Leading in Difficult Times: Racism and Inequity - National Commission on Correctional Health Care
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Leading in Difficult Times: Racism and Inequity

Part 3 of a conversation with Esmaeil Porsa, MD, MPH, MBA, CCHP-P, CCHP-A, Ron Charpentier, MBA, and Kevin Counihan, with Brent Gibson, MD, MPH, CCHP-P, moderating. Read Part 2: Is Perception Reality?

Dr. Gibson: Now more than ever, we are aware of the challenges stemming from systemic racism. What issues have emerged among your clients and within your own companies? What have you done? What do you plan to do?

Dr. Porsa: At its core, this is a social justice question. What COVID-19 did, for corrections and for the entire nation, is to shed light on the social injustice that exists in this country in terms of access – not only access to care, but also access to education and economic opportunities. The segments of the population that are most negatively impacted by COVID-19 are racial minorities, the indigent, uninsured and underinsured. And guess what? When you look at the correctional population, for the most part, it’s the same population.

The best description of diversity and inclusion that I’ve heard recently is that it’s like a dance. Diversity is when everybody gets invited to the dance; inclusion is when everybody gets to dance. I thought that was such a simple and effective way of looking at it. It all starts with a commitment to wanting to be a part of the solution, a commitment to diversity and inclusion, and that means being self-reflective and answering this question: Are we representing our communities? Inside the jails, are our providers, our nurses, and our custody staff representative of our communities? Are we able not only to have the conversation but also to listen to what we are hearing? If you treat people like human beings, they will behave like human beings. And if you don’t, they won’t. There is no reason we cannot carry on that conversation inside our correctional settings. It may sound controversial or crazy but, you know, a few years ago direct-observation housing inside the jails was a crazy idea. Suddenly, some of the jails started doing it and now all the jails want to get into it because there’s great outcomes from it.

Mr. Counihan: I agree that we need to lead by example. We must make sure that our own organizations are following these principles. There may be more that we could do to raise the bar with our clients and make more explicit our expectations about how we want to work as constructive partners. I also agree there are tangible things that we can do as organizations with respect to making sure our workforce represents the demographic makeup of our clients. We have to consciously make sure that we are interceding at the right time to develop people and promote people. I know we hope that meritocracy always wins out, but if we look at our society, historically, that has not been the case. And so sometimes we need to intercede more consciously and deliberately to make sure that our organizations reflect our values.

Mr. Charpentier: The first thing to do is to recognize there’s a problem and then commit to making meaningful changes in our organizations. Then we need to listen to our employees, our customers, and our patients to learn how they’re being impacted. At that point, we can focus on the adjustments we need to make to ensure equity across our organization. We do this, first, because it’s the right thing to do. But I also believe that diversity and inclusion are essential to team and organizational performance. Research and our own experience validate this principle. To that end, we’re revamping our diversity and inclusion training to bring our employees into alignment with our values and to create a culture of respect, inclusion, and opportunity for everyone. These are easy words to recite, but shaping our culture requires very, very hard work. We’re not only changing systems and policy; we’re also aligning hearts and minds. That’s difficult, but we believe it’s a worthy effort.

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