In today's rapidly evolving healthcare environment, few topics are more pressing than fostering trust within our communities. From reducing health disparities to ensuring equitable access, health care systems must focus on building and maintaining strong relationships with those they serve. Recently, Dr. Airica Powell-Steed,Ed.D, MBA, RN, CSSMBB,FACHE,FAAN —an accomplished healthcare executive, fourth-generation nurse, and former President and CEO of a nearly 200-year-old public health system—shared her insights on these critical issues, including the importance of addressing social determinants of health (SDOH) and promoting health equity.
Below are some key takeaways from her conversation on the The Strategy of Health podcast, along with direct quotes that illustrate her vision and commitment to transforming healthcare delivery from the inside out.
"Less than 1 percent of leaders across the country in the health care space look like me…less than 7 percent of nurses across the country look like me…less than 6 percent of physicians across the country look like me."
When asked why she was the first woman of color and the first nurse to lead a major health system in Cleveland, Dr. Steed emphasized the urgent need to break barriers so that underrepresented minorities see themselves in leadership:
"We need to really sound the alarm and create much more attention around the fact that representation matters…There's a strong likelihood for you to be able to gain that trust in the community at large…if you mirror the populations that you serve."
Her journey and experiences underscore the systemic issues that hinder equitable representation. She views her leadership role not just as a personal milestone but as a key driver for institutional change and improving population health outcomes.
Dr. Steed's commitment to health equity is deeply personal. She shared how losing multiple family members to various cancers—and having survived preeclampsia herself—shaped her determination to fix a "broken American healthcare delivery system":
"It is an absolute shame that…the United States has worse statistics in women's health, specifically in maternal mortality…our mortality rates are six times worse than some third world countries…"
These deeply personal tragedies fueled her mission to climb to the highest levels of healthcare leadership in order to dismantle healthcare access disparities from within and advocate for better health outcomes for all.
Dr. Steed pointed out that clinical care is just one facet of health. Issues such as poverty, housing, and education—often referred to as the "social determinants of health"—play a monumental role in outcomes. She noted:
"80 percent of what truly impacts the livelihood of individuals out there has nothing to do with healthcare at all, and has… everything to do with the unmet social needs…"
This statement underscores the importance of social determinants of health in shaping overall well-being. Social determinants of health examples include lack of primary care, delayed specialist access, and limited health literacy, all of which compound each other, especially in historically marginalized communities. Dr. Steed contends that addressing broader societal needs is just as critical to improving health outcomes as any medical intervention. This understanding is crucial for effective population health management and preventive health strategies.
Building trust requires more than words; it demands visible, consistent action. According to Dr. Steed:
"You need to get out there with the community…get the voice of the community at the table…really listen deeply and intentionally to what the community is telling you."
She explained that many underserved communities view healthcare institutions with suspicion—often for good reason, given the profound disparities in treatment. To break down these barriers and promote health equity, Dr. Steed advocates for health equity strategies that include:
"You have to talk the talk and walk the walk…match the words you are articulating with tangible action that truly makes a difference."
These community health improvement initiatives are essential for addressing social determinants of health and improving overall community health.
While healthcare leaders bear significant responsibility, solving disparities is not a task for hospitals alone. Dr. Steed stressed the importance of government, policymakers, and community organizations working in tandem:
"This…shouldn't be something that is done to the community in a vacuum…and certainly in a boardroom in your ivory towers."
She further explained that only through collaboration—bolstered by sound public policy and genuine grassroots engagement—can healthcare organizations effectively address inequities such as food insecurity, environmental toxins, and lack of educational opportunities. This approach to stakeholder engagement is crucial for implementing effective social determinants of health interventions and driving health system transformation.
Dr. Airica Steed's career demonstrates how visionary leadership, informed by personal experiences and grounded in robust community partnerships, can begin to mend the fractures in our healthcare system. By insisting on representation, addressing social determinants of health, and inviting the community to be co-creators of solutions, healthcare leaders can start to rebuild trust where it has long been eroded.
As Dr. Steed said, her ultimate goal is not to fill hospital beds but to empower patients so effectively that communities remain healthy and seldom require hospitalization. Though the challenges ahead are daunting—marked by insufficient access, lingering disparities, and persistent social barriers—her story stands as a powerful testament to what is possible when leadership, empathy, and advocacy converge.
Through sustained collaboration, community-based interventions, and community-centered leadership, Dr. Steed and others are laying the groundwork for a more just, inclusive, and genuinely patient-focused healthcare system—one in which every individual can thrive. This approach not only addresses the immediate health needs of communities but also works towards long-term solutions by tackling the root causes of health inequities through comprehensive population health management strategies.
To truly make a difference, health care systems must prioritize community health needs assessments, develop targeted interventions, and continuously evaluate the impact of their initiatives on the social determinants of health. By addressing the socioeconomic factors in healthcare and implementing social determinants of health solutions, we can create a more equitable and effective health care delivery system that benefits all members of society.
