Advancing Equity:

A Leadership Mandate

Renée Branch Canady, PhD, MPA

CEO MPHI

Vermont Care Partners

March 15, 2018

Engagement of / Advocacy by community

members who want to create change

Staff empowered to

respond, challenges

to status quo

encouraged and

welcomed;

organizational

readiness

Endorsement /

Mandate by

leadership

Leadership

Community

Workforce &

Organizational

Capacity

Collective Impact:

“Three are greater than One”

Leadership

Community

Workforce

Leaders in Public Health are:

• Generally driven by a profound and

fundamental sense of mission.

• A sense of purpose motivates them to

leave the comfort of the sidelines and

wade into controversy

Koh & Jackson (2009) Fostering PH Leadership, Journal of PH, 31 (2), 1999

Mission & Controversy!

“Public health problems pose special

challenges. They are generally enormous

in scale, stem from numerous and highly

complex causes, play out in the public,

impact a vast array of stakeholders, and

require unusually long-term solutions.”

Koh & Jackson (2009) Fostering PH Leadership, Journal of PH, 31 (2), 199

The practice of Leadership through a HE Lens

is not for the faint at heart!

Self Assessment:

Getting out of our Own Way!

Unconscious

Incompetence

Conscious

Incompetence

Unconscious

Competence

Conscious

Competence

COMPETENCE

CO

NSC

IOU

SN

ES

S

Introducing:

Dialogue-based Health Equity Assessment

Tool

Practice: Leadership

1 2 3 4Leaders

intentionally

avoid

considering

health equity

and the social

determinants of

health in

decision-

making.

Leaders do

not consider

health equity

and the social

determinants

of health in

determining

policy

positions,

allocation of

work force,

and budget

decisions.

There is

evidence of

leaders using

health equity

and the social

determinants of

health as

criteria in

determining

policy positions,

allocation of

work force, and

budget

decisions.

Leaders

explicitly use

health equity

and the social

determinants of

health as criteria

in determining

policy positions,

allocation of

work force, and

budget

decisions.

TONE AT THE TOP

“Starting with WHY”

Why bother?

Why have we made time to talk about

health equity?

Why would you be open to embracing

this work in your leadership role?

A Health Equity Lens

• Seeks out what is unfair in order to reverse or avoid it

• Aspires to apply justice in serving individuals and families

• Recognizes the impact of social resources on the care and

behavior of individuals and families

• Identifies and facilitates social opportunities for individuals

and families to readily/easily attain well-being

“SEEING DIFFERENTLY”

Health Equity Leadership is framed

not from having all the answers,

but from asking the right questions

“SAYING DIFFERENTLY”

Changing the Questions

Instead of only asking:

Why do people smoke?

Perhaps we should also ask:

What social conditions and economic

policies predispose people to the

stress that encourages smoking?

Who lacks health care

coverage and why?

What policy changes would redistribute

health care resources more equitably in

our community?

How do we connect isolated

individuals to social supports?

What institutional policies and practices

maintain rather than counteract people’s

isolation from social supports?

Who lacks access to healthy food

options and why?

What policy changes would redistribute

healthy food resources more equitably in our

community?

“This requires removing obstacles to health such as poverty,

discrimination, and their consequences, including

powerlessness and lack of access to good jobs with fair pay,

quality education and housing, safe environments, and health

care.” -RWJF/Paula Braveman, UCSF

• The Opportunity(personal / interpersonal)

• “Doing Your Own Work”

• The Mandate (institutional / cultural)

• The courage to take Risks

“DOING DIFFERENTLY”

• In all that you saw and heard here, what stands out for you as particularly relevant or stimulating in terms of your work?

• As you see yourself trying to apply these ideas, what challenges do you envision experiencing?

• What would you need to overcome these challenges?

• As a leader, how can you help create the world you want to work/live in?

“Be not weary in well-doing, for in

due season you will reap if you faint

not!”

The Apostle Paul