Engaging in leadership to address health inequity

The 2015 Healthy Communities Leadership Academy graduating class

Leadership is an activity, not a role or position! This is a core concept taught in the Healthy Communities Leadership Academy offered by the Health Forward for the past three years.

When leadership is an activity, it means we all have the capacity and responsibility to act. This is both liberating, because we can empower ourselves to do something, and concerning, because we can no longer simply blame others for the absence of change.

As we work toward eliminating health inequality through policy, environment, and system change, a critical tool in all of our toolboxes is leadership. It would be easier to look to those in authority or who have expertise to show us the way. However, this assumes that they alone have the answers, know the real issues, and have the will and capacity to do what is needed.  The challenge is that technical fixes, that often authority or experts can offer, will not fully resolve the issue of health inequity.

Increasing access, changing policies, improving environments, and adjusting the distribution of resources are critical to eliminating health inequity. Eliminating health inequity also requires us to address the challenges that make policy and system change difficult. It requires people from a variety of perspectives to learn together so that the deeper problems and potential solutions emerge. It requires us to have difficult conversations about things like power, privilege, racism, and sexism, just to name a few. 

We have to explore competing interests and overcome turf battles. It requires us to speak to the loss we face if we aren’t successful, as well as, the losses some face if we are successful. These adaptive challenges require something different than expertise or authority; they require many people engaging in acts of leadership.

Here are some acts of leadership to consider.

  • Look for questions versus answers. Be curious, look beyond the obvious, and ask lots of questions.  Be willing to slow the process versus bend to the pressures to act quickly and find simple solutions.
  • Bring uncommon voices to the table. Ask, “Who is not at the table that might have a perspective about this issue?” Bring to the process someone that daily and personally lives with the challenge you are trying to address. Equally partner with them throughout the entire process and trust they too bring expertise to the table.
  • Be uncomfortable and create discomfort. Build your tolerance to sit in ambiguity, uncertainty, and productive conflict. Be willing to speak the unspoken, to ask provocative questions, and bring “parking lot” conversations in the room.  Consider less noble interpretations of your own actions and explore unconscious biases that might be getting in the way.
  • Be vulnerable. Be willing to speak from your heart, to use your voice, and to let go of feeling the need to prove yourself. Be willing to say what you don’t know and be open about your agenda.
  • Act above your ‘pay grade’. Be willing to step out of your ‘role’ and take ownership for change to happen. Have a private conversation with your boss about what is really needed or publically offer ideas for solutions that are outside your scope of work.
  • Create safe environments to do difficult work. Honor the differing losses, risks, loyalties, and values of those you are working with. Engage in a trustworthy process that creates a common purpose, holds people accountable, and allows for honest exploration of competing needs and agendas.

Leadership requires us to take smart risks. Next time you are faced with an opportunity to engage in leadership and you pause to ask yourself, “Why would I take this risk?”  consider an additional or alternative question, “What is at risk if I do or say nothing?”

Eliminating health inequity requires all of us to engage in the risk of leadership. I wonder how much progress can be made if each of us engaged in leadership 10 percent more often than we currently do? Achieving health equity is important enough to me to make that stretch. How about you?

Gina C. Maree is also the director of Health Communities Leadership Academy.

Health Forward Foundation
2300 Main Street, Suite 304
Kansas City, MO 64108
(816) 241-7006