Latest / StartUp Health NOW Podcast / Prioritizing Health Equity Through Sustained Action and Equitable Innovation

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Prioritizing Health Equity Through Sustained Action and Equitable Innovation · StartUp Health NOW Podcast

• 0:00
  If your data at your institution at your company are showing disparate outcomes, um, for people, whether it's based on gender, race, ethnicity, sexual orientation, ability, immigration status, whatever it is, we are not that-- Our systems and structures are not valuing all people equally.
• 0:19
  [upbeat music] Welcome back to Startup Health Now, the podcast where we celebrate the entrepreneurs and innovators who are transforming health. I'm your host, Logan Plaster.
• 0:30
  Last year, Startup Health launched a health equity moonshot with the goal of creating a guiding equity framework for how we support health startups.
• 0:39
  That work has been led by Chief Impact Officer, Kappa Muelpalla, who goes by KP for short.
• 0:45
  One of the first things KP did was to build a cross-disciplinary impact board who could help us guide our policies, and one of the first people he turned to for that task was today's guest, Dr. Aletha Maybank. Dr.
• 0:58
  Maybank is the Chief Health Equity Officer at the American Medical Association.
• 1:03
  In the world of health equity, that's a big deal because she guides critical policy decisions for an organization that numbers more than a quarter of a million healthcare professionals. We wanted to have Dr.
• 1:13
  Maybank in for a fireside chat to get a candid look at the work she's doing with the AMA and hear her vision for the future.
• 1:20
  In the conversation, which was hosted by KP Yalpalla and held in front of a virtual audience of founders from our portfolio, Dr.
• 1:27
  Maybank draws a line between intention and outcomes and explains why more institutions need to do the hard internal work of examining their inequitable structures. Here's KP to kick things off.
• 1:41
  [upbeat music] Maybe we could start with a little bit about your background and, and, and your experiences that led you to this role at the AMA. Yeah, sure.
• 1:51
  Um, I usually, you know, start off in saying that and, and more so as I've g- advanced in my career, you know, my roots in terms of, you know, where I come from, and I'm not gonna do like a long, long book, but the context I think of where I grew up, um, as well as, uh, where my family's from, um, in the Caribbean.
• 2:09
  I'm a dual citizen. I like to focus on that as the initial point because I think that gets lost oftentimes in these conversations around equity- Right. Mm-hmm... you know, why we're really doing this.
• 2:19
  And so, you know, I went to med school. I, you know, became a, a pediatrician. Um, I was, you know, pretty turned off by, um, medical sc- uh, culture, uh, you know, very ethnocentric, but also I just...
• 2:33
  I really didn't appreciate getting told as a pediatrician, you know, when I had patients come in, and they had all these other contexts of lives, of their lives, um, you know, that weren't equitable, whether it's, like, where they lived, what food they had access to, were the, were the parents able to, like, take their kids to go exercise?
• 2:51
  They all wanted to, but the ability to be able to do it was limited for many reasons.
• 2:56
  And so, um, I also was very interested in public health, so I ended up doing a second residency in preventive medicine public health, and that kind of, kind of put me, you know, squarely in the space of not only government public health but just this broader context and being able to pay attention to this- Right...
• 3:16
  your context of what creates health, right? That's the narrative that's really off in our country, that, um,
• 3:22
  most of healthcare mindsets around health rather, l-let me go beyond healthcare, but health is focused just on healthcare and what kind of services you have, you know, in terms of, um, hospital services or doctor's offices, insurance.
• 3:36
  All those things are important. Not negating that, but what creates health for all of us is so much more broad, and I think- Yeah...
• 3:43
  you know, I w- I was fortunate to get, um, while I was doing my preventive medicine residency, um, and asked to start an Office of Minority Health in Long Island, um, in New York, and then from there, I did that.
• 3:56
  I started that office, and then I was asked to come to New York City Department of Health.
• 4:01
  I was an assistant commissioner at first overseeing kind of the, the communities that had some of the worst health outcomes and the greatest disinvestment within New York City and Brooklyn particularly. And then when Dr.
• 4:11
  Mary Bassett came on as commissioner in New York City, I was asked, um, to be, uh, uh, to start the Center for Health Equity for New York City and be a deputy commissioner, and then did that for five years, and then, um, was...
• 4:25
  I interviewed for AMA and, um, was asked and invited to come to, um, this national platform to start a Center for Health Equity here.
• 4:34
  And then I've also helped in the recent year, um, I was a senior advisor to the CDC director on doing their internal work around equity, so I've helped kind of support, um, putting the foundations in place so that they can launch more of a, a broader kind of center for health equity or office or something of that nature.
• 4:54
  Thank you so much for giving that, that frame, and I really love it when you do this because frankly, you know, we talk about this a lot, health equity as terminology.
• 5:03
  Some people may say it's new, it's this new thing, but really, I mean, we have people such as yourself, myself, others who have been working on these topics. They may, they may have been called different things.
• 5:16
  We've been working on these issues for some time. Um, so I think before we kind of dig in, um, why don't you share- And it co- and it comes before us just to be clear. It comes before us. I mean, W.E.B.
• 5:27
  Du Bois really, you know, in nineteen oh six wrote The Philadelphia Negro and, and used data and sociology, you know, to demonstrate that, you know, ex-slaves who live in Philadelphia don't have optimal health because of their living conditions, and their living conditions are, are structured the way they are because of what they use the context of race.
• 5:47
  He didn't say ism as the system, but this whole, um, construct, social and political construct around race impacted where ex-slaves could live.
• 5:57
  So w- people, you know, this has been elevated for years, and I think-The lived experience has been there for years of people in terms of the injustice.
• 6:05
  So it's beyond even, you know, me and, and us who have been in this kind of professional space of, of equity as well. Exactly.
• 6:13
  And I'm just looking at this book that came out recently, "The Political Determinants of Health," um, by Daniel Dawes.
• 6:19
  I mean, he, I think does a really kind of amazing job of drawing that line actually back to the origin story of, of the US and really looking at how the first conversations about social determinants of health actually started with people talking about slaves, and the issue-- the, and actually what he frames in the book is that the conversation was around slaves not being as fit as the person that sold them said they were.
• 6:50
  Right.
• 6:50
  And that actually was the basis for the first regulations around what he frames as social determinants of health and creating that accountability within the government system for health of slaves, which is fascinating, I think, th-that you draw that line.
• 7:04
  Um, so let's talk about this in the contemporary context. Like, how do you see health equity now in the contemporary context of how we, we think about this topic in the US?
• 7:14
  Well, I think health-- So I think it's important to have kind of, you know, the frames and the language and the concepts, right? And you hear me say this a lot in terms of the narrative, right? So
• 7:25
  health equity beyond the field of health equity, like, let's push that aside. Right. Right? It's just the concept really around everyone having the opportunities, the power, the resources, um, to have optimal health.
• 7:39
  That is what is meant by equity. We all, you know, that's just all of us, right? We all, you know, want that. And I think it ki-- you have to demystify some of these terms for folks, um, and kind of get to the...
• 7:51
  Because it becomes jargon, and then people really don't know what they're talking about, and then it's really hard to have shared conversation around it. Right.
• 7:57
  And then I think the other part about equity when we speak about it is that it's not only, like, the outcomes, right?
• 8:04
  It's not only about differences in disease outcomes that are avoidable, that are unjust, um, but it's also, you know, like, the process.
• 8:14
  The process of how we get there is what I think the profession has learned and more and more learning is really important.
• 8:22
  Um, again, people experiencing, you know, the greatest kind of a burden as it relates to health equity have known this for, for a long time, but the process is really important.
• 8:32
  So by that, I mean, and I, I go to a lot to Camara Jones, um, you know, she speaks to kind of three things around the ability to be able to get to the space of health equity, and it's, one, valuing all people equally, right?
• 8:45
  And it seems, of course, and you'll hear people say, "Of course, I value all people equally." But we know that that is an absolute kind of challenge in this country.
• 8:54
  And the reality is, if your data at your institution, at your company are showing disparate outcomes, um, for people, whether it's based on gender, race, ethnicity, sexual orientation, ability, immigration status, whatever it is, we are not that, our systems and structures are not valuing all people equally.
• 9:15
  Like, that's just, that's the bottom, that's one of the bottom lines of it.
• 9:19
  I think the other, like, important part that she always brings up, and you mentioned that already, the historical context, the historical nature of how we got here, we have to understand those roots, um, and because it just sets up the conditions of why we are where we are.
• 9:34
  And if we don't understand that to its fullest, then it's really hard to put forward solutions that are going to really counter the problems, because we're not really looking at the roots of the problems.
• 9:44
  And then the third part of, like, equity and wanting to do equity, um, and achieving it is that we are committed to redistributing resources and power.
• 9:54
  And by that, I mean, you know, it could be decision-making power, right?
• 9:58
  Because oftentimes, this is not a surprise to people, but decisions are held usually amongst a small few, whether it's in a company or not, um, or, or government or any other institution, and then also money, you know, in this country, right?
• 10:11
  P- and political power.
• 10:12
  There's decision-making power, political power, financial power, and, you know, the ability to shift it based on not only need, um, I think a lot of how we've seen data presented especially is all based on, like, deficits, um, what a community doesn't have, you know.
• 10:30
  You know, uh, just thinking about maternal mortality always comes to my mind in terms of, you know, in New York City, Black women are eight, you know, eight to, the, the range is always right, eight to twelve times more likely to die, you know, as a context of childbirth.
• 10:42
  Mm-hmm. And that's important to know, clearly, and we need that data.
• 10:47
  But also, the way that we build solutions, I think, is to also look at the strengths and the assets of people and, and what they have been able to be resilient on.
• 10:58
  I mean, if we look at Black and brown communities historically, indigenous communities, um, as well, they're here. They're, they're, they're thriving in some places. They survive.
• 11:09
  That means there's this inherent strength that these communities hold that we have to better tap into, acknowledge, recognize, and value for their lived experience as expertise, not just the quantitative data that we have, but their lived experience, and then how does that contribute to how we develop solutions and design solutions?
• 11:30
  Who is it that then we start to bring and ask to be a part of our solution development?
• 11:35
  How do we give and share capital, as I said, shift resources to communities of color so that they can be the ones who design, um, and think of solutions?
• 11:46
  And they already have solutions oftentimes, actually, for their own communities and neighborhoods, but they're not given access to the capital and the money, the resources, and the power to do so. Right.
• 11:58
  I mean, I think you bring up so many important points that I know a lot of people listening in are, are innovators trying to develop these exact solutions.Um, and we'll get into that in a, in a, in a minute a little deeper, but I-- you've touched some important themes.
• 12:10
  I think one thing I don't wanna lose is your framing even though we, we haven't used this language in this way.
• 12:16
  You're kind of framing the difference between health disparities, the numbers, and reducing health inequities. I think that's something important I just wanna draw out from what you were saying.
• 12:25
  Health disparities, um, sometimes people throw around the language, but we're really talking about differences in numbers, right?
• 12:32
  A difference, um, between two different population groups or three based on a certain metric.
• 12:38
  But that is different from reducing health inequities and what you're talking about in terms of redistributing power, who you include in solution development.
• 12:47
  So I wanna draw that out, and I think that's a, a really important theme. But yeah, do you have any thoughts on that? Yeah. Yeah. I mean, and so that was when I first started this work in two thousand six or so, six...
• 13:01
  or four to six, I would say, two thousand four to six.
• 13:04
  Um, that was the movement at that time, the health equity movement, Adewale Trotman, um, I remember hearing, um, Brian Smedley, um, a lot of our kind of our, our legends I feel within the, the modern age of health equity, I guess if that's what it's called.
• 13:20
  Um, they were really pushing for that movement and that shift from disparities to equity or disparity to equity or inequity. Mm. Um, or the context of
• 13:34
  there needed to be a greater kind of implication that these disparities didn't just happen, right? Right.
• 13:39
  They're not just simply differences, but there's a context of, like, justice and that, one, they're avoidable, um, and that there was something that we could do about it, you know, and that they were man-made, and so they needed to be kind of qualified.
• 13:53
  And so that was the kind of switch in, in the language around that, that period, a real whole movement around many people who were starting to really, and already, to your point, were leading in this space, Camara Jones being one of them, um, really switching this language to equity.
• 14:08
  It actually-- it kinda gets under the skin of, you know, some of us, you know, when we hear the word disparities 'cause it's like, uh, you know, this is, this is not, um, a normal, healthy thing.
• 14:20
  It doesn't just happen, and it's avoidable. It doesn't just happen. Right. Right. That, that's a really important point.
• 14:24
  There's something else you also share, um, in, in best practice, which is to talk about the importance inside of organizations of doing the internal work to, to get to whatever those outcomes are.
• 14:36
  I think a lot of times people have great intention. They wanna do that work of reducing health inequities, and they're spending their time looking outside towards the outcomes.
• 14:46
  And you've often said we also have to look inside within our organizations. I'm curious if you can build on that 'cause I think that's important- Yeah... for folks on, on this, uh, webinar. Sure.
• 14:56
  And I, you know, yeah, it's almost like some of this stuff, if we, you know, really sit with it and think with it, there's-- it's, uh, it's very logical. I mean, if we're thinking about even ourselves, right?
• 15:07
  And we talk about this, you know, in terms of just taking care of our bodies and being able to... If you have children, how do you care for your children? If you're on a plane, you'd, you know, what do you do first?
• 15:15
  You look at yourself first, make sure you're cool before you do things on the outside of the organization, right? Or the outside of, of yourself, right? With others. Um, and it's ki- it's the same thing.
• 15:26
  And so, you know, the reality is, is that, you know, I think it's great in terms of, um, the attention to equity and the way that it has been in the last three years on many levels, and there's a challenge, clearly.
• 15:39
  I'm sure we'll talk about that too. Um, but the, the reality is, you know, as I see all these chief health equity officer roles, um, emerging, oftentimes it's to do, like, how are we gonna partner?
• 15:51
  What are we gonna do with communities? What are we gonna do for communities?
• 15:54
  And not about what is that internal work that we need to do so that our mental models shift and we understand how we potentially are contributing to the inequities, you know, as an institution in doing this work.
• 16:06
  And this is not, and I, and I hear it all the time as individuals and institutions, it's not about good or bad intention. I believe that the majority of people have good intentions. There are many...
• 16:16
  There are people who don't. We're clear. Where there are companies that don't, we're clear. But- Mm-hmm... we're gonna go with the assumption that most people have really good intentions. Right.
• 16:23
  But it's not about that, and it's not enough. Because what our data is showing is that even in our good intentions, we're still getting bad outcomes. Mm-hmm.
• 16:31
  And that's in health overall in this country, but then when you look in the context of, like, um, looking at identities and different identities, it's even worse.
• 16:39
  And so if our impacts and, and what we're trying to impact is not moving, then it's not about the intention.
• 16:46
  We need to look and focus at the impact and what the impact of our decisions are actually, you know, doing and having, and how do we look at the process in a different way so that our outcomes and our impact can be different.
• 17:00
  So we have to look at our institutions, and we have to look inside.
• 17:03
  So when I do that work, um, and I do think that is the, the part that I bring that I've had a, a great amount of skill set around thanks to, you know, really Dr.
• 17:12
  Mary Bassett again at the New York City Department of Health, who gave me a lot of space and leverage to, um, implement that. You know, it's not new.
• 17:20
  I learned from, um, the folks who are in Seattle King County who are now at Race Forward, the leaders there, and then they have a whole government alliance for racial equity, and it doesn't even matter that it's government.
• 17:31
  It's just institutional frameworks about what- Yeah... you need to do inside. And so part of it is, you know, how do you build that shared analysis?
• 17:39
  What are, what's the training and all those components you need to have so that you can have dialogue within your, your institution and it's safe, right? But that's just one part. As most people know, it's just training.
• 17:49
  The next part is then, like, how do you organize your staff? So organizing is important outside of organizations, but also inside, and it happens all the time.
• 17:58
  Um, but how do you know and ensure that this work is not just held by one person, because that's not helpful, one- Mm-hmm... if you want impact.
• 18:07
  It's not helpful for the person who has the role 'cause that's just very stressful, and I see a lot of chief health equity officers set up in that way.Without having adequate resources and investment in teams to help build out a full strategy and plan that involves and includes folks across the entirety of the organization in a very intentional way.
• 18:27
  So that's the second- Right... part is organize. And then the third part is, like, operationalize. What are the tools? What are you gonna use to help you assess where you're at and your progress over time? Mm-hmm.
• 18:38
  Um, it's, that can be the data that you have, whether it's your workforce equity, pay equity, um, how you do your communications, and it's not just about health.
• 18:46
  Like, it's about every single-- All of those impact your health.
• 18:49
  It's about every single business unit or department that you have across your company, every single one of them should have equity plans and an understanding about equity in the context of their work, whether, whatever it is.
• 19:02
  Whether it's IT, anything. That's the- Right... that's the internal work that has to happen in order to really shift how a organization does their work, and then how-- You have different a-impact.
• 19:13
  You engage with people in different ways once you start to do that kind of work. I think that's so well put, and I mean, it gets to the sustained action component of this discussion, which is how do we sustain action?
• 19:25
  And what you're really saying is, without this internal work, it's very hard to have any type of plan that's truly operationalized and sustained in a meaningful way. I think that's, that's very dialed in.
• 19:38
  Um, we've got a que- You don't culture. I'll, I'll, I'll, I'll get that question. Just one, the other just important part of it is that you don't shift your culture either. Like, you don't have- Right...
• 19:47
  culture that appreciates and values and understands what it means, where everybody has the experience and the opportunity to be in an institution that's safe and to be thoughtful and all that, and it's beyond just diversity and inclusion.
• 20:00
  Those are very important, um, opportunities and values. Important to have diversity, important for people to feel like and belong in the space. But that's not eq-equity.
• 20:11
  Equity gets to the space of power, which means decision-making power, who has that, who doesn't have that, and we know by the data of most institutions in this country that typically at the top of our institutions, still at our companies, are predominantly white men.
• 20:25
  They aren't-- It's not women, it's not women of color, it's not men of color, it's not those who identify as LGBTQ, it's not, it's not all of that, right? So- Mm-hmm...
• 20:34
  you know, that's where, like, who's, who has the ability to change and inspire culture within the institution is really the question, and the company is really the, I think the, the, the question at hand. Interesting.
• 20:48
  And before we transition, I wanna talk about the AMA, but a question's come in that I think that I would love to hear you address. It's- Sure...
• 20:54
  what is the impact of health inequality data, let me say health inequity data, having on changing perceptions and perspectives? Very curious to get your take on that.
• 21:06
  Yeah, I mean, I think, you know, so the, it, it speaks to
• 21:11
  something where I've involving-- Like, I, I think for those who are, who don't believe, you know, at all in terms of that these inequities exist, especially at their own institutions,
• 21:26
  um, I think it's really important that they look at their data, right?
• 21:30
  And I've, e-and I've seen it where people are kind of influenced by when they answer questions differently for the work that they're doing, so they find out, like, you know, so what is the baseline data that they do have, right?
• 21:42
  Did they disaggregate their data? What do they understand based on identity? 'Cause I, I've had that experience actually in my former role, um, at the health department.
• 21:50
  It was really impactful in terms of our emergency preparedness work, where they didn't as, uh, disaggregate data as it related to some of their emergency preparedness work, and when they did, they found, like, these huge gaps across the city of where we weren't even placed to help support people.
• 22:06
  Mm-hmm. Uh, and if you don't look at data like that, you can't change who you are and what you do. And so I do think it's really impactful in terms of seeing and understanding the data.
• 22:17
  Um, and I think, one, to, for people to just believe that there really are differences and then start to investigate why, but also then to have a sense and a baseline of where you can go, and then also to understand the importance of setting up data systems and, and in ways that are always kind of meaningful and, and ways that you're able to hold yourself accountable over time, you know, as an institution.
• 22:39
  So I do think, you know, knowing, um, numbers, um, absolutely critical. And I would imagine for a lot of, um, startups who have, again, really great intention, um, in doing this work, um, the intention's not enough.
• 22:55
  You know, if you really, if you're really truly mission-driven from my perspective, from a even just this basic health perspective,
• 23:02
  um, you also should be interested to make sure that everybody has optimal a-access, opportunity, and resources as it relates to your solution.
• 23:11
  You know, that's how you develop the best solution, so that means you have to look at your data, and you have to collect your data in a particular way or understand data in a particular way beyond just generalizing and having large numbers and large swaths of, you know, this is what this group does or, or not, and, and generalizing your data.
• 23:29
  Um, so I do think it's influential. And I will say, and I think, you know, the more I do this work and what I've seen really shift people is still,
• 23:37
  um, the context of understanding and hearing the stories connected to some of those inequities that they see in their data, because that's what sticks.
• 23:46
  Like, I, I really believe, you know, this, this work and, you know, feels like now, um, that my job is about convincing people to care about the human dignity of others. Mm-hmm.
• 24:00
  Like, that's what it boils down to, and I, I, it's, it's actually a sad place to be, 'cause why, why should we get-- Why should we have to pay for that?
• 24:08
  Like, it's not a, it's not a normal thing to have to do this kind of work and to convince people. That's what equity work is. Right. We all end up finding ourselves as storytellers, right?
• 24:17
  Which is what you're saying, is moving beyond- The stories and-... real lifeYeah Because the, because the statistics like are so distant, right?
• 24:25
  So I think they're good for accountability, but they're not good for changing, I think, um, kind of the spirits and the mental, um, models which people have and the hearts of people. And leaders, let me be more clear.
• 24:38
  And that's what I've seen over the last couple of years, 'cause I've had to use different, um, tactics and strategies because the New York City Department of Health was different than the AMA. Mm-hmm.
• 24:47
  Um, my leaders, my bosses are different. Um, the people that I'm around are very different. And so, you know, I'm around...
• 24:55
  I was around a lot of kind of social justice public health folks who kind of understood a lot of the context and that we have to lead with equity, and we have to incorporate, embed equity.
• 25:06
  But in AMA, you know, the environment was different, so my strategy had to be, "I'm gonna share my story with you. I'm gonna make...
• 25:13
  You're gonna, you're gonna hear that story behind those data," um, even though people may not wanna hear them. Right. But that's where I've seen people actually move more so than anything.
• 25:22
  We're moved by stories as people more so than numbers. Institutions have to move with numbers, but people move by stories. Politicians know this through and through. Mm-hmm. That's well said.
• 25:35
  There's a couple other questions. I think they're gonna relate to some themes we'll get to in a minute. So I wanna take some time for you to talk about the AMA and kind of how you...
• 25:45
  First, I think many people may not know the scale and scope of what the AMA does.
• 25:49
  So if you can kind of briefly s- explain what the AMA does, how it works, and then what you started to do to embed equity strategies there, that'd be great. Sure.
• 25:58
  So, um, AMA, uh, is, is a old institution, almost, uh, one of the older ones, um, not the oldest, but one of the older ones, um,
• 26:08
  uh, started in eighteen forty-seven, um, and, uh, it is still the largest physician, um, representation in terms of, uh, an institution in the country.
• 26:20
  Does not represent all physicians in terms of membership-wise, but they advocate, um, you know, within the context of all, um, political spheres within the, in this country.
• 26:31
  Um, and so the way that, um, it is structured in its governance body, you know, it has a house of delegates, which is representation from each state. And a lot of this I honestly didn't know before coming to AMA.
• 26:43
  I didn't realize- I didn't know until I talked to you, which is why I thought- Yeah. Yeah... it would be good to share. Yeah.
• 26:48
  Um, I knew the history of AMA, and I'll come to that in a second, um, but I didn't know our aspects of the AMA, um, but I didn't know the structure. So it represents fifty states,
• 26:59
  and it's kinda like it operates a little bit like Congress. So they meet twice a year, um, in order to pass policy that they are going to advocate, um, for at the federal or local levels.
• 27:11
  Um, and so the House of Delegates come. It's really quite massive.
• 27:14
  Like, it's this massive room, you know, where the states are set up, and they, they get to debate policy and whether they're gonna actually pass it or not. Um, and so it's a very democratic process.
• 27:26
  Um, it is historically a very conservative-leaning institution. That is known, but the process of voting and which policies are very democratic. And then it has a board of trustees.
• 27:37
  And then because it's this large as an organization, um, and a membership organization, it has a, um, a management team, and I'm part of the management team to help execute on the policies that are put forward.
• 27:50
  So the policy that brought me in was in twenty eighteen, um, the AMA House of Delegates passed a policy that they needed to have an organizational unit that helped facilitate the process to embed equity across the entirety of the enterprise.
• 28:06
  And so I was hired in, uh, twenty nineteen, and I started in twenty nineteen. So that's, you know...
• 28:11
  So, so my position is very much rooted in AMA policy, which is one of the attractive natures, you know, of why I came on board and I felt more comfortable to come on board because it is rooted in the structure and the policy of AMA.
• 28:26
  The other things just in terms of scope, just to understand also, is that, um, you know, we have, um, three strategic arts, ARPs, rather.
• 28:36
  Um, Jim Madara, who's our CEO, um, when he came on board, uh, a little, uh, maybe about ten years ago or so, also did a little bit of reorganization, um, to make sure that there's a focus on medical education.
• 28:49
  We have a focus on how do we support physicians and sustainability, uh, practices, and then one on improving outcomes.
• 28:56
  So those are kind of another kinda core body of work, and then we have accelerators around that work of which impacts all the work. So one of them is advocacy, right?
• 29:06
  Most people, I think, have a sense that AMA has a large, uh, participation in advocacy. And then the second is innovation, um, and the third is equity.
• 29:16
  So when I came on board and, and this mandate was now in place, um, Dr.
• 29:20
  Madara made sure that equity was going to be an accelerator and to be clear that this was going to be everybody's work, and it was gonna help kind of accelerate and propel the work that we were doing and improve the work that we were gonna be doing as AMA.
• 29:33
  Um, and so that's kind of, you know, the, the s- the, the way we're structured, um, and, you know, as the management team.
• 29:39
  And then we advocate on so many different policies as it relates to healthcare, all the one areas that I mentioned just now.
• 29:46
  Um, and then, you know, we have our, what's really provides a foundation for the work that I'm able to do, um, beyond the one I mentioned in terms of the unit.
• 29:55
  Um, we had anti-racism policies passed in twenty twenty, um, you know, when, when the public were... Well, COVID-19 first, right, really exposed and generated all this attention and media attention, I guess.
• 30:09
  And thankfully for us in health equity, I mean, is it's a double-edged sword in, in some way, but, um,
• 30:15
  more people were paying attention to it, and then the public murder of George Floyd, uh, really, um, even, you know, AMA came forward with a, a pledge about-You know, racism is a, is a public health issue, and it was, it was pretty, you know, forward-leaning for AMA to do that at that particular time.
• 30:33
  Um, and then from that, the House of Delegates that I mentioned before passed policy so that it would be rooted in AMA again structure that we say that racism, racism is a public health threat.
• 30:46
  We did policies around, you know, it not it being a so- a social, um, political construct, um, and that it's not a biological construct.
• 30:55
  So all those things provided kind of the food, um, for us and, you know, to do this work.
• 31:00
  And I have to always give credit to the medical students and the young physicians in the Minority Affairs section, um, for really passing a lot of these policies at this point in time and putting them forward, not passing them, but they proposed these resolutions so that they could be passed.
• 31:15
  Um, and so we created the strategic plan that was launched in twenty twenty-one, um, and it has five kind of core approaches.
• 31:24
  Um, I already mentioned the first one about embedding, um, equity and what are we gonna do inside the institution, inside the management team.
• 31:31
  The second part is around how do we have more kind of meaningful partnerships, um, with, uh, physicians especially that have been historically marginalized.
• 31:41
  The history of AMA, if folks don't know, is that it actually, um, had policies, especially at some of the local levels across the country, to exclude Black physicians, or they didn't make an effort nationally to, to stop those policies.
• 31:56
  And so that impacted Black physicians 'cause they literally couldn't get hospital pr-privileges 'cause their license was attached to your AMA membership. I see. Mm. Yeah.
• 32:05
  That, that's the, that's ano- that's something else. I didn't realize that nuance, and so that has impact. And then we really, we also did a Flexner report, um, of twenty ten, which revolutionized medical...
• 32:17
  Uh, not twenty ten, sorry, nineteen ten, that revolutionized medical education at one, you know, side, and it created a greater level of rigor, but it also s- in their recommendations, it ended up, um, closing and shutting down five of the seven Black med schools.
• 32:32
  And so that has had tremendous impact on the lack of diversity, um, within med students.
• 32:37
  So we, we need to work with physicians that have been marginalized in very intentional ways, and it's not only just Black physicians, but across the spectrum of race and ethnicity, again, identities related to disability and ability, and, um, IMGs as well is another example.
• 32:52
  The other pillar we have is, like, pushing upstream, and so how do we educate, um, physicians on understanding public health and all these broader contexts?
• 33:02
  Again, Flexner's impacts is that really took the social context of medicine, really just made it about basic and clinical science. That's why doctors are trained the way they are trained. Right.
• 33:13
  Uh, and they're not in these other things. And then the two other areas, one, why I'm here in conversation with you and how I met you, is around equity and innovation, and I can come back to that story.
• 33:22
  And then the fifth pillar is, um, around truth, reconciliation, and healing for our past and the harms that we have caused as an institution. Right. Thank you so much for sharing that.
• 33:33
  And every time I hear this story, I new, I learn new things about you, but I think what has become clear as well is about our journeys.
• 33:41
  'Cause the fact you started in Suffolk County as the first, I think, founding director of the Office of Minority Health, then New York City, then the AMA, and I wanted people to understand this, that really what you had to do is move a whole country of delegates in a clinical profession.
• 33:57
  You had to kind of do that internal work at a national scale to, to move some of these strategies.
• 34:01
  And I, I just say that, um, we're all very honored and pleased about the work you've done and how you've used your skills and strengths to move, 'cause that is not an easy task.
• 34:11
  And I, I really want people to understand the scale and scope of what you've had to maneuver, but also your background at the intersection of policy, public health, clinical, I think really, and the mentors you've had has allowed you to be able to move this field forward for us as a country.
• 34:26
  Um, so I wanna acknowledge that. Um- Well, thanks. El- Yeah. Thank you. Yeah. I think there's a lot to your point. Uh, just... Well, not only to your point, but thank you, first of all.
• 34:36
  And it, and it, I'm not here clearly alone and, and I stand on the shoulders of many, um, who have been doing this work and, and types of work for a while. But I will also say a lot of this work is, is, it is strategy.
• 34:50
  So for all those organizations that have chief strategy officers and strat-strategic leads, equity work is about strategy, um, at a company and organizational institutional level.
• 35:02
  Um, and so, you know, that's the skill set that I think I've, I've built up over time. Um, I'm, I'm a str- uh, I'm good at strategy, I realize.
• 35:11
  Um, but I think you have to be and to do these roles, and you have to really think quickly, but you also have to really have a sense of where people are. And so to me, that's a more of a, there's a feeling to that.
• 35:22
  Um, your gut has to be really strong and responsive. But it's almost like with startups, right? Uh, you know, I've had the opportunity to do three startups within an institution.
• 35:31
  That's, that's usually how I refer, you know. That it's the same skill sets that people have had. I've had to go from scratch where it's just me. I have to identify where do the vision, mission, goals.
• 35:41
  Um, how am I gonna fundraise within the institution to get the money that I need to do the work? Um, how are we gonna staff up?
• 35:49
  Um, all the, all of those things, um, you know, I guess cumulatively kind of built for myself, um, over time and, and what I've learned. Yeah. And I think thank you for that.
• 35:59
  I think you've said something too that I, I don't wanna lose for people listening, that in, in many ways, there's a lot of information coming out about how the role of chief health equity officer, roles in diversity, equity, inclusion aren't typically empowered.
• 36:13
  They don't have budget. They kind of find themselves in very challenging spaces to have real impact. I think you've said something meaningful, which is this is for organizations to think about.
• 36:22
  When you have truly embedded equity as a part of what your organization does, it's probably not its own title.
• 36:27
  It probably sits within your chief strategy officer's unit or somewhere that is about your organizational strategy.
• 36:34
  I think those of us that have been working the space are trying to kind of move leaders to start to think that way, to say this isn't just a checked box role.
• 36:41
  Actually, itIf you really wanna do this, this is actually a strategy role inside of your overall organiz-organizational strategy.
• 36:49
  I think, um, I wanna make sure to draw that out for people listening, thinking about how you sustain action in the space. Um- Yeah. I think it's strategy, and there are functions within every unit, right? And so, right?
• 37:02
  And so whether it's your operations or all of that. And I think, you know, the important...
• 37:06
  And I think I, I think the important thing is to understand that equity is strategy, whether it sits with your chief strategy officer or not, does... I, I, I just...
• 37:15
  Those people need to be in close communication, and the person who's leading equity or has, like, the equity context needs to have access, and really, to me, needs to be at the same decision-making level as all the other senior levels within the institution.
• 37:32
  Um, optimally, you know, if the C- the CEO has that context, then that's even more fantastic or learns it and grows.
• 37:38
  You know, my, my boss, Jim Madara, has done a lot of work over the last three years, you know, has been really committed to that, and I think that's pr- and I, and I have to acknowledge that.
• 37:48
  You know, when while people, um, acknowledge the success I've had, I think it, to be really clear, you know, I've had bosses that listen.
• 37:58
  They don't, you know, they don't agree with everything I say or, or recommend, and that's fine, but they definitely have, you know, been open to learning and knowing that they, there are things that they don't know
• 38:12
  and, and to the growth of, of this work and to hearing stories and listening to stories.
• 38:18
  It's okay if we don't know what equity is or what it means, but we need to believe, um, that we can be better and that we can do better, and we need to believe that we can learn more and that we can learn more from others and that we don't know everything.
• 38:33
  Right. No, well put.
• 38:35
  Um, we have several innovators, um, on this call and that are really keen to gain some insights from you about how they can go about their work as health transformers or other entrepreneurs in the space that wanna innovate equitably.
• 38:49
  Um, and there are a few questions related to this, but I wanted to start with one that I think is relevant. Um, it says, "Dr.
• 38:54
  Maybank, what insights would you share on how one identifies a company that truly wants to go on the journey of advancing equity as compared to those that are pursuing the work as a checkbox?" Yeah.
• 39:09
  Um, it's almost like the same how do you hire people? [chuckles] Like is this, you know? And, and, and you know they're really committed to equity.
• 39:15
  And I, I say, well, depending on where, where you're coming from, is not to... If you don't have the skill set and you haven't done it a long time, um, I believe in partnership with people.
• 39:26
  Um, and so find those folks who actually do have a context and understanding of equity. So if you're in the context of a company like startup, you have KP, right?
• 39:36
  So, you know, you can engage with KP and say, "Hey, you know, w- what do you know about this company? What are, what are the, what's the language I should be looking for?
• 39:45
  You know, what should I, um, know that they've done in the past? How has, how have they designed their solution? You know, does it...
• 39:54
  Have they created opportunities to kind of hear from people that have been historically, like, marginalized or not included in the design of their solution so that that solution would be better?
• 40:05
  What is their process to do that, um, in order to make that solution better?"
• 40:10
  Um, you know, part of what we did put forward as AMA, and thankful to, um, a committee that we had over the, I would say two years now, um, of which you are a part of now, KP, um, to help influence what is it that we should be doing as AMA, and one of the gaps was, it speaks to this question, was that while people were making all these pledges around equity and anti-racism work, it wasn't grounded in principles.
• 40:35
  You know, what are those things that people should be looking for? What are the values that people and companies should hold? What are the actions related to those values?
• 40:44
  And so we put forward, um, in full health, um, which is in full health, um, you can find it, um, at infullhealth.org. Sorry about that.
• 40:53
  Um, and in that, you know, we were very explicit about all of these principles that need to exist.
• 41:01
  So, um, you as the company, um, need to do, um, but, uh, be willing to do, at least in the beginning if you haven't done it. So one of them as an example is, and I talked about this in our work, can you...
• 41:13
  Have they done an organizational assessment, right?
• 41:16
  To really understand, like, looking at their data, as I said, um, that really understands how these systems, like, show up of racism or any bias, um, as it relates to resource so that it's self-assessment.
• 41:28
  The other part is, you know, is are you using, and these companies, are they really using explicit kind of fundamental metrics that also are looking at the impact of equity?
• 41:40
  Um, and there's a lot of support, more support to do that now. Um, we know that, you know, as companies build oftentimes...
• 41:49
  So there's one thing to center people, right, and to get their ideas, but are you actually investing with the communities, um, and the people who are giving you those ideas somehow or another?
• 42:01
  You know, so that it doesn't feel and it isn't, um, you're exploiting them, um, because that's often what it... And a lot of institutions do that. But how do you do, like, the co-investing? What does that look like?
• 42:12
  Um, you know, and, and so it's like the asset ownership piece. And then, you know, what about just engaging if you are a predominantly white, um, solution, you know, how have you engaged other founders?
• 42:25
  Are you partnering? And I think I'm seeing that more so, especially around Black founders, um, and Brown founders of partnering to do some of this work, um, uh, because it's, it's really hard in isolation.
• 42:38
  The reality and the bottom line is, is that the stats still show, um-Pretty poor, um, intention from my perspective- Mm-hmm...
• 42:48
  um, and resource allocation and distribution for, to Black and brown founders, even when people know the data, you know? And, and the predominantly white institutions and led by white institutions know the data.
• 43:03
  We're still not getting the investments, um, from, you know, certain spaces.
• 43:07
  So we're having to be innovative, you know, and, and think differently of how we get capital and gain capital for the solutions that, and the ideas that we have.
• 43:15
  I don't think it's, it's always going to be through VC, et cetera. Right.
• 43:20
  And then the other, the other part that we just to be helpful also is that we on the website you'll find, um, a equitable health innovation solution development kit that will help, um, you know, developers and purchasers and investors also think just a little bit more intentionally about what does equity look like in the whole process, in the entirety of what they're doing.
• 43:42
  So we're hoping that's a helpful tool to, just to speak to the question that was being asked. Right. I, I appreciate that.
• 43:50
  And, and, uh, it is, as we think about our health equity moonshot, um, we are using that tool to help us. I'm putting it in the chat.
• 44:01
  I'm trying to see if I can get this to everyone as there have been some questions for In Full Health. Um- Yeah. In Full Health...
• 44:07
  but I think, you know, what's interesting I think for entrepreneurs is this construct of user-centered design really kind of got legs in Silicon Valley with IDEO, right?
• 44:18
  And IDEO, you know, people are wondering, "Why is it that my solution isn't getting the scale that I want, right?"
• 44:25
  And, uh, the framework was that, well, if we're a bunch of engineers in a room thinking about what we like, we're building what we like, but what does everyone else like, right?
• 44:36
  I think what's interesting is, you know, I think that IDEO, those user-centered design principles, you find companies overseas using them.
• 44:47
  So for example, innovators in high-income countries that wanna work in a low-income country, and maybe they're coming in with their idea of what the solution is, but they're not engaged in community.
• 44:58
  So I think what's interesting is in a- And they're not giving capital or co-investing or a-asset ownership, like- Or asset ownership... all of those parts. Yeah. All of those parts. Yeah. Right?
• 45:06
  But I think what's happened in our US system is,
• 45:09
  I think what your tool is doing is saying, "Well, frankly, if we use user-centered design principles for the majority population, we're leaving out a lot of people," right?
• 45:20
  So, so I think the In Full Health Equitable Innovation Principle says, goes a step further. Instead of saying,
• 45:28
  you know, "Let's just think about user-centered design for the most scale," let's think about user-centered design for the most impact, right?
• 45:35
  And I think, um, just for people listening, particularly our Health Transformers, and you think about our Health Equity Moonshot, that's the direction we're going to be moving in how we look at, um, solutions.
• 45:46
  Um, so let's see. We have several questions coming in on this thread, so I wanna, um, continue. Let's see.
• 45:54
  So for product developers like myself who are innovating on products that help individuals make better informed decisions around their health, how can we download and use this research for our work?
• 46:06
  Also that, so In Full Health is, is a free resource, right? So that's- Oh, yeah... open source. Yeah, definitely open source, and that was important to us. So it was important. That was, that was good accountability.
• 46:17
  You know, and so you can't do, you can't just say the part, like you can't do equity without accountability. And so- Mm-hmm...
• 46:22
  um, you know, the committee that we have, and then the advisory committee, you know, always continually s-hold, holders accountable that, you know, there are products of which AMA definitely charges for and, and that's, you know, that there's a desire, you know, many companies and institutions to do that.
• 46:39
  But this was, this is something that's absolutely accessible and, and free, um, and at no cost to download from our website.
• 46:46
  And then there's the ability to actually join a community as well, um, when you, um, when as soon as you download it, you'll get, you know, all the information. You'll be constantly kept up to speed.
• 46:56
  But I would, you know, and I wanna acknowledge also, um, several things to this.
• 47:01
  Uh, and, and KB, I know you have some more questions, but I also wanna acknowledge all the collaborators who kind of did this with us initially.
• 47:08
  And I'm not, I'm afraid to start mentioning them because I feel like I'm not gonna say them all. Uh, and then I'm gonna forget one, and then I'll feel really bad, badly.
• 47:18
  But if you go to the website, like you'll see all the different collaborators who really initially came on board to help with these In Full Health principles and to help, um, think them through and, and figure out what's best.
• 47:29
  But I, I just, I'm so thankful because many of them also have been really those who lead these, um, other kind of collaboratives and coalition and, and kind of thought groups around innovation and equity have been just so supportive of myself personally, um, you know, based m-um, where I'm placed, but just in this space of, of, of doing this work.
• 47:52
  And so, again, I just elevate, um, I think what's typically not kind of our principles as it relates to capitalism. Um, and this, it's not all about the individual, but this, this collective context- Mm-hmm...
• 48:07
  uh, you know, is really powerful. Um, and, and that we can learn from one another and that we can grow from one another, and that there's enough for us all, um, to have something in this space.
• 48:19
  There's a question that just came in relevant to that thread. Dr. Maybank, could you address ways in which startups/companies can promote health equity within the context of capitalism, e.g. profits over people? Yeah.
• 48:32
  I think, and that's, it's a conflict naturally, like just to be really clear. Um, and, um, I think there are people who are, who are doing it well.
• 48:42
  And so, you know, I go to a space like, you know, I think about Rock Health. I will mention Katie.
• 48:48
  I think she's doing a lot of work-Um, to elevate, um, founders of color, to make sure she's getting their ideas, not only their ideas, they're part of the organization, they have voice, they're leading the organization, and they're engaging with others.
• 49:03
  Um, I've learned a lot from, I am gonna name names now, Michael Penn, who is, um, you know, supporting my team now, but, um, you know, just really been brilliant and helpful, um, in thinking through, you know, how, um, we need to be supportive of, of one another and structure the work that we do, um, as, as Black and brown people.
• 49:23
  And I think to think about the opportunities outside the way the system typically works. Again, um, if it's not working for us, uh, our data shows it's not working for us, what do we need to do differently?
• 49:37
  Um, what are the creative ways that we need to, to access capital? I think we have to continually, um, uh, think of and pursue.
• 49:46
  Another just, I give another recommendation of a book that I think is really great, and a leader, um, Edgar Villueva wrote, um, Decolonize, uh, Wealth. And it all... He's a capitalist still, but I...
• 49:58
  Not still, but he's a capitalist, but he talks about these different ways of which we can show up, um, as Black and brown folks, um, and people, other people who are historically marginalized of how to help it work for us.
• 50:11
  You know, capitalism is here, um, and so what are the things that we need to do? Um, so those are my recommendations just to learn more. Great. And I wanna go to the flip side of that for investors.
• 50:22
  I mean, the reports have come out, I think a lot of people on this call will know the numbers, but, you know, there've been reductions, um, in venture capital investment to all-women teams, to funding that's gone to Black founders compared to prior years.
• 50:36
  Um, what advice or th- do you have for the venture capital side investors that wanna try to do this the right way, um, what might you, what thoughts might you have there? I mean, my thoughts are kinda direct, you know?
• 50:51
  Like, the right way, like, that's... I think those are choices, you know, that are made, right? And so if, if Black and brown people and founders are considered risky, um...
• 51:03
  We've heard that, like, historically in policy, right? That- Right... the whole nature of red line, right? We're deemed risky, so we can't put our, our, our, our money there and, and we...
• 51:13
  And I don't know how to change the mindset of somebody. You know? Like, that's, to me, becomes a will thing, you know, in terms of the investors, you know? And I, I... It's the value. You know?
• 51:23
  It's, it's believing that all people are actually equal, right?
• 51:26
  It's believing that somebody may have a really great idea that you don't have, um, and, and taking a risk pers- you know, in quotes, in a, in a different kind of way.
• 51:35
  It's har- it's hard for me from the investor side of it- Right... 'cause when I see that, um, those are decisions being made.
• 51:44
  It's just the same thing as, like, when I, I compare it to kind of med school and, you know, the lack of diversity in med schools.
• 51:50
  And then you see, you know, HBCUs, they're able to bring on board and fill a class with Black and brown people. You know? So it's possible, right?
• 51:58
  But it's all about the will to do something differently or to try something differently, um, to work with people differently.
• 52:04
  But if you always go back to those narratives and those lies that we've been told about the hierarchy of human value and knowledge based on skin color with white being on top, we're always gonna go back to and shift to, "People are risky, so we shouldn't fund their ideas and their investments."
• 52:20
  Um, and so then if that's the case, and if that continues, um, which we're seeing it happens, as to your point, their folks are retracting, um, they're not investing, then we again need to think about other creative ways as founders in a community to, um, support the ideas that we have.
• 52:38
  I think they're gonna have to be more collective because we don't have the generational wealth. Generational wealth. Um, we don't have all of that, but we have a lot of other things, you know?
• 52:47
  That I think we have a lot of talents and we have a lot of insights, um, and, um, historically able to figure out opportunities.
• 52:56
  And I, and I also think we need to kind of prioritize and highlight our ventures of color, um- Mm-hmm... that do exist. Um, you know?
• 53:05
  And, you know, we do see some organizations are investing in CEOs of color and, and normalizing, like, the investment within that ecosystem and, um, I think we just, we need to focus a little bit, a, a lot more on that.
• 53:18
  Um, 'cause the exclusion of, um, like, a diverse part of this, this population really hurts innovation overall at large. You know?
• 53:27
  And it's not just innovation, but innovation that's specifically centered on communities of color.
• 53:31
  So failing to c- you know, to continue to fund investments and businesses that focus and, um, prioritize our, our population just continues to harm.
• 53:41
  Um, and so I think, again, as we've done in the past, and I think as most movements are, are done, they're led by those who are experiencing the injustice.
• 53:49
  And so I think we need to collectively think about what are we going to do differently, um, as communities of color, people who are marginalized out of this space of capitalism. It's all about power.
• 54:00
  Power can come in numbers, and power can come in money and dollars. Right. Thank you for that. And this is a question I, I don't wanna lose. It came in a little earlier.
• 54:09
  How do allies best engage communities of color or communities they do not belong to, um, in general without burdening that community? Yeah.
• 54:20
  I think, and, um, and it's a great question and good to elevate be- and to acknowledge that that can happen, right?
• 54:26
  That, again, when we start to call on people to center them, to hear their voices, or, or folks like you and I, we're in institutions, you know, "Oh, what's your idea? What, how are you doing?" That just can be a burden.
• 54:38
  It's exhausting, so I appreciate the acknowledgement. The two things I'll say is, one, I would not consider yourself an ally. Like, I, I, I move away from that term. I feel it's a passive term.
• 54:49
  I think it's, we have to understand that we are all part of these systems that create either benefitsOr disadvantages. And you, you know, we're, but we're all part of these systems of oppression.
• 55:00
  And so how are you gonna be an accomplice? How are you gonna show up with a different level of kind of humility and understanding, um, and curiosity?
• 55:09
  Um, and I think when you start to show up in that way with people that you don't typically engage with, um, to learn, then you have a different opportunity to learn, again, in a different way, but also to partner in a different way, see people differently.
• 55:23
  If you see people differently, you may engage with them differently. Um, again, valuing all people equally. Um, and then you may come up with a solution that is better than you ever thought of.
• 55:34
  And then if you also think about, again, ownership, assets, all of that, how that's shared, all that, that I feel will come back- Right... in many different ways. Mm-hmm.
• 55:47
  There are so many questions here, but I'm realizing we're getting to the top of the hour. So I wanna, I wanna do this.
• 55:53
  I mean, as, as you know, like, there's, there's so many folks, particularly entrepreneurs and innovators that are, are looking to work on these problems and to have sustained impact.
• 56:04
  And I think as kind of a closing thought, maybe you could share any final thoughts you have for the startup health community, for our health transformers that are really out there doing this work.
• 56:13
  Like, what, what final words of wisdom might you share for at least for this conversation, um, with those folks?
• 56:20
  Just realize that equity is beyond just the jargon, um, to push yourselves, um, to learn more and to, to know more about what it is as an outcome, but also what it is as a process and where the roots of inequities kind of exist.
• 56:35
  There are lots of resources out there now, and there's a lot of...
• 56:38
  And I get, especially in the space of, um, companies and, and building and kind of the foundations of this country are so, you know, are c- completely rooted in capitalism.
• 56:48
  Um, but understand the roots of capitalism and how we're, uh, how, how the system was able to flourish in the way that it does, and really on, on, on the context of excluding and harming others, and, um, say Indigenous and those who were enslaved.
• 57:02
  Um, and so that historical context is really important and kind of that exclusion still happens. It might not show up exactly in that form, but that exclusion still happens.
• 57:11
  So you have to be willing to kind of accept that. Um, and I understand there's a lot of resistance across the country.
• 57:18
  Um, but when you start to hear stories of people, your colleagues that you work with, um, in different ways, um, you start to see and hear truths in different ways, and that your truth may not be the only truth that exists.
• 57:32
  Um, and so, you know, just be open and be humble, um, be curious, um, be accountable, um, I think as you, as you lead in this space and, and trust, um, those who are speaking their truths, um, those historically marginalized founders.
• 57:51
  Um, I know that- Really appreciate... they have beautiful ideas too. Yeah, I know that's gonna be supportive and inspiring to many. So, uh, thank you so much, Dr. Aletha Maybank, chief health equity officer of the AMA.
• 58:02
  We appreciate, um, you spending time with us out of your busy schedule, and I know this has been very informative, not just to me, but to our community. So thank you. Thank you.
• 58:12
  [upbeat music] Thanks for listening to "Startup Health Now." Startup Health invests in health transformers around the world who are dedicated to achieving audacious health moonshots.
• 58:27
  If you wanna learn how you can join this community of entrepreneurs, or if you wanna connect with one of our four hundred and fifty companies, go to startuphealth.com.
• 58:35
  If you'd like to learn how you can invest in our Health Moonshot Impact Fund, go to healthmoonshots.com. Thanks for listening to "Startup Health Now." We'll be back again with another episode next week. [upbeat music]