Making Racial Equity and Inclusion a Reality


Q&A with Adedoyin Eisape, MPH and Arie Hayre-Somuah, LMSW, MPH

In 2021, Health Care for the Homeless created two new positions to support racial equity and inclusion (REI) work across the agency. REI Project Manager II Adedoyin Eisape, MPH and REI Health Specialist Arie Hayre-Somuah, LMSW, MPH reflect on the challenges, opportunities and progress in their roles so far.

You both earned master’s degrees in the last year – Adedoyin in public health and Arie in social work. Following your programs, what led each of you to work at Health Care for the Homeless?

Arie: As both a public health practitioner and social worker, my goal has always been to improve the conditions of African American, Black and Brown communities. When looking for a new role, it was imperative that the organization that I would join systematically served these communities while actively working to be an anti-racist institution itself. Health Care for the Homeless was doing just that. I started January, 2022.

Adedoyin: I wanted to do work dealing with racism and power, serving people of color and communities that weren’t receiving high-quality care due to structural failings. This passion has shaped my personal and professional career. My graduate work explored how racial erasure and power inequities in government, nonprofit, and health care spaces impede our ability to look at or understand how these problems shape life and care. I was looking for a place that would allow me to continue such exploration. I came here in July, 2021.

What does it mean to be the REI Health Specialist vs. REI Project Manager II? How are your roles distinct?

Adedoyin: I’m looking at interpersonal and agency-level change management as ways to embed REI in all processes. I’m a thought partner and capacity builder across the agency. I look at how staff are conceptualizing REI and how we can work together to support that culture shift at Health Care for the Homeless. The partnership aspect is important, because to be successful requires us all to show up, be fully present and take responsibility for advancing this work. This touches on how we engage with clients, staff, and other agencies.

Arie: My work is racial equity work with a clinical focus. I collaborate with dental, psychiatry, medical, pediatrics, performance improvement and quality assurance to identify disparities in health, access, outcome and experience so that we are able to better understand how to achieve health equity. That manifests in different ways: Facilitating conversations with specific departments about health equity; working with the Quality team to look at data and determine best ways to visualize disparities data; determining the most appropriate language to use to describe disparities.

Your positions are new within the last year. How has it felt to join the agency at this stage of our REI work? What’s been challenging and what’s been most invigorating? Where are you seeing opportunities?

Adedoyin: Starting during the tail end of the initial information gathering work, I was trying to catch up and settle into this new role. Thankfully now I have been able to set a pace— but the role of accountability can sometimes be challenging. Personal responsibility must be equitably distributed to imbed the significance of this work. The time the agency has put into formalizing an REI approach through guiding principles and committees has been invigorating; we are setting ourselves up for intentional change. It’s interesting to think about what the agency will look like in a year or two and how much we put out there to hold ourselves accountable.

Arie: As the first person in this role, there’s ambiguity to navigate and trial and error. That’s also what’s invigorating about it. When you take on a feat such as dismantling white supremacy and becoming a racially equitable institution, it inevitably comes with growing pains, it comes with resistance, it comes with discomfort. We all benefit from the status quo in some way, myself included. It’s taken grace in the way I engage in the work personally and the way I engage others in this work. There’s opportunity to really call staff into the work of becoming racially equitable, because it affects clients and it’s an agency priority.

Rooted in our agency REI Action Plan, what are some of your primary goals or projects for 2022?

Arie: A big goal is to bring the theoretical into practice. One focus area is changing our kidney function and diagnosis test. The test we currently use, eGFR, is standard practice that is rooted in racist thought. It controls for race—but only for African American/Black persons, based on the inaccurate assumption that Black people have a higher muscle mass which impacts kidney function. This has resulted in underdiagnosing Black clients for kidney disease, which has severe real-world implications such as ineligibility for kidney transplants. There are labs that do different kidney function tests, so it’s a matter of doing our due diligence to find a non-biased replacement test and standardizing it across the agency.

Adedoyin: I have been supporting the implementation of Affinity Groups this summer, which is a priority in the Action Plan. So I have spent a lot of time engaging with ‘best practices' and analyzing how to share information related to this initiative. Considering new ways to intentionally engage and rethink the REI training space is another priority for me—including highlighting the role of power and personal accountability in that work.

Are there places we’re seeing practical application of REI theories already?

Arie: The Quality team is looking for disparities in every measure: levels of controlled hypertension, diabetes, breast cancer screening, cervical cancer screening and more. In each of these, they disaggregate data by gender and race. The next phase is using that data to inform interventions.

Adedoyin: Training and education have been an essential means to advance REI work at the agency. Some departments have started regular discussions in the REI space, bringing in materials from various trainings as a foundation. There has also been work in the hiring space to leverage historic partnerships to encourage an REI approach and engage with new partners that embody our REI goals.

What are you reading that you’d recommend or consider helpful for your own REI approach and knowledge?

Arie: I started reading Medical Apartheid. Practices that founded modern day medicine are inherently racist in a lot of ways that contribute to disparities today. Black people are more likely to have high levels of medical mistrust than any group (rightfully so), which perpetuates health disparities. If you’re less likely to trust your doctor, you’re less likely to go to your doctor, more likely to get diagnosed later stage, more likely to die early.

Adedoyin: I just published a paper about anti-Black racism in health systems (See Change: Overcoming Anti-Black Racism in Health Systems), so I’ve been focused on different books, papers and journal entries in that space:

  • Decolonizing the Mind: The politics of language in African literature. That’s an older work that looks at the lasting impact of colonialism in language, as it affects one’s ability to understand their own marginalization and move past it.
  • Chicago Beyond; Why Am I Always Being Researched? A free guidebook that examines the relationships between race, power, and privilege in research and ways to support more authentic engagement in that space.
  • Dr. Rhea Boyd: As a public health advocate, she offers nuanced understanding of how race, power, and privilege inherently shape our health systems.

How and where do you find space for self-care?

Arie: I am the queen of self care! I know what it’s like to be burnt out. As a therapist, I preach self care to everybody. So I’m pretty intentional about not looking at emails when I leave work. I recently discovered that you can do fun things after work—not just wait for the weekend. I dance Kizomba and Konpa, native to Angola and Haiti. I recently took up aerial yoga. I keep a running list of things I want to do like write a book, start a restaurant!

Adedoyin: I’m trying to build a better work-life balance. I’m trying to sew more, give myself spa days, and advance my yoga practice. I’m trying out roller skating and hoping to improve my swimming. I’d love to get some more sun and water around me this summer.

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