Terris King, Pastor of the Liberty Grace Church in Baltimore and CEO of King Enterprise Group, talks about how church networks can help improve access to health service and medicines and save the health system costs over time. He is convinced that the model, which he initiated during the pandemic and is now rolling out for cardio health as part of Engage with Heart, can be replicated across the United States as well as in many other countries where patients struggle to receive the health services they need. The outbreak of the coronavirus pandemic in early 2020 was a crucial juncture in Terris King’s life as the crisis blended his work as a religious leader with that of his role as a healthcare executive, giving him the opportunity to turn around ideas which he had been developing for decades. King’s actions during the pandemic not only helped the black community in the city of Baltimore, where he had been preaching for more than 30 years. His engagement also brought a marked change to African Americans and other minorities throughout the United States, who at the beginning of the pandemic had been most affected by the virus. Today, King, who is also the founding CEO of King Enterprise Group, which is trying to bridge the access gap for vulnerable communities and connect them with external partners, is lending his experience to Engage with Heart. The project, which is led by New York-based think tank Global Coalition on Aging and is sponsored by Novartis, seeks to improve heart health in Baltimore. Engage with Heart could also serve as a blueprint to other American cities, which are struggling with high death rates from stroke, heart attacks and other coronary diseases, and seek new ways to accommodate the healthcare needs of a society in which a substantial part of the populace will soon be aged 60 and older. The key to overcoming the current healthcare crisis for African Americans, but potentially also other communities struggling to get access to healthcare, lies in leveraging the power of the church as a center of trust, King told live magazine, when we met him for an extended interview in early January before meeting him in Baltimore. “No institution can out-engage the church,” King said about the role of the institution in healthcare for minority and underserved communities. “No one can gather as many people nor have a similar outreach. Why? Because we have a history that’s already built in, with our congregants and the community.” For King, who has been Pastor of the Liberty Grace Church in Baltimore since 2008 and looks back over a nearly 30-year career in healthcare, the solution is to marry the rigor of science with the networking capacity of the church, which for King is not only a place for religion, but also a place where the community bonds and exchanges views – much like the agora in Ancient Greece.

“When we open the doors of our churches across the city, it doesn’t matter what your religious beliefs are. We’re just trying to keep you alive. And the community knows this,” King explained. “The church has always been the bedrock of our community. And it’s just the fact that others know so little about our world that they often overlook and belittle the real work of the church.” The importance of the church in healthcare, especially for minority communities, is becoming increasingly evident among researchers. Over the past decade, researchers have gathered strong data showing the beneficial role of faith-based organizations for the healthcare of its members. A series of articles in the March 2019 issue of the American Journal of Public Health referred to an abundance of scientific data about the positive role of faith-based organizations, singling out the Black Church for its ability to “facilitate community engagement.” Also, it noted that the Black Church has “been effective in enhancing health knowledge, diet and physical activity patterns, and overall cardiovascular health through congregation-wide health promotion.” A pivotal moment that underlined the importance of faith-based communities and the Black Church in particular was the pandemic, when, during the early months of the coronavirus outbreak, the black community registered the highest death rates in the country. Back then, nearly 40 out of 10 000 people died due to the coronavirus, double the average of the country. The reason for the high death toll was not only that the black community lacked access to stable healthcare, but that there was a high level of distrust in the healthcare system and the connected political institutions, which led many African Americans to shun the prescriptions suggested by the medical establishment. “The distrust that African Americans have of the healthcare system in the United States of America is justified, to a great extent,” King explained. “This is because there is a litany of issues that African Americans have been through, both historically and currently, that show unequal treatment.” King not only referred to outright medical scandals such as the notorious Tuskegee Experiment, when over a span of almost 40 years some 400 black men were studied for the effects of untreated syphilis. He also pointed out the decades-long systematic shunning of African Americans when it comes to access to healthcare, which led many to develop a deep resentment against medical authorities. King is aware of these discrepancies not only through his work as a pastor, but more so in his former role as a senior executive at the Department of Health and Human Services. As part of his work, in which he also founded the Office of Minority Health for the Centers of Medicare & Medicaid Services, he learned how to leverage religious institutions to promote healthcare and access to medicines. This insight was decisive during the pandemic, when, together with other leaders, King worked towards positioning faith-based organizations as information, education and vaccination points, helping to bring about a marked reduction in the death toll for African Americans and others. “A key reason for this success was that community leaders said to our people: ‘Take the vaccine,’” King said. “So that’s exactly what I did. I worked with imams, with rabbis, bishops and pastors.”

What proved successful during the global healthcare crisis, now could also be a boon to heart health. As part of Engage with Heart, King is working with other churches, community centers and additional partners such as the Black Food Security Network and Johns Hopkins to improve cardio health by addressing one of the deadliest and costliest diseases across all race groups. The goal is not only to strengthen the heart health of black communities in Baltimore through rigorous monitoring, health education and healthy living programs, which includes external speakers, nutritionists, chefs and black farmers, among others. Engage with Heart also has the potential to grow substantially, if regulators and insurers can be convinced that the model has the potential to become sustainable and replicable in other places. This, for King, would prove not only that churches can act as centers of faith, but also their ability to create lasting bonds beyond religion.

Pastor King, how did Engage with Heart start in Baltimore? For African Americans, the health crisis reached a peak during the early days of the coronavirus pandemic, when the death rates of the black community were highest among all race groups. This is when church, community and political leaders came together and started to drum up support to deliver information, help and vaccines to the people through the network of the churches. In Baltimore, 300 religious leaders came together, and I was able to connect with other leaders around the country to support their regional efforts and convince them of the feasibility of the model. Our success, engagement and willingness to improve healthcare in general paved the way for our collaboration with Novartis and the Global Coalition on Aging to start Engage with Heart in Baltimore. What do you expect of the program? For me, it’s a great opportunity to showcase once again that the church can play a crucial role in improving healthcare, especially for minorities and underserved communities. This is less about the church’s religious influence and more about its function as a place of trust and encounter. If we successfully manage to monitor, educate and provide people with healthy lifestyle choices, we can help strengthen their overall health, relieve the healthcare system and save costs for the community. How has the program evolved so far? We only started several months ago and it’s a bit early to make a conclusion. But the first figures show that we are already having a measurable effect. This is especially important as we want our model to become sustainable and potentially leverage it in other communities. Can you talk more about the model and its potential sustainability? The program so far is sponsored by third parties, including Novartis. This allows us to work together with specialized nurses from Johns Hopkins and finance the work of our community health ambassadors, who help community members manage their health. If we can prove that their work is having a measurable health and economic effect, we hope insurers as well as the government will fund our efforts, which would relieve them of additional costs overall. Do you believe you can bring the costs down for the healthcare system? Definitely. We have support from our senior senator, the governor of Maryland and the mayor of Baltimore who believe that Engage with Heart can bring change to the communities, as we showed during the pandemic. This political support is important and could be pivotal once we can prove that our efforts contribute to the improvement of heart health in Baltimore and take out costs from the healthcare system. Another factor that stands out is that all the partners, including our sponsors, are willing to share power.

Can you talk about the power-sharing approach in more detail? Sharing power is really at the heart of what’s going on here. If an organization outside our community came in and told us what to do and we had to compromise our values to get funds, this would probably not work. As part of Engage with Heart, we are growing together as partners. We learn from each other and find solutions together. Why is sharing power better than just getting monetary support from an expert organization? I am fully aware that sharing power is not easy. I’ve been on the other side as a federal government official. I was the federal guy who had a 4-billion-dollar budget, who went into communities, and tried to get them to do what our presidents wanted them to do. But that has not always worked, mainly because such programs overshadow the trust factor that is necessary to make a program work. Why is trust such a vital element in your view? If you don’t include your partners and work towards generating trust, it won’t work. Because the community will not buy it. Also, it is vital that the intent of the leaders in the community and the outside organization are aligned, which in traditional settings is not always the case. As part of Engage with Heart, all partners compromise to reach a goal, and the key sponsors allow the community to lead. That is so refreshing – brand new, it never happened before. It’s usually a paternal method of some savior riding in on a white horse. And that’s not what the African American community needs to improve its health. Is power sharing a reason why institutions such as the Black Church Food Security Network and Johns Hopkins School of Nursing, for example, have also joined the project? I strongly believe so. Through this collaboration we can bring the expertise of all players to the table and work towards a solution that includes all key stakeholders. As I said, this is not easy – and everybody is aware of this – but I believe it is the only way out of the current healthcare challenge. Engage with Heart also has another layer of meaning for you. It is not just about heart health, but the way the partners engage with the community. Can you talk about this too? For me personally, Engage with Heart is not only the opportunity to continue the work started during the pandemic and fulfill my promise to the congregation to be back and help them with the massive healthcare issues the community faces. It’s also about how care is administered – with understanding and empathy. Engage with Heart really wants also to make a difference in the way care is organized and how it addresses other priorities the community has.