DEI, The Safety Net, and Doing More

May 25th, 2020, in the midst of the COVID-19 pandemic, we experienced a cataclysmic shift in social justice. Previously, we witnessed many failed attempts to give voice to the unheard, but that day was different. George Floyd’s murder gave us real perspective on what conversations we needed to have. The social justice conversations we had as a company, paired with the pain experienced by our colleagues who lost loved ones to the pandemic, forced us to dig deep and take stock. As we reflected on our company mission of cultural engagement, our ConsejoSano Diversity Equity & Inclusion (DEI) Council was born. 

Shortly after the formation of our DEI council, we were given an opportunity to create three training sessions that would deepen the knowledge of a consortia of Federally Qualified Health Centers (FQHCs) in California’s Central Valley. Working with Mary Renner and the Central Valley Health Network (CVHN), we quickly identified three topics that would help clinicians and clinic staff to better serve the underserved: surveying for social determinants of health (SDoH) at scale, mitigating implicit bias, and the impact of distrust on the pandemic.

Our first session focused on leveraging technology to uncover SDoH barriers. Highlighting the impact of SDoH on both patients and clinics, we zeroed in on the role of cultural competency and the opportunity to use technology to survey large patient populations without creating more work.

The second session addressed implicit bias in the clinical setting. As we began researching to prepare for this session, we realized just how critical this topic is. For instance: In a retrospective study of children who were diagnosed with appendicitis, White children were more than 2x likely to receive an opioid analgesic than their Black counterparts for severe pain. Through exploring microaggressions, we helped attendees examine their every language, and provided tools to make everyday language more inclusive.

The third and final session, the session that meant the most to me, was COVID-19 and distrust. We walked through the history of medical trauma and mistrust experienced by these underserved communities, and examined approaches to the challenge of building trust. For example, we discussed facts such as how Black and Asian women face higher pregnancy mortality rates than white women, and how it can impact how and when women seek prenatal care. It occurred to me that all of these training sessions were inextricably related, each piece contributing to patient distrust.

Throughout my research I learned many heartbreaking statistics that worried me about my own healthcare journey. Much transpired in my life and the world while conducting these training sessions. During the second session, I not only prepared for my first appointment with a new doctor, but watched footage of the insurrection at the Capitol. I agonized over whether I should disclose to my new clinician my work in telehealth and SDOH as a way of protecting myself from implicit bias. Thankfully, my doctor and their staff did everything right: They made no cultural assumptions, acted compassionately, and listened to me.  

I couldn’t have done this alone. I want to especially thank my colleagues, Genesis, Ginger, and Indira, for all of their support and assistance throughout our preparation sessions. This group not only supported me but laid the groundwork for true collaboration in the DEI space. 

Looking back, I had many worries going into this, including a small but persistent one that my outfit would be “offensively” bright, a superstition that I’m pretty sure my Haitian father made up. Ultimately, this didn’t matter, because I learned from the attendees that we were equally eager to learn from each other, regardless of what we might have chosen to wear. The clinicians wanted specific real world examples, actionable solutions to try so they could build that trust that creates better patient experiences and outcomes in their communities. 

I learned a lot through these trainings: to trust the process, give myself more time to absorb the research, to save some compassion for myself, and how powerful collaboration can be with colleagues who are as passionate as I am. It’s 2021 now, and a vaccine for COVID-19 is here, although many are still hesitant to receive it. The reason? We have yet to perfect a vaccine against systemic racism.