What is health equity?
Imagine a world where everyone has equal access to affordable, quality health care — when and where they need it. That's health equity. By working together, we can remove barriers and close gaps in care to make health equity a reality for all people.
The crisis of health inequity: Our challenge to solve
COVID-19 brought health inequities into stark relief. This pandemic brought to light significant disparities in healthcare access and outcomes. Disparities that have always been there. Health inequities are not due to individual choice or random occurrence, but instead are a result of poverty, structural racism, and discrimination. These disparities cannot continue. During the pandemic, payers, providers, employers, and government came together to meet the need. COVID-19 was a year long crisis, and our industry rose to the challenge to protect the health and lives within their communities. From remote monitoring to reimbursement. And from drive-through testing to telehealth. The industry became a champion of innovation and empathy. Health inequity is a risk as great as any of it, but we have the tools, the partnerships, and the will to address it together. We can address this bias in our own organizations, by listening to the diverse voices within, and building the teams that best connect to the people we serve.
We can build a consumer experience that eradicates seen and unseen barriers, creating ecosystems that meet people when and where they need us. We can build the intelligence and relationships capable of continually improving clinical outcomes until they are in fact equal. This is our industry challenge to solve. We are working across our country to identify where health disparities are occurring. We are embedding health equity in every decision we make, and every product or service we deliver. Health equity is at the very core of our mission, to help people live healthier lives, and help make the health system work better for everyone. We invite you to join us in this effort.
The crisis of health inequity: Our challenge to solve
Let’s come together and build a health care experience that meets the needs of all — community by community.
Driving toward health equity
See how Optum is improving access and expanding resources to achieve better health outcomes for all.
Video: How Can Health Care Leaders Create Lasting Change?
Welcome once again to the Fast Company Most Innovative Companies Summit. My name is Chris Denson. I'm going to be moderating this amazing panel. Today, we're going to be talking a little bit about health equity and some of the gaps when it comes to inclusion and diversity and what healthcare providers and healthcare services are doing about it. Thank you to our friends at Optum, and, of course, the team at Fast Company for putting this together.
I'm joined today by an illustrious panel, and I use that word very intently, Karoom Brown, Global Chief Growth and Strategy Officer OptumServe; Dr. Anjali Bhagra, Medical Director Office of Equity, Inclusion, and Diversity at the Mayo Clinic; and Dr. Seanelle Hawkins, President and CEO of the Urban League of Rochester. Thank you all for joining us.
I guess, for starters, one of the things that I admire about you all is that you're leaders in your respective fields, and as we look out into the healthcare ecosystem and we start to see what leaders are able to do and capable of doing to bridge the gap for health equity, what sorts of things are you seeing that individuals should be taking into consideration to bridge the gaps at least from a leadership perspective? Karoom, I'll start with you on that one.
From a leadership perspective. I see companies actually starting to really pay attention to where the curve is going, and there's been a bunch of things that have heightened it. The response to COVID, COVID has really shown health disparities, health inequities, and some of the imbalance in how many folks are hospitalized of different backgrounds and in particularly brown and black communities.
What I've seen is leaders from a company leader perspective, United Healthcare Optum, we've set up a whole health equity board. We've set up a committee where we're actually looking at real change and how do we impact how we deliver care differently. How do we support our customers differently but also how do we support our constituents, whether it's diverse suppliers, diverse companies?
Then you have folks that are really leaning in, and I'll use myself as an example, making sure that I'm a part of the diversity and inclusion internally in the company, making sure I'm supporting health equity from a diversity of thought and diversity of perspective. I think in order to make, for us to make real change, we need to change the way we look at problems and also who's helping us answer the problem.
It's hard to address health equity in a community you've never been a part of you. You haven't grown up in a poor community, it's hard to understand that there are not healthy foods in those communities, that nutrition is a big part of the factor, that access to good care because the strong and good doctors and some of the better doctors do not want to come and work in those communities. How do we change that? How do we change the root cause and environment?
But part of it is leaders being able to step up like me that grew up in those communities and be able to say, "I understand what's different." I understand what good healthcare is now because I'm fortunate to be able to afford it, but I also understand what it is to grow up 20 years in poverty and have not fair access and not equal access to healthcare, and that the simple doctors and providers that are in my neighborhood that I grew up in are not the same as the doctors that are in better neighborhoods, because that's where you tend to draw the higher concentration of better professional doctors, health care education, food, and nutrition.
So, I look at root cause, and then I look at us as leaders. How do we get that? How do we hire differently and hire different expertise that can address the problem, not just trying to take the same folks with the same education that haven't experienced it and try to solve that problem? So, that's the beginning of what I see, but what I'm really excited about is whether it's federal government entities, state government and local entities, or private firms, I've seen a very large concentration now on health equity and providing care.
Even when it comes to COVID, we do a lot of testing and vaccinations. A lot of the governors, the local health officials are really concentrated on making sure fair and equitable distribution of vaccines, fair and equitable distribution of testing, and even coming up with creative solutions like mobile capabilities to go into communities that are hard to reach. So, those are some of the things I've been excited about to see leaders and folks really jumping forward in the space and trying to change where we are.
Very well-stated. Thank you. Thank you. Dr. Bhagra, same question. Curious as to your perspective on this.
Dr. Anjali Bhagra:
Yeah. Thank you, Chris. First off, I want to really express my enthusiasm at being able to share some thoughts with the exemplar group here, and thanks to Fast Company for prioritizing this discussion. I think that strong leadership on behalf of Fast Company and talking on leadership imperative, I really want to build on what Karoom shared earlier. I personally feel there is space and room for advocacy, there's room for revolution when we need it, and there is always room for strong leadership.
Dr. Anjali Bhagra:
When it comes to healthcare and leadership, in addition to everything that Karoom so eloquently shared about root cause and just the systemic and pervasive nature of disparities and the need for a multi-dimensional approach, what I would love to highlight is how there is need for strong leadership. When I'm talking of leadership, I really look at it through the lens of business development. Now more than ever, I feel it's time for healthcare leaders to make equity a strong part of their strategic plans.
Dr. Anjali Bhagra:
As we build strategic plans, certainly we want to make sure fiscally we are coming up with strong plans. I also want us to look at everything through a lens of equity, because without that, we wouldn't be able to address the inequity and the disparities at the level that we wish to. One example of such a priority is at Mayo Clinic we recently declared our board of trustees committed $200 million to eradicate racism. To me, that's where the rubber meets the road.
Dr. Anjali Bhagra:
Yes, we know this. There is a philosophical, intellectual, historical... We have all these awarenesses, but we really need action plan where we hold ourselves accountable. I'm in a space of building more accountability on part of our leadership, and when I say leadership, it's not just a top down approach. It's bottoms up as well. This is not work that needs to be or should be done by an office sitting in a periphery of some organization. This is exactly where, Karoom, to your point, everybody needs to lean in. This is work that needs to be done with the people and not for the people.
Dr. Anjali Bhagra:
I think that there needs to be a very solid, fundamental understanding of, yes, there's need for a very strong strategic plan, business plan around equity efforts, and then there's need for engagement of this work to be done with the people, not just for the people. What I just shared, the $100 million commitment that we have on behalf of Mayo Clinic, these are efforts addressed towards our patients for disparities, equity initiatives within the practice, towards education, and finally towards our staff and community. It's a triple-facing initiative that addresses need for equity for our staff, patient, and communities.
Thank you. Thank you. And Dr. Hawkins, I think, from your perspective, it's almost working on both sides of the equation, right? On one hand, you're representing the Urban League and also bridging the gap with health care providers. What are some of the expectations you have for healthcare leaders?
Dr. Seanelle Hawkins:
Sure. First of all, thank you for this opportunity, but I'm expecting leaders to call out the root cause for what it is. Racism is a public health crisis. That's the root cause, racism. So, when we talk about health biases, systems change, we have to look into these practices and scan for the inequities and make the change. I'm looking to leaders to articulate the vision, and everybody needs to work the vision together.
Dr. Seanelle Hawkins:
As you mentioned earlier, this is not just a top up approach. It has to be every one, all inclusive plan. So, you have to talk about, "What is America, what is my state, my city, my organization look like if we have evidence of health equity?" What does that look like? Communicate that vision and work the vision.
Thank you. Thank you so much. You talked a little bit about scanning for inequities, which leads me to this idea of data and analytics, especially in healthcare systems. We have so much information, but I'm curious as to how we can use these tools to bridge the gaps and to develop more equity. Karoom, I'll start with you on this one as well, just in terms of what sorts of technology tools and how are those being reimagined to help bridge the gaps that we see.
So, I'll start with the reimagine piece. We have to go back to our datasets. The technology is there. Data analytics, advanced, predictive analytics, science, when you look at genomics and things of that nature, but we have to go back and look at the data source. So, where are we getting those data sources from? It's easy to say technology can do a lot of things, but if it's not built on the right foundation of data, then therefore the output that you're getting won't be correct.
So, are you collecting the input from folks in those communities, the communities of interest, community leaders within those blocks, folks that the doctors that have been treating those patients that can tell you what's different? What have they experienced? And then also, I think science is a big part of it, not just technology. Data analytics, we have invested a lot in our business in data analytics, and we continue to evolve that by looking at the data sets and making sure we're inclusive of all data and the right data.
But science is also a part of it. You start looking at genomics, DNA. There has to be a correlation between the DNA in the ancestors of black and brown communities that have struggled year-over-year on nutrition, have lived in poverty because of racism, slavery, and the things that you say, "Oh, that was 350 years ago." Well, it was for 350 years. If you have one culture that all they did was smoke cigarettes, for example, for 350 years, you got to imagine that that DNA is altered in a way where its health impact is going to be different than those that didn't smoke cigarettes for 350 years. So, put that in perspective.
If you think about slavery and the fact that slaves weren't afforded nutrition, so for 350 years, they eat scraps. They eat the leftovers. They eat whatever they can muster up on the plantations, but not eating right for 350 years. Then you have poverty after that, that also took out your ability to feed your kids, to give them the right nutrition, to teach them what the right nutrition was, what good doctors look like.
For a while, even after slavery, and you have segregation of doctors. You can't go to the good doctors. You go to the best doctor you can possibly go to, and that's not good enough, or you can't even afford to go to those doctors. You're not taking care of your teeth. You're not taking care of your heart. You're not taking care of your body. You're eating foods that are served in your community that are high in sugar and sodium. Those things have an inadvertent effect long-term on the DNA of these minority communities that struggle in health care.
So, we can look at the root cause and say, "Okay. Yes. It is racism. Yes, it's slavery." But the question is, now that you know that and you can really dig deeper, how do you change the course or speed? How do you make the next 300 years better eating, better living, better access to care? How do you incentivize doctors, the right doctor? You just talk about technology and data analytics. How do we look at the pool of where the best doctors are claimed to be in the country and the correlation of that in the underserved communities?
What's stopping the doctors? And how are we using that technology and analytics to say, what will it take to get the better doctors, the better healthcare into these communities to make it equal for all? If it's cost or if it's incentive that you need to motivate people to work in those communities, or if it's working with community leaders to say, "How do we create green zones?" Green zones that say regardless of crime rate and anything in those communities, how do you make it safe for doctors of all kinds to go in those communities that understand those communities, but also can afford to be in those communities because the pay is equitable?
So, I think there's a lot of things, but I think the first thing you look at is technology and analytics. How do you drive the science behind that as well and drive better care and treatment through real analytics that are based on foundational data that come from the communities, that come from the patients of interest, that come from the doctors that have been serving those communities for decades, not just the brains that are outside of those communities, trying to understand those communities better?
I love that you touched on this almost like an intangible data point, which is psychology. The things that we learn, the habits that we learn, and it's hard to measure, especially when it comes to tools and data and analytics. Dr. Anjali, I'm curious as to your take on data points and analytics and the tech tools behind the efforts of institutions to bridge these gaps.
Dr. Anjali Bhagra:
Yeah. No, Chris, thank you for including this question. I want to build on what Karoom shared earlier. To me, data is destiny. There's no doubt that for us to make change at the level that we wish to make change, we've got to rely on big data because we need to make and we want to make big change. Now, big data comes with a flip side of bias within the data and issues around ethics, confidentiality. How do we respect all of that?
Dr. Anjali Bhagra:
I think the other opportunity that we have is technology. In addition to leveraging data, along with analytics that can inform us with in-time plans to address disparities, the fact that we can combine all of this and utilize machine learning to address populations that we haven't really been able to reach because of inaccess to those segments, Karoom, to your point, to a marginalized population. So, I think there are big issues that we need to address as we harness data, and bias is one of the biggest ones. We want to make sure that we use as much as possible data that's de-biased and that's inclusive, that truly represents the population that we wish to leverage its information on.
Dr. Anjali Bhagra:
The second, I would say, is teams that work on data analytics need to be diverse. If you have a group, an over-representation of one demographic working on these data analytics tool that is not going to serve us right, because that's where there's a pooled impact of unconscious biases. So, in order for us to create those unbiased data sets, we want to make sure our teams are diverse and our teams are very inclusive. I just want to make sure as we harness data we pay attention to what the issues around bias and access are, leverage technology to improve access of healthcare to populations that we are not traditionally reaching right now.
Dr. Anjali Bhagra:
One thing that at Mayo and I know many other healthcare institutions are very particular about, and that's data privacy. I think that we cannot talk enough about that. That's an imperative for us, and we have several teams, including our teams of AI scientists, ethics, our own team of equity and inclusion, working collaboratively to make sure we protect the data of our consumers who place so much trust in us.
Chris, I just wanted to jump on with Anjali said that, when you talk about data ,and we talked about the quality of the data, biases have an impact but also unconscious bias. Sometimes you can mean well, and look at COVID. When we first started looking at folks said, "Okay, well, how do we simply get testing in underserved communities, in black and brown communities." But the equation wasn't that simple.
An unconscious bias could be you assume everybody has a car like you do. You assume everybody has access to the internet like you do, so therefore you can go on and schedule your tests and drive to that testing location. But dive in a layer deeper and have an unbiased but a actual data fact that says not only are they having trouble to getting the testing near those communities, but they also need easy access. Are you located close to public transportation? Are you putting it in a place where it's walking distance to high density apartment builders and things of that nature?
So, the data sometimes, and how you use the data, we're learning as we go into health equity, you have to be conscious of the unconscious bias. The folks that tend to be the brains behind the operations in healthcare tend not to live in those locations and therefore can't truly come up with the data in a fully unbiased nature. Therefore, that's where it comes in where we need that diversity of thought and experience added to the technology to make the data analytics do what it's supposed to do.
I hope that the folks that are listening to us take that into consideration, making sure that the data is not based on biases on unconscious bias, and you inadvertently as good as your intentions are, you're still leaving out a population or leaving out a solution because your data's not built on the foundation of those communities and what their challenges really are.
Dr. Seanelle Hawkins:
Karoom, I think that's where the partnerships are so important because having a group like the Urban League at the table helps to remind you of that because we're focused in on the populations that we serve. We're looking. We're scanning for unconscious bias. We're scanning for how this impacts the people that we're looking to impact.
Dr. Seanelle Hawkins:
Also, I wanted to say that with the data, it's important to make sure that the data is broken down into layman's terms, so that those that are impacted by the data understand the data. We can't forget that. The people with the lived experience have to have the understanding so that they can begin to make changes, and not only that, also use their voice to advocate for the change that we all seek. So, it's important not to dismiss that, but I think partnerships are critical to our success to achieving equity in health.
And I was going to say to that point, when you look at data, there's also an important data point which is the data that you do not have. So, when we talk about access and not having the tools or a different level of access to technology, from your perspective Seanelle, what efforts are you seeing to bridge the gap and give access, put these tools in the hands of the people that need them most.
Dr. Seanelle Hawkins:
Yeah. You know what? I saw this with the access to the COVID vaccine. There was a great idea to have the website available, and people can just click on. It didn't work like that because there were so many people that didn't have access, not only to the technology, but didn't know that you had to click 100 times, get yourself in a waiting room, then go back, click... No one has the time to do that or even to understand it.
Dr. Seanelle Hawkins:
So, one of the things at the Urban League of Rochester, we partnered with our medical provider, Trillium Health and said, "Look, you have the vaccines available. We will have people call us." We partnered with our local radio station. I went on the radio station and broadcast, one, information about the vaccine, provided that education to the community, and those that wanted it called. We received thousands of calls.
Dr. Seanelle Hawkins:
That helped our partnership with Trillium because the Urban League was the trusted partner. We worked with Trillium Health, and they were able to get folks vaccinated. Those are the things that we have to think about when you think of technology being a great idea, but some people need just a good old phone call. We have to remember that, and that's why partnerships are critical for us creating access.
Very, very good. When it comes to social determinants, we've kind of touched on them, but how should we better understand those? Maybe it's not data. Maybe there's getting out in the neighborhoods like Dr. Hawkins just suggested. What are some strategies and things you see in terms of, again, removing some of those social determinants?
First is you get to understand what they are and, I mean, truly understand. It's one thing to say, "Oh, it's poverty. They're poor people that can't afford it." It's another thing to understand what the poverty has caused and all the things around it if you're really going to affect health equity. First, you say, "Okay, well, there's not enough. They can't afford to go to the doctor, but there's also not enough good care." What are driving the doctors out? What is stopping the doctors from coming into those communities?
What is is the other things? Is is it access to transportation to healthcare? Do we need to do more virtual healthcare, more videos? Is it a technology gap? Do we partner with technology companies? Do we partner with the T-Mobile's and the Verizons of the world to get communications into the homes? I mean, part of the reason why virtual school got going is because they were able to extend the computers and the internet access into certain communities that wouldn't have normally had it.
But the whole theory of just, oh, well, you know what? Everybody could work virtual. One thing I think Seanelle pointed out, even COVID that we experienced this, the reach, digital divide digital. The digital divided in the minority and poverty stricken communities is real. If you don't have access to the generic things then you can't access education for healthcare, learn about better healthcare access, simple things like picking a doctor and being able to look at a website to see which doctors are the best doctors.
For the first time, in a while, I got a Yellow Book delivered to my house, and it was probably about that thin. It wasn't as much information in it as it usually is because people are relying on the internet. But if you don't have that, then you don't have access to certain care. So how do we bridge the gap there? Understanding the community, partnering, as Seanelle said, with churches and community groups that understand and community healthcare systems to understand what these folks are experiencing.
When folks say, "Hey, I haven't been at a doctor in two years," why? Is it because of the work hours? So is it making care more available easily at the places of employment? Is it strategically locating some type of mobile care unit that can do health checks for young children and making sure vaccines are getting to those right communities? But you have to understand, truly understand the socioeconomics and the things that are driving the communities back.
I mean, just simple things like food. I mean, I grew up in places like New York that you go in a minority neighborhood, and it's nothing but convenience stores. There's not a Whole Food. It's not another bunch of healthy eating and smoothie places. You bail bondsmans and check cashing places and liquor stores and convenience stores that sell nothing but unhealthy food. Well, if that's all, you're eating day after day, you can't afford to go to the gym, you don't have anybody teaching you about wellness on a regular basis, and you can't afford the gym at that or exercise equipment.
Who's teaching alternative ways of working out? Who's teaching alternative ways of living? You got to understand what's there. But I do think that what I see is communities adapting, and that's a positive change. So, we talk a lot about the negative, but I'll talk about the positive over the last year I've seen. My company when responding to COVID the first response to some folks that they didn't understand those economic challenges was like, "Oh, yeah. We just make everybody sign up on the internet."
And I said, "No." I said, "You got a digital divide problem, technology. You got transportation. So how do we address that?" What we did is we opened up a call center for those that didn't have computers that can call in and schedule their appointments and figure out where to go. We set up walk-up sites and worked with our customers in estates to make sure that you could just walk up and take a test. You didn't have to go on the internet or place a phone call. Those things, we make sure we have transportation. We make sure we set up temporary testing and locations where folks would normally not be able to afford transportation but can walk to it.
Then we moved those sites around the community, so it wasn't just the folks that could walk there. But then you move it 20 blocks out, and then those folks can walk to it. That type of adaptiveness is what we need anymore. Until we can truly spread out health equity, you have to understand the causes. I am big believer of it. We got here through hundreds of years. I think we're going to get to the solution quicker if we understand where we came from, and we start to adapt quickly by understanding. It's okay to be different.
It's easy to look at the problem, and the problem can even feel daunting to a point where it's like, "I don't even want to touch it because it feels too big." But, Seanelle, from your perspective, what have been some elements that have driven adaptation like Karoom just mentioned? I like to think of things like telehealth, the fact that we've all been forced into telehealth appointments. It breeds a bit of familiarity and comfort with technology and tools and other methods of healthcare. But what have you seen more of the upswing trends from an Urban League perspective?
Dr. Seanelle Hawkins:
Yeah. There are lots of upswings, trends, including partnerships. I think partnerships are critical to the success because when you collectively pool your resources, we can attack the problem. I know you wanted to talk about the positive, but we absolutely have to attack the root cause. So, when we think about, just as Karoom mentioned, the multiple traumas that manifest in our bodies from all the problems from mental health, because of COVID-19, lack of housing, and so that leads to the stresses.
Dr. Seanelle Hawkins:
Imagine when the moratorium is lifted on eviction, what is going to happen to our community? So, we have to really advocate together, pool our resources together, and I'm seeing that. I'm seeing that more, that there's a collective effort to attack the problem. This is reflected today in this panel here. We're talking about how we're working together to make change, and that's what's necessary. We collectively have to pull together.
Anjali, I want to get your take on this topic.
Dr. Anjali Bhagra:
I really want to lift Seanelle's idea of partnership, and partnership can look so different in different settings. In this setting, when I think of partnership, I'm really thinking of life sciences, social sciences, political sciences, and health sciences coming together. In other words, this is the health care sector. I'm really looking at the public sector, the private sector. Seanelle, I love your suggestion of, like I said earlier, this is the work we need to do with the people, not for the people. Really, that cannot be done without partnership.
Dr. Anjali Bhagra:
One thing that I'd love to share on the technology and the telehealth aspect, Chris, that you mentioned. With partnership with our IT team here, we were able to extend televisits to COVID-positive patients, and we were able to take care of them right in their homes. They did not need to come to Mayo Clinic for the care. We took care of them, right where they were. We actually saw more televisits in a day than we had seen in an entire year pre COVID.
Dr. Anjali Bhagra:
So, you're right. It is happening. There is an acceleration. The pace at which we are going to roll this change out is way faster than the number of years and centuries of inequity that have existed. Another thing I want to mention here for partnership. We recently were, the founding members Mayo Clinic, was a founding member of the Racial Justice and Business agreement, which is via the World Economic Forum. This is that partnership. I'd love to work with Urban League. We are already working with technology partners, such as K Health, Cerner, where we are trying to optimize tools such as symptom checkers. Can we reach out to individuals without them having to come to us?
Dr. Anjali Bhagra:
So, it's an entire frame shift of how we within healthcare want to provide care to our consumers. It's not about you finding the transportation. Certainly for complex conditions and conditions that need you to come here, we want to improve the access. But we want to be able to get to you where you are, meet you where you are to move that. That cannot happen without partnerships, so I'm personally really excited about all the collaborative collective efforts that we all are going to make over the next decade to really drive this change in a meaningful direction.
Well, first of all, I want to thank all of you for educating me. When you see a complex problem, it's hard to know where to start, but personally, I walk away with the idea of partnerships. You don't have to go it alone, and then just education. With complex problems there are multiple pieces of the puzzle that need to be solved almost simultaneously and not necessarily in order, and it is a continual work in progress.
So, I want to thank you all for joining us. Thank you to Optum for helping us put this together. Thank you again to the team here at Fast Company, and we will continue to educate you guys more. Thank you for joining us at the Most Innovative Companies Summit. We'll talk to you soon.
From Fast Company's Most Innovative Companies Summit
What can health care leaders do to create lasting change? Panelists from Optum, Mayo and the Urban League weigh in.
Health inequity is a risk as great as any, but we have the tools, the partnerships and the will to address it together.– Michael Currie, Chief Health Equity Officer of UnitedHealth Group
Moving the needle
Making health equity real by building trust, expanding access and tailoring support to meet the unique needs of individuals and local communities.
Optum Hemet Clinic - Whole-Person Care Under One Roof
Hemet, California, while it's growing, it's still considered pretty rural. When we started looking at Hemet and really thinking about the population that we serve there, we serve everything from pediatrics all the way up to our senior members and patients, there's a real need around the socioeconomic challenges in Hemet and there's a diverse population. We decided that instead of maybe just focusing on the seniors, this community needed something more.
We use a multidisciplinary team, integrated services, to tackle the problem from multiple corners.
It's about helping the health system work better for everyone and Hemet is no exception. It was very important to us to find a way to create that one-stop-shop so that everybody has convenient access to the care that they need in a single setting. We decided to bring in laboratory services, radiology services, and then we also partnered with our other Optum organization, Genoa Pharmacy to bring in pharmacy services.
Pharmacy is a great resource for the patients. When I prescribe something from my computer, I pick up the phone and speak to the pharmacist and find out if this is covered before the patient leaves the clinic. We have also the community center in the Hemet clinic where we provide classes, healthy lifestyle, management of diabetes, classes about preventing obesity, mental health resources, supportive groups.
We have a pretty deep connection with behavioral health services and the community of Hemet. We're also able to make those connection points for our members and our patients. We also have a pretty robust gym available to all of our patients and members as well.
Hemet is known as an underserved population and there are a lot of patients that have problems with access to care, a lot of patients that struggle with the transportation, problems with ability to afford their medications.
We know that in the depth and breadth of the Optum services that we have solutions to bring, to bear, to break down those barriers. We decided to stand up our social determinants program which we call Bridges. That's really about breaking down those barriers for our underserved population. Being in community, Care Delivery Organization, we want to treat the whole person as fast as we can and bring as many Optum assets to the table to show up for that person as possible.
We had the patient that was discharged from the hospital and this patient really need to be seen after that discharge. Immediately, the social worker was contacting many resources, arranging transportation for the patient to be brought into the clinic, pharmacists to prepare all the medications that we [inaudible] after the discharge off the hospital. The patient showed up after that for two follow-up appointments without counseling or no-showing. Actually, she wrote me a note yesterday, she said, I need you in my life. The trust that I got from my patient, it's indescribable feeling. That's what motivates me every single day that I have the ability to help someone in need.
Equitable care, access to quality care, inclusion, is something that we live and breathe every day. Every day I wake up thinking about how am I going to make a difference, and even if it's in one person's life, that's one person's life that we made easier and made sure that they could get access to the care that they needed in the time that they needed it.
Revolutionizing the Maternal Health Experience | Optum
our next speaker
cali chamberlain has a bright light
that shines from within she has been a
champion for health equity throughout
and today she will walk us through the
of maternal health and health equity so
hi everyone i'm thrilled to be with you
even if only virtually i'm really
looking forward to our time together
my name is callie chamberlain and i'm
the director of social responsibility at
optum is one half of united health group
we are the products the services
and the technology the other side of
united health group is
the organization united healthcare which
some of you may be more familiar with
that's the insurance provider and before
i tell you a little bit more about what
i do in our maternal health strategy at
i'm going to tell you a little bit about
who i am and how i come to this work
i'm a woman i'm a person of color i'm of
i'm based in minneapolis and i have
spent so much of my summer
thinking about systems change and racism
in large part due to the murder of
george floyd that happened right here in
and as we go through this um you might
actually hear sirens or helicopters as
we prepare for the trial of derek
fair warning professionally i've been
fortunate to have a number of
that have profoundly shaped my path and
continued to guide me in terms of the
values that i use every day at work
i started my career in health and then i
left for a few years
um one of the things that i did during
that time was i launched a leadership
and development program called new
leaders council twin cities that
organization is committed to advancing
equity across the region
and bringing together young people who
are leading from a similar set of values
so then in 5 10 15 years as we become
we can pick up the phone and call on
each other to get things done
that organization is five years old and
has more than 70 local alumni
another thing that i did is i went to
the greek island of lesvos
with six other women to film a
documentary on the syrian refugee crisis
in greece that film debuted in times
square in 2019
it went on to win seven awards and most
it told the stories of women refugees
and because of the relationships that we
developed on the ground
and a consistent asset we heard for
people that just wanted dignity through
we created a microwork application that
connects refugees to income
opportunities on their cell phones to
leverage the six hours that they spend
every day waiting in line
and as a result of that i had the
privilege to work
across the middle east and north africa
with the united nations as a peace
to develop more comprehensive migration
that time away also included running a
and a political t-shirt shop so it was a
lot of fun
and i learned a lot and despite those
experiences or i guess maybe because of
them right i made my way back to
um around this time the social
determinants of health were just coming
into focus which had much more expansive
definitions of health and health care
ones that i really felt like i could see
and because of my work with refugees i
really started to realize that health is
the base of
equity and without it we don't have
you can have the best education in the
world you can have a safe place to live
you can have a fridge full of food you
can have a job with a paycheck that you
know is coming every two weeks
and none of that matters if you don't
have your health so as healthcare
i think the work that we do is really
unique because we have the opportunity
to positively impact the health and the
of thousands of people of millions of
or not the decisions that we have the
privilege to make
they really matter and i don't mean to
be dramatic about that
but oftentimes it really is life or
death and almost
always about quality of life when people
are still alive
and to me there's nothing more sacred or
profound than having the opportunity to
do something about that
and in a capitalistic society with the
for-profit health care system
i think the opportunity to be able to do
real social good
is most prevalent in the private sector
and that's why i'm at optum
but this work is also deeply personal to
me i am one of the one in five
people who have experienced
discrimination in the health system
as a result of my race or ethnicity i
up close the ways that this system
wasn't built for me or people like me
and anyone i know we say that all the
time right the health system is broken
it doesn't work for everybody
but what we don't always say is that
a system functions exactly as it was
designed to function
and this system this health system was
and created in 1798 and at that time
women were not seen as full human beings
much less women of color
so when i say that this system wasn't
built for us i i mean that that's fact
and with the coven 19 pandemic and the
increasing violence in our communities
the social uprisings that were happening
globally and right outside my front door
is ground zero
it really became clear how many public
crisis we are operating
within and how many systems are
as they were designed to function we
just can't ignore it anymore
we just can't look away anymore right we
all the statistics that we're seeing all
the inequities that have been laid bare
that's something else i hear all the
yeah we can't ignore that that's
happening we can't ignore that race is
at the foundation we have to do
something about it
and i don't know about you but i feel
that right it's not just
systems change and racism across america
out there it's right here in our work
in the health system in the medical
right right across our laptops right
that's the opportunity
and that means that we have an
unbelievable moment to meet
and i think that we can lean into it and
understand our ability to impact social
issues at scale
and i think the way that we're doing
that at optimum is really unique
we're reflecting on who we are and how
we arrive at this work at this moment
and i think that what we're doing can
provide a really unique framework that i
hope is helpful to you and your
and that's what i want to share with you
today so to give you some background
my colleague and i started the social
responsibility program at optum three
we both come from very entrepreneurial
so we run a very entrepreneurial
non-traditional social responsibility
which is to say that we're not a
philanthropic grant-making body
we are the second largest health system
in the world
so we believe that the most impactful
responsible thing that we can do is
change the way that we do business
right so that means changing our
processes our operations our culture
and in doing so we really believe that
we can shift the industry and change the
so about a year ago we decided to focus
on health equity
and then about eight months ago we
decided to zoom in on maternal health
we did an incredible amount of research
there are so many things we could have
we read over a thousand studies we
talked to experts we surveyed our staff
and we considered where we might be best
positioned to authentically move the
and around that time i was completing my
birth doula training
so all right what's a bird zula if we
were in person i would literally make
you be like what's a bird too listen
just pretend you're doing that
and i'm gonna pretend that i can hear
you and oh my gosh i'm so happy you
asked all right so a birth doula
is somebody who supports a birthing
person throughout pregnancy delivery and
a doula helps a birthing person have the
experience that they want to have
and prepare for an addition to their
family they help someone advocate for
themselves and navigate the health
system which are two things that have
never really sat right with me so let's
the first thing that i said is that a
doula helps someone advocate for
um and what this is inherently
acknowledging right is that
oftentimes women are not heard they're
not believed in care settings and they
suffer as a result of that so the doula
is there to help amplify their voice
the second thing that i said is that the
doula helps somebody navigate the health
so we've already landed on this system
was not created for us
and that has real ramifications today
the doula is there to help navigate that
in academic and historical terms
i believe the correct term for a doula
is a village auntie
which is to say somebody who has been
through the experience of birth
and rearing children and is able to
support the birthing person throughout
in spiritual terms a doula is someone
who bears witness
to someone throughout the experience of
birth a doula is someone who recognizes
birth not just as a medical event but as
a spiritual one
they are someone who facilitates a
conversation between the birthing person
and god allah buddha the great whatever
they hold the space well a child moves
from the spiritual realm
into the physical one now i see my work
in deeply spiritual terms
and i take the tenets of dealership with
me into everything that i do especially
my work at optum
and i think it's a really beautiful
metaphor to think about how we can
transition and change because we're
always cycling through something right
that's a natural process of life
beginning and end
life and death we're constantly birthing
something creating something
whether that's a new idea or something
that we can physically see
right we do it at work we do it in our
we do it in our communities we're doing
it across society right now
we're birthing a new world and we're
laboring for that
so i see my role in social
responsibility in a similar way that i
see my work as a doula
my role is to clear out all the barriers
that prevent the spiritual experience
that means addressing everything from
implicit bias to paperwork
administration all the business side of
things right and on the patient side
it's about preparation
education translating materials i'm
clearing out a way for
anything that prevents a patient and a
from both showing up fully present in
their complexity and humanity
to be in deep relationship to one
that is the kind of experience that i
believe every person deserves to have
every single time that they interact
with the medical system and especially
when they're having a child
what i'm talking about is seeing people
as patients in care settings
instead of consumers in a marketplace
and this idea is at the very core of our
maternal health strategy at optum
that's our opportunity that's the
invitation to work at the intersection
of race and gender and change how
maternal health looks across this
country and let me give you that
right because it it's important context
kind of horrifying so in the united
we have the highest maternal morbidity
and mortality rate of any developed
i want you to know that most of those
deaths are considered preventable
think about that most of those deaths
are considered preventable
we have an under supply of maternal care
and we are the only country to guarantee
to not guarantee excuse me
access to provider home visits or paid
parental leave two things that we know
bolster maternal health
so in total what this means is that we
spend the most on our health care
we have the least amount of services and
and therefore we have the worst maternal
now two other things i don't think we
realize that most people are one
paycheck away from being on medicaid
so that means that we need a broader
definition of who we're caring for and
how that happens
the second thing is something that a
provider said to me they said
callie sometimes i have a patient that's
pregnant they have their baby right
and then maybe i don't see them until
they get pregnant again because life is
and they can't get a ride to my office
or their coverage changes
or they're working a lot of jobs
oftentimes it's all of those things
and then if there's any risk any
the rate of morbidity is already so high
that by the time i see them again i'm
already working backwards
this really helped me put the work of
maternal health into a broader social
we can't talk about reduction in
maternal mortality and morbidity without
talking about women's health
we can't talk about reduction without
addressing the social determinants of
without talking about access and care
and with these things in mind we got to
work we put our most vulnerable birthing
populations in the center
because i believe that when we solve for
our most vulnerable populations we
actually sell for everybody
and for us that means black indigenous
women of color
that means women who are incarcerated
birthing people who are experiencing
that means people who can't easily
access care and people whose experiences
never make it into any of the research
that informs clinical practice that's
who we centered
and we selected grassroots organizations
that were on the ground that were doing
the work and we said
we want to allocate dollars to you which
we don't normally do like i said but
we said look we want to partner with you
we love what you're doing we can amplify
this work together let's go
we launched pro bono projects to build
organizational capacity within our grant
you know helped them stretch their
dollars it had the secondary benefit
for us of being able to engage our staff
and helping them understand more about
the maternal health space
that also helped them interact with and
understand patient populations that
they didn't understand before they don't
look like they haven't had a chance to
interact with right
and as a third benefit that actually
started to change our organizational
people started to think more expansively
about who we were providing care for
how we thought about creating our
products and services all of that right
we match our partners with internal
sponsors who could further identify
opportunities for our work to support
and then because our social
responsibility program is focused on
internal systems change
um we work with our partners to see how
their strategies and insights can inform
and then how we can continue to advance
their work on the ground
it's a virtuous cycle works really well
one of our partners ladies of hope
ministry is launching a doula training
program for incarcerated
people participants will learn to become
and then once they're released they'll
be able to obtain support to launch
their doula businesses
they'll also have the opportunity to
join a speakers bureau where they'll
help pass legislation to prevent
i don't know how many of you know this
but today in 23 states it's
common practice and totally legal to
physically restrain someone who is
incarcerated and having their child
to a bed shackle them to a bed
and from a doula perspective when you
are having sexual intercourse
and when you are physically laboring and
having a child your body's actually
running in parallels
biologically physiologically so what
is that if you have experienced any
level of sexual trauma
and now you are being physically
you are likely being re-traumatized how
dehumanizing that is the furthest thing
from a spiritual experience
so we're starting to work on that one of
our partners the morehouse school of
medicine center for maternal health
is conducting research on near misses to
ensure that the lived experiences of
women of color become a data point in
it's the first of its kind we're working
with the wake forest baptist health
and the family justice center in
winston-salem to intervene at the time
of a domestic violence 9-1-1 call
if there's a pregnant person there we'll
make sure that they've got all the
supports that they need that they have a
medical pathway that they're getting
their prenatal care
we're expanding access to care by
developing financial sustainability
models with a federally qualified health
which is where most people who are
uninsured or underinsured are receiving
and like i said people are moving
between the population of being insured
or uninsured all the time
we're hoping that we can take that more
broadly across the country
we're developing a remote patient
monitoring program with our clinics in
to ensure that birthing people
understand how to advocate for
themselves and monitor for their own
um their own symptoms another is scaling
the work of cradle cincinnati
in ohio hamilton county they had the
highest infant mortality rate and then
they started creating spaces for black
what they call queens village and they
were able to reduce
that rate by 24 in five years that's
and as their executive director says to
make better decisions on infant
we followed black women
so all of this in total i think is great
i'm obviously biased right
but it's really not about us it's not
about how we show up
as a fortune 5 company it's not
just about how we do good it's about how
we fundamentally shift
maternal health across the health system
and bring it closer to equity
it's about how we show up as
co-conspirators in the work
and we establish trust with communities
it's how we heal this part of the
medical industry's past and begin again
together i think of two things almost
the first is a quote by martin luther
king jr he said
of all the forms of injustice inequality
in the health system is the most
shocking and inhumane
and the second is something that i saw
written on a sidewalk and it said
you're more powerful than you think it
was in little kid's handwriting
um so i want to pass those messages on
and i want to encourage you to think
about the second quote
could to consider how you address the
first you or more are more powerful than
you think that you are
and inequality in the health system is
the most shocking and inhumane it is the
most shocking and inhumane
and if i may i'm going to ask you to
deploy your social
financial institutional capital to join
me in building a just and equitable
health system that actually works for
i'm going to encourage you to draw a
circle around your most vulnerable
and to design the systems with them that
they need and that's a distinction right
you're not designing for them
you're designing with them and in doing
that what i'm also inviting you to do
is to be awed by what people are forced
instead of judgmental of how they carry
all of that in service of building
authentic relationships with our
communities which we're a part of right
individually as a group as an
as a medical industry we're a part of
and to show up with the sole intention
learning and being in deep service and
let's model what we want to see
happening within the four walls of a
in our organizational partnerships and
ask yourself the questions that i opened
who are you how do you show up to this
and then ask yourself those questions
from an organizational perspective
we need every single person here
thinking about how we orient toward
health equity it will literally require
all of us that's what i'm birthing
i'm willing to labor for it every single
day and i hope that you'll join me
thank you so much cali for your
opening keynote and for inspiring us
with your work
your passion and your mission
Revolutionizing the maternal health experience
Callie Chamberlain, director of social responsibility at Optum, inspires us to be champions of health equity.
Black mental health and wellness matters
Get the facts on barriers to care for people of color — and resources for culturally competent and sensitive care.
Our commitment to social responsibility
Everyone should have the opportunity to live a full and healthy life. Our focus on social responsibility is a key part of how we can help make it happen.