Building Perspectives on Health Equity

This month, I’m going to broaden the lens of my ongoing, inclusive leadership series to share my reflections based on a recent and very impactful conversation about health equity at the Aspen Ideas: Health conference. I was privileged to be on a panel with four leading health care equity experts: Dr. Jay Bhatt, executive director of the Deloitte Health Equity Institute; Tawana Thomas Johnson, chief diversity officer from the American Cancer Society; Dr. Megan Ranney, dean of Public Health at Yale; and Dr. Sheila Davis, CEO of Partners in Health, who served as moderator. We explored the root causes of health inequities and then talked about actionable steps that organizations can take to create greater health for generations to come.

Health inequities have existed for centuries but often lived in the shadows until the pandemic brought them into the light. According to a Centers for Disease Control and Prevention report, while health indicators such as life expectancy and infant mortality have improved for most Americans, a disproportionate burden of preventable disease, death and disability are experienced by minority populations compared with non-minorities. The economic burden of health inequities is significant, equating to at least $421 billion (about $1,300 per person in the U.S.) among historically marginalized racial and ethnic groups in the United States.

The work toward greater health equity is incredibly complex, layered and nuanced. As we learned during the panel, there is no common definition, though many similar themes exist.

At Takeda, we believe health equity is achieved when everyone has a fair and just opportunity to attain their full health potential regardless of social position or other socially determined circumstances. That last part is important because 80% of what determines a person’s health happens outside of the physician’s office – these are also known as the social determinants of health. That means that your zip code has more to do with your health outcomes than your DNA.

Sometimes it makes it hard to know where to begin.

In the absence of a defined roadmap, several key themes emerged from the panel – I’ll cover a few here and tie some back to inclusive leadership practices. And if you’re thinking to yourself, “I’m not in the health care industry, so this doesn’t really apply to me,” consider this insightful point made by Dr. Bhatt: “If you have employees, you’re a health care company.” Indeed, health equity is everybody's business. 

Embedding an equity mindset

Health equity is a strategy that must permeate throughout an organization. Organizations that will be most successful in their efforts will tie this work to their mission and core values. Takeda’s values of Integrity, Honesty, Perseverance and Fairness are more than 240 years old, brought to life through our decision-making framework of Patient, Trust, Reputation, Business (PTRB) – always in that order. This framework, followed by everyone in the company, gives us an anchor from which to build our health equity principles so they become as ingrained into our ways of working as PTRB. 

It's also about acknowledging (and it’s ok to do so) that addressing issues of health equity is as much of a business strategy as it is a moral imperative. This work goes beyond corporate social responsibility (though that is an incredibly important aspect of business) and looks at the entire value chain. This helps increase the addressable market, grow our customer base, aid us in excelling at value-based health care outcomes, accelerate clinical trial timelines, as well as other opportunities to grow our global impact to create a more sustainable business.

Nearly three years ago, Takeda created a global Center for Health Equity and Patient Affairs (HEPA), as well as a focused Health Equity team within our U.S. region, solely focused on embedding an equity mindset across the value chain of our business. They help our teams identify gaps and determine what additional information or resources may be needed to address those. Most importantly, they help build bridges to impacted communities so that we can better understand – and meet – their needs. This type of equity mindset is one component of what’s also needed to be an inclusive leader, it’s just applied at a community scale rather than an individual or organizational scale.

Listen and let communities lead

Social determinants of health, such as food insecurity, housing or transportation limitations, inaccessible health care and education create a personal, complex, sensitive and multi-faceted challenge for individuals and communities.

That’s why we must come humbly to our work and approach conversations with curiosity, ready to listen. I’ve shared in a previous post why empathy and listening are such important skills for leaders, and it’s the same when addressing health inequities in communities. We should start with recognizing and acknowledging the historical and justifiable origins of mistrust that some communities may have, taking the necessary steps to re-establish trust and allow communities to lead us, not the other way around.  As Dr. Davis from Partners in Health said, “It’s about accompaniment, walking beside people, meeting them where they are.”

However, too often, communities are left out of the foundational research work. Both Dr. Ranney of Yale School of Public Health and Tawana Thomas Johnson of the American Cancer Society talked about the importance of community involvement in not just data collection but later, accessing the data about their community and utilizing it to advocate for the policy changes they need. The exchange must be two-way with a feedback loop.

Both underscored that this kind of full 360 engagement helps build and maintain trust while empowering communities to quantitatively understand their largest issues. This provides a foundation when engaging partners to ensure a focused approach.

 It takes a village

This work is not a solo venture – to be successful we must cross traditional lines and collaborate between industries and between the private and public sectors. Each organization has an important and valued role to play from the convener who can bring the right stakeholders together to the subject matter expert who intimately understands local, community dynamics, to the funder who has financial means to support a program.

Take food insecurity, for example, which is a key focus of Takeda’s corporate social responsibility, where we are in a position to convene stakeholders and provide funding. Creating an equitable and sustainable program within any given community requires the support of multiple organizations. Tawana Thomas Johnson painted the picture of bringing together five families to plan a wedding – everyone has the same goal but may have very different ways on how to get there.

This is where inclusion and humility are key – remembering that the often historically marginalized communities must maintain a central role in creating and executing solutions. Equally important is for organizations (especially larger, more resourced ones) to maintain an inclusive and equitable mindset WITHIN the stakeholder group to ensure that the voices of the local communities are always clearly heard.

Creating possibility

As someone who always looks for the possibility in challenges, I know that there is no simple solution to tackling the socially determined circumstances that impact a person’s health. Yet, I also know that we have an incredible opportunity to listen, learn and act, as Tawana Thomas Johnson emphasized, not only as we engage communities and partners, but just as important, our own employees.

Bringing an organization along on this journey takes time, commitment and investment. I am proud of where Takeda is on this journey right now, excited about where we will go, and the impact I hope we have toward helping every single individual reach their full health and wellness potential.

I hope you’ll listen to our full discussion at Aspen Ideas: Health and share with me the unique role that you and your organization are playing in addressing health inequities. #healthequity #aspenideashealth #inclusion #leadership