Culture of Equity
Raising awareness and promoting anti-racist approaches to quality improvement.
The goal of the Culture of Equity pillar is to develop a platform of health equity in the CQI community to raise awareness and tackle cultural and structural racism historically present in healthcare institutions.
*Definitions for anti-racism, health equity, and structural racism are below.
There are a few factors that are needed to create a culture of equity:
1. Familiarize yourself with the definitions.
In order to clearly communicate a message, we must understand what things mean. Having shared understanding helps to reduce confusion. Here are a few definitions to start with:
Anti-Racism - Actively acknowledging the fact that we live in a world that has and continues to uphold white supremacist, racist views, and positioning yourself to stand against all acts and systems that are racist.
Health Equity - The ability of each individual to experience the full potential of their health, without encountering barriers that are based upon one’s social standing or other perceived limitations.
Structural Racism - The compounding impacts of the cultural norms, policies, laws, and practices that produce racial inequity (Lett, E. Asabor, E., Beltran, S., Cannon, A., & Arah, O., 2022); The totality of ways in which societies foster racial discrimination through mutually reinforcing systems of housing, education, employment, earnings, benefits, credit, media, healthcare, and criminal justice (Bailey, A., Krieger, N., Agenor, M., Graves, J., Linos, N., & Bassett, M., 2017)
Read more definitions of common terms in our Culture of Equity Glossary.
2. Explore and acknowledge what is true: Racism is real. Learn the past and present history of oppression and inequities in this country and the healthcare system.
Efforts continue to be made to exclude pivotal information from the history books. This attempt to white wash the world has resulted in a lack of awareness of the true history of this country. If you desire to be antiracist, it is necessary to give yourself permission to explore (i.e., do your own research) and acknowledge the true history. With acknowledgement comes growth and change. Most importantly, we can only make changes when we acknowledge what has occurred. Although the truth may cause discomfort, it is more uncomfortable for those living with the oppressive effects of the truth. As we learn to accept the truth and sit with discomfort, we can work towards being anti-racist in our interactions with others and the work that we produce. This is a necessary component of fostering a culture of equity.
3. Begin the conversation.
Engaging in conversations about race and health inequities can sometimes feel new, old, challenging, exciting, risky, and/or very needed. However, they are necessary, especially if our goal is to foster a culture of equity. While engaging in these conversations, we invite you to be authentic and open, while being aware of your reactions and experiences (i.e., how your own identity impacts your engagement with others; mistakes you’ve made working with others across lines of difference).
4. Have shared language in your message.
To ensure that everyone is on the same page, it is necessary to be clear about what is meant through language that is used. When we speak the same language, we reduce confusion and can have goal-oriented conversations and a shared focal point.
5. Stay engaged in the work.
Establishing a culture of equity is an ongoing process and requires consistent engagement. In order to be effective and have a lasting impact, we must treat the mission of establishing a culture of equity as more than a task to check off of the list. Doing so communicates our recognition of the fact that this work is meant to have an impact beyond ourselves.
Heath Equity Champions (HEC)
A part of achieving the goal for the Culture of Equity pillar is identifying a health equity champion for each Collaborative Quality Initiative (CQI). Evidence showed that, although there has been a focus on health equity, a focus on anti-racism has been lacking across the CQI portfolio. Racism is a key driver of social determinants of heath. Interventions targeted toward mitigating racism at every level are necessary for the creation of an anti-racist environment. To meet this need, Anti-Racist Action Labs are offered to the HECs. These labs will focus on:
What is the goal/role of the HECs?
The goal/role of each HEC is to grow their collaborative’s knowledge on health equity and antiracism and identify opportunities to incorporate a health equity and antiracism approach into their work.
Who is eligible to be a HEC?
The Health Equity Champion should be an existing full time staff member within your collaborative. CQIs are not limited to 1 HEC. If you are interested in being an HEC, please contact Sheryl Kelly, PhD, LP at sheryl@med.umich.edu.
What are the expectations of HECs?
HECs are expected to attend regular workshops led by MSHIELD and act as a liaison between MSHIELD and their CQI. HECs commit to allocating 5 hours a month to participate in learning opportunities that are purposed to increase their knowledge of health equity and antiracism so that they can assist in the growth of their collaborative’s knowledge and efforts. By the end of their first year as a HEC, this person will be able to provide presentations and materials that will describe social determinants of health (SDOH) in the context of their collaborative’s specialty, identify opportunities and challenges in integrating health equity and antiracism into their approach, and propose next steps for their collaborative and member sites to address health inequities.
All Blue Cross Blue Shield of Michigan (BCBSM) CQIs have identified a HEC. For more information about the CQIs, please click the button below:
Anti-Racism Framework
All of the HECs will participate in Anti-Racism Action Labs and associated learning modules. These labs will assist each champion in gaining applicable knowledge to be implemented in their CQI. The following figure outlines the learning approach that will be utilized when working with the HECs:
