The above infographic is a summary of HCIF’s Anti-Racism Council’s (ARC) first year in operation. During it’s first year, ARC undertook internal educational and development opportunities, conducted an organizational assessment among staff, contributed to sign-on letters that advance health and racial equity, and more.
We are now in the process of engaging a health equity consultant who will assist us in applying a health equity lens to programming, as well as offering anti-racism educational opportunities for staff.
In addition to engaging a consultant to support our continued work over the next year, we will launch workgroups to focus on specific priorities identified by our organizational assessment. These include cultural diversity and HR policy and practice.
It’s been a year since George Floyd was murdered. Not unlike many organizations, we at HCIF have expended many resources over the past year thinking about racism, talking about our goals as an organization, and planning ongoing educational activities. Admittedly, we have grappled with the amount of time our staff has dedicated to this work, given that our primary work is typically grant-funded and staff have limited time to work on anything besides their projects. We have also grappled with what HCIF’s role should be in speaking out against racism in contexts unrelated to healthcare.
Let me share a bit about this difficult and challenging journey and where we are going.
Six months ago, we gathered the leaders of our staff Anti-Racism Council to discuss how HCIF should respond to Walter Wallace, Jr.’s killing at the hands of police while experiencing a mental health crisis. We felt our best path was to continue educating our internal team about structural racism and re-double our efforts to dismantling racism within our own organization. We also offered resources for staff to learn about how they could volunteer, donate to or otherwise support organizations aligned with our anti-racist agenda.
And then six Asian-American women were murdered in Atlanta. And 13-year old Mexican American boy, Adam Toledo, was killed by police. And another African-American man, Daunte Wright, was killed by police not far from where Derek Chauvin was standing trial for the murder of George Floyd. And each time, I gathered the leaders of our Anti-Racism Council to discuss the HCIF response. Should we develop another statement condemning racism? Or develop a social media campaign? Or hold another educational session for our staff? Or provide listening sessions so our team can vent their concerns, sadness, and frustration?
And each time, we asked the same question, what is HCIF’s role in advocating against racism and promoting equity? The answer has actually become clearer each time a new racist incident or event gains media attention. The roots of racism are deep and intertangled not only in our criminal justice system, but in all facets of our society, including our public health system. If our vision as an organization is to “create a responsive, coordinated health care community that fulfills the needs of patients and consumers, and achieves better health,” we can’t possibly achieve our vision without improving the issues that lead to poor health, including addressing equity. To build an equitable healthcare system for all, we must fight against the injustices that lead to healthcare disparities including various social determinants of health: violence, poverty, food insecurity, and polluted air and water.
We know we can’t solve every issue and in some cases, our expertise and focus should be on how we can address racism specifically within the healthcare system. However, there are other ways we can and will not only show our support, but do our own work to dismantle racism. This includes having a long-standing commitment to becoming an anti-racist organization. Our Anti-Racism Council recently conducted an organizational assessment and we recognize that while we have a long way to go, we are committed to running the marathon, not just the sprint. We will be developing a roadmap for how we intend to address bias and privilege in our own programs. We hope to engage an external expert to advise on the development of this roadmap and other ways we can ensure equity in all we do. We commit to aligning ourselves with housing, criminal justice, mental health, and other stakeholders who have missions that contribute to the health of communities.
And when racist incidents or events occur in the future, as they almost undoubtedly will, we will continue to formulate authentic responses based on the needs of our staff members, our partners, and our community. These responses will be based on the premise that racism is a threat to the public health and just as we would fight against a virus, we will engage all of the tools and resources at our disposal to fight racism.
When the shut-down orders began to sweep across America in
mid-March, many of us in healthcare already knew the collateral damage
coronavirus would cause to disenfranchised communities. Communities of color are
not only experiencing disproportionate rates of infection and death, but also greater
economic impact due to higher rates of unemployment and being in frontline
low-wage jobs that put them at higher risk. In some American cities, African
Americans make up the majority of both infections and deaths from coronavirus,
despite being a population minority. African American deaths account for over
50% of coronavirus deaths in Philadelphia, while this community only makes up
40% of the total population.
The culprit for these glaring disparities? Longstanding
racial and social injustices that have been swept under the collective rug for
as long as America has existed. These
have resulted in: higher mortality rates during childbirth for college-educated
African American women; African American men who suffered the indignities of a
research protocol that allowed them to become sick and die from syphilis, while
there was known treatment; and a public health epidemic of gun violence that is
more than 500 times likely to kill African Americans. Injustices in the
healthcare system alone certainly can’t be singled out for causing these disgraceful
outcomes– policies and practices have led to and sustained multi-generational
poverty, lack of access to affordable, safe housing and healthy food; mass
incarceration; and homelessness at disproportionately high rates for
communities of color, as compared to their white counterparts.
And now a new series of events have led to further
disenfranchisement of communities of color – racist acts perpetrated because people are doing
everyday things while being black: jogging, birdwatching, and even breathing. These are not new issues, but have inflicted
trauma, pain, and emotional anguish on communities for decades in ways we can
no longer ignore as a country.
Healthcare organizations have an important role to play in
the ecosystem that contributes to inequities and bias.
We need to attend to our own employees’ mental health needs, particularly in times of crisis. This is a not a one-size-fits all approach, but rather an opportunity to identify multiple strategies to support individual needs, such as checking in with staff about their emotional health, developing opportunities to learn and value individual differences, and offering resources when appropriate.
We need to make a conscious and systematic effort to address health disparities, including: collecting and analyzing data on race, evaluating differences in outcomes, and regularly discussing why disparities may exist.
We need to challenge existing biases, including those that are unintentional or unconscious. For example, when data show that white health care professionals perceive African American patients as “difficult,” or are less likely to prescribe pain medications to African Americans, what contributes to those beliefs and how can they be combatted?
We need to stand in partnership with communities of color when developing healthcare policies, including payment reform, clinical guidelines, and treatment protocols. We should be doing more listening to and less “doing to” and truly engage in care that reflects the unique preferences and determinants of health for diverse communities.
Finally, we need to develop cross-sector collaborations that lead to holistic solutions for addressing the root causes of poverty and poor health, including diverse stakeholders such as the criminal justice system, environmental agencies, housing officials, and government organizations.
During this time in our history, the Health Care Improvement
Foundation is taking this opportunity to reflect on our own programs and
policies to ensure that we are supporting a healthcare system that’s just,
equitable, and high quality. We are proud
of our longstanding vision for a responsive healthcare community that fulfills
the needs of patients and consumers to achieve better health. With programs focused on food insecurity, the
opioid epidemic, prostate cancer, health literacy, and assessing community
health needs, we are committed to working in partnership with all communities
to combat bias and the issues that contribute to poor health outcomes. We will use our commitment to advance trauma
informed practice to support diverse stakeholders who have not had a voice in
sharing their needs and frustrations, and come to solutions together. We are ready to walk this path with all
others seeking a more just, equitable healthcare system, though it might be
challenging to traverse. We invite you to join us.