Thanks to the work of Black Lives Matter, more people than ever seem to finally be ready for a racial reckoning – acknowledging systemic racism and racial inequalities and seeking ways to address them.
We can question the motives and be skeptical about actions that may or may not just be surface-level, reputation management on the part of organizations that don’t want to lose customers – but every one of us should be hoping and working for real change.
Our nation’s economic recovery depends on it. And the pursuit of social justice in turn depends on economic recovery.
In June, Barron’s offered a detailed exploration of Why the Widening Wealth Gap is Bad News for Everyone. Senior writer Reshma Kapadia does an excellent job of connecting the dots from our nation’s wealth and income disparities to health and education disparities to vulnerabilities during the pandemic – and why this entrenched system of injustice is not only wrong but also will make economic recovery much more difficult (if not impossible).
Kapadia writes: “The wealth and income disparities that have been building up for decades (fueled by structural racism and inequalities in the U.S. educational, financial, and healthcare systems) are reaching a breaking point, with broad implications for the economic recovery, the stock market, tax policies and more.”
The Barron’s article includes this quote from Abby Joseph Cohen, senior investment strategist for Goldman Sachs: “Economic history clearly shows that the strongest, most durable periods of economic expansion in most countries occur when the middle class expands.”
But Kapadia notes that the middle class in the U.S. has shrunk … it’s getting harder to move up the income ladder … and Covid-19 could reduce social mobility further. Kapadia also notes:
- Some 40% of the people who have lost their jobs (due to the pandemic) were earning less than $40,000, compared with 13% of those earning $100,000 or more.
- The bottom 80% of earners have lost share of total income, wealth, and consumption since 1989, according to the Federal Reserve.
- Black households headed by a college graduate had 30% less median wealth than white families headed by someone with no college degree.
- In a consumer-driven economy, lower-income households are a critical source of growth because they are more likely to spend any additional money they get.
Healthcare and education are both at the heart of many of these disparities, so I’ve been speaking with leaders in healthcare and higher education to explore these topics in more depth. Today I’ll share insights from healthcare leaders, and in October I’ll write about education.
I believe we can’t tackle our healthcare challenges without reaching beyond traditional health organizations to also engage large corporations. Every employer (whether tech, aerospace or consumer products) is also in the business of health – because they manage the benefits that provide the care that people need, and they create a work atmosphere that either promotes or harms health on a variety of fronts (physical, mental and financial health, to name a few) that are all interconnected.
Today, I’ll share insights from two Black leaders in healthcare:
- Nicole Cooper, DrPH, MPH, is head of Healthcare Policy at Lyft. Previously she was VP of Corporate Social Responsibility for UnitedHealthcare, a policy adviser in the Obama administration, and named a Top 25 Emerging Leader by Modern Healthcare.
- Gyasi C. Chisley, PMP, FACHE, is President, CTCA® Hospitals and Clinics at Cancer Treatment Centers of America. Previously he was Chief Strategy Officer and SVP, Strategy and Payment Policy/Innovation for UnitedHealthcare, CEO for Methodist Healthcare, and SVP for Methodist Le Bonheur Healthcare in Memphis.
We spoke about the trends of injustice mentioned above, and the important perspective Black leaders can bring to organizations.
Stop Blaming Your Pipeline and Start Changing Your Pipeline
Dr. Cooper said her life’s work is centered around helping people access healthcare because of her own lived experience and her first-hand knowledge of the challenges when you grow up feeling shut out from the American Dream.
“I’m a first-generation college graduate, and in many ways I’ve escaped poverty,” she said. “And the fire that lit for me is making sure that I’m not ‘the only.’ I don’t take solace in being the only Black woman or the only Black leader in certain corporate spaces. I continue to pose the question to other leaders in power, ‘Why am I the only? What else are we doing [to bring more people in]?’”
She said too many people stop at the easy answer, which is to blame a scant pipeline.
“We have to be thinking about how we can build that pipeline and about all the systems that are intertwined,” said Dr. Cooper. “The problem with the U.S. healthcare system, and why so many people go without proper access to care, is the same reason that as a country we under-invest in our public education system. They’re intertwined. We are simply okay with a second-class system that is quite difficult to navigate and to escape. And so what we need is to take the long view and really look at the more upstream issues that are at play – the policies and how all of these issues are intertwined.”
Is it Desirable – Or Even Possible – to be Colorblind at Work?
Chisley said, since the murder of George Floyd, he’s heard people make the all-too-familiar claim that they don’t “see color.” I’ve heard this as well, too, and all it does for me is just remind me that people don’t want to acknowledge each other’s individuality, because to do so invites complexity and complication. Neither of those things is “efficient,” so our workplaces are not designed for them.
But that’s just forcing people to assimilate rather than be their authentic selves.
“If you tell me you don’t see color, I’ll take you at your word – but I know that I see color all the time because I have to,” said Chisley. “I know the hiring manager sees color. I know that the cops see color. I know when I’m applying for a bank loan, they see color. I’m seeing color all the time. I would challenge those that stipulate this phrase on a regular cadence to work to see color, so that you can acknowledge and respect my heritage, my culture, and my struggle in this country.”
Dr. Cooper agreed, saying it’s a privilege to be colorblind: “The racism that has happened since the beginning of the founding of this country was based on color and race, or perceived color and race. So, to undo it, to untie such a complicated racist reality, we cannot be colorblind.”
I like Dr. Cooper’s language of untying such a complicated reality. It’s a tangled mess. Complexity tends to paralyze us into doing nothing and into reverting back to the standards that we’re so comfortable with. That’s what keeps us trapped in our systems that force people to assimilate rather than be their authentic selves.
Can Corporations be Genuinely Socially Responsible?
I’ve always felt that corporate social responsibility (CSR) was a reputation management ploy. It’s not that corporations never do good, but it often becomes another brand management strategy.
Dr. Cooper acknowledged that some corporations take the brand management and marketing approach. But she also noted that there are companies who do it well and with the best intention make a commitment to a social need.
So, what does true CSR look like?
“It is committing to doing what’s right for customers and clients in certain markets and communities across the country, but also serving those communities where a company doesn’t have a foothold or a footprint, because they see it as their social mission and their mandate to serve all – going beyond their core customer client base,” said Dr. Cooper. “For a healthcare company, that means not just caring about their members, but also the communities where members live. That means they might be helping the patients and the members of other healthcare entities – in many ways helping people who they’re not ‘responsible’ for. It’s going the extra mile to do what’s right for communities in a way that’s not always attributed to the company.”
Healthcare’s Mandate to Provide Community Benefit
When it comes to CSR, healthcare organizations have a mandate to provide community benefit.
As Dr. Cooper summarized, the Affordable Care Act mandates that healthcare systems and hospitals conduct Community Health Needs Assessments as a way to make sure they’re learning and listening to the community. From her experience, she sees a spectrum of awareness among health systems of the true level of need within the communities they serve.
“There are some entities that get it right because they have a listening ear to what’s happening in the communities where they are, because they’re seen as contributing partners,” said Dr. Cooper. “I’d say, in thinking about where we are as a country right now with our racial reckoning and trying to achieve racial equity across institutions and in healthcare in particular, it’s going to take listening differently.”
So, how can an organization “listen differently”? That’s something that won’t happen unless leaders create the systems and processes that interrupt the standard ways of listening (or not) that already exist in an organization. What would that look like in terms of systems or processes within the organization?
Chisley offered an idea for expanding the external approach: “Healthcare really has to make sure that it’s stretching its arms a little bit, meaning that it is no longer viewed as this sort of siloed industry – that it takes a horizontal approach across the board with things like access to food, housing and banking. It’s imperative now. It’s not only a social and moral imperative, but it’s also a business imperative.”
Dr. Cooper brought the focus back to the internal organizations: “Listening differently is something that requires changing who’s in the C-suite. Often there are not leaders in those spaces who in any way reflect the community. For example, there are no leaders who themselves have experienced poverty and the many other social ills that these entities are trying to help communities to address. They’re people who are in no way familiar with the needs of the community. Without meaningful racial and ethnic diversity there, without people of color in leadership roles, the voices of the communities – very diverse communities across our country – are simply not heard and definitely not represented.”
Are We Ready to Make Actual Progress?
We’ve been talking about the issues of population health and recruiting more diversity into healthcare for years, with little progress.
Part of my concern is that we have a tendency in healthcare to benchmark what everybody else is doing and measure ourselves against those standards. We end up taking surface action that doesn’t become systemic throughout our organizations – like putting out a Black Lives Matter press release but not investigating our own processes that wittingly or unwittingly contradict that very statement.
When standardization is being met with such a force of personalization that’s been driven now by the Black Lives Matter movement, standardization responds in the extreme. I would say standardization for the sake of reputation management becomes tokenism. I’ve heard from white executives that people are okay with that, because it’s a way to solve representation. But I’m not sure it’s actually solving anything – I think it’s a way for a leader or an organization to look like it’s solving for diversity, letting them off the hook of doing the harder work of inclusion.
“There’s a difference between gesture and actual change,” said Chisley. “Dr. Cooper and I want to make sure that we’re solving for systemic change, specifically in healthcare. We’ve dedicated our lives to that, and that’s what we’re leveraging our respective companies for – serving as a platform for that change. And hopefully that’s what companies are hiring for – not just a CEO or senior vice president, but truly a change agent, a change maker. Some gestures are fine – having one Black person in your C-suite or one Black person on your board of governors or board of directors is fine. But that’s a threshold – that’s not going to bring about meaningful and sustained change. We want pervasive change, not merely a substitution that will blow past catalysts like the ones we are enduring now in this country with the pandemic, protests and significant loss of profit. What is going to get to change is truly economic empowerment, economic equality, which will ultimately solve for racial inequality.”
I believe what’s been ignored about the Black community is what they’re capable of actually solving. How do Black leaders inherently operate or think differently?
I posed this question because each of us carry our lived experience with us into our work and how we approach our missions. And too often we’re forced to assimilate and ignore our lived experience – which means we’re not able to contribute to the mission of the organization at our fullest capacities.
I appreciated Dr. Cooper’s honesty with me about her reaction to my question.
“I struggled with this question,” said Dr. Cooper. “One, because I don’t feel that we should be thinking about what Black leaders bring to the table as one for all. Every Black leader is not the same – which I know you fully recognize. So, it’s a really nuanced response. I would say certain Black leaders have a shared cultural experience because of the generational lack of opportunity. So we have very unique experience compared to all other people of color and all other racial, ethnic minority groups or country. And so born out of that reality is a proclivity to understand communities that struggle. When Black leaders do make it to the C-suite they are much more likely to be aware of the needs of communities who are struggling for basic access across healthcare and education.”
Chisley gave an example of what that lived experience can look like.
“I can be in the office working on multimillion-dollar deals, and I can leave the office at night and not be able to catch a cab in Chicago,” he said. “That, to me, is an inherent disparity that makes you feel and think differently. I am bringing a whole culture, a whole struggle to my current position, with my current team. It’s not a victimized sort of culture, [but the experience] is inherent, it’s palpable, it’s tangible and it’s mine. Please acknowledge it and respect it, and I’m hopeful that you will help me change it.”
How Can We Shift From Talking to Doing?
We’re experiencing the extremes of standardization and personalization. For all of America to reinvent itself, we have to move to the center. I’m not talking about politics here. I’m talking about our struggle to find balance between the standardization that wants efficiency at all costs versus the personalization that wants individual contribution to a shared mission.
We cannot focus on capitalism without focusing on the people who benefit from it or not. We need to find leaders and people that can move us to the center.
So what does it take?
“It takes multigenerational leaders who care enough and who see themselves as agitators and in some ways ‘intrepreneurs,’ who can disrupt and improve these systems from within,” said Dr. Cooper. “I largely see myself as one of those individuals, one of those leaders that I’ve made the decision to work with large corporations. I’m drawn to these types of institutions and companies, because I want to change something at scale. I’m not patient. Enough is enough. In thinking about healthcare in particular, we’ve reached a societal imperative and we are now saying that this is a business imperative – that for healthcare businesses to truly get at their mission of improving people’s lives, they have to address the social inequities that are rampant in our society.”
Wondering what you can do as a leader? Chisley and Dr. Cooper said we have an urgent need for bold leaders to take these actions:
- Build and elevate executive teams that are fully committed, actively engaged, and curious enough to move institutions forward to make seismic-level change to improve the health of underserved consumers/patients and broader communities.
- Increase the racial and ethnic diversity of your Board of Directors.
- Listen differently within C-suites, stand behind specific, never-been-used, tactics and policies that lead to change – including fostering and seeking often-ignored experiences, perspectives, insights and ideas.
- Move beyond corporate rhetoric and easy/lazy actions to truly build more equitable institutions that serve to improve community health at scale.
And here’s one from me: recognize the value of the lived experience from each of your employees, and interrupt your current systems that keep people from contributing to your mission based on that lived experience.
As demonstrated by the honesty from Dr. Cooper and Chisley, Black leaders have known adversity and they’ve had to fight their entire lives for the justice and equality that everyone wants. These are the things that every organization right now is saying they want. Are those just words, or do you mean it? If you mean it, stop trying to stifle the very people who can help you get there.
What I see too often is a company that hires people of color and then standardizes them to think just like everyone else already thinks. They hire for diversity and then force everyone into conformity. That approach stifles individuals and limits the organization’s impact by extension.
People at all levels within organizations are battling the gulf between assimilation and authenticity. Examine your systems and process to identify and eliminate the ways that you’re keeping people from authenticity.
Learn more at www.ageofpersonalization.com.