Where health, culture, and community meet.

After 30 years bridging the gap between public policy and communities, Darolyn Davis knows why most public health engagement efforts fail—and more importantly, how to fix them. In this episode of The Healthy Project Podcast, host Corey Dion Lewis speaks with Darolyn Davis, founder of D&A Communications, about the critical disconnect between well-intentioned public health initiatives and the communities they aim to serve. This conversation goes beyond surface-level community engagement to explore what it really takes to build institutional trust.Darolyn shares the pivotal moment in her career when she realized that policymakers were making decisions for communities without including the voices of those most affected. Working in the California State Legislature, she witnessed firsthand how missing perspectives—particularly women and people of color—led to unintended harmful consequences in public policy. This realization launched three decades of work focused on equity-first communication strategies, where community voices aren't just heard, but actively shape outcomes.Key Discussion Points:Why Traditional Outreach Fails Darolyn explains why treating outreach as a distribution problem rather than a relationship problem dooms most initiatives from the start. Sending mailers, holding meetings, and posting information online doesn't equal meaningful engagement—and communities see right through it.The Trust Gap in Healthcare. The conversation addresses uncomfortable truths about why communities, particularly communities of color, distrust healthcare institutions. With Black women facing maternal mortality rates 3-4 times higher than white women, and Black Americans comprising only 5-7 percent of clinical trial participants despite representing 14 percent of the population, historical and ongoing systemic failures shape present-day healthcare decisions.Measuring What Actually Matters Most agencies measure engagement success by counting meetings held or materials distributed. Darolyn argues for a completely different approach: measuring sentiment, behavioral change, and whether you've actually moved people from one understanding to another. She reveals why superficial metrics waste resources and erode trust further.Real-World Case Study: Six Years to Build Trust Darolyn shares the remarkable story of working with the Bayview Hunters Point community in San Francisco. When a public agency wanted to build a new 62 million dollar community facility, residents initially refused—they didn't trust that promises would be kept. It took six years of consistent relationship-building, honest dialogue, and demonstrating follow-through before the community agreed. The result: a state-of-the-art Southeast Community Facility that now serves as a healthcare, education, workforce training, and community hub.This case study illustrates a critical truth: meaningful change takes time, and there are no shortcuts to building trust.Institutional Responsibility vs. Personal Choice One of the most important reframings in this episode is shifting from "Why don't communities trust us?" to "What are we doing that earns trust?" When trust is treated as an institutional responsibility rather than a personal choice, the burden shifts from communities to the organizations that serve them.What Keeps Failing After 30 Years Darolyn identifies recurring problems: communities brought in too late in the decision-making process, equity treated as a checkbox, budgets too small for genuine engagement, organizations moving faster than relationships allow, and failure to acknowledge historical harms that shape current perceptions.The Question Every Public Health Leader Should Ask Before launching any campaign or initiative, Darolyn advises asking: "Who is not at the table?" This simple but profound question forces organizations to identify missing voices and perspectives before making decisions that will impact those very communities.About This Episode's Guest:Darolyn Davis is the founder of D&A Communications, an equity-first communications agency that has spent three decades specializing in public health, education, transportation, and workforce development. Her work focuses on authentic community engagement that doesn't just inform communities about decisions already made, but involves them in shaping outcomes. She built her agency on the principle that all people deserve a voice in policies that affect their lives.Why This Conversation Matters:Public health professionals, healthcare administrators, policy makers, and community organizers face increasing challenges in building trust and achieving meaningful health outcomes. Misinformation spreads rapidly, historical harms create justified skepticism, and communities increasingly push back against initiatives designed "for them" without "with them."This episode provides both diagnosis and treatment for broken engagement systems. Whether you're launching a vaccination campaign, developing health policy, running a community health center, or working in any capacity where trust matters, this conversation offers practical wisdom earned through decades of on-the-ground experience.Connect with Darolyn Davis: Website: https://davisimpact.com/About The Healthy Project Podcast: The Healthy Project Podcast brings you conversations with leaders, innovators, and changemakers in public health who are transforming how we approach community health, equity, and wellbeing.Host: Corey Dion LewisShow NotesEpisode Summary: Darolyn Davis, founder of D&A Communications with 30 years of equity-focused communication experience, reveals why most community engagement efforts fail and shares the six-year journey it took to build trust for a $62 million community facility in San Francisco's Bayview Hunters Point neighborhood.Key Topics Covered:The policy-making disconnect: Why decisions made without community input failEquity-first communication: Moving from "for communities" to "with communities"The distribution vs. relationship problem in public health outreachWhy communities feel ignored despite official "engagement" effortsTrust as institutional responsibility rather than personal choiceHistorical context of healthcare distrust in communities of colorHealthcare disparities: Black maternal mortality, clinical trial participation, pain treatmentHow to measure engagement impact beyond attendance numbersThe true cost of superficial community engagementCase study: Bayview Hunters Point Southeast Community FacilityWhat keeps failing after three decades in the fieldHow quickly trust can be lost versus how long it takes to buildSocial media's role in spreading both information and misinformationThe most important question to ask before launching any public health campaignNotable Statistics Discussed:Black women are 3-4 times more likely to die in emergency rooms compared to white womenBlack Americans represent 14% of the U.S. population but only 5-7% of clinical trial participantsBlack patients receive pain treatment approximately 22% less often than white patientsThe Southeast Community Facility project cost: $62 millionTime investment to build community trust for the facility: 6 yearsFeatured Case Study: Southeast Community Facility, Bayview Hunters Point, San FranciscoCommunity initially rejected new facility due to distrustSix years of relationship building and demonstrating follow-throughResult: State-of-the-art facility with healthcare, education, workforce training, art installations, CBO offices, and shared workspacesNow serves as the neighborhood's central community hubKey Quotes:"Outreach fails when it's treated like a distribution problem instead of a relationship problem.""When trust is treated as institutional responsibility, the question shifts from 'Why don't they trust us?' to 'What are we doing that earns trust?'""Communities are asked for feedback that never shows up in the outcome of a project or policy.""It takes years to build and it can be lost completely by just a word or one action.""The main and most important question is to ask yourself who is not at the table, who is not represented before we start this conversation."Resources Mentioned:D&A Communications: davisimpact.com/ Southeast Community Facility, San Francisco (Bayview Hunters Point)Guest Bio: Darolyn Davis is the founder of D&A Communications, an equity-first communications agency focused on bridging the gap between public policy and the communities it serves. Her career began in the California State Legislature, where she witnessed firsthand how policy decisions were made without adequate representation from affected communities. For 30 years, she has specialized in public health, education, transportation, and workforce development, building strategies that center community voices and lived experiences. Her work emphasizes that effective engagement requires acknowledging history, building relationships over time, and ensuring communities have genuine input in decisions that affect their lives.Relevant For: Public health professionals, healthcare administrators, policy makers, government officials, nonprofit leaders, community health workers, communication strategists, public health students, health equity advocates, community organizers, social workers, health department staffEpisode Credits: Host: Corey Dion Lewis Guest: Darolyn Davis Podcast: The Healthy Project PodcastSubscribe and Follow: Don't miss future episodes with public health leaders and changemakers. Subscribe to The Healthy Project Podcast on Apple Podcasts, Spotify, or wherever you listen to podcasts.Feedback: Have thoughts on this episode? Questions for future guests? Reach out to The Healthy Project Podcast hello@healthyprojectmedia.com

Corey Dion Lewis sits down with Dr. Margot Kushel, a practicing general internist with over 30 years of experience at San Francisco General Hospital and Director of the UCSF Benioff Homelessness and Housing Initiative, to explore why homelessness is fundamentally a housing problem—not a healthcare problem—and what this means for medical professionals and communities.Dr. Kushel shares compelling insights from her three decades of clinical practice and research, revealing how the lack of affordable housing creates impossible situations for healthcare providers trying to treat patients experiencing homelessness. From managing diabetes in a tent to storing insulin without refrigeration, she illustrates why "there is no medicine as powerful as housing."What You'll Learn:Why regions with high homelessness rates are defined by housing affordability, not mental health prevalenceHow structural racism and redlining created the current crisis, with Black Americans 4-5 times overrepresented in homeless populationsThe stark reality: only 36 affordable housing units exist for every 100 extremely low-income households in AmericaWhy Housing First policies work better than Treatment First approaches, backed by evidence from veteran homelessness reductionThe hidden homeless population: workers living in cars, college students couch-surfing, and older adults losing housing for the first timeHow the politicization of Housing First policies threatens progress and patient outcomesPractical ways healthcare providers can advocate for housing as a health interventionKey Clinical Insights:Dr. Kushel explains why treating chronic conditions like diabetes, hypertension, and mental health disorders becomes nearly impossible when patients lack stable housing. She shares real stories from her practice, including a 63-year-old patient who hadn't eaten in four days while fighting eviction, and discusses how readmission penalties unfairly penalize hospitals serving homeless populations.The Evidence for Housing First:Learn about the dramatic 85% housing retention rate of Housing First approaches compared to 5-10% success rates of traditional Treatment First models, and why the George W. Bush administration adopted this evidence-based policy. Dr. Kushel also shares findings from California's comprehensive statewide homelessness study, debunking myths about people traveling from other states.For Medical Professionals:This episode is essential listening for physicians, nurses, nurse practitioners, physician assistants, medical students, residents, community health workers, social workers, case managers, and anyone in healthcare who treats patients experiencing housing instability. Dr. Kushel provides a framework for understanding how to advocate beyond the clinic walls.About Dr. Margot Kushel:Dr. Kushel is a physician and researcher who has dedicated her career to understanding and ending homelessness. She directs the UCSF Benioff Homelessness and Housing Initiative and the Action Research Center for Health at the University of California, San Francisco. Her research informs policy at local, state, and federal levels.Resources Mentioned:UCSF Benioff Homelessness Initiative: homelessness.ucsf.eduCalifornia Statewide Study of People Experiencing Homelessness"There Is No Place" by Brian GoldstoneEpisode Takeaway: "There is no medicine as powerful as housing. Homelessness is a housing problem."Whether you're a healthcare provider frustrated by social determinants of health, a medical student learning about population health, or a community advocate, this conversation will change how you think about the intersection of housing and health.SHOW NOTESEpisode: Housing as Medicine: Why Homelessness is a Housing Crisis Guest: Dr. Margot Kushel, MD Host: Corey Dion Lewis Category: Medicine Duration: ~49 minutesABOUT THIS EPISODEDr. Margot Kushel, Director of the UCSF Benioff Homelessness and Housing Initiative, explains why homelessness is fundamentally a housing crisis and how this understanding transforms medical practice and healthcare advocacy.GUEST BIODr. Margot Kushel, MDPracticing General Internist, San Francisco General Hospital (30+ years)Director, UCSF Benioff Homelessness and Housing InitiativeDirector, Action Research Center for Health, UCSFLeading researcher on homelessness and health outcomesPolicy advisor at local, state, and federal levelsKEY TOPICS & TIMESTAMPS[00:00] Introduction: The Housing-Health Connection[02:00] Homelessness is a Housing ProblemWhy mental health and substance use don't explain geographic variationsThe role of affordable housing shortagesComparing high vs. low homelessness regions[05:00] The Clinical Reality: Hands Tied Behind Our BacksTreating diabetes in patients living in tentsWhy standard medical care fails without stable housingThe frustration of healthcare providers[08:17] The Numbers: America's Affordable Housing Crisis36 units per 100 extremely low-income households nationallySan Francisco: 24 units per 100 householdsOne million units short[09:15] "There is No Medicine as Powerful as Housing"Using physician voices in policy advocacyThe limitations of healthcare aloneAddressing root causes[13:55] Hospital Readmissions and Housing InstabilityHow readmission penalties penalize safety-net hospitalsPatients discharged to sidewalksThe need for systemic change[17:08] Structural Racism and the Homelessness CrisisBlack Americans: 4-5 times overrepresentedThe legacy of redlining and housing discriminationHow wealth gaps perpetuate housing instabilitySan Francisco example: 5% population, 37% of homeless[19:28] Historical Context: How Housing Policy Weaponized RacePost-WWII home ownership boomRedlining and mortgage discriminationIntergenerational wealth transfer blockedOngoing discrimination in rental housing[23:49] The Hidden Homeless PopulationWorkers living in cars (Uber drivers, janitors, fast food workers)College students experiencing housing insecurityThe invisible crisis in CSU, UC, and community collegesPeople with addresses who aren't truly housed[27:17] Older Adults: The Growing CrisisHalf of single homeless adults are 50+40% experiencing homelessness for first time after age 50Bodies breaking down from physical laborThe eviction-to-homelessness pipeline[28:14] Clinical Case: The Amoxicillin StoryPatient in garage without refrigerationAntibiotic treatment failure due to housingWhy "having an address" doesn't mean housed[29:11] Debunking the Migration MythCalifornia study: 90% lost housing in-state75% in the same countyThe logic failure of migrating while brokePolitical narratives vs. research evidence[32:00] Policy Deep Dive: Housing First vs. Treatment FirstHistorical "treatment first" approach and its 5-10% success rateSam Tsemberis and the birth of Housing First85% housing retention with Housing FirstGeorge W. Bush administration adoption[36:19] The Veteran Homelessness Success StoryHow Housing First + VA healthcare system reduced veteran homelessnessThe only healthcare system guarantee in AmericaReal money + coordination = resultsWhy non-veteran homelessness increased while veteran decreased[38:21] The Political Weaponization of HomelessnessHow a Republican idea became a Democratic wedge issueJoe Lonsdale and the Cicero InstituteDemonizing stigmatized populationsThe assault on evidence-based policy[40:43] Trump Administration Policy ReversalsUnwinding Housing FirstConsequences for veterans and all homeless populationsFighting disinformation[42:14] The False Dichotomy: Housing vs. TreatmentWhy forcing treatment before housing fails both goalsSupporting treatment through housing stabilityThe pragmatic case for Housing First[43:53] Barriers to Treatment Access26% tried to get substance use treatment and couldn't"Come back when I'm housed"Maslow's hierarchy in clinical practiceThe impossibility of treating homeless patients effectively[46:12] What Healthcare Providers Can DoRaise your voice: "There is no medicine as powerful as housing"Fight disinformationAdvocate for patients beyond the exam roomUse your credibility as a healthcare professional[47:41] Community Action: Show UpAttend housing development meetingsCounter NIMBY opposition to affordable housingSpeak at churches, PTAs, and community groupsSupport affordable housing in your neighborhood[48:16] Resources & How to ConnectWebsite: homelessness.ucsf.eduSign up for updates and webinarsAccess research reports and dataEducational resources for healthcare training[49:15] Closing: The Core Message "Homelessness is a housing problem. There is no medicine as powerful as housing."CLINICAL PEARLS💊 For Physicians & Advanced Practice Providers:Screen for housing instability as a vital social determinantDocument housing status to justify treatment challengesAdjust expectations and treatment plans for homeless patientsAdvocate with hospital administration about readmission penalties💉 For Nurses & Care Coordinators:Housing status affects medication adherence, follow-up, and outcomesConnect patients to housing resources before dischargeRecognize the futility of some discharge instructions without housing🏥 For Medical Students & Residents:Learn about social determinants of health beyond textbooksUnderstand policy as a tool for improving patient outcomesDevelop advocacy skills as part of clinical trainingSTATISTICS THAT MATTER📊 36 affordable housing units per 100 extremely low-income households (national average)📊 24 affordable housing units per 100 extremely low-income households (San Francisco)📊 4-5x overrepresentation of Black Americans in homeless populations📊 85% housing retention rate with Housing First policies📊 5-10% success rate with Treatment First policies📊 50% of single homeless adults are age 50 or older📊 40% of older homeless adults experiencing homelessness for the first time after age 50📊 26% of people with apparent substance use disorders tried and failed to access treatment📊 90% of California homeless residents lost housing in-state📊 75% of California homeless residents are in the same county where they lost housingRECOMMENDED READING📚 "There Is No Place" by Brian Goldstone: Ethnography of families experiencing homelessness in Atlanta📄 California Statewide Study of People Experiencing Homelessness Available at homelessness.ucsf.edu📄 UCSF Research Reports on Housing and Health: Evidence-based policy recommendations and dataKEY QUOTES"There is no medicine as powerful as housing." — Dr. Margot Kushel"Homelessness is a housing problem. It's all about the mismatch between the cost of housing and lower income people's ability to afford it." — Dr. Margot Kushel"When you compare regions with high rates of homelessness to regions with low rates, what separates them is not mental health or substance use problems, and interestingly not poverty. It's the housing crisis." — Dr. Margot Kushel"I can be the best doctor I can possibly be, but if our patients are experiencing homelessness, our hands are tied behind our back." — Dr. Margot Kushel"If you make housing the prize, you get neither housing nor treatment." — Dr. Margot KushelCONTINUING EDUCATION VALUEThis episode addresses:Social determinants of health in clinical practiceHealth equity and structural racism in medicinePopulation health managementHealthcare policy and advocacyChronic disease management in vulnerable populationsSubstance use disorder treatment barriersMental health care delivery challengesRelevant for CME topics: Population Health, Health Equity, Social Medicine, Primary Care, Internal Medicine, Emergency Medicine, Psychiatry, Addiction MedicineCONNECT WITH DR. KUSHEL🌐 Website: homelessness.ucsf.edu 🏥 Institution: University of California, San Francisco 📧 Contact: Available through UCSF Benioff Homelessness Initiative websiteABOUT THE HEALTHY PROJECT PODCASTThe Healthy Project explores critical health topics affecting communities across America, featuring conversations with healthcare leaders, researchers, and advocates working to improve health outcomes and equity. Hosted by Corey Dion Lewis.🎙️ Host: Corey Dion Lewis 📧 Contact: [Your contact information] 🌐 Website: [Your website] 📱 Social Media: [Your social handles]SUBSCRIBE & SUPPORTIf this episode changed how you think about housing and health, please: ⭐ Rate & Review on Apple Podcasts 📢 Share with colleagues in medicine and public health 💬 Discuss in your hospital or clinic 🔔 Subscribe for more episodes on health equityMEDICAL DISCLAIMERThis podcast is for educational and informational purposes only and does not constitute medical advice. For specific medical concerns, please consult with qualified healthcare professionals. Information about homelessness services and housing resources should be verified with local providers.

Today’s episode is not the one I planned to release. I was supposed to share an interview I was excited about, but it didn’t feel right to move forward after the tragic killings by ICE agents in Minnesota. Families are grieving. Communities are scared. And pretending everything is normal felt like the wrong move.In this solo emergency episode, I speak honestly about not having the right words, but choosing to not stay silent. The Healthy Project was created to shine a light on the systems that harm people, and what happened in Minnesota is not just a headline. It is state violence. It is the predictable result of a system built on fear and enforcement.This episode is about sitting with discomfort, naming what’s happening, and turning awareness into action. I share why immigration enforcement has always been violent, why no human being deserves to die because of documentation status, and what you can do right now to support impacted communities.We talk about:The ICE killings in Minnesota and why this matters to all of usHow silence protects harmful systemsThe human cost behind immigration enforcementWays you can take action through education, mutual aid, and community supportThis is a heavy episode. But it’s a necessary one. You don’t need perfect words to show up. You just need to refuse to look away.

Support the show Help sustain independent mental health conversations https://buymeacoffee.com/coreydionlewisStay connected Sign up for the Healthy Project Media newsletter for new episodes and resources www.healthyprojectmedia.comIn this powerful episode, host Corey Dion Lewis sits down with Patricia  Barbee (Patty), Executive Director of Project Bridging and educator, for an honest conversation about navigating life's transitions.From morning routines to major life changes, Patty shares her wisdom on helping youth and adults alike move through difficult transitions with grace and intention. They discuss the importance of mentorship, positive reinforcement, love languages, and why sometimes you just need to "be positive or be quiet."KEY TOPICS:• Understanding transition in childhood and adulthood• The power of mentorship and community• Love languages beyond romantic relationships• Positive consequences and reinforcement• Getting out of your own way• Why asking questions matters• Building routines that support growthABOUT THE GUEST:Patricia Adrienne Barbee is an educator and the Executive Director of Project Bridging, a program focused on middle school students during their critical transition years. With over 20 years in early childhood education, Patty is passionate about advocating for children and helping them navigate life's changes.MEMORABLE QUOTES:"Be positive or be quiet.""If you care, you will learn.""Give yourself time to adjust to things.""You're worth it. Get you some help and get you some people who love you."RESOURCES:Support the show: https://buymeacoffee.com/coreydionlewisNewsletter: www.healthyprojectmedia.comCoffee Can't Fix Everything is a mental health podcast that breaks stigma through authentic conversation. If you or someone you know needs help, please reach out to a mental health professional.CHAPTER MARKERS:00:00 - Introduction & Welcome00:09 - Meet Patricia Barbee: Educator & Advocate01:39 - The Shoe Game & Personal Style02:34 - Corey's Journey: Turning 42 & Transitions03:30 - What Makes Transition So Hard?04:40 - Learning from Early Childhood: Daily Transitions05:55 - The Role of Mentorship in Transition06:36 - Middle School: The Lost Land08:00 - Love Languages & How We Receive Care09:45 - Asking the Right Questions11:27 - "Be Positive or Be Quiet"12:41 - Fighting Through the Quicksand14:53 - From Wasting Time to Investing in Yourself16:41 - It's Okay to Say "This Isn't For Me"18:04 - Consequences: Positive & Negative19:52 - Believing in Yourself More Than Outside Voices20:52 - Patty's Personal Transitions: Loss & Healing22:00 - The Power of Positive Reinforcement23:03 - Every Day is a Fresh Start25:42 - Morning Routines & Self-Care27:38 - Building Your Village29:04 - Learning to Be Yourself30:47 - Not a Morning Person: Embracing Your Process32:26 - Final Advice: Give Yourself Time34:11 - Closing Thoughts: You're Worth ItMental health resourceshttps://www.iowahealthieststate.com/back-the-blackCall or text 988 for the Suicide and Crisis Lifeline (24/7, free, confidential) https://988lifeline.orgNational Alliance on Mental Illness (education and support) https://www.nami.orgMental Health America screening tools and resources https://www.mhanational.orgTherapy for Black Men directory https://therapyforblackmen.orgFind a therapist near you https://www.psychologytoday.com

In this first episode of Change in Plain Sight, hosts Victoria Henderson Weber and Heather Jones-Brown, with guest and founder of Healthy Project Media, Corey Dion Lewis, introduce the purpose of the podcast and the work behind it.You hear why understanding systems matters, how civic engagement shows up in everyday life, and why community power is tied to health, opportunity, and wellbeing.This episode covers:Why health is shaped by more than doctors and hospitalsHow policies affect daily life, from speed bumps to schoolsWhat civic engagement really meansWhy you don’t need to be an expert to create changeHow systems and relationships work togetherThe value of lived experience and confidence in leadershipWhat listeners can expect from future episodesThis podcast invites you into the process. Growth happens in real time. Questions are welcome. No topic is off limits.Have a question for the hosts? Email: chips@healthyprojectmedia.comLearn more about the network:podcast.healthyprojectmedia.comSubscribe and follow to be part of the conversation.