Photo: Jon M. Fletcher
"It's more than a Band-Aid. It really is infrastructure-changing," says Kelli Tice.
Health Care Landscape
Florida Blue teams up with local organizations to change attitudes and outcomes.
Physician Kelli Tice needs only to look back one generation in her family to understand the devastation wrought by health inequities: Her grandmother died young from a preventable disease.
“My mother was born and raised here in Jacksonville, in the New Town area. She was a nurse; she graduated from Brewster-Duval School of Nursing that was created because Black physicians in the area needed support staff; they needed nurses,” Tice says. “My grandmother died at the age of 57 from diabetes. She was on dialysis. My mother, who was a nurse, lived in fear of her 57th birthday.”
The story illustrates how communities over time can come to see disease as inevitable.
“We become accepting of the losses, the impact of poor health outcomes, in communities like this. It becomes normalized — that people ‘leave’ early. They lose toes or limbs; they have to go to dialysis. When communities that have not had appropriate understanding of and access to resources for such a significant period of time, it’s more than getting them covered (by insurance). They have to know what to do with that coverage, and we have to undo attitudes about health that have existed in families. There are people who’ve never been to a dentist. Their parents didn’t go, and they don’t either.”
For three decades, including 17 years of county-level and state-level work with the Florida Department of Health, Tice taught physicians to incorporate cultural awareness into their practices, redesigned processes at local clinics to be more patient-centered and advocated for data collection practices to more accurately inform health policies.
When COVID-19 hit, Tice had been with Florida Blue for two years. The company assigned her to lead its pandemic response on behalf of its members, especially those with the least access to health care. She flooded the zone with education and clinical resources to help members understand the threat of the virus, take precautions and get testing, treatment and vaccines.
Nationwide, health care companies were appointing equity executives in the aftermath of the 2020 murder of George Floyd and the pandemic. For many Eastsiders, Floyd’s murder was a reminscent of Ax Handle Saturday, Aug. 27, 1960, when a mob armed with bats and ax handles attacked civil rights activists in East Jacksonville taking part in lunch counter sit-ins at segregated restaurants. The Jacksonville Historical Society says the violence was initially denied by authorities, but film evidence emerged years later. A mural on a wall of the Eastside Brotherhood center commemorates the incident.
Florida Blue started by identifying communities in need that have local support agencies with whom to partner. Skeptics might have thought the corporate overtures of 2020 were performative, but many of the initiatives have since taken hold and created partnerships working toward change.
“We are working to re-create a culture of health, while we re-create a financially and socially healthy community,” Tice says. “And we also have to tell the truth about how we got here.”
Interrupting the cycle
In Eastside, the infrastructure of change looks like this: Florida Blue provides funding to support grassroots projects, which include restoring Debs Store, where Goodwill and VyStar Credit Union are setting up shops. As community quarterback, Lift Jax and its main partner, the Historic Eastside Community Development Corp., work with organizations such as Local Initiatives Support Corp. of Jacksonville, United Way and the Delores Barr Weaver Foundation to improve housing and promote ownership, so that legacy residents can afford to remain in place and not be displaced as property values and curb appeal rise. Through Project Boots, Local Initiatives Support Corp. works to attract construction on hundreds of vacant lots. With too few children reading at grade level, Lift Jax partners with the Duval County School District to support the John Love Early Learning Center in Eastside. The Jacksonville Jaguars have invested $1 million in various projects, including Debs Store and job-training programs such as Construction Ready Jacksonville. The City of Jacksonville is helping, too, and others.
“We know that adverse childhood experiences — living in poverty, experiencing violence, being housing- or food-insecure, all those things — actually translate into higher incidence of chronic illness when those kids become adults. So, we have to interrupt the cycle,” Tice says. “Otherwise, we’ll be having these same conversations in 15, 20 years, as we’ve done for the last couple of decades.”