Prostate Cancer Screening in Black Men

When Dr. Earl Stewart thinks about health equity, he thinks about patients who delay care because they can’t take time off work, who are seniors silently battling chronic disease in food deserts and who live in communities hit hard when summer heat bears down on the South.

“Health equity,” he said on  The Weekly Check-Up podcast, “means making sure every person, regardless of ZIP code, income or background, has access to the care they need delivered with dignity.”

Dr. Stewart is the medical director of health equity at Wellstar and an internal medicine physician. He’s at the forefront of building a more just healthcare system rooted in listening, proactive outreach and community-based care. His work is redefining what community health looks like in practice.

Health equity starts with access

One of the biggest misconceptions about health equity is that it’s only about insurance coverage. But that’s just the starting point.

“Access doesn’t mean only having a clinic nearby or having insurance,” Dr. Stewart said. “It means that care is affordable, culturally competent, geographically reachable and provided in a way that meets people where they are.”

In Georgia, especially in urban and rural areas, barriers to healthcare can have many forms: long travel times to the nearest physician, language barriers, gaps in preventive care and social factors like food insecurity and housing instability. Each of these affects whether patients seek care at all and what happens when they do.

That’s why Dr. Stewart is helping lead efforts at Wellstar to address care beyond hospital walls, including thinking outside the traditional healthcare model.

Food as medicine for chronic disease

Health happens everywhere, not just in exam rooms. For example, conditions like diabetes and hypertension, wo diseases that disproportionately affect ethnically minoritized and low-income populations, are directly linked to access, or lack of access, to healthy food options.

Wellstar is working to reduce the health impact of food insecurity and chronic disease across the state through:

• Fresh food as medicine initiatives
• Mobile Markets in partnership with Goodr
• Partnerships with local organizations

“If you don’t have access to healthy foods, your ability to control your blood pressure or manage your blood sugar is already compromised,” Dr. Stewart said.

By addressing food insecurity head-on, Wellstar isn’t only treating illness—we’re preventing it through community investment and education.

Mobile health removes barriers

For patients who can’t easily get to a clinic or pharmacy, Wellstar is bringing the clinic to their neighborhoods. Through mobile health programs, including pop-up clinics and food markets, patients can get screened for high blood pressure, pick up healthy groceries or receive preventive education.

“These programs reflect a shift in strategy—from reactive to proactive and from system-centered to patient-centered care,” Dr. Stewart said. “This is PeopleCare in action.”

“Mobile care gives us the chance to address healthcare access in a tangible way,” he added. “It removes barriers before they become complications.”

Health risks presented by climate

In a season of extreme and dangerous weather events, Dr. Stewart noted the connection between climate and health risks, especially for older adults and low-income populations.

“We see emergency department visits spike when the temperatures rise,” he said. “Older adults, people who work outdoors and people with chronic heart and lung conditions are especially vulnerable. Heat isn’t just a weather issue—it’s a health equity issue.”

For communities with limited cooling, transportation or healthcare providers, rising temperatures create a dangerous, often deadly situation. Dr. Stewart sees climate resilience as part of the activities needed to build health equity, calling for stronger connections among climate data analytics, care strategies and community outreach.

Leading with empathy & listening with intention

Health equity starts with listening. Dr. Stewart grounds his leadership in the belief that every patient story matters and empathy is as important as data to the future of healthcare.

With Wellstar Mobile Markets, social determinants of health screenings and mobile health outreach units, Dr. Stewart, the Wellstar Center for Health Equity team and Wellstar clinicians are working to transform healthcare from the inside out.

“Equity is not just the right thing to do morally,” he said. “It’s how we get better outcomes for everyone.”

Hear the full conversation.

Robert Frederick was living a typical life, going to work and spending time with his mother, siblings and children. But then it became hard to breathe when walking short distances or climbing stairs. He got dizzy. Perhaps most disturbingly, he passed out several times—once at a Braves baseball game he attended with his siblings.

"I didn't know what was going on!" Robert recalled.

Difficulty controlling AFib with medication

After passing out the first time, he went to urgent care and was then taken to the hospital by ambulance. He learned his symptoms were caused by atrial fibrillation (AFib), an irregular heartbeat.

Robert began to see Dr. David Caras, a Wellstar general cardiologist, and learned AFib is related to high blood pressure. Successfully managing high blood pressure often helps people keep AFib under control. Despite their efforts, AFib sent Robert to the emergency room two more times.

Suspicion of HCM

Dr. Caras reviewed Robert’s hospital records and found he had increased wall thickness of the left ventricle and a gradient—a pressure difference between the left ventricle and the aorta when the heart pumps. These findings were consistent with a condition called hypertrophic cardiomyopathy (HCM). Characterized by abnormal thickening of the heart muscle, this disease makes it difficult for the heart to pump blood effectively.

Dr. Caras referred Robert to Dr. Melissa Burroughs, an HCM specialist at Wellstar. As a Center of Excellence designated by the Hypertrophic Cardiomyopathy Association, Wellstar is one of the leading providers of comprehensive HCM care in Metro Atlanta.

"We have physicians in the group—designated HCM specialists—that are the point person of the patient’s care," Dr. Burroughs explained. “This includes close communication and collaboration with electrophysiologists, surgeons, advanced heart failure specialists, social workers and behavioral health professionals.”

A rare finding leads to Mayo Clinic Care Network collaboration

Robert said, “Dr. Burroughs wanted to do genetic testing to verify that I had HCM."

But genetic testing revealed a rare genetic variant—one not known to be associated with HCM. Dr. Burroughs called it a “diagnostic conundrum.” The genetic variant found was typically associated with a different cardiac disease that Robert did not have. However, he did have clear signs of HCM.

To investigate further, Dr. Burroughs collaborated with other HCM experts through the Mayo Clinic Care Network, of which Wellstar is a member. Mayo Clinic, which is also an HCM Center of Excellence, provided access to its unpublished database, finding Robert’s rare mutation was present in two other family groups with HCM.

“It’s very important that we add to the science—that we include our patients in the registry to enhance what is already known about HCM,” Dr. Burroughs said.

Robert added, “Dr. Burroughs is very persistent. She wanted to know, ‘Why are you having these problems? What’s the root cause?’ She went above and beyond to find that out.”

Maria Fernanda Ortiz was a college junior, pursuing a degree in interior design. But at just 26 years old, her life took an unexpected turn. She discovered a lump in her breast, which led to a cancer diagnosis and expert, multidisciplinary care at Wellstar that would shape her professional aspirations in the future. Maria feels her hopeful attitude and compassionate care team at Wellstar helped her come through treatment with positive outcomes.

Feeling heard in healthcare

After Maria discovered a lump, she initially saw a doctor who went through the motions but didn’t seem to take her concerns seriously. 

“He was so sure it was nothing because I am so young,” she remembered. “I didn’t think it was cancer, but I wanted someone who would get to the bottom of it.”

She then saw her OB/GYN who referred her to Dr. Laura Pearson, a Wellstar breast surgeon at Wellstar North Fulton Cancer Center, for a second opinion. 

Maria got what she was looking for: a doctor who listened and would help her find answers. 

“Maria is the perfect example of a patient advocating for themselves,” Dr. Pearson said. “She did exactly what she was supposed to do for someone her age who finds a lump. When it didn’t go away, she got it looked at. When she didn’t feel like she was being heard, she didn’t let it go.”

A surprising cancer diagnosis

Dr. Pearson immediately performed an ultrasound in the office, followed quickly by a biopsy, which came back positive for cancer. 

"The diagnosis was scary," Maria said. “Dr. Pearson made it as simple as possible to understand by making sketches. She took the time to answer my questions—and she gave me hugs.”

Dr. Pearson added, “I try hard to be methodical and build a story: ‘This is what this means. This is how it applies to you.’ It’s important for patients to understand their plan and how it’s based very specifically on their situation.”

Maria was diagnosed with stage 2A breast cancer, meaning it was a small tumor but had spread to a nearby lymph node. 

“The stage helps us understand how the patient is going to do with standard treatment,” Dr. Pearson explained. “At stage 2A, we’re looking at a 90% survival rate.”