me at that time, the only representation that I had any experience with as a black person being a doctor was Bill Cosby on The Cosby Show. Being from Philadelphia, he was a staple show in our household, but it was lack thereof representation or having someone that I can speak to face to face in real time, in real person that made me more interested in being that representation for somebody else. It's why I dedicate probably half of my professional career to mentoring other minority medical students, pre-medical students, and high school students. Just showing them that anything is possible and that there are doctors and surgeons and nurse practitioners and PAÕs who look like them, and that they are career paths that are obtainable despite having someone in your family having that experience.

CARMENN MILES
We are just thankful to have you here on the show, and I know that your patients and those who you mentor are thankful as well that you chose this career path. So, you've accomplished quite a bit, and I have a feeling that you're just getting started with making your own history. Not only in black history, but medical history as well. So, thank you for being with us today. I want to take a moment to welcome those who may have just joined us. You're listening to the award winning Docs in a Pod by WellMed. I'm Carmenn Miles, alongside Dr. Tamika Perry and our guest, Dr. Brooke Mobley. We're talking about the number one killer in America. Heart disease. It doesn't affect everyone the same way, but we're going to talk about some disparities. In some communities, the risk starts earlier, hits harder in some communities and last longer. Dr. Mobley, this is a conversation we don't have often enough but desperately need to. Why is it that where you live and maybe where you work and grow up seems to have such a strong impact on heart health?

DR. BROOKE MOBLEY
I'll say this is a topic that is multi-layered, and we probably could do seven episodes on it, but it starts with genetics. A lot of people don't understand that it's just not African American people who have an increased risk for heart disease, but it's melanated people in all. There's a lot of Indian populations where they are predisposed to heart disease and things of that nature. So, they're working on studies and doing studies to see how melanin and a hormone called Renin, which helps control how your kidneys treat blood pressure to predispose people for that. So, it starts at our genetic foundation. Then we have to go back to historical times where the black community did not have access to the same typical foods that the majority population did. They got scraps, they got the cheapest food, they got the food that other people threw away, such as intestines and pig snouts and pig feet and things of that nature. The way they could preserve it because they did not have access to refrigerators and electricity the way other people did, was putting a lot of salt on it to preserve it. Traditionally, a lot of our foods are what other people look at as parts of animals that would be discarded, but we made them a delicacy because we make everything great. In making the delicacy, we tend to add a little more salt than other people. Then we can fast forward to where we are now, where it is a known fact that we are predisposed to it. It is a known fact that your environmental factors will also increase the likelihood of having such diseases. Like living in an urban community where a grocery store with fresh produce and fresh food could be 25 to 50 miles away. If it's an area where the majority of the population is using public transport, it is very difficult to do so with a lot of bags. Then they have to resort to corner stores. If you are up North, Bodegas. Convenience stores. They're buying things that are in cans and in boxes and things that come easy to them. It is more cost effective to buy a bag of chips and a soda than it is to buy a banana and fresh vegetables. So, we have these food deserts. We have positions who unfortunately do not explain risk factors and things of that nature to patients saying they should cut out sodium rather than saying cut out salt and people not saying, hey, I don't know what sodium is, just shaking their head and being like, yes, not realizing that the thing they want you to cut out, they're putting on their food every day. So, it's multilayered, but then you get to the diagnosis of heart disease. In urban communities, there is a 8 to 18 week delay on newly diagnosis heart disease to see a cardiologist. A lot of times the cardiologists are far away from where they reside. So, now we're talking about delay of care because they don't have access to the physicians and the specialists that they need to address the issue that they were diagnosed with.

DR. TAMIKA PERRY
I think it's important to realize, too, that Dr. Mobley makes an excellent point. ItÕs a delay in care, then once you actually get there, a lot of times the standard of care is not made privy to you. When I say that, what I mean is, for example, if you're a patient who has heart disease and we look at a number called your ejection fraction, which is the amount of blood that goes into your heart versus what comes out. If your ejection fraction is low, that means your heart isn't pumping efficiently and your mortality rate goes up, every percentage rate that gets lower. At a certain percentage rate, your heart can go in this abnormal rhythm and call a reticular tachycardia, and that's when we typically will shock you. We try to put it back in a rhythm, and if we don't you die. We can put a device on the inside of you called an AICV, automated internal cardiac defibrillator, that senses that abnormal rhythm. So, it gives you an internal shock. So, if nobody else is around, you don't have to wait for me and Brooke to take the ICD off the wall and put it on your chest. It'll do it itself. However, African Americans, Native Americans and Hispanics, particularly African Americans, but all minority groups are offered this less than the majority population. Some of it isn't just our DNA, it is the innate bias of the country. It is what it is. It's not that we're making this up. This is validated by the CDC, it is validated by the Mayo Clinic, it's in all kinds of studies. WeÕre seeing it over and over and over again. So, it takes us a long time to get to care, and once we do get to care, a lot of times the standard of care isnÕt offered up front. Same thing happened with COVID. People were saying, oh, black people are dying from COVID. Brown people are dying from COVID. Because they are. But in the early days, less testing was done and less hospitalizations of minority patients up front.

CARMENN MILES
Thank you for that. It's very interesting information. It's time for us to take a quick break but stay right here with us. My co-host is Dr. Tamika Perry, along with our special guest, Dr. Brooke Mobley. We will continue to unpack the importance of heart health right here on Docs in a Pod presented by, WellMed.

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CARMENN MILES
We're back on Docs in a Pod by WellMed. I'm Carmenn Miles alongside co-host Dr. Tamika Perry and our special guest, Dr. Brooke Mobley. We're discussing heart health for minorities. Dr. Mobley, tell us, what are some of the warning signs we should look out for? How does our body tell us you may want to see a health care professional to determine if you are having heart problems.

DR. BROOKE MOBLEY
Being diagnosed with high blood pressure automatically makes you at risk for heart disease. So, if you are on any blood pressure medications, then you are at risk for heart disease. If you have any diagnosis of kidney insufficiency or failure, you are at risk for heart disease. If you have any risk factors in your families, mother, father, grandparents, aunt, uncle, siblings who have had a history of heart disease, you are at risk for heart disease. That's why knowing family history is important so you can make sure that you are getting the annual checkups that you need so that we can diagnose things early or possibly prevent the development of certain things. By the time you have symptoms of heart disease, you clearly already have heart disease. It could be becoming winded during normal activities where other people do not become winded. Going up and down steps. It could be having an increase of fluid or swelling or edema in your legs. It could be heart palpitations or your heart beating in an irregular rhythm. It could be having episodes of passing out that have been untriggered. Sometimes you pass out because you are sitting and standing too fast, or you go from extreme things like you're in a shower and it's really, really hot, and you go out and it's cold. Some people are predisposed to having thinkable or passing out episodes at that time. But if you're having them untriggered by something, that or could be a sign that there is some heart disease or issues going on with your heart. I will say that high blood pressure and kidney disease are the two leading causes for heart disease, and heart disease also being the leading causes of hypertension and renal disease. It is a circle of unlife I like to call it because having these three things together and you add something like diabetes puts you at risk factors for a lot of things. That's why it's important to have annual visits and to know your family history to try to prevent things, but to also be prepared for some diagnoses that are just going to come regardless of what your lifestyle is. Then it's important to follow whatever it is your physicians are telling you to do, and then doing your own research because, as Dr. Perry said before, unfortunately, we still live in a world where people who look a certain way don't get treated the same. So, it's important to do your due diligence as a person to try to come up and find out what standard of care is so that you can advocate for yourself if you're ever in a situation where you believe you're not getting standard of care.

DR. TAMIKA PERRY
I can't agree with her anymore. That's absolutely correct. If we circle back for a second to symptoms, sometimes you're asymptomatic. Like Brooke said, by the time you have symptoms, clearly you have it and weÕre actually a little bit behind the eight ball at this point. There are certain populations that even when the eight ball is up and rolling, you still don't have symptoms. So, that would be women and diabetics, and heaven forbid that your both your heart disease may be, my left shoulder hurts a little bit. I'm a little bit more tired. I sleep longer than I usually sleep. Very insidious symptoms. It's not like on the aspirin commercial where the dad is playing basketball and he clutches his chest and he falls to the floor. That's stereotypical crushing elephant on my chest. You may have very, very insidious, if any symptoms. So, the other important thing Dr. Mobley said is your visits with your doctor. It is very important that you visit your internal medicine, your family medicine, at least your PCP once a year to have that physical, if not more. It's important that we look at trends over time. Dr. Mobley is a nephrologist by trade, so she'll appreciate this. What I like to look at with my patient is trends. What is your glomerular filtration rate over time? Remember she said kidneys cause heart disease. The kidneys and the heart work together. They are in an intimate relationship. Sometimes it's toxic, sometimes it's great. We want it to be great, not toxic. So, we look at one of those numbers called the glomerular filtration rate. The speed at which your kidneys filter blood to make urine. There's a range of what's normal, but we want to look at over time. What's happening to your number? Did your number go from 80 to 90 to 60? You are still technically in the normal range, but why are we trending down? But you know that when you have a relationship with a doctor who's in tune with you. You know that when you have a relationship with a good doctor.

DR. BROOKE MOBLEY
A good doctor. I think that's the key.

DR. TAMIKA PERRY
We don't treat a piece of paper, we treat people. So, if I'm looking at this GFR that's 70 now, that's cool, but your GFR was 90 a year ago. Why did we go down by 20? What's happening?

DR. BROOKE MOBLEY
I think preventative medicine is going to be important as well. Doing things before there is a problem. Cutting sodium or salt out of your food. Deciding to cook at home rather than going to these fast food restaurants so much. Making sure you're doing physical activity. You can be obese, you can have arthritic pains, but I created something called chair exercises, so it's not limited to just people who are already physically fit. I tell my people who have motion issues or who are obese, you take your favorite 60 minutes show, and during every commercial break, you pick either your legs or your arms, and you do some physical activity. If you do that for every commercial break, what you will see is in a 60 minute show, you will have done 20 minutes of cardiac exercise, approved and recommended by the American Heart Association just by watching your favorite TV show.

DR. TAMIKA PERRY
I'll even tell them, after 2 to 3 weeks, switch it around. Exercise during the program and rest during the commercials. Because at this point, now your endurance has it has increased. Cardiovascular exercise preserves the integrity of your heart. It's free y'all. It's free.

CARMENN MILES
What about tobacco usage? Does that come into play at all and cholesterol and things of that nature?

DR. BROOKE MOBLEY
100%. That goes all back to preventative medicine to be quite honest. There is no person on earth who should be smoking cigarettes. 75 years ago, we did not know what the harm is, but at this point in time, deciding to smoke cigarettes is almost deciding to do a long term suicide. I don't care if we're talking about vape pens or if we're talking about strictly nicotine. Unfortunately, we're also talking about socialized hookah smoking. If it has tobacco in it, then it is dangerous for your body, especially if something that you do on a consistent basis. So, that's a part of preventative medicine because you should not start it. If you are somebody who have started it, it's important to stop as soon as possible.

DR. TAMIKA PERRY
Aren't you always amazed you find patients who say, yeah, I started smoking last year. Why?

CARMENN MILES
It's an expensive habit.

DR. BROOKE MOBLEY
I donÕt know why we even make it anymore. We can control what we produce in our country. Why are we making something that we know studies have shown is killing people at alarming rates? That's another thing. You have to care about yourself more than your country cares about you. If I could wrap that up, you have to be an advocate. You have to do your own research. You also have to know that Wikipedia is not the same as an experiment, or a case study, or something done by professionals, but it's important to start before you have a problem. Do your research, go to a doctor who's going to treat you fairly, and tell your family what medical conditions impact you from a genetic standpoint.

CARMENN MILES
All right. Good. Well, the bottom line is heart health disparities among minority populations are real but preventable, right? I love that you ladies are telling us that we can take matters into our own hands and improve our heart health. It's not just about genetics. A lot of it is about genetics, but it's largely influenced by our everyday choices. We can make small, consistent changes, and can drastically reduce our long term risk and improve our overall health. Access to sound health care is important. I love that you mentioned advocating for ourselves and listening to those warning signs and actually seeking early prevention. So, taking these steps leads to better heart health for everyone, not just minorities, which we focused on today. Ladies, we're close to being out of time for today. That was a quick conversation. Like you said, we could have six podcasts just on this subject matter alone. We want to thank everyone for joining us on this episode of Docs in a Pod. Don't be a stranger. Subscribe to this podcast and listen in weekly. Sharing is caring. Share the podcast with your friends and loved ones who might also benefit from this conversation. You can listen to Docs in a Pod wherever you get your podcasts, and don't forget, you can also catch us on the radio in several Texas cities as well as Florida. Thanks for listening to Docs in a Pod, presented by WellMed, where we share real stories, real facts, and real solutions. Until next time, stay well.

OUTRO
Executive producer for Docs in a Pod is Dan Calderon. The producer is Cherese Pendleton. Thank you for listening to Docs in a Pod presented by WellMed. Be sure and listen next week to Docs in a Pod presented by WellMed.

DISCLAIMER
This transcript is generated using a podcast editing tool; there may be small differences between this transcript and the recorded audio content.

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