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Becker’s Healthcare Podcast
Health Equity Leadership Amid Minnesota ICE Raids and Systemic Strain
00:17:35
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- [00:02]
A
This is where healthcare leadership comes together. Becker's 16th annual meeting brings more than 3,500 hospital and health system executives and nearly 800 speakers to Chicago, April 13th through the 16th. This year's event includes keynote conversations with Dallas Cowboys legend Troy Aikman and former President George W. Bush. For the agenda and event details, visit Beckershospitalreview.com and click on the Events tab in the upper right. We're looking forward to hosting you in Chicago.
- [00:32]
B
This is Laura Dardo with the Beckers Healthcare Podcast. I'm thrilled today to be joined by Neka Sederstrom, who is the Chief Health Equity Officer at Hennepin Healthcare neca. It's a pleasure to have you on the podcast today.
- [00:43]
C
Thank you. Nice to talk with you, Laura.
- [00:45]
B
Absolutely. Now, I'm looking forward to our conversation because I know there's so much happening in healthcare today and particularly a lot that you're working through at Hennepin Healthcare. So I'm excited to learn more and hear from you as well as get your perspective on the future. I think you've got a really, really strong background to tell us a little bit more about how you're thinking about things ahead of in healthcare as well as set the stage for how so many folks are looking at and dealing with health equity across the board. So, thank you. Thank you so much for your time.
- [01:17]
C
No, thank you. And I want to say that Hennepin is not unique in this space. There are hospitals all across our nation right now that are struggling with the ever living crisis around the healthcare inequities on top of changes in health care policy from a legislative perspective and the impact on our communities. Health care is hard right now. Financially, it's struggling. Maintaining health and wellness for populations is struggling and all of that hit on top of us not yet reaching a point in inequity work where black and brown communities have increased their clinical outcomes to keep them safe. So Hennepin and others are all struggling to continue to do right by community given the external factors that are making it really challenging.
- [02:07]
B
Absolutely. That's such a great point and so important to keep in mind and front and center as leaders are making decisions and planning for the future. Now, I know we're going to get into a few of those items, but before we do, can you introduce yourself, our audience? Just tell us a little bit about your background in Hennepin Healthcare as well.
- [02:27]
C
Sure. My name is Dr. Naka Cedarstrom. I am the current chief Health Equity officer for Hennepin Healthcare. My background is in clinical ethics Race, class and gender inequalities, and medical sociology. I have had 20 plus years of bedside medicine and critical care medicine, specializing in clinical ethics and end of life care. And I moved into the health equity space as the first chief health equity officer in the state of Minnesota at Hennepin Healthcare, which is the big inner city, level one trauma, the only safety net in the state, and our patient population is roughly 75% of color. And we are in downtown Minneapolis and take care of the sickest of the sickest and have the best staff that work tirelessly to address inequities in Minnesota.
- [03:15]
B
Absolutely. That's helpful to understand and great context leading into our discussion. When you think about the last year or so, what is the most important initiative that you've led? What did you do and what were the results?
- [03:27]
C
I think the most important initiative that we've led over the last year is truly our initiative of future thinking. If we think about what tomorrow is going to bring and what we need to set up in order to move things forward, it really is about how are we building the pipeline for young people of color in particular to see themselves in hospital spaces, to see themselves as the physicians, the caregivers, the nurses, the dentists, the surgeons, to know that this is an area where they belong. Because we know that the biggest impact on inequities is clinical concordance with racial clinical concordance with the person taking care of you. If you look like me, you talk like me, you sound like me, you come from my cultural background. It's easier for me as a patient to trust you initially, which makes it easier for me to pay attention to what you're saying and do my treatment plan, because I believe that you have my best interest. Data has shown that racial concordance is a significant improver of outcomes for people of color. And so in order to do that, we have to be really clear and making the next generation understand that these spaces are for them. They are what a doctor looks like, they are what a nurse looks like. So we created what we call the Talent Garden program, which is a program that's dedicated to introducing medicine in all its glory to youth of color. In the Twin Cities area. We've had kids from out of the state to come to our programming, but we really do focus within the Hennepin county area. And we have successfully had over 1600 kids come through our doors to spend a day falling in love with medicine. And then we have a paid internship every summer, the last three summers, where 22 to 24 kiddos who are really serious about wanting to maybe go into healthcare, get to come and spend a summer getting paid to learn. And they rotate through various departments and spend time shadowing physicians and nurses. They rock the babies in the nicu. They help hold a hand while someone's dying. They learn truly what it means to be in this space. And I'm really excited about our first cohort in college now getting ready to graduate. And several of them have already told me that they're applying to medical school or already in nursing school and are doing the programs that we know will build our workforce for tomorrow. And I'm excited for them to come back and work at Hennepin.
- [05:50]
B
That's amazing to hear. I mean, that sounds like a program that is so beneficial in thinking far ahead and how you're building that pipeline and making a difference within the community. I think in hearing you talk about that, you have me choked up, honestly. And knowing how much that you care for these children in this community and then the opportunity that they have to get that support that they need in order to go into a healthcare role in career and industry is just fascinating. So that sounds like an amazing opportunity. Now I wanted to take a moment to think about where you're at today and then looking ahead as well. I can imagine where you're positioned in Minnesota. There's so much happening on the ground and you know, the things that are happening with the ICE protests and everything else within the community impacts health care and the health care that you're providing. So how is that impacting you today as well as how you're thinking about the future?
- [06:45]
C
Yeah. As you can imagine, it is a struggle to try and work through the inequities and the trauma that we already have every day with this added extra traumatic experience of having ICE in our backyard and intentionally terrorizing our community, mistreating patients within the walls of the hospital and in surrounding areas. It is, it's a challenge and it is something that I think the entire country is watching, which I hope that they're watching. That history has shown in the past, these kinds of actions, these kinds of gestapo like actions have led down roads that people do not want to travel again. And we need to be stewards of history and remember and know that we can be better than that. And so my hope is that enough of community uprising and community unity will lead to moving people like the ICE agents out of our city so that we can get back to the business of taking care of each other. The headwinds on top of this kind of scenario that we're facing now that I believe are also big impactors of health for 2026 are the stressors around the Affordable Care act and the changes with the new premium hikes. Many, many millions of Americans are going to become unre, uninsured again. When things like this happen, those who are already impacted from a disadvantaged perspective, whether it's regionally disadvantaged because you live in rural Minnesota and you don't have access to the big academic centers, geographically located, most centralized in Minnesota, or if you're, you know, racially segregated as a result of poverty and social economic status. Like all of the different things that make inequities in health care will be exacerbated with these new laws and limitations for our underinsured and uninsured patients. And that's going to tax the system at levels that we've never seen before, especially a system that's already overly taxed. And with the cost of health care being unaffordable with the way we do healthcare already. So it is going to be a very, very hard year for healthcare. But one of the things that I am hopeful for is that we will finally take a second to recognize that the way we do medicine in America right now is just not going to work. It doesn't work this way. The system was not set up to care for all people equally. And it is not based on equity, which means, of course, it gives you what you need. It has nothing to do with a resource pie that somehow one gets smaller than the other. Everybody gets exactly what they need. We didn't build healthcare in America based off that strategy. And as a result, we cannot care for all Americans the way we need to right now. And so my hope is that the continued pressures will finally allow those in charge, legislative action, the system builders, to say, we have to do something better, and we need to build it in a way that actually honors everyone who is in this country who needs care. Because health care is not a right for some, it's a right for all.
- [09:50]
B
Absolutely. I think that makes so much sense and to truly understand that big picture and global view of the health care ecosystem and how, you know, its design does not meet what we need in order to have that kind of equitable distribution of care. And access to care is so important and especially important to elevate as we have opportunities to transform the system in certain ways and trying to continue to be disruptive and make those transformations happen. How are you looking at, you know, the hardest thing you have to do in the coming year? What do you think that will be. And, you know, where do you see some of these other transformational efforts coming from?
- [10:27]
C
The hardest thing, honestly for me will be to not allow myself to get completely beat up by the challenges. I think one of the struggles as an African American woman, especially in this space of inequities and shouldering this work of being seen as the people to do the disruption, right, it's a little bit of like the badge that we wear as black women is where we are the ones with the loudest voices. We are the ones standing up against the inequities and, and trying desperately to fight against the wave of, of everything that comes at us and trying to stem it for the people who we're protecting behind us. And what happens is we succumb. And what I find has been a telling outcome is over the last year, with all the attacks on diversity, equity, inclusion work that have systemically hit African American women the hardest, there hasn't been a lot of attention paid to not only the hits on social, economic, ability to maintain health and wellness for themselves, but for their families, but also the astounding number of African American women who have died as a result of the extra stress that has come with trying to maintain. So I personally am trying to just stay alive, which is very depressing to say, but also a reality that I think we all have to face. I mean, if you are too sick and incapable of working on this work, you're not going to help the community. So we do have to have the audacious goal of resting and stepping back and saying, enough. I choose me. I don't need to be in toxic environments. I don't need to continuously have to hold up everything for others. Someone else needs to step in so that I can take my rest. If we have enough of that, I think we'll be able to heal enough to be able to move into whatever the next phase is to actually push forward. But my worry is that it will be really challenging to step back because it feels a little like failure when you walk away. It's when so many people are counting on you. But we do know that sometimes you have to step back in order to step forward. So 2026, I think, is going to be a lot of like, figuring out how to step back before I step forward.
- [12:41]
B
That's such an excellent point and great way of framing the real challenge upon yourself as well as black women across the country. And they're looking at these things and advocating for what's right and what they need to do in order to uplift overall I'm curious, when you look at it and talk about having that moment, being able to step back, what have you been doing or building, you know, over time to make sure that as you're stepping back, you know, you can be confident in those that can step forward and really carry the torch for you.
- [13:13]
C
Yeah, I'm really proud of the work that the health care, the health equity team at Hennepin Healthcare does. That team is full of phenomenal humans who have stepped into spaces that never existed before and have defined what those spaces are and has demanded respect in those spaces. The system that was set up there is second to none. We are the model in the country and we do it right now. Just because we do it right and just because we're the best doesn't mean that people understand that, respect that and want to keep that, but it does show that it can be done. I fully believe in everyone who works on my team. I know that they are committed. I know that they, they have the creativity and I know that they have the courage to stand up and say what needs to be said and do what needs to be done. So I am very proud of any legacy that I leave and I'm very proud of what was done when, when we started, where we are today and what we're going to be in the future.
- [14:10]
B
Absolutely. That's so helpful to know. And I think just for one moment, you know, there's so many hospitals and systems out there that, to your point, have had to try to figure out how to build a great health equity team in weathering many of the same signals from the federal government as well as other places, you know, and how they, they have had to be cautious about it. But from your perspective, what can hospitals and systems do, what's, you know, important for them as they're setting up these teams that serve in that purpose, that function of creating more health equity within their organizations.
- [14:43]
C
Most important thing I think these hospital systems can do is truly find members of the community who can speak for the community in the hospital. Oftentimes, health equity departments, any of the traditional diversity equity inclusion departments, are not necessarily ran by people who, one, have the full community voice and two, have the authority within the hospital to actually make a difference. I think hospital systems need to stop trying to just embed health equity or any sort of equity work under bigger umbrellas like population health or like HR for the DEI stuff. They have to stop assuming that this is a tangential thing because there's no way to actually do medicine the right way and truly be a center for excellence and truly have good outcomes with your patient care and all the wonderful things that our hospitals are looking for. If we are not doing medicine through an equity lens, it's just impossible. So if standard of care means that your patients of color still are having worse outcomes than adding a DEI or a health equity team under an umbrella that doesn't directly get at that or directly have the authority to get at that, is just performative. My hope is that hospital systems stop being performative and honestly honor what is necessary in order to improve the patient's outcomes.
- [16:01]
B
Absolutely. That's so helpful to understand. Thank you. Thank you so much for digging a little bit deeper there. Now, before we wrap up, I'm curious, where do you see some of the best opportunities for Hennepin Healthcare's growth in the future?
- [16:13]
C
Well, you know, I think right now Hennepin has got a take a second and stabilize. I think the world is really challenging from a cost perspective from external factors like ice in Minnesota being a target right now, and they need to take a second and stabilize, and then I believe they will be really ready to figure out our next steps. I mean, we grew from a department of me plus 5 others to over 150 strong in my department. We know how to do this work and we know how to do it the right way and to grow it the right way. But there's also a time when just kind of pausing and surviving the storm is necessary. So right now that would be what I would push forward. And I think my team is all on board with, let's just keep surviving until we feel more stable and then we can move forward.
- [17:04]
B
Absolutely. I 100% understand that. Dr. Cedarstrom, thank you so much for joining the podcast today. This has been an incredible conversation. I appreciate your candidness and honest perspective. And certainly it's been a great opportunity to learn from you and grow as well. And I'm excited to meet you as well at our annual meeting. I know you'll be speaking on a panel there, and so it'll be really fun to meet face to face and continue on this conversation.
- [17:30]
C
Great. Yeah, it's so good to meet you.