J Burroughs

James Burroughs: "Improving health equity outcomes to address structural racism and its impact on racial health disparities will lead to positive health outcomes in the Black Community. Investment must be made in eliminating structural racism which is at the root cause of the problems that have led to unequal health outcomes. EQUITY is not EQUAL"!

The Equity Lens is a popular term in the field of equity, diversity and inclusion. The Equity Lens is not available in stores. The Equity Lens is not something you can actually touch and feel. The Equity Lens does not come with instructions or a score sheet to assess whether you are using it correctly. The Equity Lens is behavior change, culture change, equity actions, and systems change. The Equity Lens is vital as the world responds to COVID-19 and the impact it has had and will continue to have on communities of color.

The world must apply an equity lens to solve equity disparities exacerbated by COVID-19. These disparities were not caused by this virus. Instead, COVID-19 exacerbated the disparities and intensified their negative impact. Some of these disparities include, but are not limited to: health, education, economic development, employment and housing. This article lists a few suggested factors to consider when authentically applying an equity lens (solutions) to these issues related to the impact of COVID-19. These disparities must be addressed immediately and intentionally. Although this list is not perfect, I suggest these factors be used as a starting point towards equity action that in turn will lead towards positive outcomes for communities of color as we deal with the impact of COVID-19.

1. Define equity and demonstrate how to apply an Equity Lens

Equity is giving people what they need to be successful. Health equity adds to that equation by extending the need to produce healthy communities and positive health outcomes that are not predetermined by race. Equity requires treating people and groups DIFFERENTLY based upon their circumstances, situations or outcomes. Equity gives groups different amounts of time, monetary investments and resources based upon their needs. Equity is not treating people, problems or solutions EQUALLY. Racial equity can only be achieved by addressing racial inequities independently. Structural and Systemic racism must be addressed for different communities and identity specifically tailored solutions. These solutions can uniquely work for each community of color and addresses inequities in these communities through targeted and specifically tailored solutions. EQUITY is not EQUAL!

To make the point that equity is not equal, let’s look at the impact of COVID-19. COVID-19 has caused a high number of deaths in Black communities throughout the United States. The number of deaths is disproportionate to the Black population in those states and also disproportionate to deaths in other communities of color. These deaths are directly caused by structural racism and bias. Racism and Bias in healthcare has led to poor health outcomes in the Black community. Any equitable solutions to address these issues must invest resources in the Black community to address these specific health causes and outcomes. A non-equitable (equality) solution to these issues is to equally invest resources in all communities of color and posit that we need to help everyone. An equitable solution is realizing that the Black community will need something different from other communities to address specific disparities and that application of an equity lens and solutions will not be the same as in other communities. EQUITY is not EQUAL!

2. Identify the racial impact of COVID-19 on all communities of color.

COVID-19 is impacting racial/ethnic communities differently. Racial impact and outcomes within each community must be analyzed before equity solutions can be implemented. In order to design, develop and implement solutions to COVID-19 and its impact on communities of color, the impact must be specifically addressed for each community. Communities of color cannot be treated as one. Racially Disaggregated Data in health, education, employment, economic development, housing, discrimination and other areas must be analyzed and solutions must be jointly created and implemented with members of the impacted communities. EQUITY is not EQUAL!

3. Identify racial outcomes of COVID-19 solutions for the Black community

COVID-19 solutions in the Black community must be designed for positive health outcomes and eliminating health inequities for Black people. Asthma, high blood pressure, diabetes and other conditions are disproportionately affecting the Black community. This has led to a higher death rate for Black people diagnosed with COVID-19 in Chicago, Detroit, St. Louis, New Orleans and New York City. Structural and Systemic Racism has led to or caused poverty, redlining, racial covenants, housing restrictions, gentrification, food deserts and healthcare disparities in the Black community. Improving health equity outcomes to address structural racism and its impact on racial health disparities will lead to positive health outcomes in the Black Community. Investment must be made in eliminating structural racism which is at the root cause of the problems that have led to unequal health outcomes. EQUITY is not EQUAL!

Helpful Hint: Focusing on the Black community’s needs is not ignoring other communities of color, instead it is giving attention in an equitable manner to that community and realizing that other communities are being impacted differently. Immigrant communities for example are being impacted differently, different equity actions may be required. Equity solutions require equity actions that boldly, directly and unapologetically address the needs of a community. EQUITY is not EQUAL!

4. Racial identification and negative sssociation of COVID-19 with the Asian community will not be tolerated

Bias and Discrimination against the Asian Community cannot be addressed through silence. Equity solutions to COVID-19 require partnership with the Asian community to explicitly identify and address explicit bias and discrimination. This requires consistent actions that challenge mischaracterization of the virus as an Asian or Chinese virus and also hold people and systems accountable that engage in such inappropriate characterizations. Bold and direct support of the Asian community is imperative. Martin Luther King said it best, “The ultimate measure of a man is not where he stands in moments of comfort and convenience, but where he stands at times of challenge and controversy.” We cannot let the Asian community stand alone during this time of ignorance, bias and discrimination. We must say and do something. EQUITY is not EQUAL!

5. Intentional recruitment of employees of color must be a priority

The negative financial impact of COVID-19 and the current economic shutdown and downturn has led to furloughs, layoffs and reductions in force. These actions will undoubtedly negatively impact communities of color at a higher rate than the white community. Communities of color will experience higher levels of unemployment and layoffs. True equity actions is investing in these impacted communities of color and reducing the impact on these communities from furloughs or layoffs. The easy way out is to apply a traditional lens that will lead to supposed equal treatment, but unequal outcomes. If true equity is to be applied, action to protect the most underserved and marginalized communities must be a priority. Increasing efforts to recruit and hire employees of color is imperative. Companies must interview candidates of color for opportunities and create a pipeline for employees of color to work. Regardless of the current status, hiring pauses or hiring freezes one day will be lifted and companies must position themselves to still be in position to hire diverse talent. Intentional recruitment of candidates of color must be a top priority. EQUITY is not EQUAL!

6. Intentional retention of employees of color must be a priority

The saying is: last hired, first fired or laid off. Too often communities of color experience disproportionate impact when layoffs or furloughs occur. Many times companies do not use an equity lens when it comes to significant employment changes. Instead, they rely upon traditional factors such as seniority and performance (typically applied unevenly) to make lay-off and furlough decisions. While these are not bad factors, additional factors such as: 1) retention of employees of color to reflect communities served, 2) creating an inclusive and welcoming environment for a diverse group of employees and 3) creating an environment to promote diversity of thought and creative solutions, just to name a few, should be considered. Also, acknowledging biases and doing something about how biases impact tough decisions like who to lay off must also be addressed. These biases must not be allowed to negatively impact equity and diversity outcomes. Managers tend to retain people who are like them, people they went to the same school with, and people they spend personal time with. Sometimes those people retained are also people of the same race as them and not people of color. In order to maintain a strong equity, diversity and inclusion priority, retention of people of color must be an intentional focus. Any new workforce demographic after layoffs or furloughs should still reflect and maintain a diverse workforce. EQUITY is not EQUAL!

7. Intentional investment in businesses of color must be a priority

For the last month, businesses have been shut down. From Fortune 500s to Mom and Pop shops, limited sales are happening in the nation’s economy. The shut down is having a grave impact on the economy, especially in communities of color. Most of the businesses owned by communities of color are small businesses. They are successful in their own right, but they for the most part cannot handle long periods without revenue. These business also employ the most diverse workforce and contribute heavily to the growth and development of communities of color. With a prolonged business shutdown, these businesses are in the greatest jeopardy of going out of business for good.

Now is not the time to ignore supplier diversity strategies that intentionally invest in small people of color owned businesses. Instead, companies and individual consumers must double and triple down on their investments so that these businesses will survive and thrive again one day. Do not allow these restaurants, consulting companies, construction companies, law firms, musicians, visual artists, beauty and hair salons and others to close their doors for good. We must be even more intentional and diligent in using stimulus/bailout dollars given to large companies and individuals to invest in the supply chain for businesses of color. The application of equity actions is key to their survival. EQUITY is not EQUAL!

Helpful Hint: Non-profits that are led by and serve people of color must continue to be supported through donations and sponsorships for events and operations.

8. Conclusion and call to action

Many companies have signed off on pledges to be more equitable, diverse and inclusive. Many have equity, diversity and inclusion statements and committees. Many have hired Chief Diversity, Equity or Inclusion Officers. A few companies have even committed to building equity, diversity and inclusion principles into future business strategies for their respective companies. These strategies even have accompanying metrics and financial investment. These are all good things.

However, the best thing at this time is to demonstrate EQUITY ACTIONS in response to COVID-19 and the subsequent aftermath of its impact. Now is not the time to be silent. Now is not the time to ignore discrimination against the Asian community. Now is not the time to disinvest in equity, diversity and inclusion. Now is not the time to ignore equity, diversity and inclusion principles during layoffs and furloughs. Now is not the time to stop sponsoring and investing in non-profit and for-profit businesses led my people of color, serving people of color and employing people of color. Now is not the time to ignore equity, diversity and inclusion in the recruiting, hiring and retention processes.

Now is the time to show people where you stand in a time of crisis or controversy and do it with an EQUITY LENS and not an EQUAL LENS.

James Burroughs, Chief Equity and Inclusion Officer, is responsible for developing, implementing and advocating for a comprehensive health equity, inclusion and diversity strategy at Children’s Minnesota. He serves as an advisor to Children’s medical and operational leaders to address inequities in the health care system and advance efforts to align equity with clinical objectives and priorities.

(0) comments

Welcome to the discussion.

Keep it Clean. Please avoid obscene, vulgar, lewd, racist or sexually-oriented language.
PLEASE TURN OFF YOUR CAPS LOCK.
Don't Threaten. Threats of harming another person will not be tolerated.
Be Truthful. Don't knowingly lie about anyone or anything.
Be Nice. No racism, sexism or any sort of -ism that is degrading to another person.
Be Proactive. Use the 'Report' link on each comment to let us know of abusive posts.
Share with Us. We'd love to hear eyewitness accounts, the history behind an article.