The Healthy Project Podcast explores the powerful intersection of health, society, and equity through real conversations with changemakers on the front lines of social impact. Each episode features thought leaders, researchers, and advocates who unpack how social structures — from policy to culture — shape the health of communities.
Topics we explore include:
Health equity and structural determinants
Community-driven research and innovation
Lived experiences of marginalized populations
Public policy, systemic bias, and health outcomes
Whether you're a public health professional, social science researcher, policymaker, or community advocate, this podcast brings you grounded insights, bold ideas, and practical tools to drive change where it matters most.
Corey Dion Lewis (00:00.844)
Okay, today we're talking about what happens when societal bias follows people into healthcare and how institutional practices can shape whether a person's experience experiencing substance use receives support or punishment. A recent study found that black patients treated in emergency departments after an opioid overdose were less likely than white patients to receive an outpatient treatment referral.
That gap raises hard questions in how health systems interpret substance use, who needs that prioritized, and what happens after a patient leaves the emergency department. My guest today is Joel K. Johnson. He's the president and CEO of Task Treatment Alternatives for Stronger Communities. Joel has spent his career working across behavioral health, child welfare.
healthcare and the criminal legal system. And today we'll discuss how bias can become policy and practice, what health systems can do to reduce disparities, and how communities can build pathways to care that protect people's dignity. Joel, welcome to the Healthy Project.
Joel Johnson (01:12.162)
Thank you for having me.
Corey Dion Lewis (01:13.646)
Yeah, so let's just jump right into it. how do broader societal beliefs about race and substance use shape the way black patients are treated when they seek care?
Joel Johnson (01:27.06)
you know, African Americans and and and substance use in African American communities or by African Americans is largely looked at as as problematic and and more criminal oriented, juxtaposed to
perhaps a health crisis in for for non African Americans. So we saw like the war on drugs was this attack on not only the the the drug dealing but the the consumers of those drugs in the eighties and nineties. But when looked like the opioid crisis crossed boundaries, color barriers, then it became a healthcare crisis and we were wanted to be kinder and gentler and figure out ways to get treatment dollars into communities across the country. And so
Corey Dion Lewis (02:00.857)
Right.
Joel Johnson (02:15.408)
So there is a dichotomy that we're trying to overcome and shift and ensure that it's always been a healthcare crisis. Task as an organization is 50 years old. We've been treating this crisis embedded in the criminal legal system, showing that there should be an alternative to incarceration. Treatment works and everyone is able to receive, should be able to receive treatment equally.
Corey Dion Lewis (02:41.933)
Yeah, no, I I love that. And it's it's interesting how, you know, a simple change in how you s you speak about something or the wording can change the treatment or the outcome for the individual being served. it it may not seem like a whole lot, but man, the treatment makes a big difference when you're talking about, you know, OPO crisis when it when a d certain community is being affected.
Joel Johnson (03:10.014)
Absolutely. When when when there is a sports injury that a prescription is is is provided for a sports injury and use becomes misuse, becomes abuse, becomes addiction, again, there's a kinder, gentler approach to this this bad thing happened to this person.
Corey Dion Lewis (03:10.979)
No, I'm sorry, go ahead.
Joel Johnson (03:38.946)
But in the absence of that, of that sports injury, we're really talking about someone who's misusing a substance, a prescription turned illicit. and and and the the treatment approach should be consistent and the compassion should be consistent. The the the the language should be consistent.
Corey Dion Lewis (03:46.744)
Right.
Joel Johnson (04:02.76)
addict, dirty, you know, so many times that that that we approach communities differently and and we you're not you're dirty. Clean and dirty shouldn't really be words that we're using when we're talking about treating people and healing people. Substance use disorder is a chronic illness. And like other chronic illnesses they should be treated there should be a treatment plan and a strategy built in collaboration with the patient and we move towards healing.
Corey Dion Lewis (04:18.585)
Right.
Corey Dion Lewis (04:32.001)
No, absolutely. What assumptions about drug use, danger, or personal responsibility can influence whether someone receives treatment or face greater scrutiny and punishment?
Joel Johnson (04:47.688)
you know, that the that that the patient has a character flaw of some sort. That that that they approach or they they somehow deserve what they got for some of the decisions that they made. And while sure there's some personal accountability that we all should have, we don't point the finger at cancer patients, even smokers, right? We we we we have compassion for the illness and and trying to figure out, you know, what the
strategy, the intervention and strategies are to help them overcome and live. And so I think, you know, there's some some basic assumptions that that that that
People have a a a a moral failing, that they don't try hard enough, that just stop using as if that is something that is so easy to do. It's possible, but there's a process and there's a whole system of care designed around helping people move into recovery. And so I think there's a lack of compassion, even from healing practitioners, there's a lack of compassion. we talk about bedside manner.
in in in in the healthcare system. Same is true in in in the in the treatment system, in the recovery continuum of care. And sometimes people would lived experience themselves.
Are often harder on those who've traveled the path that they've traveled. and so there's a lack of compassion sometimes in that regard too. So we're always trying to a task and and and in our field ensure that people are approaching their work with the utmost compassion, not bringing their own
Joel Johnson (06:31.212)
bias into the conversation, but acknowledging that everyone is different, everybody's treatment plan is unique, and that that with the proper support we're all able to move from point A to point B.
Corey Dion Lewis (06:43.883)
No, you you make it you make a good point, Mr. Johnson, of as far as the the the bias and I I don't think people really understand yeah, when someone gets cancer, people feel bad and there's there's no no one says, well, you gave yourself cancer. You know what I mean? And like, but I think when it com I believe and and really I would love your thoughts on this, when we're talking about substance use, or and sometimes and sometimes abuse.
Joel Johnson (06:59.469)
Exactly.
Corey Dion Lewis (07:13.839)
context to why that person even got to that point is so important. I feel like that the learning the context is is missing because once you hear somebody is a substance abuser, all now you're thinking, but well they did they they didn't have to do that or they didn't have to do this or they did they gotta get themselves out of it. And it's not that easy.
Joel Johnson (07:39.148)
It it's not that easy. I mean we you know
There are different reasons why people travel different paths. And so trauma, you know, sometimes it it is self-medication, trying to to to heal their own depression or other issues. And and we're talking about alcohol, we're talking about other illicit drugs, converting prescription medication for illicit use. I mean, there's any number of things that cause or contribute to people traveling down.
the path of substance use, misuse, and abuse. and definitely acknowledging the why helps in the healing process.
But the fact that they need help or and are reaching out for help in those instances where people are are want do better, harboring on the why is not necessarily the primary focus as much as it's a part of the full healing process. And so again, you know, using cancer as a as as an as an example is is it's not we don't focus on why do you smoke that long or et cetera. We just wanna we wanna help you live.
And so reducing harm and and and helping people move towards recovery is really where we want to go, where we should be going in the field and eliminating as much stigma as possible to help people get the help that they they desire.
Corey Dion Lewis (08:53.262)
Right.
Corey Dion Lewis (09:08.377)
No, absolutely. On that thought of reducing harm, how can those beliefs, you know, those the the sti the biases and those things of that nature, how can those beliefs become institutional discrimination through hospital policies, screening practices, discharge decisions, or even access to treatment?
Joel Johnson (09:30.506)
Yeah, I mean, you know, sometimes people in an emergency room setting, people present with sometimes manufactured or perceived to be manufactured symptoms and we you know, we like to say well there's drug seeking behavior. And the reality is we don't always know we we can look at trends and so I think systems of care have to be
careful not to prejudge people that present in crisis. and then they have d continue to develop tools to help assess the the the legitimacy and the consistency of those persons presenting. you know I have managed teams and and sent teams into
emergency rooms, safety net hospitals across Chicago. and you know, we see people in one hospital that present the next day in another hospital. So I'm not saying that it people do not attempt to identify ways of of of securing medication by false presentation, but I think it is it is shortcoming of a healthcare professional and a system of care to make broad assumptions about people particularly
based on the community where they are presenting for that help, the the color of their skin and their socioeconomic background. And I think that
We have to keep medical diagnosis medical and and the criteria is is should be consistent across all demographic breakdowns to ensure that people in need of care are receiving the care that they need, regardless of of their age, gender, sexual orientation, race, et cetera, et cetera, et cetera. And sometimes again, our personal biases as nurses, physicians, et cetera, et cetera, we have
Joel Johnson (11:34.668)
to s we have to acknowledge that we have implicit bias and then address that accordingly. If we assume we don't or determine that we don't, we're lying to ourselves and it impedes our lens of of to be able to provide sufficient care.
Corey Dion Lewis (11:44.236)
Right.
Corey Dion Lewis (11:50.734)
No, one 100%. I was reading 2025. There was a study found that black patients treated in emergency departments after an overdose were less likely than white patients to receive an outpatient treatment referral. what does that disparity reveal about how health systems respond to overdose?
Joel Johnson (12:14.86)
Well, I I think it reveals a couple of things. first of all, most healthcare systems do not have a community based part of their system of care. Hospitals are hospitals largely. And so
There's this need for a collaborative approach to the work. People don't live in hospitals. Our healthcare system, our system of insurance doesn't it it frowns on payment for crisis care.
Corey Dion Lewis (12:45.455)
Mm-hmm.
Joel Johnson (12:46.156)
So the whole idea is to reduce the cost of healthcare to get people out of hospitals and into the community as fast as we can. that being said, if a healthcare system doesn't have outpatient clinics or or collaborate with outpatient providers, then it's fragmented care. And so I think the opportunity is for community based
health systems or community-based organizations to partner with health systems and and manage care insurance providers to ensure that there's a a linkage of care. discharge planning starts at admission. And so if somebody's presenting with an overdose and recovering from from an overdose, you know first of all, thank God they survived that overdose. Second of all, how where we need to send you you know before you
go home or as a part of you going home, what things do we need to put in place to ensure that you have the support you need back in community. So whether that is you know outpatient treatment whether that is methadone or or some other medication assisted treatment program whether that is a step down to a residential treatment program and then into an outpatient setting those things should be discussed with the patient you know as soon as they've stabilized and start planning
for the next day. And so failure to do that, you know, across, again, racial or any any other barriers is just really a failure of the system. And it may also highlight the lack of resources in the community, which is another thing that we need to address and ensure that all communities have access to quality care and those needs that make the community safe and healthy.
Corey Dion Lewis (14:25.017)
Mm.
Corey Dion Lewis (14:37.133)
Absolutely. You know, one one of the things I I don't think we really talk about a lot is the fact that maybe a lot of these there are maybe some communities that may be under resourced. And what is that, what kind of pressure is that putting on the system to do the best that they can in whatever the situation may be. that is I don't think that's a conversation we really talk a lot about is the under-resourced solutions.
Joel Johnson (15:05.833)
under resourced and or under under documented resources, right? So there's no there's no cent where where do you go, you know, Google, but but where do you go to find if I need a restaurant or if I I want somebody to deliver something this Uber Eats and and I can go and say all right they can deliver food within 30 minutes, where can I find treatment within 30 minutes of my of where I am?
Corey Dion Lewis (15:12.334)
Mm.
Corey Dion Lewis (15:27.534)
Ray.
Psh. Man.
Joel Johnson (15:31.794)
where can I find access to to healthcare within 30 minutes from where I am? And there's no central repository here in in Chicago, let alone Illinois, a central repository of resources where that are easy, easily accessible. So I think it creates now and I and I dare to say across the country, there are very few markets that have some sort of searchable platform where you can find help.
in a in a timely manner. And I think that's a a a an opportunity that a a lost opportunity today, but something that we need to capitalize on as a people.
Corey Dion Lewis (16:06.679)
Absolutely. And that kind of and that kind of leads into, you know, my next question is how can systems distinguish a clinical response that supports a patient from one that increases surveillance or pushes them towards the criminal justice system?
Joel Johnson (16:24.91)
So so first let me start by saying I think that from a health perspective we operate in crisis in instead of prevention. And and and and because we operate in crisis, there are crisis points in the continuum and not necessarily a a a refined system of care. I also, and I'll use Chicago as an example, I think that oftentimes we don't work
Corey Dion Lewis (16:45.988)
Mm-hmm.
Joel Johnson (16:54.786)
the the the the pieces of a system don't work as well together as they could. So you have state funding, you have perhaps county funding, you have city funding, you have hospital systems, you have community-based organizations.
And there's no real defined role for everyone in a system that says, okay, the state does this, the county does this, the city does this, community-based organizations do this. And oftentimes, in the name of innovation, you know, somebody gets a grant and say, I'm gonna do this. And but that may already exist somewhere, or part of it exists. And then because I got this new pot of money and I got these, you know, five million dollars to do this work, I'm gonna hire the best person. Well, that person you're
Corey Dion Lewis (17:34.521)
Yeah.
Joel Johnson (17:42.024)
You're hiring work somewhere else in the continuum. So when you hire them, you're pulling them away from where they were already doing great work. So we've actually weakened the system in the name of innovation. but then back to your other point, you know, oftentimes, again, back to assumptions made about how people present. And so we we, you know, you're overdosed, so now I gotta call the police because.
Corey Dion Lewis (17:45.496)
Right.
Joel Johnson (18:08.066)
There's a there's criminality associated with this health crisis, and then the police are present and perhaps there's an arrest and maybe there isn't an arrest, and and and then now you've you're brought into the to the criminal legal system and you have mechanisms like drug court or task as an inter intervention model in the court system where we screen, assess, and we refer people to treatment as an alternative to incarceration. Every jurisdiction is not really focused on alternatives.
You know, there's this law and order. We need to lock them up. If I lock you up, you'll stop doing drugs. It's a lot of illicit substances found behind the correctional walls across this country and across this world. And so incarceration is not the answer to a health crisis per se. so you know, we work towards creating alternatives to incarceration where it's appropriate.
Corey Dion Lewis (18:46.627)
Man.
Joel Johnson (19:02.592)
Where society and the individual will be better served in community than in a carceral setting. And we address those, not only the substance use needs, but the other socioeconomic, so social determinant health needs, housing insecurity, food insecurity, educational support, workforce. How do we empower you to meet your goals of recovery and sustain your life in community and be a contributing member of society?
Corey Dion Lewis (19:17.709)
And
Corey Dion Lewis (19:32.578)
Yes. Man, I can't I couldn't have said it better. When our when our basic needs aren't met, you know, things start to or can unravel really, really quickly. I know we've been speaking heavily on, you know, healthcare and and this in this issue, but I'm really I'm also very curious on the the policy and advocacy work that Task may be doing.
What kind of policies and and advocacy that you are you guys promoting, trying to that need need support? What is what does that piece look like for for this for the work that you do?
Joel Johnson (20:13.87)
Sure. Well well task, we were really kind of three components. We have a direct service model which does the work in courts. We work with law enforcement on the front end to provide treatment and prevent people from being arrested. and then we work on the re-entry part of with people coming home from car show settings and we help them transition back into community. and we we work we do these things both with adults.
As well as youth and families, and and and and we work with families who are engaged in both juvenile justice part of the court system as well as dependency with child welfare. and so that's our direct service model, and we serve all 102 counties in Illinois. We have a training and technical assistance arm known as our Center for Health and Justice that
looks at the work that we do directly and and helps build models for alternative to incarceration that we then train other jurisdictions through some of grant dollars that support us
across the country and internationally. So we provide technical assistance for alternatives to incarceration, systems reform, and like for instance, we're the subject matter experts on this that front end system known as deflection, where we get people into treatment as an all before there's an arrest. And so we've trained other jurisdictions, Africa, Central America, Europe, and then other states like in Oregon and other places where our team have gone in and trained people on how to implement this this work.
Okay.
Joel Johnson (21:44.621)
And then we look at you know what's not working in in in in the system and we help work with our policy team helps develop policy or we advocate for policy changes where we think community would be better served, people presenting with certain challenges would be better served if we overhaul or tweak aspects. So we work very closely with advocates from across the state to implement and design.
the the the pretrial services when when cash bail was was was removed here in illinois and it was it was controversial
to be the first state to to get rid of cash bail. but we thought that it was the right thing to do for persons who were poor, right? I mean, at the end of the day, your ability to pay bail really was predicated on your ability to come up with cash. And so a lot of really dangerous diabolic
Corey Dion Lewis (22:45.486)
Right.
Joel Johnson (22:50.126)
pr you know charges if people got got got bailed they could afford to pay they could afford to pay the bill and they got out in the streets to commit more crimes and people who who may be in incarcerated for shoplifting w awaiting trial et cetera et cetera who just didn't have the resources so we helped not only develop the language that ultimately became law but we helped design the service component
and and a mechanism to to provide services to people once they were released so that they got ahead of any sanctions while they were waiting awaiting trial and community. And so could we help with rehabilitation even before there was adjudication on the case? And those that's our approach to the work is that people deserve a second chance and we would like to work with them in a clinical way and an administrative way in community to help them realize their goals.
And and then they can stand trial and if the court still deemed them to be guilty or something, then we've helped at least address some of those needs in the community before they before they were went away. And then if if they were found not guilty or draw charges dropped, we've we've jumpstart their their pathway to again independence and being a positive contributor to society.
Corey Dion Lewis (23:52.878)
Right.
Corey Dion Lewis (24:07.875)
No, I love that. Mr. Johnson, as I was preparing for our conversation, one, I can I can tell, I could tell you you've been around this for a long time. You know this, you know this world like the back of your hand. And and I read in 1993 you volunteered at a juvenile detention center in Tallahassee, and a young man that you met there was later sentenced to life in prison. Can you talk a little bit about how that
a pr that experience and that story brought you to where you're at today.
Joel Johnson (24:44.63)
Yeah. it defined my career and I ironically, we just had a shooting in Tallahassee this past week.
And a 15-year-old has been arrested and charged as an adult. And it brought me right back to that moment 33 years ago. The young man was always in juvenile detention. My fraternity, we would go in every month and volunteer to try to provide some group mentoring. And this young man was always there. And, you know, it's not that he was never released, he was released and rearrested in the time between our visits. And he it just he just always
Corey Dion Lewis (24:54.233)
Hmm.
Joel Johnson (25:19.446)
It bothered me. And and and then in the summer of between nineteen ninety-three and nineteen ninety-four, there was a a murder of a of a of a European tourist in Monticello, Florida at at a rest stop. And this young man and and and the co-defendant were arrested. They were identified as the shooters that ultimately took a life. And they were charged as adults and they were sentenced to life and
It it it could have been me but for you know the support that I had growing up, my father, my uncles, my coaches, you know, positive the men in my church, positive role models.
you know, positive women role models of a the structure that I grew up in, organized sports, church, education, expectations to be a college graduate and to do great things, he didn't share those same things. And for whatever reason, you know, there weren't a lot of you know, in talking to him it was a little bit of hopelessness, a little bit of depression. He had seen some things at that point in his life. And, you know, that summer of nineteen ninety four it was two big news stories that Tourist murder and OJ Simpson.
And I'm watching the news and I I like I know that kid and I I had a a a degree in business administration. I was trying to figure out I knew I didn't like corporate America, but what
Corey Dion Lewis (26:34.731)
mm.
Joel Johnson (26:46.732)
What was I gonna do with the rest of my life? My mother was a high school counselor. I grew up with other people's children in my home my whole life. She would bring her students home and you know, try and pour into them. And and you know, thanks to her, a lot of her students were college graduates and people who thought they'd never even go to college, teachers and lawyers and everything. And I told my mother I was going back to to to graduate school to get a degree in counseling, and she cried a little. she said, I I did that so you didn't have to. I said, Yeah, but I feel like
Corey Dion Lewis (26:48.868)
Right.
Corey Dion Lewis (27:12.591)
Ha ha
Joel Johnson (27:17.174)
I feel like I have a calling to and I didn't know I thought maybe I wanted to teach or whatever, but I ultimately married both of those degrees in this space in human services. So I've worked in juvenile justice and child welfare and behavioral health. And my motivation has always been
Corey Dion Lewis (27:18.424)
Yeah.
Joel Johnson (27:33.976)
black and brown communities, particularly young men who could have been me had it not been for some intervention or some structure. And so that's always been my professional motivation, where I pivoted from a a potential business world and career to a helping career and I've I've always tried to you know I I also think you know
rising tide lifts all boats. I've always argued if we could if we make conditions and improve conditions in communities that are most disenfranchised, then we improve conditions for everybody. And so I grew up on the South Side of Chicago. I still live in the community I grew up in. It's been disinvested over the years.
Now I live down the street in you know from the Obama Presidential Center. So there's improvements coming to the community. Those improvements should include investments in healthcare, investment in activities, and and and resources for those communities, for the youth in those communities, so we can transform those communities. And so that that young man changed my life in a in ways, you know, that that are
Corey Dion Lewis (28:26.553)
Mm-hmm.
Joel Johnson (28:45.694)
immeasurable and I hope by doing so I've helped change the lives of some young men and women and communities for the better as well.
Corey Dion Lewis (28:54.903)
No, I no, I love that. And and what I appreciate about that story, Mr. Johnson, is that, you know, somebody can hear that who was in a helping profession and the stress of being in that be like, may I maybe I might go to corporate America. So I'll have to just you know, they may not, you know, they it is it's har it's hard. Impact work is is mentally, physically, spiritually, and emotionally, it can be very difficult.
And so like hearing stories like that, but still being able to endure is is is definitely motivating and inspiring and and it should really help people to understand that hey during these dark times there there is still light because of that happened to you, you're still able to help people now, many, many, many years later.
Joel Johnson (29:48.194)
Yeah. And and and I I appreciate
All of my classmates that went down that corporate path because I need to lean on them sometimes to help fund the mission. but yeah, we we all we all listen, I I have a brother that is actively using substances, and that's a part of my daily motivation as well to meet him where he is and hopefully empower him to move towards recovery one day. some days are better than others. It's a process, it's a journey, and he's still my brother, he's still a human.
Corey Dion Lewis (29:56.729)
You
Corey Dion Lewis (30:17.966)
Right.
Joel Johnson (30:21.604)
still love him. And I think that's the other part to your earlier question. Sometimes we dehumanize people in those clinical settings in a way that demotivates them from seeking help. And so, you know, I I want to encourage everyone who thinks that they want help to seek it.
Corey Dion Lewis (30:33.432)
Yeah.
Corey Dion Lewis (30:41.571)
Yes, what whatever whatever the issue is or the struggle, there's there's always there's always a story and there's always some context that is necessary. Joel Johnson, president CEO of Task, thank you so much for being on the Healthy Project podcast. This was super informative and I really appreciated it. if a health system leader is listening to this episode or watching, what is one concrete step they can take?
Joel Johnson (30:48.419)
Yeah.
Corey Dion Lewis (31:11.523)
To make care more equitable and less punitive.
Joel Johnson (31:16.536)
Yeah, I think there are a lot of implicit bias assessments and trainings, and I think that systems of care should definitely take that step to assess their biases. and and ensure that we we scrub our language almost annually to make sure that it's it's destigmatized to the best of our ability. Our website, our documents, and I think all systems of care on the on the criminal legal side.
and the healthcare side should just try and humanize and and and treat people as individuals. And so I would encourage healthcare leaders to take that bold step if they haven't already done it. But then don't don't do it once. You have to to reassess and make sure that we're continuing to be on top of that. And you know, make sure that you have people with lived experience as a part of your
advisory council governance structure. our chief external affairs officer ten years ago was a client of task. And he holds me accountable and and our board accountable for his lens through his lens of any changes that we're making or not making that that you know as he
Corey Dion Lewis (32:21.123)
Mm.
Joel Johnson (32:36.566)
He he he he he often talks about task, you know, saving his life, but he also is helping us transform the way that we approach helping the next group of people who who come to us. And so having someone with lived experience, not throughout our workforce, but having somebody from lived experience at a level of advisory is is key, I think, in being the type of transformational leaders in institutions that we hope to be.
Corey Dion Lewis (33:03.351)
Awesome, awesome. Mr. Johnson, again, thank you so much for being here. For anybody listening that wants to learn more about the organization, connect or anything of that nature, where can they reach out? Where can they find you?
Joel Johnson (33:18.542)
I think the easiest way is to f go to our website www.tasc.org, www.task.org, and you can follow us on all of our socials and reach us by phone as well and find out more about what we're doing and where we're going.
Corey Dion Lewis (33:35.554)
Awesome. Again, thank you so much for being here. Everybody, thank you so much for listening to the Healthy Project podcast. I'll highlight you next time.