Improving Health Equity Through Leadership Development

McKenzie Schrank

When someone walks into a healthcare setting, there is a wide array of experiences they might have. If they are lucky, they might interact with a provider that has the capacity to listen and have a full conversation, and will dutifully tend to their needs. However, currently, in the American medical system, many providers are stretched thin and burnt out while others, in my experience, do not have the social skills or training to have effective conversations with their patients.

I knew I needed to go into preventative medicine before I even knew what public health was This decision was rooted in personal experiences that exposed the shortcomings of our healthcare system in treating patients

Growing up as a track athlete and the daughter of physical therapists, I was accustomed to attentive and effective care. However, when seeking medical attention as a college athlete and young adult, I found that healthcare professionals often dismissed my concerns and failed to provide adequate treatment. When my symptoms were not easily diagnosable, I had to advocate for myself to receive the care I needed.

Reflecting on my experiences in various healthcare settings, there have been times I’ve felt the provider did not understand me when I explained certain symptoms that could not be definitively seen or diagnosed by whatever test that provider conducted tIf I had not insisted on a treatment plan aside from “rest and fluids”, several issues could have been way worse than they ended up being. In these situations, I find myself feeling like I did in college in the athletic trainer's office after I knew I had injured my ankle during track practice. I remember trying to convince them that something was truly wrong; as if there needed to be a defined issue in order to be offered anything that would aid my pain or be treated with dignity and respect. As someone who has access to medical insurance and privilege in society, I recognize that those without these advantages face even greater barriers to quality healthcare

An issue that further compounds these communication issues for people of color is systemic racism and microaggressions. In Linda Villarosa’s book Under The Skin: The Hidden Toll of Racism on American Lives and on the Health of Our Nation, she tells the story of a woman who lost her baby due to complications during her pregnancy that medical personnel did not address adequately The patient came to the emergency room with legitimate complaints prior to going into labor, and the medical providers she saw sent her home where she continued to bleed The patient described feeling ignored while doctors downplayed her complaints

Black women across the United States are suffering from mistreatment, racial bias, and toxic stress triggered by discrimination. Villarosa notes that the consequences of this systemic injustice are dire, with rates of maternal death during pregnancy and childbirth increasing at an alarming rate, particularly among black women even those with higher income and education, which should help protect them against negative outcomes (2). I have been fortunate enough to receive the upbringing and education necessary to advocate for my own health and well-being, and to be heard when I’ve expressed additional concerns. However, the individuals described in these stories were not afforded the same opportunity due to the pervasive impact of structural racism. Healthcare providers who fail to adhere to the principle of "do no harm" are complicit in perpetuating this injustice

Awareness and conversation are not enough Community leaders, stakeholders, and medical professionals must be trained, confronted, and ultimately transformed into the leaders and agents of change we need them to be. If healthcare providers had the tools and training to have effective conversations with patients of all backgrounds, many life-threatening medical issues could be prevented, and treatment would be more successful. Then, if truly preventable diseases are circumvented, the medical system will be less burdened Lastly, if we bring people who have experienced the shortcomings of the American medical system into leadership and healthcare provider roles, they would better relate, converse with, and treat patients who are currently underrepresented and marginalized in those roles

As someone with privilege, I feel a responsibility to advocate for those who are marginalized and to shed light on the health inequities that exist in America. It is apparent to me that individuals without these privileges must fight to be heard and receive the care they need and deserve. While the issues I have come across as a patient in the American healthcare system have caused inconveniences and frustration, I know marginalized communities suffer severe consequences, both in the short and long term.

To this end, I want to bring attention to a program dedicated to empowering underrepresented voices and equipping communities with the skills needed to address health disparities that exist in America. As public health professionals, we have the platform and an obligation to advocate for those who cannot advocate for themselves

People, especially from marginalized communities, should be able to advocate for themselves in a healthcare setting and be heard by the people who are working to prevent and treat their ailments. They should also have the opportunity to be the leaders and agents of change that provide unbiased, equal treatment not just in the healthcare setting, but all over Colorado. That is why I have partnered with the Center for Creative Leadership (CCL) as a Communications Specialist for their newly launched leadership program This program is a partnership with The Colorado Health Foundation (TCHF) and is called the Colorado Collective Leadership Initiative (CLI) The Collective Leadership Initiative was highly informed by community members through interviews with stakeholders such as health and program leaders. The program was designed with the goal of creating better health and wellbeing for all Coloradans. It brings together individuals working in formal and informal leadership roles to tackle real health equity challenges in Colorado communities.

Co-designed and delivered by the CCL, this program offers a unique experience where participants – regardless of job title, skill level, or experience – can choose how they want to expand their community leadership skills and networks to have a greater impact, free of charge. Dedicated to racial justice, equity, and diverse representation in learning groups, participants work in teams with others across the state and their communities to tackle current, pressing health equity challenges This is achieved through Action Learning Projects During the 2022 program year, projects covered topics such as housing, resource access, food systems, and mental health Types of education provided include experiential leadership development, team coaching, access to the latest leadership development content, and opportunities to learn from experienced individuals, ask questions of panels, and participate in site visits. One alumnus stated she never had access to the type of leadership training she received during the program and learned more about herself and her leadership style just from completing one of the initial assessments.

During the pilot year of the Colorado Collective Leadership Initiative (CLI) in the spring of 2022, 95 leaders completed the program and gave feedback during and after participation Participants cited direct impacts on their personal networks, growth, knowledge, and skills Overall, 91% of responding leaders indicated they were on target or better in the focal leadership capabilities, and 75% indicated they were on target or better in the focal technical capabilities (1). Several leaders acknowledged specific helpful skills they learned during the program such as project management, communication, and time management skills.

One expressed, “In CLI, I learned resilience skills, which are beneficial to myself, and as secondary knowledge, I can share with others” Leaders also benefited from the guidance of mentors provided by the program Another leader said, “I learned from my mentor to recognize my bias and then to approach difficult situations from a lens of acknowledging the bias" (Kosovich, 2023) Beyond the leadership development program, these leaders are now part of a leadership collective they can lean on and reach out to send their messages farther and wider than they were able to before.

Updates will be made to each program to increase the impact of this unique program utilizing feedback from the 2022 participants Leaders gave feedback through formal and informal structures: morning debriefs, daily surveys, and side conversations This feedback changed program structure, content, and various other elements immediately when possible.

Using feedback gathered directly from program participants is just one example of how the CLI is working to increase health equity by providing space for marginalized community members to express how the initiative should be changed to meet their needs and the needs of future participants In this way, the Colorado Collective Leadership Initiative is not only giving community members a voice, but also gathering leaders from across the state to join together to bring much-needed awareness to health equity and access issues

Applications for the 2023 cohort are now closed; however, Individuals who identify with and serve communities of color, women, LGBTQ Coloradans, and those from formal or informal organizations who are passionate about improving health equity for all are strongly encouraged to apply for the 2024 cohort. To stay up to date on all things related to the Colorado Collective Leadership, visit our website at https://cocollectiveleadershipwordpresscom/ and sign up for our newsletter