Last year, the COVID-19 pandemic ravaged communities and widened inequities while racial injustice caused civil unrest and uprisings around the globe. In its wake, companies were held accountable by an increasingly activated consumer base demanding changes that centered on BIPOC communities, addressed disparities, and furthered justice.
One half of UnitedHealth Group, Optum has a history of commitments to health equity. Last year, in response to the compounding crises, they stepped that up. A big part of that reason is Callie Chamberlain, who co-leads the company’s social responsibility program.
“We needed to continue our strategic work while responding to the moment with an even bolder focus on equity. To do that in an authentic way, we needed to think about how to leverage our assets and expertise in a focused way and ensure we were being guided by the people most impacted by structural inequity,” emphasizes Chamberlain.
With a history of social activism across sectors, Chamberlain consistently knits together her insights and experiences to address challenges in a fresh way. As she was completing a birth doula training program last year, she was learning about the country’s maternal health crisis. “Our health systems are set up in a way that often requires a birth doula to advocate on behalf of a birthing person. That is fundamentally wrong. That means as a health system, we’re not listening. When I learned that Optum provides services to one in ten babies delivered in the United States, I thought about what an opportunity we have to do things differently.”
Birth doulas are critical parts of a care team. They support birthing people in having a meditative and transformative experience during pregnancy, labor, and delivery while offering educational and emotional support.
She takes these practices to scale at Optum. “My firsthand experience as a doula showed me some of the ways we might start, so I pitched a strategy to address it,” she said.
As Chamberlain describes it, poor maternal health outcomes are a health issue that sits at the intersection of race and gender. The United States has increasingly dire outcomes for birthing people. Of all developed countries, the United States has the highest rate of maternal mortality and the CDC says that two-thirds of these deaths are considered preventable. In addition to mortality, there are an estimated fifty thousand to eighty thousand people who experience maternal morbidity, or what is commonly referred to as a ‘near miss’ experience. These outcomes impact disproportionately those who are Black, Indigenous, and people of color.
As birthing people undergo momentous changes mentally, emotionally, and physically throughout pregnancy and childbirth, their voices remain systemically silenced, leaving them feeling alone- and sometimes resulting in poor health outcomes.
“Birth is a spiritual experience. As a doula, I realized that for far too many people, they weren’t having that kind of experience. They were having deeply traumatic and near-death experiences. In some cases, they were being dismissed by their providers and not getting access to the things they needed to enjoy their pregnancy and stay healthy, resulting in a very transactional and impersonal, even dangerous experience. This is especially true for BIPOC birthing people,” Chamberlain notes.
She goes on to explain how this experience has shaped her view and that of Optum’s social responsibility program. “Our social responsibility program is built on the belief that as a company we can harness our talents and resources, partner with community organizations, and listen to birthing people. It’s why we invest in cultural competency training for our providers. It’s why we partner with Morehouse’s Maternal Health Equity Center to fund qualitative research on near-death experiences that we pair with quantitative analyses to understand where improvements can be made. It’s why we fund internal initiatives, like a pilot in our Pacific Northwest clinics supporting at-risk women in monitoring their health, and why we invest in scaling pilots and models that work. Our goal is a health system that works for everyone.”
Chamberlain emphasizes the importance of this multi-pronged approach that leverages internal assets and capabilities alongside external partnerships as the key to success. While Optum is focused on maternal health, she believes any company can follow its path to making a meaningful difference. The following are her suggested strategies for a company to address the most pressing equity issues in their communities:
Think about where you’re positioned to advance equity.
Look at the industry you’re in and consider how to leverage existing connections and expertise to address a problem authentically. “The goal is not to do more, but to do things in an equitable way by thinking differently about whom you’re serving and how. At Optum, we are positioned to address maternal health because of our focus on health, partnerships, and capabilities. Reflect on where you are uniquely positioned and start there.” For example, a food and beverage company could decide not to build playgrounds in low-income neighborhoods as part of their social responsibility strategy, but change their products to be healthier or offer them at lower price points to increase accessibility.
Solve with, and for, your most vulnerable populations.
The people closest to the problems are those who are best-positioned to address them. “We’re working with populations who are often overlooked: birthing people experiencing domestic violence, incarcerated women giving birth while shackled, and people without consistent access to care. We’re contributing to research that informs clinical practice and rebuilding relationships with communities of color by taking their lead. When we solve with, and for, our most vulnerable, we solve for everyone.”
Think about how you shift company culture in the process.
In addition to philanthropy, Optum developed pro-bono projects that extended grant dollars and engaged Optum staff on the maternal health crisis. “Staff can sign up to volunteer their time and expertise to our external partners. Afterward, we hear staff say their pro-bono experiences changed how they think about creating products and services in their day-to-day work, exposed them to populations they might otherwise never have the opportunity to learn from, and made them feel more purposeful and connected at work.” Another approach is to consider how internal changes can drive equity externally. “We’re piloting projects to see how changing practices within our clinics changes health outcomes and hoping to share those best practices across the field. Complex problems require collaboration across sectors. Private business has an incredible role to play,” says Chamberlain.
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