Health

“To truly achieve health equity, we need political mechanisms”

What is your philosophy for DEI at a university clinic?

Our story has a lot to do with the principle of health equity. Our hospital, like many large institutional structures throughout this country’s history, supplanted one of the most prosperous black communities in the country about a century ago. And then, during the civil rights movement in the 1960s, there was a public uprising in Newark precisely because the government did not meet the needs of all in an equitable manner. So our hospital was the main subject of the agreements that effectively ended the rebellion in Newark. And those agreements were enshrined in the Newark Accords, which I keep on my desk to remind me why I’m here.

Where do you see your duty to society in relation to justice?

It is important to really break down these concepts because you cannot really consider them or operationalize how you solve them until you understand them. So the first is the baseline, which is just an injustice and, unfortunately, in terms of health outcomes, the opportunities were not balanced for people based on their zip code.

One approach was based on equality, which is the provision of universal benefits for all. Of course, if you have groups of people who start at a much lower baseline, these benefits won’t end up being enough. A classic example is Medicare, which is a universal benefit for everyone over 65, but does not necessarily address the inequalities that people of color have faced in this country for so long. This is often not enough, especially for our dual eligible patients and patients who were born and continue to live in poverty.

Thus, the next level is equality, which is essentially a patchwork solution to the problem of the fact that marginalized groups of people do not have equal access to opportunities.

Explain how hospital programs can help you realize these concepts.

Our Violence Intervention Program focuses on treating vulnerable people who have been victims of or even committed violence in the community, but then we provide comprehensive services to help prevent future violence and reassure people that there is an opportunity to thrive. But in the end, the real goal is justice. And justice presupposes the correction of systemic inequality at their core, in their very essence. And the key to this, without exception, is economic development – so that everyone has the opportunity to participate in the economy, to have a career path, a career path. And you can do whatever you want with targeted benefits and programs, but if you don’t fix the system to provide better economic prosperity for everyone in the community, you are not going to do it.

How do you feel about economic development?

We are among the largest contributors to the Mayor of Newark initiative. And we are also making great strides in procurement from local small businesses and businesses owned by minorities and women. We are building a new hospital, and we need local small businesses and contractors to support this work so that more people are employed, wages are raised, and more people can prosper.

How do you ensure that these efforts are effective?

As an example, I will tell you about two of our programs. In terms of the Violence Intervention Program, referrals to social services and housing for the homeless and survivors of violence have increased dramatically since the program began. We are seeing a decline in overall emergency department utilization through the combination of our hospital-based violence intervention program and our trauma care program.

Another program deals with readmission. Again, this is largely due to the lack of social support at home and, first of all, to the absence of a home. We have been able to expand the intervention of healthcare professionals in the community and their interaction with patients in the community. We have noticed improvements in some preventive measures, such as screening for cancer and screening for hypertension and other chronic conditions. But to truly achieve health equity in this country, we need political mechanisms. We need to balance inequalities in, for example, reimbursement for things like mental and behavioral health and drug dependence treatment. Because these are conditions that do reduce quality-adjusted life years and cause death to a much greater extent than is commonly believed. This is just one example of what the federal, state and local governments can do to achieve health equity.

How do you work with policy makers to address these issues that benefit the community and you as a service provider?

I think every organization, especially in vulnerable communities, needs to think about more than how we recruit talented people of color from outside and outside the organization. There are ivy league institutions that offer color graduates the opportunity to do a great job across the country, but policies can help invest in career development locally.

We want our entry-level employees at University Hospital to undergo internships, undergo training to be the most qualified candidates for promotions and move from scratch to leadership, management and ultimately executive levels. Because if we do not offer economic mobility, we do not develop people or contribute to the economic prosperity of the community.

I think every organization can do it. This requires investment. This requires a clear priority because it is not cheap. It costs money. But it’s worth it because the trust you get and the talented people you can bring up in such a system are truly amazing.


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