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As COVID-19 continues to infiltrate communities across the country, I’ve done my best to keep my distance socially. One of my primary activities during this time has been online streaming services, discovering new and rewatching beloved movies and shows.
A few years ago, I was fortunate to see Hamilton on Broadway, and when it was released last summer for streaming, I dove in. What can I say? I love everything about that musical—the songs, the talent, the storylines, the intention and the diversity in cast and perspective. It left its mark on me: the power of how to reimagine structures, the beauty of perspective, the importance of inclusion.
But this time it was more than just being a fan…something about it hit deep when I watched it in 2020. I experienced it against the backdrop of growing social awareness and action against our society’s injustices. I watched it while mourning the many who have lost their lives to systemic racism and discrimination in criminal justice, health care, employment, housing and other social structures.
And in that context, the song, “The Room Where it Happens” became an earworm for me. It underpins the critical nature of diversity, equity and inclusion in all we do—especially in health care. The song depicts a dinner where Alexander Hamilton, Thomas Jefferson and James Madison have closed-door negotiations, each walking away with what they wanted:
“….No one really knows how the parties get to ‘Yes’
The pieces that are sacrificed in every game of chess
We just assume that it happens
But no else is in the room where it happens”
This refrain commands the push and pull of policies, programs and decisions developed in a vacuum. It is the experience of communities that have been historically marginalized, that are on the receiving end of work that occurs in the “rooms” that are often closed to their participation, will, experiences and concerns. Historically and in present day, many communities are acutely aware that they are not in the room when it happens.
As I write this, the health care industry is going through a wave of changes, steeped in awareness that equity cannot be only an “add on” to health care solutions. I applaud this! We’re having conversations, making pledges and presentations across the industry on embedding equity, diversity and inclusion into the standard practices of health care. And at NCQA, Accreditation standards are changing to enhance equity, revamping how
demographic data is captured to reflect the diverse needs of communities, enhancing the allocation of SDOH.
Yet, with all this growth, past mistakes continue to be made. As I sit in rooms where changes are being considered, the familiar faces and voices still don’t reflect people who have been affected by
inequity, discrimination and disparities. Often, I’m the only minority in the room. Why?
Equity in health care requires diversity. It requires looking at issues through multiple lenses and experiences and including them in solutions. It requires intersectionality of opinion, experiences, cultures and lives. Most critical and essential, it requires the voice of the community in order to effect true change and develop solutions that work. This is something every organization can do.
As Aaron Burr says (via Lin-Manuel Miranda):
“We want our leaders to save the day
But we don’t get a say in what they trade away
We dream of a brand new start
But we dream in the dark for the most part
Dark as a tomb where it happens
I wanna be in the room where it happens”
When you are in a room where decisions are being made, ask yourself who’s missing—who has been traditionally excluded? Then, make the change.
We all need to be in the room where it happens.
“The Room Where It Happens,” by Lin-Manuel Miranda
Danielle Brooks | Director of Health Equity | AmeriHealth Caritas Family of Companies
Danielle J. Brooks, J.D. has spent over a decade designing, leading and managing research, project development, strategy and implementation programs across a variety of industries including healthcare, media and communications, human rights, policy, and law. She prides herself on bridging creativity with strategic approaches that result in true impact. She is a recognized thought leader and expert in the field of health equity.
Danielle has served on the Health IT advisory board for the Transdisciplinary Collaborative Center (TCC) for Health Disparities Research at Morehouse School of Medicine, and the Advisory Panel for Health IT, Health Disparities, and Improving Industry for the Patient Centered Outcome Research Institute (PCORI), co-chaired the Academy Health Low-Value Care Group. Danielle is the former owner and Managing Director of Bridges, a boutique healthcare consulting firm with national reach; the primary author of the Petal Framework, a Bridges and Morehouse School of Medicine project; and, a producer for the Healthcare Road Trip.
Currently, she is the Director for Health Equity, for AmeriHealth Caritas Family of Companies where she develops programs and initiatives both internally and externally to close disparities and create a culture of equity for the communities we serve. She also serves on the NCQA Health Equity Standards Committee and was appointed to the Biden Administration, Health and Human Services, Office of the National Coordinator Health Data Systems Task Force. The purpose of the task force is to inform Health and Human Services’ response to President Biden’s Executive Order on Ensuring a Data-Driven Response to COVID-19 and Future High-Consequence Public Health Threats.