How to build community trust as a healthcare executive: Airica Steed Answers

<p>it is an absolute shame that uh that the United States has worse statistics in in women's health specifically in in uh maternal mortality our mortality rates are are six times worse than than some third world countries [Music] hello everyone this is Cole from the American Journal of healthc care strategy joined by a really tremendous guest today with just an unbelievable amount of experience uh so I'm very uh honored to to have her on uh Dr Erica Steed please introduce yourself yes well um I'm so honored to be with you today and I uh certainly appreciate the the invitation and I always thoroughly enjoy um really really giving voice to uh topics that are very near and dear to my heart um so by way of introduction Dr Erica Steed um I am a longtime uh a career transformational healthc care executive uh fourth generation nurse uh multiple generation byproduct of of self-made entrepreneurs and self-made people um uh more recently I I I served as um the first female first person of color and first nurse to actually lead uh the Metro Health System uh in Cleveland Ohio which is a uh nearly 200 years old but very proud to have served in in a capacity where I can really make a difference in in uh communities of of of need um and uh so I'm just proud to be here today we're really honored again to have you and I appreciate you giving your time your resume is impressive I I think clearly uh you're an excellent choice for the role that you have but I have to ask why you know Cleveland's a diverse City it's an urban area right it's a big city as well so people from all over the world are coming to Cleveland why are you the first I think that's just a kind of a question what has what has gone on where not just you know nurse but you're the first in many aspects right so what's the reason for that honestly I think that that progression has has certainly been slow and uh uh just speaking of Statistics uh you know um I'm certainly the first um a person in in that capacity um but it's always been my personal goal to ensure that um I'm not the last and I really open up the floodgates and and allow for more opportunities for uh individuals just like me um and that reflects the the same image uh to really Thrive and be able to uh really start to shatter that that glass ceiling and that concrete ceiling to be able to uh arrive at similar roles I just think that that the progress has been slow but I think that we need to really sound the alarm and and create much more attention around the fact that representation matters it it certainly matters in in health in the health care field where uh statistics are proven that um if you mirror the populations that that you serve uh there's a strong likelihood to be able to deliver high quality outcomes there's a strong likelihood for for uh you to be able to gain that trust in the community at large there's a strong likelihood for you to be able to widen the front door and really address the access to care gaps and and and start to uh really adapt and adopt uh care across the care Continuum in a in a much more powerful way so representation does matter but the reality is less than 1% of leaders across the country in the health care space look like me so we have ways to go um less than 7% of uh of nurses across the country look like me um less than 6% of Physicians across the country look like me so we have some work to do as it relates to representation um but the translation to positivity of impact and being able to eradicate Health Care disparities are very true I'm actually a bit embarrassed to to say I did not know the statistics were that die were that Bleak right I mean that's that's concerning so thank you for you know I'm sure I'm going to be educated a lot during this episode but um you know I I didn't realize that things were that were that challenging I mean that that's a concern because those are some low low numbers right I mean even for the nursing section 7% I mean that's that's concerning so yeah I I think the first thing is I see where you're getting some of your motivation from in that area but how about kind of earlier on if I can just you know kind of a personal question where did get the motivation to start going into Healthcare and handling this because if I was I feel like kind of reversed I would say well I don't want to be part of this industry which clearly doesn't value or respect me yeah well uh you know certainly in my in my opening remarks I really touched on it um I come from a long line of nurses in my family so it it was a baton that was passed down from multiple Generations that that started with my great-grandmother um so I'm I'm very proud to live the legacy of my of my family and I'm very proud to have St stood on the shoulders of my ancestors So I entered into this profession uh quite honestly uh naturally and organically through that multiple generation uh you know handoff and transition but I stayed in this profession and what I'm personally motivated by is the various stories that I have uh that really Propel me and motivate me and encourage me um to make a difference and uh uh quite honestly I've experienced more tragedy than than than one should imagine or one should have had to endure um I lost my mother at a very young age unfortunately I lost my mother to tragedy of healthc care disparities um my mother uh unfortunately was misdiagnosed multiple times uh for what turned out to be a rare form of cancer a rare form of leukemia um and I was on the front row seat witnessing a broken American healthc care delivery system and I witnessed information not always being shared I witnessed poor access to care I witnessed multiple hiccups and delays and multiple um areas that that really shouldn't be occurring in this modern day and this as technologically advanced as we are in healthc care um our outcomes unfortunately uh match some third world countries and I and I witnessed that very early on as I was entering into the profession of nursing I almost exited as quickly as I entered it because I lost my mother when I was only 23 years old wow and she was 46 years old um and then fast forward several years later I lost both my grandmothers uh to breast cancer unfortunately and their their tragedy was was just as Grave as my description of my mother um multiple misdiagnoses multiple instances of hiccups in care delivery poor communication poor engagement which which led to their demise um also lost unfortunately my younger sister also to breast cancer at a very young age after being denied a mammogram um so I I really took what I saw as tragedy and I reversed it and I wanted to change the narrative for other other individuals I I vow to make a difference and and incline climb to the highest level of healthcare leadership so I can start to re-engineer and help to re-architect a broken Health Care delivery system and then also on just on a personal level if if that's not personal enough I'm a two-time Survivor of preeclampsia which is a high-risk condition that unfortunately impacts women of color more so than it it it it impacts any other uh demographic and is is pure miracle and blessing combined that I survived to tell a story about my my own personal story um but with that being said it is an absolute shame that uh that the United States has worse statistics in in women's health specifically in in uh maternal mortality our mortality rates are are six times s worse than than some third world countries uh in in some populations of of the of the world so I am very encouraged and motivated by by these tragedies in order to um ensure that we we not just reduce in uh the the various disparities that are out there but to eliminate them man I am I'm tremendously sorry of course for for those experiences and at the same time I mean huge admiration that you have turned them into a in just an incredible career right kind of a dream career for probably many of the people uh watching especially the early careerists you know they look at the resume but to have that you know that powerful tremendously powerful kind of motivation is is really incredible I just can't really understand why we're seeing and especially when you brought up um the you know maternal kind of mortality I just don't exactly understand why it's it's occurring in 2024 and what's also doesn't make a lot of sense is it's not by wealth or Insurance level or area of the city that you live in of course those all play some factors but in the research that I've done it seems to be race alone is a determining factor in a lot of these areas I I don't understand how there's that much kind of bias going on in medicine when you know these people are not you know racists they're they're a lot of them are very invested in their communities they care deeply about their communities but yet there's still this bias yeah I mean how how do we tackle how do we even you know comprehend that if you could maybe educate me a little bit on that yeah so I would I would say certainly diversity and representation is a factor but is is not the full equation so I can I can honestly say that widespread disparities are impacting the health and lives of the most vulnerable underserved communities for certain but also at the same time they're impacting the nonvulnerable UN in in most served communities and I can I'm G to use myself as an example I'm an educated nurse I have all the resources at my disposal and and at my fingertips uh where I have access to more resources than than those underserved vulnerable communities and I certainly have access to um providers that look like me um but yet and still uh the the the statistics didn't pan out in in in my favor so it's is a multi-pronged issue that we're that we're um that we're working with here and um ultimately this this speaks to the fact that health is shaped by where we we live where we work work where we play and what we can access and the resources that we can afford so it's a combination of factors that really that really uh uh add into this uh particular crisis so there's certainly access challenges where there's an underinvestment in health care delivery um and the infrastructure in underserved communities so we're we're seeing Primary Care deserts we're seeing uh in inability to access and tap into those Specialists maybe delayed three four five six months so by the time you get access to those those Specialists um your your condition uh is so far past being able to address it so you you're you're seeing the access challenges being a major contributor to this but then you you couple that with what we're calling the social determinance of Health where I would say 80% and and research has proven on this 80% of what truly impacts the livelihood of of individuals out there are are impacted by factors that that have nothing to do with health care at all and has nothing to do with anything else but the the unmet social needs and that means uh poverty and un unemployment under employment housing insecurity food insecurity barriers to Transportation racism discrimination violence all of those things coupled together or individualized 80% of the impact on on how long you're going to live is impacted by those factors so I can honestly say in in in the city of of Chicago where I'm from originally there's in in some communities there's a 20year life expectancy Gap by just go driving a mile radius in some communities based off of those unmet social needs so I can honestly tell you that education and poverty is a predictor of how long you're going to live as opposed to you know having access to uh a diverse provider so it's it it is really a con drum of sorts so in order to really address the challenges that we're that we're really up against we have to go after the combination of addressing the access issues and and and ensuring that we're feeding the the primary care and Specialty Care deserts and ensuring that you you have mechanisms to tap into the health care that you need at the highest possible caliber but you also have to address insur uring that there's food on on on the table and not only ensuring that food is on the table that you have healthy options and that you're educated on on what those those food sources are you're also going to have to address ensuring that there's a roof over the community's head but not only that you have to address the environmental factors that go into those environments in which they live because those various allergens and and uh uh just the environment can play into uh the chronic disease uh State and in the in the various indicators out there as well so at the end of the day what this really paints a picture on is there is a National Health Equity crisis that is occurring and we have to really St take a couple steps back and address this in a multifaceted way we all have to be octopuses and and really uh you know multitask as as we uh navigate through this really a great overview I think of that and thanks for answering I mean I you know kind of a difficult questions I pose sometimes so I appreciate it this I think this is another difficult one um and it comes to kind of the fiscal responsibility of of hospitals right I mean and not kind of a political question but more so a financial question how is it viable for hospital in you know or Healthcare instit institions to work on providing food and providing you know like you said a roof over their heads or making sure that pollution isn't going on uh you know next to an elementary school or all these things that we've seen that seems like that's challenging because you're primary job of course is to provide health care but you can't really provide Health Care effectively or efficiently if those other things aren't going on like you just mentioned yeah how do you financially balance that as a CEO and and I I would say is is is most definitely challenging but um but most certainly I think that the biggest challenge here is the fact that um it's almost too late by the time individuals tap into and Access Health Care Systems and yes I'm a a health care executive but at the end of the day my personal goal is to keep the community well and out of the hospital that should be everyone's goal the the goal of a c o should not be oh let me fill all of my beds I I actually want my hospitals to be uh busting it the seams busy no that is absolutely the opposite effect of of what I want to accomplish my a great day for me would be for me to be able to uh say that the community did not have to access my emergency department because often times they're using the emergency department as the only form of primary care or specialty care because they can't access those resources on a day and day out basis but at the end of the day to to Really address the the fiscal question this is not a one-sized fits-all where where the Health Care system is the single most accountable person for addressing all of these various needs because really and truly what we're talking about is public health what we're talking about is Community Health and in order to address public health and Community Health it needs to be a community centered public centered approach to really addressing this and a key constituent to that obviously is the Health Care Systems Executives and and administrators but really what we need to do is we need to approach this collectively and and really start to get out hit the hit the the feet to the ground and and really at a Grassroots level get out there and work with the community so so this this shouldn't be something that is done to the community um in a vacuum and certainly in in a boardroom in your Ivory Ivory Towers you need to get out there with the community get the voice of the community at the table really tap into what they need and really listen deeply and intentionally to what the community is telling you you and this is this is something that honestly has has me been so meaningful to me uh as a as a leader I'm I'm not only navigating through the four walls of the organization that I'm leading I'm most certainly getting out out uh putting my my feet to the ground and actually listening to the community and I I I take a very intentional approach of establishing Community listening sessions and establishing Community advisory councils where I'm welcoming the community in and actually offering up a seat at the table for the community to to to play a very pivotal role in the conversation because if if if the community is not having the conversations with you you're not able to really brainstorm on how you can how you can skin this cat and there's multiple ways to skin a cat you also have to get the POC policy makers in in the room because policy change is is pivotal to the sustainability because you you have several millions and billions and trillions of people living across the country in poverty and the The Advocate The Advocates and the policy makers need to really get involved and engaged at addressing that so absolutely there's accountability on on the health system level but is a larger crisis than than just a health system so you have to really balance things from from what you're saying and then so with the community work that you're doing you know as a CEO of course your your time is is valuable um you know so every every hour that you spend somewhere has to uh you know Drive some kind of of result for some of the CEOs listening has that taking that time with the community being there with the community has that benefited the organ organization in terms of trust in terms of members having an or patients having an easier time interacting with your institution uh I can tell you that the the walls of the community is always up uh just becau and and and I can honestly tell you speaking from the voice of the most underserved vulnerable black and brown communities especially especially knowing full well that and and I I I really high at this that um and and here's the reality Shock black and brown people specifically are far more impacted and fair worse on virtually every Health Care issue out there from heart disease to kidney disease to asthma to diabetes to hypertension to cancer mortality to maternal mortality to stroke to mental illness to addiction across the board and with that being said with that reality shock the trust is not there the trust is fundamentally broken and I can honestly tell you from my perspective my trust was impaired my trust was fractured my walls were up and I I almost did not believe anything that I that I was hearing and and any intention to to engage was met with resistance on even on my side because of of these plaguing statistics but I can honestly tell you the approach that I described on continuing to be persistent and getting out there in a very um authentic way engaging with the community opening up multiple seats at that table and unmuting the muted voice of the community and giving voice to the voiceless and really hearing and understanding on a different level breaks away the walls of distrust that often occurs in in so many respects in in in so many ways and um and is a very effective strategy and it and also in order to really start to break away at a lot of that uh you have to talk the talk and walk the walk so you have to match the words that you you are articulating with action with with with tangible action that truly makes a difference and some real examples of that in terms of really starting to build up the Trust In in the community is is doing what you say you're going to do and one of the the very proud things that that I've offered as as a leader is getting out into the community and offering free uh community Community Health uh fairs where where you're providing that free access so you're you're going out to the community and offering and and opening yourself up to to be able to deliver real time gratification and that real time impact and starting to demonstrate that result that starts to break down the cycle of what we're seeing and starts to reverse the statistics that have uh last it for far too long very important advice for not just the sea Suite but all leaders out there who are looking to make a big impact I know that I'm definitely taking a lot of this start so I really really appreciate you coming on the podcast thank you so much for your for your time and I hope that we can uh invite you on again in the future absolutely please please do invite me and I just wanted to uh just uh thank you so much for just really giving this a platform uh it's most definitely uh a very imperative topic so very near to and dear to my heart</p>