“Health and wealth are intricately connected,” says Thea James, MD, MBA, co-executive director of Boston Medical Center’s Health Equity Accelerator and vice president of Mission, in a new mini documentary. The video is part of Healthier Together, a BBC StoryWorks series that explores the untold stories of resilience, compassion, and innovation in healthcare systems across the world. Launching this month, it features James, as well as other voices from BMC Health System (BMCHS), speaking out about its commitment to delivering expert care that works to close health disparities. James continues, explaining: “When people don’t have financial security they cannot prioritize their health. They’re prioritizing survival.”
BMC’s video was made possible by the MassMutual Foundation, an early supporter of Boston Medical Center’s Health Equity Accelerator and financially supported the launch of an Economic Justic Hub, which strives to address economic insecurity, which impacts overall health. The mini documentary focuses on the story of Yesenia Valentin, a BMC patient and also features Sara Stulac, MD, MPH, medical director of BMC’s Pediatric Primary Care Clinic, including Practice of the Future and the SOFAR program.
Stulac and James spoke with HealthCity to elaborate more on what participating in the film meant for them and their driving visions of working toward health justice at BMC and beyond.
HealthCity: What do you hope people learn about the importance of health equity from this mini documentary? How does it feel to share BMC’s mission on this platform?
Sara Stulac, MD, MPH: In my work, I see the Pediatrics department as this incredible group of people that has a long legacy that is inspiring and unique. It has been a leader in commitment to children and families and to equity over the years. We don’t do it for any recognition, but it is really nice when there’s an opportunity to share, partly because I want to elevate our patient stories and our staff’s stories, and partly because I want to be able to be part of helping this kind of work happen elsewhere.
Thea James, MD, MBA: I enjoy telling that story. It inspires people, but in many cases, they also get directives they can apply to their work. For example, if you see inequities in data and you want to address it, traditionally, what people do is they go in a room and they try to come up with a plan to assess and address these inequities. But what they really have to do is ask the subjects of the data, and they will interpret the data for you. And they will also, if you allow it, provide solutions to make those data change. That is what we have been doing at BMC, and that’s why our outcomes happen so fast. That’s how equity gaps close.
In doing so, you have to let go of these old, antiquated models of providing healthcare. You have to give up your power, the idea that you, as a medical professional, have all the knowledge. You can’t determine what’s best for people when you’re not familiar with their life course or their lived experience.
We’re able to do this work because of our funders. It’s great to have a supporter like the MassMutual Foundation. They really recognize what everyone needs to thrive. Their willingness to support us in economic mobility is monumental.
HC: How did it feel to hear Yesenia tell her story?
TJ: It aligns with our intentionality and thoughtful, insightful decision-making in how we can best partner with patients on their chosen journey to thrive. And it drives home the point that, until we can provide people with opportunities to eliminate gaps and systemic barriers, so they have self-determination and are able to achieve at their highest levels, nothing changes. Her story is a perfect depiction of what our intentionality is. The goal is to enable thriving for people and to remove all the barriers — structurally and otherwise — that prevent that from happening.
SS: I think it shows what’s possible, what we hope to see for all our families. I see families every day with parents who are so motivated to care for their child and the rest of their family. With the right connections and building blocks they can not only get to a stable place for themselves, but they can also become a part of helping other people. It’s so powerful for a parent like Yesenia, who can say, “I’ve been here, I’ve been in this situation, and I’m not just going to help you, but I’m going to empower you.” You get into this very virtuous cycle, and that really is where the magic happens.
HC: What are key lessons you’ve learned in championing health equity at BMC? And then what are things that you hope for the future?
SS: The biggest lesson is that we must listen to patients, and we must listen to the members of the healthcare team who are the closest to patients. For example, the Practice of the Future model was built by doing interviews with families to hear how they conceived of their health and what they wanted from their healthcare provider. We have to do that every step of the way, because the more we pay attention, the more we really will stay true to what patients need. We have to particularly pay attention to the voices who have less power. And we can’t just say these things, but we have to create structures within our health system to specifically emphasize and amplify those voices to get to a place of equity.
TJ: I’ve learned that support and commitment from the very top of a healthcare system is the best chance to operationalize health equity with great outcomes. You have to be willing to allow yourself to be vulnerable and look inside your own house. For example, a few years ago we hired a company to interview patients and community members about their experiences at BMC, and we had to be ready for whatever came up. We had to be ready to manage that and stand in our discomfort. And we did that very well. I feel like we will change the nation because of the work we’re doing. We have proof of concept, proof that it works. And there’s more to come.
This interview has been edited for length and clarity.
