Latest / Becker’s Healthcare Podcast / Health Equity Leadership Amid Minnesota ICE Raids and Systemic Strain

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Health Equity Leadership Amid Minnesota ICE Raids and Systemic Strain · Becker’s Healthcare Podcast

0:02
This is where health care leadership comes together.
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Becker's sixteenth annual meeting brings more than 3,500
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hospital and health system executives and nearly 800
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speakers to Chicago April.
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This series event includes keynote conversations with Dallas
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Cowboys legend Troy Aikman and former president George
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W. Bush. For the agenda and event details,
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visit beckershospitalreview.com
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and click on the events tab in the
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upper right. We're looking forward to hosting you
0:29
in Chicago.
0:32
This is Laura Dierda with the Becker's Healthcare
0:34
podcast. I'm thrilled today to be joined by
0:36
Nneka Sederstrom, who is the chief health equity
0:39
officer at Hennepin Healthcare. Nneka, it's a pleasure
0:41
to have you on the podcast today. Thank
0:43
you. Nice to talk with you, Laura.
0:45
Absolutely. Now I'm looking forward to our conversation
0:48
because I know there's so much happening in
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health care today, particularly a lot that you're
0:53
working through at Hennepin Healthcare. So I'm
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excited to learn more and and hear from
0:58
you as well as get your perspective on
1:00
the future. I think you've got a a
1:02
really, really strong background to tell us a
1:04
little bit more about how you're thinking about
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things ahead of in health care as well
1:08
as, set the stage for how so many
1:10
folks are are,
1:11
looking at it and dealing with health equity
1:13
across the board. So, thank you. Thank you
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so much for your time. No. Thank you.
1:18
And I wanna say that Hennepin is not
1:21
unique in this space. There are hospitals all
1:23
across our nation right now that are struggling
1:26
with the ever living crisis around the health
1:29
care inequities on top of changes in health
1:32
care policy from a legislative perspective and the
1:35
impact on our communities.
1:36
Health care is hard right now. Financially, it's
1:39
struggling.
1:40
Maintaining health and wellness for populations is struggling
1:44
and all of that hit on top of
1:46
us not yet,
1:47
reaching a point in inequity work
1:50
where black and brown communities have increased their
1:53
clinical outcomes,
1:55
to keep them safe. So,
1:57
Hennepin and others are all struggling to continue
2:01
to do right by community
2:02
given the external factors that are making it
2:04
really challenging.
2:07
Absolutely. That's such a a great point and
2:09
so important to keep in mind in front
2:10
and center as leaders are making decisions and
2:13
planning for the future. Now I know we're
2:15
going to get into a few of those,
2:18
items. But before we do, can you,
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introduce yourself for our audience? Just tell us
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a little bit about your background in Hennepin
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Healthcare as well.
2:26
Sure. My name is doctor Naka Seiderstrom.
2:29
I am the current chief health equity officer
2:31
for Hennepin Healthcare.
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My background is in clinical ethics, race, class,
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and gender inequalities, and medical sociology.
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I have had twenty plus years in bedside
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medicine and critical care medicine specializing
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in clinical ethics
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and end of life care.
2:47
And I moved into the health equity space
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as the first chief health equity officer in
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the state of Minnesota
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at Hennepin Healthcare, which is the,
2:55
big inner city level one trauma, the only
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safety net in the state.
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And our patient population is roughly seventy five
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percent of color,
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and we are in Downtown Minneapolis,
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and take care of the sickest of the
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sickest and have the best staff that work
3:11
tirelessly to address inequities in Minnesota.
3:14
Absolutely. That's helpful to understand and great context
3:17
leading into our discussion. So when you think
3:19
about the last year or so, what is
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the most important initiative that you've led? What
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did you do, and what were the results?
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I think the last the most important initiative
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that we've led over the last year is
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truly
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our initiative of,
3:34
future thinking. If we think about what tomorrow
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is gonna bring and what we need to
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set up in order to move things forward,
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it really is about how are we building
3:43
the pipeline
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for
3:45
young people of color in particular to see
3:47
themselves in hospital spaces,
3:49
to see themselves as the physicians, the caregivers,
3:52
the nurses, the dentists, the surgeons,
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to know that this is an area where
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they belong because we know that the biggest
3:59
impact on inequities is clinical concordance
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with racial clinical concordance with the person taking
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care of you. If you look like me,
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you talk like me, you sound like me,
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you come from my cultural background.
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It's easier for me as a patient to
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trust you initially,
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which makes it easier for me to pay
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attention to what you're saying and do my
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treatment plan because I believe that you have
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my best interest.
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Data has shown that racial concordance is a
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significant
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improver of outcomes for people of color. And
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so in order to do that, we have
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to be really clear in making the next
4:32
generation understand that these spaces
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are for them. They are what a doctor
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looks like. They are what a nurse looks
4:38
like. And so we created what we call
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the Talent Garden Program, which is a program
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that's dedicated to introducing
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medicine in all its glory to youth of
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color in the Twin Cities area. We've had
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kids from out of the state to come
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to our programming, but we really do focus
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within the Hennepin
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County area.
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And we have successfully had over 1,600
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kids come through our doors to spend a
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day falling in love with medicine.
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And then we have a paid internship every
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summer, the last three summers,
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where 22 to 24 kiddos who are really
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serious about wanting to maybe go into health
5:13
care get to come and spend a summer
5:15
getting paid to learn. And they rotate through
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various departments and spend time shadowing physicians and
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nurses.
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They rock the babies in the NICU. They
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help hold a hand while someone's dying. They
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learn truly what it means to be in
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this space. And I'm really excited about our
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first cohort
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in college now getting ready to graduate, and
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several of them have already told me that
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they're applying to medical school or already in
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nursing school and are doing the programs that
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we know will build our
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our workforce for tomorrow, and I'm excited for
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them to come back and work at Hennepin.
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That's amazing to hear. I mean, that sounds
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like a program that is so beneficial
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in thinking far ahead in how you're building
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that pipeline and making a difference within the
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community. I think in hearing you talk about
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that, you have me choked up honestly,
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and, knowing how much that you care for
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these children in this community and then the
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opportunity that they have,
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to get that support that they need in
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order to go into a health care
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role in career and industry, is just fascinating.
6:15
So, that sounds like an amazing opportunity. Now
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I wanted to to take a moment to
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think about where you're at today, and then
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looking ahead as well, I can imagine,
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where you're positioned in Minnesota. There's so much
6:27
happening,
6:28
on the ground and, you know, the the
6:31
things that are happening with the ICE protests
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and everything else within the community,
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impacts health care and the health care that
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you're providing. So,
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how is that impacting, you know, you today
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as well as how you're thinking about the
6:43
future?
6:44
Yeah. As you can imagine, it is a
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struggle to try and work through the inequities
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and the trauma that we already have every
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day,
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with this added extra
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traumatic experience of having
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ice in our backyard and intentionally terrorizing our
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community,
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and
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mistreating patients within the walls of the hospital
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and in surrounding areas.
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It is it's a challenge,
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and it is something that I think the
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entire
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country is watching, which I hope that they're
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watching.
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History has shown in the past these kinds
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of, actions, these kinds of gestapo like actions
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have led down roads that people do not
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wanna travel again, and we need to be
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stewards of history and remember
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and know that we can be better than
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that. And so my hope is that
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enough,
7:33
of community
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uprising and community unity will lead to moving
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people like the ICE agents out of our
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city so that we can get back to
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the business of taking care of each other.
7:45
The headwinds
7:46
on top of this kind of scenario that
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we're facing now that I I believe are
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also,
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big impactors of health for 2026
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are the stressors around the Affordable Care Act
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and the changes,
7:58
with the new premium hikes.
8:00
Many, many millions of Americans are going to
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become uninsured.
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Again,
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when things like this happen, those who are
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already
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impacted from a a disadvantaged perspective, whether it's
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regionally disadvantaged because you live in rural Minnesota
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and you don't have access
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to the big academic centers
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geographically located most centralized in Minnesota or if
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you're, you know, racially segregated,
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as a result of poverty and social economic
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status, like, all of the different things that
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make inequities in health care will be exacerbated
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with these new laws,
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and limitations
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for
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our underinsured
8:38
and uninsured patients. And that's gonna tax the
8:41
system at levels that we've never seen before,
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especially a system that's already overly taxed and
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with the cost of health care being unaffordable
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with the way we do health care already.
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So it is going to be a very,
8:53
very hard year, for health care. But one
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of the things that I am hopeful for
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is that we will finally take a second
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to recognize that the way we do medicine
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in America right now is just not gonna
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work. It doesn't work this way. The system
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was not set up to care for all
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people equally,
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and it is not based on equity, which
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means, of course, it gives you what you
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need. It has nothing to do
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with a resource pie that somehow one gets
9:18
smaller than the other. Everybody gets exactly what
9:20
they need. We didn't build health care in
9:22
America based off that strategy.
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And as a result, we cannot care for
9:26
all Americans the way we need to right
9:28
now. And so my hope is that the
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continued pressures will finally allow
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those in charge, legislative action, the system builders
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to say we have to do something better
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and we need to build it in a
9:40
way that actually honors everyone who is in
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this country who needs care because health care
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is not a right for some. It's a
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right for all.
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Absolutely. I think that makes so much sense
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in it to truly understand that big picture
9:54
and global view of the health care ecosystem
9:56
and how, you know, it its design does
9:59
not meet what we need in order to
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have that kind of equitable distribution of care
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and access to care,
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is so important
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and especially important to elevate as we have
10:08
opportunities to transform the system in certain ways
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and and trying to continue to be disruptive
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and make those transformations happen.
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How are you looking at, you know, the
10:19
hardest thing you have to do in the
10:20
coming year? What do you think that will
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be, and, you know, where do you see
10:23
some of these other,
10:24
transformational efforts coming from?
10:27
The hardest thing, honestly, for me will be
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to not
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allow myself to get
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completely
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beat up by the challenges.
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I think one of the struggles as an
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African American woman, especially in this space of
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inequities and
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shouldering this work
10:45
of being seen as the people to do
10:47
the disruption. Right? It's a little bit of,
10:49
like, the badge that we wear as black
10:51
women is where we are the ones with
10:52
the loudest voices. We are the ones standing
10:54
up against the inequities and trying desperately to
10:57
fight against
10:58
the wave of
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of everything that comes at us and trying
11:02
to stem it for the people who we're
11:04
protecting behind us.
11:06
And what happens is we succumb. And what
11:09
I find has been a telling
11:12
outcome is over the last year with all
11:14
the attacks,
11:15
on the diversity, equity, inclusion work that have
11:18
systemically
11:19
hit African American women the hardest,
11:22
there hasn't been a lot attention paid to
11:24
not only the hits on social economic ability
11:28
to maintain
11:29
health and wellness,
11:30
for themselves, but for their families, but also
11:32
the astounding number of African American women who
11:35
have died
11:36
as a result of the extra stress that
11:38
has come with trying to maintain.
11:40
So I personally am trying to just stay
11:43
alive,
11:44
which is
11:45
very depressing to say, but also a reality
11:48
that I think we all we all have
11:50
to face. I mean, if you are too
11:52
sick and incapable of working on this work,
11:54
you're not gonna help the community. So we
11:56
do have to have
11:58
the audacious goal of resting and stepping back
12:00
and saying, enough. I choose me. I don't
12:03
need to be in toxic environments. I don't
12:05
need to continuously
12:06
have to hold up everything for others.
12:09
Someone else needs to step in so that
12:11
I can take my rest.
12:13
If we have enough of that, I think
12:15
we'll be able to heal
12:16
enough to be able to move into whatever
12:18
the next phase is to actually push forward.
12:21
But my worry is that it will be
12:23
really challenging
12:24
to step back because
12:26
it feels a little like failure when you
12:28
walk away. It's when so many people are
12:30
counting on you. But we do know that
12:32
sometimes you have to step back in order
12:33
to step forward. So, 2026,
12:36
I think, is gonna be a lot of,
12:37
like, figuring out how to step back before
12:39
a step forward.
12:41
That's such an excellent point and great way
12:43
of framing the real challenge
12:45
upon yourself as well as black women across
12:47
the country, and they're looking at these things
12:49
and advocating for,
12:51
what's right and what they need to do
12:53
in order to uplift,
12:55
overall. I'm curious when you look at it
12:57
and talk about having that moment, being able
13:00
to step back, what have you been doing
13:02
or or building,
13:03
you know, over time to make sure that
13:06
as you're stepping back, you know, you can
13:08
be confident in those that can step forward
13:10
and really carry the torch for you?
13:13
Yeah. I'm really proud of the work that
13:15
the health care the health equity team at
13:17
Hennepin Healthcare does. That team is full of
13:20
phenomenal humans who have stepped into
13:23
spaces that never existed before and have defined
13:26
what those spaces are and has demanded respect
13:28
in those spaces.
13:30
The system that was set up there is
13:32
second to none. We are the model in
13:33
the country,
13:35
and we do it right. Now just because
13:37
we do it right and just because we're
13:39
the best doesn't mean that people understand that
13:41
respect and wanna keep that.
13:43
But it does show that it can be
13:44
done. I fully believe
13:47
in everyone
13:48
who works on my team. I know that
13:50
they are committed. I know that they have
13:52
the creativity,
13:53
and I know that they have the courage
13:55
to stand up and say what needs to
13:56
be said and do what needs to be
13:58
done.
13:59
So I am very proud of any legacy
14:01
that I leave, and I'm very proud of
14:04
what was done when,
14:06
when we started, where we are today, and
14:07
what we're gonna be in the future.
14:10
Absolutely. That's so helpful to know. And I
14:12
think just for one moment, you know, there's
14:14
so many hospitals and systems out there that,
14:17
to your point, have had to try to
14:19
figure out how to build a great health
14:20
equity team in weathering many of the same
14:24
signals from the federal government as well as
14:26
other places, you know, and how
14:28
they they have had to be cautious about
14:30
it. But from your perspective, what can hospitals
14:32
and systems do? What's, you know, important for
14:35
them as they're setting up these teams that
14:37
serve in that purpose, that function of
14:39
creating more health equity within their organizations?
14:42
Most important thing I I think these hospital
14:44
systems can do is truly find members of
14:46
the community
14:48
who can speak for the community in the
14:50
hospital.
14:51
Oftentimes,
14:52
health equity departments,
14:55
any of the traditional diversity, equity, inclusion departments
14:59
are not necessarily run by people who,
15:02
one, have the full community voice and two,
15:04
have the authority within a hospital to actually
15:06
make a difference. I think hospital systems need
15:09
to stop trying to
15:10
just embed health equity or any sort of
15:13
equity work under bigger umbrellas like population health
15:16
or, like, HR for the DEI stuff. They
15:19
have to stop assuming that this is a
15:21
tangential thing because there's no way to actually
15:23
do medicine the right way and truly be
15:26
a center for excellence and truly have good
15:28
outcomes with your patient care and all the
15:30
wonderful things that our hospitals are looking for
15:33
if we are not doing medicine through an
15:35
equity lens. It's just impossible.
15:37
So if standard of care means that your
15:39
patients of color still are having worse outcomes,
15:42
then adding a DEI or a health equity
15:45
team under an umbrella that doesn't directly get
15:47
at that or directly have the authority to
15:49
get at that is just performative.
15:52
My hope is that hospital systems stop being
15:55
performative and honestly honor what is necessary in
15:58
order to approve the patient's outcomes.
16:00
Absolutely. That's so helpful to understand. Thank you.
16:03
Thank you so much for digging a little
16:04
bit deeper there. Now before we wrap up,
16:07
I'm curious, where do you see some of
16:08
the best opportunities
16:10
for Hennepin Healthcare's growth in the future?
16:13
Well, you know, I think right now, Hennepin
16:15
has gotta take a second and stabilize. I
16:18
think the world is
16:20
really challenging from a cost perspective, from a
16:24
external factors like ICE,
16:27
and Minnesota being a target right now.
16:29
And they need to take a second and
16:31
stabilize, and then I believe
16:33
they will be really ready to figure out
16:36
our next steps. I mean, we grew from
16:38
a department of me plus five others to
16:41
over a 150 strong in my department. So
16:43
we know how to do this work, and
16:45
we know how to do it the right
16:46
way and to grow it the right way.
16:48
But there's also a time when just kinda
16:50
pausing and surviving the storm is necessary.
16:53
So right now, that would be what I
16:55
would push forward, and I think my team
16:57
is all on board. Let's just keep surviving,
17:00
until we feel more stable, and then we
17:02
can move forward.
17:04
Absolutely. I a 100% understand that.
17:07
Doctor Cederstrom, thank you so much for joining
17:09
the podcast today. This has been, an incredible
17:12
conversation. I appreciate your candidness and honest perspective,
17:15
and, certainly,
17:16
it's been a a great opportunity to learn
17:19
from you and and grow as well. And
17:20
I'm excited to meet you as well at
17:22
our annual meeting. I know you'll be speaking
17:23
on a panel there, and so it'll be,
17:26
really fun to meet face to face and
17:28
continue on this conversation.
17:29
Great. Yeah. It's so good to meet you.