Name: Mia R. Keeys
Hometown: Yeadon, Pa.
Position: Health policy adviser for Rep. Robin Kelly, D-Ill.
Alma mater: Cheyney University; Vanderbilt University and Meharry Medical College
Washington Examiner: How did you end up working on the Hill?
Keeys: It was really quite intentional. I’ve always believed that policy is where you go to change people’s realities. When I was in college my final year, I applied for an internship program through the Kaiser Family Foundation called the Barbara Jordan Health Policy Scholars Program. I got in. That was in 2008, at the time Barack Obama was a senator, and he was running for president. I was placed directly across from his office in Sen. Tom Harkin’s office. I was able to work as a health policy intern on what I didn’t yet know was the nascent beginnings of the Affordable Care Act. It was really a quite powerful introduction to health policy on the federal level. It was also overwhelming in the sense that I didn’t really have the most true understanding of how federal policy, especially in health equity, affects people on the ground.
After a couple of months of that program, I opted not to take a permanent job here, and I moved back home to Philly and did some work with the deputy mayor’s office for health and opportunity under then-Mayor Michael Nutter. I served as the immigrant health and language access coordinator to the deputy mayor. Because of the recession, we had these parallel phenomena where people were presenting for care at free federally qualified health centers if they were citizens, but then we had people who were clearly not coming any longer for care because they were afraid they would be deported. It really opened my mind up to how health is a lot more than about individual behaviors. It’s about feeling safe around choices that you can make, or feeling like you can exercise healthy choices and have access without your life being targeted.
I said to myself, "OK, I’ve got the federal policy perspective, I’ve got a little bit of the local, now it’s time to expand my world." I moved to South Africa and worked for LoveLife in Johannesburg, an HIV/AIDS advocacy youth brand. This organization was really about supporting lifestyle changes and lasting changes for born free youth, meaning those who were born following the Apartheid generation. I traveled all across the country talking to young people about what their barriers to care were. It was humbling work but also really very affirming in the sense that I felt that this was definitely the kind of work that I was called to do, being able to relate the research to the people, and consistently thinking about the people when you’re writing policy and when you’re talking to lawmakers and national figureheads who are able to make those firm decisions.
It was also the year of the World Cup. I’m a huge soccer fan. I was very excited to be there at the time. But because the World Cup was there I was able to also see just how in concert things move when you’re talking about countries making decisions about where to put their money. South Africa at that time was trying to build up new stadiums to bring in tourist dollars, but it also meant taking money away from the public services people really needed, like clean water, electricity, safe roads.
In one town, we were talking to young people about risky behaviors, asking them, “Why do you feel like you don’t have much at your disposal, or why do you do X, Y, and Z? Why do you have sex without condoms, or why do you have multiple partners?” The responses, consistently, were: “I don’t have anything to do. If I go to school, there is no running water, or the electricity is out, or the teachers aren’t there.” What I took away from that situation was: When governing bodies make decisions about where their monies go, the judicious policymaker will look at where the monies did not go and really start to register those effects.
I was selected for a Fulbright in 2010, and I moved to Indonesia. Religion and gender were the two elements that probably jumped out at me the most when thinking about health outcomes in a place like Indonesia, compared to a place like South Africa where for me, race and racism and colorism were issues that one had to really think through when you’re talking about evaluating health outcomes and comparing one community to another.
I was an English teacher, a creative writing teacher in a high school for about a year. And I also did some public health work in the community. Because I lived in a very rural place at the time — I mean very rural. I had a well in front of my little blue house. My bathroom and my kitchen were outside. Beautiful area. It rained six months out of the year I was there. My electricity was going off all the time. So, most of my time I spent with myself, by myself, thinking through, reading, a lot of writing, also just with my neighbors, establishing relationships. Which, if you knew beyond this conversation, you’d think was a feat in itself because I am quite the introvert. It became necessary, honestly to my survival and to my own health, to establish relationships with people. Mostly because, like I said, gender is a big thing to consider when navigating different worlds, at least certainly in Indonesia. It’s very uncommon for a woman to be on her own, especially a young woman. At the time, I was 24. A single woman, black woman, and also not Muslim. So, all of those things make a major difference in that country, and I learned so much about myself and my conviction to really explore and then explain to other people. But also just explore what it means to be healthy as an individual, the concept of health from a communal perspective in places where these identities pop up. And it means so much in terms of why people make the decisions that they do and the access that they have to those healthy choices.
I stayed in Indonesia for three years, and I moved from a rural place to Jakarta, mostly to shore up my language and also just to learn more and more about what it means to be healthy in this space. And then, it was time for me to come home, so I came back to the states and moved to Nashville, which might as well have been a whole other country for me.
Washington Examiner: Yes, Nashville would be different.
Keeys: Beautiful time, I learned a lot, that’s where I got my training in terms of medical sociology and health policy at Vanderbilt University. I left with my master’s. It was a PhD program, but I opted not to complete the PhD there, mostly because by this time, 2016, there was an opportunity to come back to the Hill. And now I’ve seen quite a bit, I’ve experienced quite a bit, talked to so many people, have gone through so many teachers in terms of learning what health equity looks like in different spaces. I felt, “Now is the time to come back.” Honestly, I was under the impression that we’d have quite a different political outcome, and operating in that space would have meant more in terms of what it means to be a health policy adviser. But I’m so very glad that I’m here during this time and have landed where I have. There is a lot of work that comes out of this office in terms of thought leadership. Congresswoman Kelly is extremely passionate about tackling equity issues from myriad perspectives, because health is literally in all policies. So, given her position as Congressional Black Caucus Health Braintrust chair, I’m able to walk with her through that. We have congressional briefings on everything, including mental health in terms of how it affects young black women and maternal mortality and the disparities there. That’s probably the biggest thing we’re working on now.
Washington Examiner: Do you feel like tackling maternal mortality could be an area of bipartisanship?
Keeys: Absolutely. Because the thing about maternal mortality is, here in the U.S., we have outcomes that align with under-developed nations. We have the highest number of morbidity and mortality than any developed nations. And that’s just deplorable. The issue is that it’s not about individual behaviors. It’s not about whether an expectant mother is going for prenatal care or taking all of her vitamins or anything like that. It has mostly to do with whether or not a woman has social support. It has everything to do, especially in the case of women of color, particularly with African American women, with the chronic stresses of gender discrimination and of racism. Those are issues, particularly from a policy perspective, that vex me. Because it’s not as though you can legislate away racism. You can’t legislate away gender discrimination. You can’t legislate that any provider not be biased. So, how does a really very thoughtful policymaker look at that issue? If no one else, Congresswoman Kelly is the one to really spearhead that investigation. So, we have been doing a lot of sitting down with organizations just thinking through, "OK, well from a provider standpoint what’s the issue?" And listening, doing a lot of listening.
Washington Examiner: What have you found out from that?
Keeys: It really comes back to, yes we have these standards in place, we have emergency protocol, but because certain issues like preeclampsia and other hypertensive heart issues are really so very rare, a lot of times providers don’t know that’s what they’re seeing. And they may not respond in a timely fashion, not because they aren’t necessarily wanting to but because they don’t know that’s what they’re looking at.
But we are also hearing over and over again that implicit bias is a very real thing in the healthcare delivery system. If you’re a provider and you’re not practiced or skilled or compassionate or thoughtful enough to consider, “How do my own biases play out in my interaction with this patient?,” then that can be deadly.
I read a story about a woman who came in and she had long dreadlocks. She was pregnant. And the provider presumed that she smoked marijuana because of the way she wore her hair. I don’t know all of the details in terms of how the patient found that out, but that is a bias. If that sort of thing goes unsaid, or unchecked, that carries into the way a provider would then prescribe pain medication or the way a provider interacts with that patient or considers her to be noncompliant. And that really does dilute the provider’s ability to really give a careful examination and care to that expectant mother. And again, it’s very difficult for a provider to — at least in the space of maternal mortality — to think about ways that legislation can make a difference unless we’re in concert with providers, with patients themselves, with other stakeholders. I say all that to say this is a timely process, the development of Ms. Kelly’s bill, in this way. I’m fortunate that she’s of a patient mind enough to say, “In this political environment if nothing else — especially because this issue crosses class, it crosses ethnicities — we’ve got to take time and evaluate it.” Because it is a bipartisan issue, but we’ve got to be very careful to make certain that people understand the disparity is driven by implicit bias in a lot of ways. I’m learning a lot just by watching her. I’m learning a lot by being here. I personally feel that the respect is mutual, and that is an empowering place to be.
Washington Examiner: What do you do for fun? What are your hobbies?
Keeys: I play basketball; I’ve been playing since I was 7 or 8. And also, I’ve recently picked up tennis again, and I'm taking lessons. Also, I’m a writer. Most recently, I wrote a children’s book on health equity. I’m very excited about that. A good friend and I were able to collaborate. She was the illustrator for this particular book. It’s called: "Cole Blue, Full of Valor." It’s a story about him growing up in an inner city, and he feels like his neighborhood is sick. He sees a lot of corner stores in his neighborhood, but the corner stores don’t have fresh fruits and vegetables. A lot the kids that he grows up with, as they’re aging through the book, aren’t going to school. Or if they are going to school they are spending a lot of out-of-school time not doing much of anything. The parks aren’t safe places to play. I can’t give the ending away, but basically he comes up with ways to heal his neighborhood. He resolves to. I’m hoping it’ll be published in 2018, but we don’t have a date. I’m also working on a novel, which I’ve been working on for four years. This goes back to the introvert in me, where I think I need to hold onto this for a while, but it’s time for me to look into putting that out. So sports, writing, and reading, and like Ms. Kelly, I love to dance. So on the oddest of nights, I’m dancing the night away.