Collaborating for Health Equity Amid Trauma

Episode 2 August 05, 2021 00:35:06
Collaborating for Health Equity Amid Trauma
Unsung Stewards
Collaborating for Health Equity Amid Trauma

Aug 05 2021 | 00:35:06

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Show Notes

During the COVID-19 pandemic, many health systems did not prioritize Black and Brown communities. When faced with this reality in Pittsburgh, Fred Brown founded the Black COVID-19 Equity Coalition to increase COVID-19 testing and address the social determinants of health for his community. From a self-defined “street kid” to school teacher to probation officer, Brown’s range of life experiences shaped how he approaches systemic change.
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Episode Transcript

Speaker 1 00:00:09 Hi, I'm Eli. So from Rethink Health, a Ripple Foundation Initiative, and we're hosting a new podcast series called Unsung Stewards. Yours are people like you that are taking responsibility to tackle the big question of our time. How do we create conditions so that all of us, everyone can thrive? You're not alone in wondering, can we break from business as usual in practical ways? Can we lead our communities and institutions to think and act in ways that will actually make a difference? In this series, you'll hear human stories about real people in real places who are taking on these questions. In this turbulent season, we find ourselves in today, we are speaking with Fred Brown, the president and CEO of the Forbes Funds in Pittsburgh. When Covid 19 hit his community in Pittsburgh, Fred noticed two things. One, the existing healthcare and public health ecosystem was not prioritizing black and brown residents and two institutions went back into their silos. Instead of working together, Fred helped to create the Black Covid 19 Equity Coalition, a collaborative of healthcare, university government, and nonprofit institutions to increase Covid 19 testing and address the social determinants of health for black and brown residents. Speaker 1 00:01:44 Fred's approach to system change is deeply human recognizing that institutional and personal trauma can often serve as a barrier to collaboration. Speaker 2 00:01:55 You cannot solve a problem traumatize, you can't hear a solution traumatize. But with what you will do in trauma is you'll revert back to what you know, Speaker 1 00:02:09 What is it about your life journey, you know, where you grew up, your family life, events that have happened to you, that that draws you to be a steward in this time. Speaker 2 00:02:20 So growing up, I had a duality. Um, I was a street kid, um, but my mother ensured that I was academically sound and she reminded me every day that I was in high school that when I turned 18, I had two choices, uh, three military college or outta her house. And so, and I knew she meant that and this important value of education. And so my mother instilled, doubted me in a way that no matter what I did, no matter, I mean, I've been arrested by the police several times. I've gotten to, I've had fist cuffs with the police growing up. Um, the police did not treat me well as a kid or as a young adult. And so I have a very vivid experience of having a gun put to my head by the police when I was a teenager. And so that journey led me to, um, becoming a school teacher early on because I felt like I, I understood kids, I made a connection to kids, and, um, I was, I felt like I understood what they needed. Speaker 2 00:03:35 And so early on in my career, I was a school teacher and a probation officer. And so I, I worked on both ends of the spectrum. So I got to work with kids who were academically inclined and also got to work with kids who were criminally minded, right? And so I was able to express to them repeatedly that you can spend time with me in the daytime here, or I could see you at night in the facility. And so I would be able to tell kids like, I'm probably gonna see you in my other job cuz you don't listen. And sure enough, I would see them and they would put their head down when they saw me and I would be like, you know, what does it take for you to hear me so I don't have to have this experience? And so during that phase of my professional career, the gang epidemic hit, the gang epidemic had a severe impact on my community. Speaker 2 00:04:34 Um, during a three year period, I buried partially over 50 kids from gang violence. And during that time period, I had a kid kind of die my arms. And one of my worst cases was I got a phone call, um, to leave a kid in the hospital because this is before they put police on the hospital, emergency room doors when gangs first hit, if they a gang members would follow an ambulance to the hospital and then shoot, come in the hospital and shoot the kids while they still were on the operating table. And so, because of my reputation, I got a text, I called the number, and it basically told me that they're coming to finish the job on this particular kid. That was one of my paroles. And if I was there, they couldn't guarantee my safety. And that just broke my heart. Um, this kid was brilliant, had got him a scholarship to college. Speaker 2 00:05:36 Three days later they got him and it, it did something to me on the inside that just changed me. You know, the death actually watching a black kid turn blue. Um, you hear that, but actually watching the life leave somebody is it, it haunted me and has haunted me the rest of my, my life. And I remember a mother coming up to me who I got pointed out in the street to, and she came to my office and said, I need you to help my son. And I said, uh, which department is he with? Which, which jail is he in? And she's like, he's not in jail. He's, I want, I don't want him to, to go to jail. And I said, well, I can't help him. And she looked at me with this quizzical look and was like, did you hear what you just said? And I said, I mean, I'm so locked into if you're not on probation, I can't help you. Um, it didn't occur to me that she was trying to prevent her kid from being on probation, which I, I'm all about, but at this time I didn't have any, um, experience with the system that I could create within the system. Speaker 1 00:06:50 Yeah, that's, that's such a heartbreaking, but, but also fascinating journey, um, to becoming a system thinker. Fred, one of the remarkable ways you've, you've stewarded leaders during these turbulent times is through the Black Covid 19 Equity Coalition. And in Pittsburgh, what you've done is you've been a part of creating a coordinated strategic network to mitigate the impact of the pandemic on black and brown communities through testing, um, through addressing comorbidities and social determinants of health. And you've galvanized, um, hospitals, federally qualified health centers, universities, um, some government institutions and nonprofits all in this effort. Um, could you tell us more about the story around that? Speaker 2 00:07:35 Make a long story short, I made some phone calls and convened a group of epidemiologists, epigeneticist bioethicists doctors, FQHC leaders, the cultural nuances that Covid will present, require culturally specific responses that we don't feel the current system is capable of addressing in a salient manner. Um, they said, thanks, but no thanks. We were disappointed but not discouraged. And so we doubled down and reached out to Dr. Levine, who is the secretary of the Department of Health for the state. And our idea at that point was we thought we could leverage the existing resources in the sector to optimize the use of the FQACs and wrap around and create a wraparound service models with nonprofits based upon my role and poise foundation, Mark Lewis. And so both of us was at the table and thought that our platforms would allow strategic collaboration. And so Dr. Levine loved the idea, got on board, the work with her is beyond covid. Speaker 2 00:08:41 Our theory of change was that Covid was the tip of the spear, but the comorbidity issues that contribute to the disproportionate impact in black and brown communities predated covid. And so this notion that we would, would fix this as a covid matter just wasn't real to us. And if she wasn't interested in a long term relationship, then we, we don't need to have any further dialogue because we're not talking about the same resolution that she was a hundred percent on board. And since that day, we have a monthly meeting with her, this group has volunteered their time for over 33 weeks for free. Speaker 1 00:09:20 Wow. Speaker 2 00:09:21 Um, there, over the course of this time, we've created eight Covid 19 task force, either created co-chair support. And so we, there was a group that was, uh, a data group that, that was being supported by the Hines Endowment. Um, we got caught into that group, began to really cultivate a cross-sectoral approach to the work, which really took off and really led us to believe like the power of inclusion. The words that we got from, uh, researchers were, we would've never thought about problem solving if we had not been in this relationship with y And the other thing they realized, like the docs and epidemiologists were, they didn't understand how difficult it was to be us in the non-profit sector. Like Hmm. Now that they saw it on a day to day basis. The, the hurdles we had to jump over the hoops, the education, the telling people over and over stuff. They were like, how do you do this? Like every day? I'm like, that's the work. Dr. Levine wanted us to share our ideas across the state. And so she asked us to create a statewide coalition, which we did. And her expression, the complexity and the coordination of what we put together she's never seen before. And because we're talking about optimizing existing resources and then executing a gap analysis to look at what's needed, Speaker 1 00:10:52 That's really interesting cuz it's, um, there's so many nonprofits and foundations that, that give a lot of lip service to oh, the importance of strategic collaboration, but in these kind of moments actually tend to sort of constrict. But this is, this seems like it's a really specific example of, of why it's worth it. Um, and yeah, Speaker 2 00:11:12 It's definitely worth it because we're all vulnerable. Our, our philosophy 33 months ago when I took over at the Forbes funds was that the sector would have a stress and shock that would have a similar impact that it did in 2008 and nine. And that we need to be forward thinking and create strategic coalitions that ward off the threat to the sector because the collective work of the sector was more important to the community than to any one institution. And so when I got to the Forbes funds in 2018, I froze our assets for a quarter, restructured our grant making, partnered with the Community Research advisory board, and basically required grantees to strategically collaborate to even sit down at the table to ask us for money. And we didn't want letters of support. I've been writing letters of support for 30 years. I wanted to know that you and your board talked to this board and y'all have thoroughly assessed what makes sense and what doesn't. Speaker 2 00:12:17 And so our resource is gonna be catalytic to support your idea or we're not gonna support that. And so we've created a whole new network of strategic practitioners who are now seeing the value of that work in no way that we ever believed a pandemic was coming out. I would be lying if I told you we knew that was coming, but because our infrastructure was being prepared for the stress and shock, it didn't take a lot for us to ramp up and create new programs. And so on March, April-ish, we started a, a call for community solutions, which we've had since March 978 Zoom meetings and 12,586 participants. Wow. And so we used that platform to really test the validity of ideas, inform the, the sector about what content experts are saying out of their mouth. So we had funders on the school, superintendent on Dr. Speaker 2 00:13:22 Levine's been on the show. So anybody that's leading the charge on anything COVID related, we've invited them into the call to talk about their work. My raw estimate is on an annual basis in the city of Pittsburgh and Allegheny County, which is a compliment of 1.3 million people, there's about 4.5 billion in assets being distributed in the region. That you tell me what you see that's been solved mm-hmm. <affirmative>, right? I, I challenge people on this and they get mad. I'm like, I'm not Debbie Downer or Danny Downer, I don't wanna pick on women. It could be Danny Downer. I'm just saying if it, it is not about money, like we have more than enough money to fix the problem, there's something else wrong. Mm-hmm. <affirmative> right there. There's something else inherently wrong. If almost 5 billion in assets in multiple sectors is not fixing a problem, one is because those sectors don't work well together. Speaker 2 00:14:29 They don't collaborate. Yeah. And so for us, we've been trying to figure out how to work with each of those institutions behind the scenes to really lift up examples of collaboration and to really, um, create space for strategic alignment and to honor each other's difference, but to do it in a way that we get something done. I don't believe any of us can solve today's problems by ourselves. Today's social phenomenon is far different than anything I've ever experienced in my lifetime. I believe that Einstein said, and I believed this, that you cannot solve a problem with the same energy that created it to arrive at collective genius. It requires everybody participating in that process to be fully vulnerable and available at the same time. Um, I use the word naked, right? Speaker 1 00:15:31 Yeah. And you, you know, you mentioned in the previous conversation about the resistance you've experienced to collaboration. Um, and you used the word, you know, it's connected to different traumas people are experiencing. Um, and if I may just quote you from one of your articles, you put, you said, the cycle biological impact of stress and trauma on our ability to react to our environment is undeniable in many ways. We cannot generate new thoughts, emotions, and responses if our minds are preoccupied with holding onto the past. So take me back to the, the Black Black Covid 19 Equity Coalition and what you mean by like, how did, how did trauma inhibit different people or organizations? It could be institutional trauma, it could be personal trauma. Um, but but how did that show up with kind of not allowing people to be sort of vulnerable and you know, what you were just talking about naked in some ways to, to to work together and respond and adapt to a new situation? Speaker 2 00:16:29 For me, what I realized when I was in these spaces and high levels, the people who had the title of leaders were managers, not leaders. And it became very apparent to me when we started talking about problem solving anding, that that wasn't where their mind was at. It was really about optimizing the existing, existing system. And for me that was a problem because the existing system in February wasn't kind of black and brown people. So I wasn't interested at all in maintaining that and getting back to it. As a matter of fact, I thought this was a watershed moment that we actually can be different. And so I began to push people to think outside the box and got a lot of resistance. Um, and at first I labeled the resistance as racial racially charged, right? Because I was just like, I'm black and I'm asking white people and they're just not about it. Speaker 2 00:17:23 And so I walked away with this notion that maybe they're, I didn't think that person was racist. Like I thought I, I knew them a little bit better. Um, but them not listening to me, I don't understand that, right? I'm, I think I'm making good sense. And so what I realized is as I had deeper conversations with people, they began to express their trauma on a personal level, organizational level, community level, institutional level. And it came out in different comments they would make that didn't actually relate to while I was talking to 'em. So I was like, they saying this, I'm talking to 'em about that. Why are they bringing this up in this conversation? Like they, couple of that, well, um, people start talking about other historical traumas in different eras being relevant in today's situation, right? And so if, if you bring up, you know, what happened in Haiti or what happened in Africa, what happened in Germany, um, and you equate that to today, I have to assume in that conversation that you're holding onto some trauma that the pandemic has triggered in your personal life that is being brought to bear in this moment when we have a new set of issues that pandemic can build on, but it's not a result of the pandemic, right? Speaker 2 00:18:51 Mm-hmm. <affirmative>. And so there wasn't a XY correlation with the statement and the causal relationship with the pandemic. This person's undiagnosed trauma. Like there's undiagnosed trauma here. So I started talking to other people, they start seeing the same thing. And then I realized, oh, okay, this makes sense to me. You cannot solve a problem traumatize, you can't hear a solution traumatize. But what you will do in trauma is you'll revert back to what you know, you are not gonna take on the journey into the unknown because you, you can't predict what's gonna happen in the unknown. But to me, this is my experience as a person of color. For 246 years, our people was enslaved by Europeans for 135 years. We suffered institutional racism by the federal government. And for 56 alleged years, we've been free 56 years. Right? And you and I both know, and everybody that might listen to this know that that's not true. Speaker 2 00:19:52 It's not happening. We still live in tyranny in certain places of the country. There's still a plantation like mentality in people that has just been optimized into the 21st century global economy and plantation like activity about controlling people, how they think, what they think, how they execute what they think is very similar to being on a plantation. And so now new ideas that come out that you don't control and you don't understand creates fear. And if you already are suffering from trauma, I'm adding to your trauma by pushing ideas on you that you aren't comfortable with. And because I don't recognize your trauma, I push harder, which now becomes an atta now becomes an attack on you because for me, black people are dying and you're not listening. And so we have two different lenses we're looking at problem solving from. One is for somebody else, it's a matter of logic for me, it's a matter of life and death. Speaker 2 00:20:55 And so my tenacity, my anger, my passion could come across as being angry because for you, your people ain't dying at the same rate as my people. Your people got way more healthcare than my people. Your people got way more support than my people. Your people are sheltering a place better than my people. And so I gotta care about my people cuz you ain't caring about my people. Mm-hmm. <affirmative>, right? And, and if you going to criticize me and critique me and judge me for caring about my people, I never once said anything about you caring about your people. Mm-hmm. <affirmative>. But if you're in a position to control the resources, the execution of ideas, and you do that offer the benefit of your people and subjugate other people to the possibility of their ideas while you make the, is you have a reality that's duplicitous that's not serving humanity. And for me, I'm struggling in this space because the nonprofit sector is oppos is supposed to be about humanity of all people, not some. And so I push back intensely when I see the dichotomy that we're not serving humanity. Speaker 1 00:22:08 So it seems like you are saying that if, if we're gonna engage in any collective problem solving for humanity, um, we're gonna have to understand the complexity behind what people are holding onto, um, their trauma. Do you have any examples where it was important for people to understand your complexity and, and what you were carrying as you were engaging in collective work? Speaker 2 00:22:31 Um, I'll give you an example. Two years ago the work I do in Berkeley around cancer, I co-chair a group out at Berkeley around in the Cancer Free Economy Network. Um, and two years ago I pitched this idea to create an advances program to create a leadership continuum. Cause I'm trying to ensure that leadership and minority representation remain about 25% in our, in our ecosystem. You know, I would just acknowledge that I'm, I could be very technical and analytical in my pronouncements of my ideas. And so I think people got the idea, but they kept asking questions and it was frustrating to me. I kept saying over and over the stuff wasn't seeping in some younger people got the idea, they renamed it and re retooled it and called it the Emerging Leaders Cohort. And it's taken off. It's not my idea anymore. It got turned over to some young people. Speaker 2 00:23:24 Mm-hmm. <affirmative>, they took it. I mean, I was on one of the calls and they talked about their idea. And to be honest with you, a part of me was bristling and sad. Like, well, how the hell y'all wasn't thinking about this two years ago? Yeah. And y'all can't even say I created it and then I had to like put my ego and check and like pat myself on the head and tell myself to calm down because this really was one of my babies. I did wanna see, you know, it wasn't just, I have a million ideas, but this was one that was close to my heart. And so it did, I did feel a certain kind of way. Initially I felt relieved and also I felt, okay, I can let go. We live for the innovation, we live for the human transformation. But the thing that gives us life is that people take our ideas and make 'em nears. Speaker 2 00:24:15 Mm-hmm. <affirmative>. But the thing that makes our life sustained is that people acknowledge that we were thought partners in that process because for people of color, and most people won't recognize this as a issue, but black people's ideas have been being stolen since the beginning of time. This is another one of those cultural nuances that people just don't get. Right? They don't take into account what's happened to black people and brown people and Native American people since the beginning of time. And so today, because you didn't actually enslave somebody or you didn't, um, lynch somebody or you didn't, um, beat 'em over the head, you didn't run a fire hose on them and their kids. That doesn't mean it. That takes away their emotional content and feeling of historical trauma and your lack of sensitivity to the things that trigger. That to me illustrates a level of your lack of situational awareness. If we wanna create harmony that ultimately creates collective genius that allows us to problem solve how we honor each and every person is our daily responsibility and duty. Speaker 1 00:25:31 It's really, it's really interesting that you're able to, to really notice, um, and reflect and interpret your own personal experiences and emotions, uh, around engaging in collective work. Um, relatedly, how do you, how do you navigate moments when you feel misunderstood when you're problem solving in a collective capacity? Speaker 2 00:25:51 I was recently a keynote speaker on the panel conference, and for the first time that I've been in a meeting, it was with three white women. The white women all acknowledged that I was brilliant. And one of them in particular didn't say a black man that was brilliant. They said a brilliant man, right? They just acknowledged that my thoughts and ideas were brilliant not to be defined because I was black or white, but the ideas themself were, had a causal relationship for problem solving. It was brilliant nonetheless, whether I was black or white. And it was the first time I can acknowledge that I've been in a group of white women who readily accepted me for who I was, acknowledged my brilliance and gravitated towards it as a problem solving mechanism. In most instances, white people become fearful of me because of my intellect and they expect me to stand down and I won't. Speaker 2 00:26:54 And because I won't, this is where I think the slave subconsciousness comes in. I should submit to them because they're uncomfortable. And if I don't, I'm the angry black man, right? Which I don't subscribe to any of that. I am a person of human nature serving humanity with black skin. I'm a spiritual being, having a human experience. I don't see myself, um, in a way that should define my ability to have or have not. I see myself as a doorway and a pathway to resolution and solves problems for humanity. And so for me, I've come to a point in my journey where those people who don't wanna be on that train, who don't wanna take that journey with me at this stage in my life at 56, I cannot give that energy. I can only give energy to people who will at least own their own issue, their own ism and acknowledge through whether calling me bright, brilliant, collaborative, a partner, a thought leader. Speaker 2 00:28:03 I can only give my insight to that. Amplifying stewardship and the other things I'm involved with really has created a space for me to be me that doesn't exist in normal places. And I think anybody in this space needs to be around people who you could be your authentic self around, but realize that you might have to scale that up or down in different environments. The greatest challenge I have is when I start, when I start unleashing who I'm, what I'm thinking, 99% of the people around me walk away. They, it's too much for them. And, and I keep telling them like, this is how I think. I can't help, but I can't help that my mind processes dated the way it does. And it comes out like that. And I feel bad because I know it turns some people off. I know that, um, people don't always understand what I'm saying, but I'm also beginning to be in love with the fact that that's who I am before I hit it. Speaker 2 00:29:13 Now I'm finding spaces like with the rsa, the club will run with you guys where I could be my authentic self. And, and I'm sure everybody doesn't get it, but more people do. More people comment, more people acknowledge, oh, I think differently. This is what I was thinking. This is what I heard. That is a space where it's biblical to me that that's where it's still sharpened steel. Mm-hmm. <affirmative>, right? Because if I don't actually share my big idea, it can never be sharpened to be the best idea, right? If it just stays in my head and I never share it, and then I put it out in the universe and it flops, I, my subconscious is gonna blame the system cuz y'all didn't get it. But if I was in a room with other people pushing back on the idea and they showed me the flaws and the blind spots I had, then I would make the idea better if I believe in it or I would catapulted and let it go. Speaker 2 00:30:14 Some of us are in spaces where people don't recognize our brilliance and our own families and our own communities. And so to be in a space where people recognize you're brilliant and don't shy away from it, but actually pull theirselves into a relationship with you to optimize that. I'll tell you this, I haven't had a job yet that the team I was with got me. Do you know what that feels like to be at work and never can fully express your real ideas that you always have to compartmentalize the idea in such a way that it didn't scare off people and make 'em feel whatever. And you were sitting there sitting on nine more things that that idea encapsulates, but you only could share one aspect of it. Speaker 1 00:31:03 And so what I'm hearing is that it's a challenge to translate and, and pull apart and uncover some of these brilliant but complex content and ideas. Speaker 2 00:31:13 And this is the thing that got me, this is a, a coach. I had a mentor and a coach. So for a whole year I'm telling them these ideas and things like that. So I was telling him something recently and he said, I get it, I get it. That makes sense to me. And so I paused and I said, what do you mean you get it? I said, I've been telling you this for years. He said, I never told you I got it when I was listening. He's like, oh, I get it. You thought, because I could regurgitate what you said, I understood, I didn't understand. I just was repeating back what you said for clarity. I never knew he didn't understand. I thought because he repeated back what I said, he's brilliant that he got it. And so when you know somebody that's brilliant tells you they didn't get it, and the whole time you've been rolling with 'em, you think they got it and they like are honest and transparent and say, I just got it. That's when you realize, man, who else is not getting it? Who else is sitting in the room saying nothing or shaking their head, but in reality they're not getting it and he pushes back and say, that's on you. You gotta be a different communicator to me to help me get it. And I know this is frustrating to you because you already off to the next thing thing, but if you can't do this by yourself, it's on you to help me understand. Speaker 1 00:32:45 That's actually, it's actually a really profound and relatable story for a lot of stewards who, who wear hats as system thinkers. You know, how do we become better communicators? Um, that's so fascinating. One thing I'm noticing is that you're really reflective and you're, you're really contemplative, you know, how do you, how do you ground and anchor yourself? Are there any practices that you engage in? Speaker 2 00:33:12 One is I push my, my team to push me to push back to if they don't like something I say or I want to do, I push them to push back to own their space. Two, I have a group of elders who keep me grounded. They remind me no matter how big my head might get from whatever, they remind me how small my head really is. Um, I stand on their shoulders. Um, they remind me how brilliant I am, but how much more I have to, to do, to be better. Um, I'm humbled by the opportunity to serve humanity and I'm humbled by people acknowledging my contributions to humanity. It just forces me to think more deeply about how I need to be better, how I need to share, how I need to be a better communicator, how I need to create some balance. Speaker 1 00:34:16 Well, um, Fred, thank you so much for your time. We've gone way over. So I really, really appreciate it and I know that you are like triple booked and whatnot, so, um, I really appreciate it. Um, this has been a really fascinating conversation. Thank you for sharing your life journey and also just some of your, just like what you're currently thinking about and wrestling with. Speaker 2 00:34:33 Appreciate it. Speaker 1 00:34:37 Red Brown is the president and CEO of the Forbes Funds in Pittsburgh. You can learn more about the great work of his [email protected]. This podcast would not be possible without the talents of Bobby Millstein, Jane Erickson, Brad Gerard, and Jessica Estelle Huggins. I'm your host ua. So from Rethink Health, a Ripple Foundation initiative, and you're listening to unsung Stewards.

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