C E L E B R AT I N G B L AC K AC H I E V E M E N T T H RO U G H O U T F L O R I DA
BACK TO SCHOOL
GETTING KIDS READY FOR FALL
NEW JOB SEARCH
TIPS TO GET THE ONE YOU WANT
SUMMER VACATION
CHECK OUT THE CARIBBEAN
VOLUME 26 ISSUE 4 JULY/AUGUST 2023
CELEBRATION HALF A CENTURY AS AN INDEPENDENT NATION
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CONTENTS 6
Publisher/Masthead
7
ONYX Salutes: Rev. Dr. Randolph Bracy
8
Black History: Moments this month
9
Black Business Month: Find and support Black businesses
10 Smart Tips: Back to school edition 12 Travel: Caribbean family vacation pploading 14 Medically Speaking: Dream deferred –
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COVER STORY
CELEBRATING 50 YEARS OF INDEPENDENCE IN THE BAHAMAS
Medicaid with oral health in crisis 16 Perspective: Off the Beaten Path 18 Advertorial: Lift Orlando and West Lakes 20 The Quad: What’s happening on the yard 22 Entertainment: Disney Junior greenlights Ariel 23 ONYX Reads: Thought provoking selections for summer 24 Art & Culture: Young Readers Find Hope in Fantasy Books 27 Washington Notes: Supreme Court Decisions 28 Family: Entertaining this summer 30 Education: How to spot fake news 32 Real Estate: Sky High: Mortgage rates hit highest point 34 Community: How to stop school shootings 36 ONYX on the Move: 100BM, Mayor fundraiser 37 SAGE: Flexibility is key to a thriving retirement 38 Health & Wellness: Health blurbs for your life 40 Workplace: Finding the right fit job 42 Feature: Bahamas celebrates 50 years of independence 44 Wealth & Finance: Back to school shopping 46 Food & Wine: Tart Key lime smoothie
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M E D I C A L LY S P E A K I N G
HOPE DEFERRED
DESPITE BEST EFFORTS, MANY FLORIDIANS MAY LOSE MEDICAID HEALTH BENEFITS WITH DENTAL COVERAGE, SETTING OFF A BEVY OF HEALTH CHALLENGES. BY PENNY DICKERSON
L
aQuoria Lloyd is a single parent to 9-year-old Mia Rhymer and 6-year-old Davion Young. She is a Jacksonville native, Black, in the lower income financial bracket and inhabits a feisty spirit to defy
Mia Rhymer, 9, and Davion Young, 6, are Jacksonville-based siblings who endured oral surgical extractions under general anesthesia. Due to high indulgence of of candy and sugary drinks, their baby teeth developed corrosion and cavities. Florida Medicaid paid for the procedure at Greenberg Dental in Jacksonville. They now eat healthier and are scholarship recipients at The Guardian Catholic School photo by Jusny Mackenson Louis-Jean
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odds. The 35-year-old mother has experienced unemployment, transportation woes and housing instability over the past five years, but no challenge rivals witnessing both children endure oral surgical extractions under general anesthesia. Poor nutrition led to corrosion and cavities in their baby teeth. It was normal for Mia and Davion to indulge in candy and sugary drinks from corner stores or relatives and caretaker’s homes. Lloyd says her children began regular dental check-ups at Greenberg Dental in Jacksonville when they reached age 3. The same practice completed the procedures — Florida Medicaid paid the bill. “It was scary watching both my kids go through that,” Lloyd said. “Mia was 5 and had silver caps placed in her mouth as two front teeth. One cap came off before her permanent teeth grew in. Davion was only 3, and his bad teeth were in the bottom and lower back.” Lloyd told ONYX Magazine that after being terminated from Amazon and the US Postal Service, she was offered a job in 2019 as a security guard for Duval County Public Schools. Her rate of pay is $18.25 per hour, and her children are recipients of Step-up for Schools scholarships at The Guardian Catholic Schools in Jacksonville’s Northwest quadrant. “My kids eat better and now drink a whole lot more water,” Lloyd said. “Mia eats more vegetables and would eat salad and fried chicken every day if I let her. Davion loves mashed potatoes, sandwiches and chicken nuggets. They have learned candy is a special treat.” The latter represents triumph, but also a familiar indemnity for the Black family — one positive outcome becomes an elusive gauge for long-term stability. With a steady job and salary, Lloyd is still deemed low income. She no longer qualifies for food stamps through SNAP and is not receiving child support. Government agencies like the Florida Department of Children and Family (DCF) may view Lloyd as back on her feet, but this year, she joined the ranks of nearly one-million Floridians at risk of losing health care coverage through Medicaid. Lloyd says DCF contacted her by mail to reapply for Medicaid and sent mobile text message reminders.
“The process was easy because I was already in the DCF system,” Lloyd said. “I just completed forms online and waited for a decision. Mia and Davion were re-approved, but they said I was ineligible for Medicaid based on my income.” In a June report, Kaiser Health News said 82% of Floridians or a quarter-million people in the state have lost coverage. State data shows that most of those people are still eligible but lost coverage for procedural reasons such as having outdated contact info or computer glitches. The report further said that 10% of those who lost coverage were terminated because they were ineligible or hadn’t used Medicaid over the past 12 months. In Florida, most Medicaid recipients are enrolled in the Statewide Medicaid Managed Care program that has three parts: Managed Medical Assistance, Long-Term Care, and Dental. All people on Medicaid must enroll in a dental plan. Daniel van Hoogstraten is an Ohio-based consultant and healthcare advocate who has devoted decades of support in the nonprofit space. He works in various states and on Capitol Hill with a focus on groups who are trying to help people. He says Medicaid falls into that bucket very often. “So, there's two big things going on with Medicaid right now in Florida and that's obviously the disenrollment that was paused, but then continued on,” van Hoogstraten said. During Covid-19, the federal Public Growing evidence connects a healthy mouth with a Health Service Act was implemented. It healthy body. Here are some examples showing why thatmore youthan couldn't oral healthstipulated is about much a smile:roll people off Medicaid, but it ended May High Blood Pressure 11 of this year. Florida began rolling Putting off dental during early who adulthood is linked to people offcareMedicaid had been an increased risk of having high blood pressure.1 on it for a long period of time. Now, Patients with gum disease are less likely to keep their blood pressureare underlosing control with medicationbecause than are people Medicaid those with good oral health.2 they are not eligible or because they didn't properly complete the enrollDiabetes ment process.” Untreated gum disease makes it harder for people with diabetesvan to manage their blood glucose levels.3for many Hoogstraten says Diabetes raises the risk of developing gum 86%.4 states, if not all, Medicaid isdisease theirbylargest state expenditure. Obesity It is big money and taxpayer money, so Brushing teeth no more than once per day was linked with the he and offellow development obesity.5advocates are currently talking to Frequent consumption of sugar-sweetened drinks the risk of both government administrations toraises determine if their obesity6 and tooth decay among children7 and adults.8 process is working well and transparent. He thinks states are generally trying to do the right thing. “I also think Medicaid departments are behemoths because of the really Sources large population they serve,” van Hoogstraten said. “The populations are 1. Oreskovic, NM et al. (2017). Oral health status and longitudinal cardiometabolic risk in 4. Baranowski MJ, et al. Diabetes in dental practice-review of literature. Journal of a national sampleoften of young adults. of the American Dental Association, Health and Sport. 2019; 9(2), 264-274 soJournal hard to reach, and148(12), they're Education, constantly shifting and changing. The 930-935. 5. Furuta M, et al. (2020). Longitudinal associations of toothbrushing with obesity and 2. Pietropaoli D, et shortcomings al. Poor Oral Health and Blood Pressure Control among US hyperglycemia. Journal of Epidemiology, JE20190165. or mistakes are usually not nefarious or ill intentioned, but Hypertensive Adults: Results from the National Health and Nutrition Examination 6. Luger M, et al. Sugar-Sweetened Beverages and Weight Gain in Children and Adults: A Survey 2009 to 2014. Hypertension. 2018 Dec; 72(6): 1365-1373. Müller F. Oral Hygiene Systematic Review from 2013 to 2015 and a Comparison with Previous Studies. Obesity they're inevitable.” Reduces the Mortality from Aspiration Pneumonia in Frail Elders. Journal of Dental Facts. 2017; 10(6): 674-693. Research. 2015 Mar; 94(3 Suppl.): 14S–16S. Bleich SN, Vercammen KA. The negative impact of sugar-sweetened beverages on Despite the State’s best intent,7. without Medicaid, Floridians like Lloyd 3. Preshaw PM, Bissett SM. Periodontitis and diabetes. British Dental Journal. 2019; children’s health: an update of the literature. BMC Obesity. 2018; 5(6). 227: 577–584; Teeuw WJ, et al. Effect of periodontal treatment on glycemic control of 8. Bernabé E, et al. Sugar-sweetened beverages and dental caries in adults: a 4-year struggle to findDiabetes affordable diabetic patients:will A systematic review and meta-analysis. Care. 2010 Feb; health coverage that includes a dental plan. prospective study. Journal of Dentistry. 2014; 42(8): 952-958. 33(2): 421-427. She is potentially an unwitting contributor to Florida’s state of poor oral health — a precursor to a bevy of extended health diseases. The Jacksonville Urban League played an integral role in Florida's Oral Health Crisis by hosting a Town Hall meeting in April 2022. The organiza-
Impacts Beyond the Mouth
tion's core vision is to be a leading advocate for promoting access to quality education, economic opportunity, civic engagement, health, and wellness. The following statistics emerged from the oral health gathering: 1. More than five-million Floridians live in areas that have limited or no access to dental care and more than 23% of third graders in Florida have untreated tooth decay, making Florida sixth in the nation for the highest percent of third-grade children with unfilled cavities. 2. 34% of senior citizens have lost six teeth due to tooth decay or gum disease. 3. In 2019, hospitals in Florida billed more than $630 Million for preventable ER visits and hospital admissions stemming from preventable oral health issues. 4. Poor dental health has been said to be the cause of 57 systemic diseases and illnesses. 5. Patients with serious dental conditions are 25% more likely to suffer from heart disease and have an increased chance of autoimmune diseases, anemia, gastrointestinal disorders, and renal disease. The largest burden of disease occurs among marginalized groups such as those living inDementia poverty and members of Black, Indigenous, and People ofyears Color (BIPOC) commu- was Having 10 of chronic gum disease (periodontitis) associated with a higher risk of developing Alzheimer’s disease. nities. Low-income families spend 10 times of Researchers report that uncontrolled periodontal disease their total income on dental the care than that “could trigger or exacerbate” neuroinflammatory phenomenon seen families. in Alzheimer’s disease. of wealthier Without dental coverage or the ability Respiratory to afford care, Health many adults delay treatResearch shows that improving oral hygiene among mentmedically whichfragile leads to more expensive seniors can reduce the death rate from 11 pneumonia. andaspiration extensive oral care than they Patients with ventilator-associated pneumonia (VAP) who would require had they seen a dentist engaged in regular toothbrushing spent significantly less time on mechanical ventilation than other VAP patients.12 earlier in the disease process. Improving veterans’ oral hygiene reduced the incidence of Lloyd has valiantly rebounded hospital-acquired pneumonia (HAP) by 92%, preventing about 13 136 HAP casesdropped and saving 24off lives.the from being Medicaid roll. Her employer offers a Blue Cross Blue Shield of Florida plan and Adverse Birth Outcomes Delta Dental, but cumulative payroll Gum disease among pregnant women is associated with preterm deductions are near $100. Withouta pregnancy births, low birthweight babies and preeclampsia, complication that can cause organ damage and can be fatal.14 Medicaid, she will also have to budget co-pays for appointments. “My health is already not good,” Lloyd said. “I have high blood pressure, and if I go to the dentist and it’s high, they won’t treat me. I am headof-household. It’s just me, so one entire paycheck goes to rent and the other pays JEA electric and car insurance. With food skyrocketing and two kids, it’s hard, but I am determined to make it work.” 9
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9. Chen CK, et al. (2017). Association between chronic periodontitis and the risk of Alzheimer’s disease: a retrospective, population-based, matched-cohort study. Alzheimer’s Research & Therapy, 9(1), 56.
13. Munro S, Baker D, 2018. Reducing missed oral care opportunities to prevent nonventilator associated hospital acquired pneumonia at the Department of Veterans Affairs. Applied Nursing Research, 2018; 44: 48-53.
10. Teixeira FB, et al. Periodontitis and Alzheimer’s Disease: A Possible Comorbidity between Oral Chronic Inflammatory Condition and Neuroinflammation. Frontiers in Aging Neuroscience. 2017 Oct; 9:327
14. Daalderop LA, et al. Periodontal Disease and Pregnancy Outcomes: Overview of Systematic Reviews. Journal of Dental Research Clinical and Translational Research. 2018; 3(1): 10–27.
11. Müller F. Oral Hygiene Reduces the Mortality from Aspiration Pneumonia in Frail Elders. Journal of Dental Research. 2015 Mar; 94(3 Suppl.): 14S–16S.
Citation: Penny Dickerson isSuggested innovation and entrepreneur CareQuest Institute for Oral Health. Impacts Beyond the Mouth. Boston, MA; June 2020. DOI: 10.35565/CQI.2020.4002 reporter for the Jacksonville Business Journal. Copyright © 2021 CareQuest Institute for Oral Health, Inc. Reporting for this story in ONYX Magazine was made possible by a health equity fellowship sponsored by The Commonwealth Fund and Association of Health Care Journalists.
12. de Lacerda Vidal CF, et al. Impact of oral hygiene involving toothbrushing versus chlorhexidine in the prevention of ventilator-associated pneumonia: a randomized study. BMC Infectious Diseases. 2017 Feb 27; 17(1): 173.
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LIFT ORLANDO
HEALING, HEALTH, and HAPPINESS: THE HEART OF WEST LAKES WELLNESS CENTER HAS IT ALL FIND OUT HOW THIS INNOVATIVE CENTER IS CHANGING THE GAME FOR COMMUNITY WELLNESS IN ORLANDO. BY MARK SHAMLEY
I
still remember the energy on February 10, 2023, when I arrived at the ribbon-cutting ceremony of the Heart of West Lakes Wellness Center, located west of downtown Orlando, Fla. I could feel the excitement in the air as if I was about to witness something incredibly special. And I was; I was about to witness history being reborn. At that time, I had just started my role as Lift Orlando's first-ever vice president of Community Impact. For those unfamiliar, Lift Orlando is a nonprofit that strengthens neighborhoods so people can thrive. We bring people, places, and partnerships together to help create mixed-income housing, cradle-to-career education pathways, health and wellness services, and economic viability opportunities. My job is to collaborate with my colleagues and commu18 ONYX MAGAZINE
nity partners as we strive to achieve this vision alongside the residents of West Lakes. As I sat there contemplating the magnitude of the moment for the residents of Rock Lake, Lake Lorna Doone, Lake Sunset, Clear Lake Cove, and Bunche Manor/Hollando, who had brushed aside skepticism to embrace a vision, I knew the real work was just about to begin. The Heart's ribbon-cutting ceremony was the culmination of nearly a decade of hard work. In 2016, a study had shown that the West Lakes community had limited access to healthcare. There were only 12 healthcare access points for the five historically Black neighborhoods that make up the 32805 ZIP Code near Camping World Stadium. In comparison, in that same year Winter Park’s 32789 ZIP Code had 112. These results were unacceptable, and some-
thing had to be done. Together with neighbors, business leaders, and healthcare and philanthropic leaders such as AdventHealth, Orlando Health, Florida Blue, Dr. Phillips Charities, and Truist Foundation, we put together a plan. The dream: a new take on community wellness that would focus on ensuring residents could connect, learn, and thrive in every area of their lives. The Heart of West Lakes Wellness Center was born. Fast forward to today, and the Heart, also known as the community’s living room, is finally here, thanks to the additional support of new funding partners like the Trisons Foundation and the Deibel family. Located at the gateway into the West Lakes Community Campus, the approximately 30,000-square-foot, two-story building offers first-class amenities and services designed to promote physical and financial well-
being, lifestyle services, and places for the community to gather — all in the heart of the West Lakes neighborhoods. As you walk in, you will find the Legacy Café, the West Lakes Financial Wellbeing Center, which is also home of the Small Business Institute and the Prosperity Platform powered by Goodwill Industries of Central Florida, the Florida Blue Center Orlando West Lakes, and the Heart of West Lakes Event Space. The exterior of the building boasts ample green spaces for neighbors to relax and gather. Upstairs, Community Health Centers, Inc., offers comprehensive healthcare services, providing a vital, new resource to combat the area's lack of access to healthcare services. But the Heart is more than just a building with amenities. It is the result of the first-ever, large-scale collaboration of this type between healthcare powerhouses such as AdventHealth, Florida Blue, and Orlando Health. Most importantly, it is the result of collaboration between these powerhouses and West Lakes residents. Decades ago, the area we now call “West Lakes'' was a thriving community steeped in pride and cul-
tural significance. But over time, disinvestment and inequitable practices led to many of the resources crucial to residents’ success being cut off. Thankfully, the pride and spirit of the residents never waned. Today, thanks to the dedication of HOA leaders, residents, and partners, the Heart will now help restore access to many of those lost resources. As Orlando District 5 City Commissioner Regina Hill said during the ribbon-cutting ceremony, "To thrive, you need a healthy community. [The Heart] means that the community will have access to quality healthcare–from cradle to the golden years." Residents will continue to shape the character, services, and programming of the Heart. By the time you read this article, nearly 30 neighbors will have joined a focus group to hone and guide the Heart's healthcare services.
Today, when I look at the Heart, I see the rich history of The Communities of West Lakes and the prosperous future that awaits us inside. If you're interested in learning more about the Heart of West Lakes Wellness Center, including hiring information and opening details, please visit HeartofWestLakes.com to sign up for the newsletter and to keep up with updates on social media. And we’re open to your ideas and feedback about the events and programs hosted at the Heart. Please scan the QR code to share your ideas and to sign up for our newsletter. If you're interested in learning more about Lift Orlando and our work in West Lakes, please visit LiftOrlando.org.
Mark Shamley is the vice president of Community Impact at Lift Orlando.
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