Building a Culture of Health in Health Care and our Community
Kajua Lor, PharmD, BCACP
We as healthcare professionals and leaders need to recognize that to build a culture of health, we must take off our white coats and meet the community… The neighborhoods we live in, the places we work and play, impact the health of our community…
George Floyd. A Black man who died on May 25, 2020, as a white police officer in Minneapolis knelt on his neck for nearly nine minutes. A name that goes does down in history as a flashpoint of inequities faced by people of color and vulnerable communities. A death captured by a bystander on a video that went viral and sparked one of the largest protest movements in U.S. history, as well as a movement within health care.
Together, George Floyd and the COVID-19 pandemic revealed the true colors of our broken healthcare systems and the inequities faced by people of color and people disadvantaged by the system.
My experience as a Hmong American refugee
As a Hmong American refugee growing up here in Wisconsin, I was oftentimes the only person of color in the room, the only woman in the room, the only pharmacist in the room. I struggled with my identities and many times would feel like I was “lucky,” and I was the “underdog” in many of the spaces that I was in personally and professionally.
Being the “first” and or the “only” person made me question if I could be my own authentic self in the spaces that I was in. Early on in my professional career, I would hide myself and my identities as I felt that showing any vulnerability would mean that I may not be good enough.
Since the COVID-19 pandemic, I’ve learned that life is so precious, that there are so many things to be grateful for, that I can show up as my own authentic self and that I need to know my allies, people who support and are able to create positive influences around me.
When I saw the video of George Floyd’s death, I was shocked, angry and, then, sad. I felt disappointed in humanity. How can I influence change? Where is the love for humankind? What can I do to make things better where I live, work, and play?
I remember a white coworker who said to me, “I don’t understand why those Black people are so angry.” And I thought about my own privilege as an Asian American. Why did they feel comfortable speaking with me? Was it because I was Asian American?
I remember being part of a virtual listening circle to create safe spaces to hear from others from the MCW community after the death of George Floyd. I volunteered to participate as a note taker for the circle. I appreciated being a part of this circle as I learned from others in the room about their stories. As the only person of color, I realized that this was a safe space with many allies, raised my “virtual” hand, and said, “As an Asian American woman and leader, I experience microaggressions almost every day at MCW. There hasn’t been one week that I have not had a microaggression.”
Microaggressions happen and are real. Psychologist Derald Wing Sue, who has written two books on microaggressions, defines the term: "The everyday slights, indignities, put-downs, and insults that people of color, women, LGBT populations, or those who are marginalized experience in their day-to-day interactions with people.”
Research has shown that microaggressions, although seemingly small and sometimes innocent offenses, can take a real psychological toll on the mental health of their recipients. This toll can lead to anger and depression and can even lower work productivity and problem-solving abilities.
Some microaggressions I have experienced:
- Patients asking me “Where are you from?”
- Direct reports seeking recognition from male leadership as my recognition as a woman leader was not “good enough.”
- After returning from maternity leave, a coworker stated, “hope you had a nice vacation.”
- A staff member referring to Asian Americans as “Oriental.”
- After sharing that I was attending a blessing ceremony over the weekend, a colleague saying, “Oooooo! Spooky”
- A staff member’s written comment about a candidate that they “didn’t speak English good enough.”
Mountain or mole hill? I’ve learned to pick my battles. Will I be working with them in the long term? Is it worth it to say anything?
I learned that one of the officers in the video who was a bystander, watching the death of George Floyd, was Hmong. I remember the hatred toward the Hmong community for letting George Floyd’s death happen. Many Hmong were targeted with death threats. It seemed that there was a perception the inaction by one member of the Hmong community reflected the entire Hmong community.
How do we create change with people who “don’t see color?” How do we change when there are differences in opinion on the approach to building inclusion and belonging? How do we learn from one another and embrace our differences? How can we move forward when we remain behind in the work that we do?
Race was created as a social construct, not a biological construct.
We as healthcare professionals and leaders need to recognize that to build a culture of health, we must take off our white coats and meet the community.
According to the Robert Wood Johnson Foundation, “Building a Culture of Health means working together to dismantle structural racism and other barriers so that everyone has the chance to live the healthiest life possible.”
The neighborhoods we live in, the places we work and play, impact the health of our community.
I’ve learned over the years, working with community, that I can be my own authentic self in the spaces that I’m in and that I need to show up when times get tough as an ally for others.
Each of us has a different story and a different walk of life. We need to embrace each other as humans to be able to “see” one another and develop a deeper understanding -- to learn from one another to be able to move forward.
Take action: Practice inclusive leadership
Has the needle moved? Progress has been made; however, the journey has just begun and will continue to be a long one. Many hospitals and healthcare systems have expanded positions and resources to support health equity efforts. Many organizations have provided more budgetary resources and infrastructure in efforts to build health equity.
At MCW, the Office of Diversity and Inclusion developed the Inclusive Excellence Framework. This framework showcases how we all can create communities of safe spaces for others to ensure all feel they belong.
We must develop inclusive leadership skills. Inclusive leadership is defined as “leadership that assures that all community members feel they are treated respectfully and fairly, are valued and sense that they belong, and are confident and inspired.” (“Workplace Inclusion Network – Reflections from our Virtual Roundtables ...”)
Strategies to practice inclusive leadership:
- Take time to make a personal connection with your team and your patients (if applicable).
- Develop topic discussions with your team that incorporate inclusive leadership principles.
- Describe resources for health and well-being.
- Address fears – listen with empathy.
- Cultivate compassion for yourself and others.
Spend some time to reflect on equity, diversity, and inclusion:
- What does diversity mean to me?
- "When have I or someone else been treated equally, but should have been treated equitably?" (“Discussion Guide DEI: The Basics – Part 1”)
- Think of a time when you felt excluded. What were your feelings? How did they impact you?
- Think of a time when you felt included. What were your feelings? How did they impact you?
- How can I help others to be/feel included? Valued?
Take action:
In the next month, what one action will I commit to that promotes diversity, equity, and/or inclusion? (i.e., “I will engage in a conversation with someone whose opinions differ from my own.”) (“Discussion Guide DEI: The Basics – Part 1”)
For further exploration:
Resources from the MCW Office of Diversity and Inclusion:
Videos:
Kajua Lor, PharmD, BCACP, is Founding Chair/Associate Professor in the Department of Clinical Sciences at MCW School of Pharmacy. She is a clinical pharmacist at Sixteenth Street Clinic, a federally qualified healthcare center serving Spanish-speaking communities one day per week. Dr. Lor was a fellow of the Robert Wood Johnson Foundation Clinical Scholars Program from 2017 – 2020, a leadership program to build healthier and equitable communities. She is a community-engaged researcher building a culture of health with Hmong refugees.
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