Advocating for Health Equity: The Story of Dr. Ian K. Smith

    Dr. Ian K. Smith might be called the face of Black health and wellness. As a longtime co-host of daytime television’s The Doctors, medical correspondent for NBC and bestselling author, he is known and trusted by millions for his easygoing, informed manner and commitment to helping people live long and well.

    Though he always intended to pursue medicine, becoming the nation’s informal Surgeon General, as he has, was not part of the plan. “I don’t know if I chose that path versus the path choosing me,” he says. Smith went to medical school to become a neurosurgeon. Then he met famed NBC Chicago news anchor Art Norman at a gala he and his then-girlfriend went to “because we were struggling students with no money and this was a nice free meal.”

    It turned out to be a pivotal encounter, which Smith references when he is mentoring others, telling them all the time, “young people particularly, it’s so important to network.” That meeting paved the way for a television internship during which time “I fell in love with the business of journalism, the art of journalism, and decided to combine that with my medical degree and experience.”

    Still, his focus on nutrition came about unexpectedly. Writing magazine columns about a wide range of health topics, he found most of his reader inquiries were about weight loss. “I wrote an article about the Tylenol scare, way back in the day, and my mailbox was full of fat-burner questions,” he recalls. “So, I said, man, there’s something out there.

    “As a physician, a medical student, we had no training whatsoever in nutrition, zero. And so I said, ‘I have got to learn this,’ because I felt an obligation to my readers. I felt like they were asking me these important questions and I didn’t have the answers to them.”

    He has shared what he learned in countless television appearances and through 20 books (which include several novels), most recently Fast Burn!: The Power of Negative Energy Balance. Released earlier this year, it offers a health and weight-loss program “based on all the reasons why people say they can’t follow it.” Rather than telling people to completely cut out favorite foods like pizza and pancakes, it advocates moderation. “I introduce those foods in a healthier way, so you still have the taste, but you’re not over-consuming and they’re not high in calories.”

    Needless deaths

    Smith has watched the disproportionate impact of COVID-19 on the Black community with a mix of concern and anger. “How our people have behaved and made decisions during this pandemic has been one of the most disheartening periods of my life professionally,” he says. He likens it to people going into a blazing building even though others are warning them not to.

    He understands mistrust of the medical community because of inequities in the past, “but there’s a difference between having skepticism and some mistrust versus being vulnerable to complete mythical creations, lies, misperceptions and being deceived. Those are two very different things.”

    Because common underlying health conditions make Black people more vulnerable to COVID-19 and its variants, “we need vaccines the most, and we need masks and social distancing and all types of mitigating factors the most,” he says. “It’s very frustrating… the number of our brothers and sisters who are in the ground unnecessarily is ridiculous.”

    So many of our people… just don’t get access to quality care.


    Smith has strong words for celebrities who have spoken out against vaccination. “I’m not an electrician,” he says. “You don’t want to listen to me about how to fix the wiring in your house; I’m not a reliable source. And to have as many people as we’ve had during this pandemic who are not medical professionals, who don’t know a thing about science, to virology, the study of viruses, stand up and make the statements they’ve made has been so infuriating, literally infuriating, and history is going to look back at this time and call it like it is, which is that a lot of people have misled and sent people to their graves.”

    With this in mind, Smith believes better health education is essential. “We need to get many communicators from different backgrounds to be able to try to communicate real, scientifically credible messages to our people,” he believes. “We have to educate—that’s just where it starts. If we don’t explain things to people and break it down—What is high blood pressure? Why do these foods contribute to high blood pressure?— they’re not going to understand. They need to be able to understand the basic causal relationship between what we eat and how we behave and the decisions we make and the impact on our health.”

    This needs to start at an early age. “We can’t wait until our kids are graduated from high school. We got to start talking about farm-to-table right in the beginning, when kids are five and six, and teach them these things, because a lot of times studies have shown that kids are the ones who bring the message back home to the family.”

    Major barriers
    Knowledge alone isn’t enough to ensure better health, though—there also needs to be better access to good health care. “So many of our people, unfortunately, for all kinds of reasons, just don’t get access to quality care,” Smith notes. They get access to some care, but that care is not quality.

    “People who are under-resourced and don’t have money should walk into a health clinic in an urban environment and get the same level of care and experience as someone who walks into a clinic in a more affluent and posh area, and unfortunately that doesn’t happen.” He cites someone walking into a clinic where the security guard or receptionist is rude, snapping their gum and not paying attention. “That mars the experience… so how we interface with the system has to change.”

    Part of the problem is the small number of Black doctors; he has teamed up with fellow TV medical personality Dr. Oz to try to redress that imbalance. “There is something inherently cultural about an African American physician or nurse or health care provider talking to an African American,” he says. “I’m not saying that white and non-Black doctors and medical professionals can’t do it. But studies have shown that when people who look like you and talk like you and come from where you come from communicate that message, it’s received in a much better way.”

    Smith identifies three major barriers to better Black health. First, a lack of willingness to acknowledge what is healthy and what is not. “We are very proud people and we do not like people to judge us or to misrepresent us,” he says. “We love who we are—and we should love who we are. We come from a great place of resilient survivors.”

    However, he believes too many people have “confused healthiness with aesthetics.” Tending to be curvier and fuller-bodied is “an aesthetic thing and we have to separate that from health implications,” he says. “So one of the barriers has been trying to get African Americans to realize the desire to get us to lose weight and to reduce our fat and eat healthier is not making a judgment call on your aesthetic, how you look. Rather it’s about trying to reduce your risk for all these diseases that we tend to lead the categories in—heart disease, high blood pressure, diabetes, you name it.”

    Next, there needs to be a reckoning with “our culinary history.” Popular, Southern-influenced cuisine, “while it’s very tasty, tends not to be very health-promoting. And it’s very difficult to get people to break away from that style of eating.” It’s a preference that is compounded by economics, he says, “lack of financial resources, particularly in urban areas where access to good food is not there.”

    Finally, Smith advocates some straight talk. “We’re so worried about being cast a certain way or being judged in a certain way. We don’t tend to acknowledge kind of where our faults are, and we have to understand that acknowledging where our shortcomings are is an acknowledgment that helps us move forward.

    “It’s not to be pejorative or to be negative. It’s to help us understand this is where we are; now we know where we need to go. And so we have to, as African Americans, have a real conversation and acknowledge where we are, where we fall short, to give us the inspiration to move forward.”

    Positive changes
    For those ready to make some positive changes in regard to their health, Smith has a four-point prescription. “The first thing is sit down and have a conversation with yourself,” he says. “It all starts above the neck and between the ears. It starts in your head… gaining a perspective about our lives, where we’ve been, where we want to go.”

    Step two is put together a strategy. “People don’t understand how to set goals,” he observes. “A big reason people don’t succeed is because they don’t have the right goals, both short-term and long-term.” Take someone who wants to lose 30 pounds and says they will do so by eating better and exercising. “That’s not a strategy,” he points out. “That’s a concept. And so people have to have real, specific strategies about how they are going to reach those smart goals that they set.”

    Part of doing so will require prioritizing. “You can’t attack everything,” Smith explains. “You have to really decide what is most important and give it some kind of rating. That gives you guidance where you need to focus and when you need to focus on those different items. I say to people, ‘Hey, list five to 10 things and try to put them in order.’”

    Finally, build a support team. “Find other people who are successful, who are positive. Studies have shown that a positive attitude can be contagious. Good habits can be contagious. Find people who are positive, who are moving forward in their life, and associate more with them.”

    Given the unexpected turn his professional life took, Smith has career advice to offer in addition to his medical expertise. He passes along what he says is the best counsel he was given when he was starting out: No matter what you decide to do, make sure you understand it from top to bottom and bottom to top.

    “Even if you’re high up, you need to understand the work and how to do the work of those who may be lower on the totem pole. And that has served me so well in my life,” he says. Starting out, he didn’t have someone handling public relations, so he booked all his interviews himself.

    “So I understood how do you put together a pitch? How do you sell the idea to a station? So when I got bigger and I needed to hire people to do that, I now understood what they needed to do, and I could tell if they were doing a good job or bad job.” Understanding something “from soup to nuts” like this “makes a big difference,” he says. “It allows you to be more productive.”

    While Smith’s success is due in no small measure to his discipline and drive, he also acknowledges the important part others have played. After Art Norman gave him his first taste of television, NBC news executive Paula Madison hired him as a newbie in New York.

    “Never had a job in my life,” he remembers. “It’s the No. 1 market… She made a way. There are so many people along the way who believed in me, encouraged me, inspired me, which is why it’s so important for us to do the same thing, because we stand on the shoulders of those who come before us, many that we will never meet or know the names of.

    “And I think that is the great legacy of Black people, that we’ve always believed that the next generation should have it easier than our generation and have it better. I think that’s part of what being a waymaker is, making a way for others to pursue and reach their dreams.”

    We’ve always believed that the next generation should have it easier than our generation.


    My family: I grew up without a father and my mother was my mother and my father. She and my grandparents really set the table for me. I am the man who I am today because of them; watching them work hard, sacrifice, be resilient, fail and get back up. I didn’t have a very wealthy childhood from a financial standpoint, but I was wealthy in lessons about love and hard work.

    From an interview with Louis Carr

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