Bryan Stevenson says 'health equity is really health justice' | American Hospital Association Leadership Summit

Stevenson, the author of “Just Mercy” and inspiration of the film, has spent his adult life representing the disadvantaged in the criminal legal system. He urged hospital leaders to fight to end disparities in healthcare.

San Diego - Bryan Stevenson has devoted his life to justice.

He founded and leads the Equal Justice Initiative, which has spared more than 100 defendants from the death penalty and helped many who received unjust sentences. He led the development of the National Memorial for Peace and Justice in Montgomery, Alabama, which pays tribute to African-Americans who were enslaved, lynched and terrorized. His memoir of his legal career became a best-seller and inspired the critically acclaimed film, “Just Mercy.”

At the closing session of the first day of the American Hospital Association Leadership Summit Sunday, Stevenson challenged hospital leaders to confront health equity. Stevenson acknowledged the enormity of the problem but encouraged leaders to believe that it is possible.

“Health equity is really health justice,” Stevenson said. “Healthcare has to mean doing the most we can for those who have the least.”

Stevenson talked repeatedly about the need to finding ways to get closer to those in need, including those are poor, those struggling with substance abuse and those with disabilities. Hospitals and health leaders won’t be able to make progress on health equity without engaging and listening to those individuals.

He repeatedly touted the importance of healthcare providers being “proximate” to those less fortunate.

“When you get proximate to the poor ... you will hear things you will not otherwise hear,” Stevenson said.

“In science and medical research, we are all in when it comes to proximity,” Stevenson said.

“We don’t adopt proximity when it comes to addressing inequality.”

To make progress on reducing disparities, Stevenson said, “We’re going to have to make a commitment. We’re going to have to be intentional” about being proximate.

‘Change the narrative’

Health leaders need to change the narrative to dispel the stereotypes that have contributed to inequities. He said that requires a process of truth telling, followed by action. Many narratives are rooted in bigotry and violence.

For the healthcare sector, it means recognizing the failed policy of putting those struggling with addiction behind bars instead of in treatment, he said. It requires acknowledging that the evils of slavery and discrimination have a direct line to the wealth gap of Black Americans. It means openly addressing the killing of Native Americans and how “we live in a post-genocide nation.”

“We’re going to have to talk to things we haven’t talked about,” Stevenson said.

Even for Black people who are successful doctors, nurses and hospital CEOs, “If you’re Black or Brown, you will go to places in this country where you have to navigate a presumption of danger and guilt.”

“And it’s exhausting,” he said.

To achieve health equality, Stevenson said, “We have to change the narrative.”

In Germany, children are required to learn about the Holocaust, and there are no statues to Hitler and the Nazis, Stevenson said. He contrasted that with the statues of Confederate heroes across the South.

Discussing the sins of slavery and the Confederate statues elicits powerful emotions, but Stevenson said, “I have no interest in punishment. None. My interest is liberation.’

“There is something better waiting for us,” he said.

‘Stay hopeful’

Even in dealing with the pain of health equity and the crushing despair that accompanies the quest for social justice, health leaders must have hope, Stevenson said.

“We have to stay hopeful,” Stevenson said, adding that medicine “is the epitome of a commitment to hope.”

Without hope and the belief that progress is possible, it’s too easy to become numb to injustice and inequality, Stevenson said.

He recalled a landmark report in 2001 that found one in three Black males who are born could end up in prison.

“We didn’t have a pandemic-like response when that data was released,” Stevenson said. Instead, “We kind of just shrugged our shoulders and allowed this to play out.”

“This profound absence of hope is shaping decision-making in too many communities,” he said.

Maintaining a sense of hope is necessary in the face of overwhelming challenges and disappointments.

“Our hope is key to our capacity to make a difference,” he said. “Hope is our superpower.”

“It takes courage to have enough hope to believe we can do better in health equity.”

Do the uncomfortable

For the health sector, tackling health equity requires the willingness to embrace the difficult road ahead.

“We’re going to have to be willing to do uncomfortable things,” he said.

It also requires enduring even what seems to be unbearable. Stevenson recounted the heartbreak when he couldn’t delay the execution of a man who had intellectual disabilities. His legal appeals failed when the U.S. Supreme Court, following previous rulings in lower courts, ruled it was too late to make that defense.

Even in that awful moment, Stevenson recalled the defendant, sobbing and then having difficulty speaking (he would stutter when anxious), mustering the will to thank the lawyer for his efforts, and telling Stevenson he loved him for trying to save his life.

“You don’t have to be unbroken to provide healing to the world,” Stevenson said. “It is the broken who can teach us what humanity requires.”

Stevenson closed by telling hospital leaders that nothing is more important than trying to repair inequities and encouraged them “as we find a way to heal our communities.”

Wright Lassiter III, CEO of Henry Ford Hospital and the chair of the American Hospital Association board of trustees, talked about the need to address health equity in the beginning of the session. The association has produced a “Health Equity Roadmap.”

“Covid has shied a bright and painful light on deficiencies in our healthcare system,” Lassiter said. “We need to do more. We need to do better.”