Black Longevity: Who Wins If You Live Longer?
Ask a neurosurgeon and you get a single word instead. Quality. Ask a psychiatrist and you get another one. Presence. Both answers came from a recent panel following a screening of Black Longevity, WellWithAll's short-form documentary, where co-founder Demond Martin put the question to the two physicians directly: what does longevity mean to you? The neurosurgeon is Dr. Theresa Williamson. The psychiatrist is Dr. Kevin Simon, MPH. For Black Americans, the distance between living long and living well is not abstract. Life expectancy has trailed for generations, and the gap can open up between neighborhoods a few miles apart — Dr. Simon named Dorchester and Back Bay. Watch the full conversation below. What follows are the moments worth sitting with. What Actually
Determines How Long We Live? | Doctors on Longevity & Health Equity
What does longevity actually mean?
The answer is quality
Dr. Williamson did not hedge. She had just watched the film — people gardening, walking, deep inside their own lives — and set it against a conversation she has constantly in clinic. A patient is 74, weighing spine surgery. How much time do I really have left? Her answer reframes the arithmetic. Someone alive right now is 115. Some researchers believe the first person who will reach 150 has already been born. Which makes the real question not how many years, but what is inside them.
“If you're going to spend from 70 to 150 sitting down, not able to walk around, not able to enjoy your grandchildren, that to me is not meaningful longevity.”
Dr. Simon came at it from the other end of a life. As a psychiatrist, his patients start at five years old, and some are already struggling to want a long life at all. So he is describing something he has watched people lose early, and the clinical work of helping them find their way back. People being present is what stood out to him in the film. Gardening. Yoga. Music. He noted that the men living long lives on screen were married, and that every one had something creative going.
Why does community matter so much for health and longevity?
Your everyday contacts matter more than you think
Dr. Simon highlighted the everyday interactions that actually matter, and they are smaller than you would expect. The postal worker who walks the same route for thirty years and retires with no plan for Monday. The person who loses a partner at 68. The routine goes, the structure goes, and the decline can be fast. “You don't understand how valuable it is to say hello to that person that you walk by every day,” he said. The one you buy coffee from. The security guard you greet on the way in. In his own family, the answer was to make room. When his grandmother needed care, they rearranged the living room and it became mama's room. She lived to 98. The grandchildren gave her energy, he said, and she gave them calm. It is why, when he sits with a young patient, he asks about their friends.
“If you can tell me about the five people that you most spend time with, you're going to give me a mirror of who you are.” Dr. Kevin Simon, MPH, Boston's Chief Behavioral Health Officer
Who is waiting at home shapes the care you say yes to
For Dr. Williamson, community is not a soft benefit. It decides whether people get care at all. “My part is easy,” she said. “You're going to be under anesthesia. I'll do the surgery. I send you home — and then what?” Then what is where it gets complicated. Who is at home. Who can lift a gallon of milk, since that is the weight limit for weeks. Which floor you live on, and whether the elevator works. Her team studied roughly 20,000 patient encounters within the Mass General Brigham system. Black and brown patients reported worse symptoms — more pain, more physical dysfunction — and were still less likely to have surgery. Their outcomes were worse. So the team asked why. The answer that kept coming was not cost, and it was not fear of the operating room.
“I don't want to be a burden to the people around me.” The theme researchers heard most often from patients, as described by Dr. Theresa Williamson
People are declining the care that would keep them in their families' lives, in order to spare their families. Dr. Williamson's counsel now runs in the opposite direction. Call your grandchild. They probably do want to be involved. Why let people be alone, she asked, when they are surrounded by potential community.
How do purpose and presence shape wellbeing?
Everybody needs a why
Asked what people should carry out of the film, Dr. Simon went straight to purpose. Your why. His own examples were deliberately ordinary: making it to church on Sunday, calling the friend you keep meaning to call. And calling, he insisted, rather than texting — he beats his friends to the phone every time. He makes the same case for the handwritten note. Small things, but they change how the person on the other end feels, and how you feel for having done it. Purpose is about doing. The other half of his answer is about not doing. Something is always ringing, buzzing, pushing us toward the next thing. He described sitting with a patient in silence and being asked why he wasn't doing anything.
“Oh, actually the quiet is the thing that we're doing.” Dr. Kevin Simon, MPH
What should healthcare providers take from this?
Raise your expectations. Stay curious.
Dr. Williamson answered with a patient. A man had been in and out of the hospital several times trying to explain his weakness. He was sent to her because she is a spine surgeon and perhaps it was his spine. It was not his spine. The spine does not affect speech, and something about his was off. He is Jamaican; her grandfather is Jamaican, and she can usually follow. This time she couldn't. So she asked his son directly: is that his accent, or is he slurring his words? Slurring. The diagnosis turned out to be ALS, missed for months — because nobody had stopped to register that an articulate man who could no longer make himself understood represented a change. His normal had been higher than anyone thought to check.
“Raise your expectations and be curious.” Dr. Theresa Williamson, on what providers should take from the film
Can what you believe about your health change your outcome?
Expectation is a clinical variable
This is Dr. Williamson's research: how patients' perspectives on their own health affect the treatment decisions they make. What we believe. Who we talk to. What our doctor tells us. She traces the interest to her own family, and to the distance she watched open up between their experience and the healthcare system. What it keeps surfacing is a relationship. How we feel about our health, and about what treatment might do for us, connects directly to the decisions we make and the outcomes we get. Her team is now studying whether the documentary itself can move that. Patients watch Black Longevity before surgery, and the study asks whether they come away more open to their options — and whether they actually do better. Dr. Simon named the mechanism. Everybody knows placebo. Fewer know nocebo: the negative expectation a clinician has to work against. Then he named the gap the film is working around. Many Black patients never see themselves reflected in the person treating them, and a film can stand in for some of that — showing people who look like you living long, full lives.
What can we carry forward?
For a conversation about longevity, remarkably little of it was about optimization. What the doctors returned to was small and human and free. Stay connected to people. Keep the routines that give your week a shape. Make the call — the actual call, not the text. Ask for help, and then let yourself accept it. Make room for quiet. Go to the doctor when you need to, and talk to someone when you need to. Demond Martin closed the night by asking the room to shut their eyes.
“Who wins if you live a longer, healthier, more joyful life?” Demond Martin, co-founder and CEO, WellWithAll
Almost nobody answers that with only themselves. The answer is a spouse. A grandchild. A congregation. A friend waiting on a call that keeps not coming. Which is what all three had been saying from three directions: your health was never only yours. It runs outward into a family and a community, and forward into people who are not here yet. So take the small steps. The people you saw behind your eyes need you around.
Who was in the conversation?
Dr. Theresa Williamson is a neurosurgeon and bioethicist. Her research examines how patients' perceptions of their own health shape the treatment decisions they make. Dr. Kevin Simon, MPH, is a pediatric psychiatrist and addiction medicine specialist, and serves as Boston's Chief Behavioral Health Officer. Demond Martin is the Co-Founder and CEO of WellWithAll and moderated the panel.