History and Health: VCU looks to the past to inform a future of better health care for all

Leaders of a new educational series say learning, reflecting and involving the community are vital to determining how VCU and VCU Health take action toward achieving health equity.

An archival image shows white patients on one side of the outpatient waiting room in the old Virg... [View Image] This archival image from VCU Libraries shows white patients on one side of the outpatient waiting room in the old Virginia Hospital at the Medical College of Virginia and African American patients on the other. A new program at VCU plans to explore historical practices in health care, VCU's role in that history and opportunities for input on how to enhance the care provided to the diverse communities the health system serves. (Courtesy Special Collections and Archives at VCU Libraries)

This week, Virginia Commonwealth University and VCU Health introduced the History and Health program. VCU and VCU Health teammates and community members who participate in the program’s learning opportunities will explore how the university’s complex history affects the health system’s patients today and will have an opportunity to shape how the VCU community will use these lessons to improve health care for all.

The inaugural series, History and Health: Racial Equity, is open to all faculty, staff, students and VCU Health team members, as well as to the community. VCU and VCU Health employees and students who participate in a majority of the program events and online modules can earn a digital badge. The series’ first monthly virtual event begins March 24.

“We are embarking on a journey to learn and to reflect,” said Sheryl Garland, chief of health impact at VCU Health and one of the leaders who established the new series. “The reflection is going to be just as important as the information that’s shared because we need to take information in, and our leadership needs to hear what’s important to all the constituents that we touch — both inside the organization and across the communities we serve.

“I’m not sure how we can truly achieve greatness as an organization if we don’t take the time to listen, reflect on what we hear and then incorporate those reflections,” Garland said. “It will be important to incorporate what we learn along the way into how we shape our organization for the future as we continuously define our culture, our values and the type of organization that we want to be.”

The History and Health: Racial Equity series will include education about historical practices and current health disparities and opportunities to review how to enhance the care provided to diverse communities the health system cares for and serves, said Arthur Kellermann, M.D., senior vice president for VCU Health Sciences and CEO of VCU Health.

Garland and Kevin A. Harris, Ph.D., associate vice president for strategic initiatives and engagement in the Office of the Senior Vice President for Health Sciences at VCU, who co-led development of the program, emphasized the importance of learning about all aspects of VCU’s past in considering how the organization arrived where it is today. Both referenced Spanish philosopher George Santayana’s famous quote: “Those who cannot remember the past are condemned to repeat it.”

“When I hear that quote, I tend to add a component because that statement assumes that there’s no good in our history. I amend it to say, ‘Condemned to repeat the mistakes of that history,’” Harris said. “That, to me, is the fundamental importance of all of us as a collective community having a level-set of grounding as to how we got to where we are now.”

The program emerged both as part of the VCU Health Equity Initiative and as a response to the VCU community’s feedback requesting more avenues for reflection on the university and health system’s role in history. The Health Equity Initiative was created to ensure the principles of health equity were integrated into VCU’s core missions of service, education and training, and research to assist in ensuring that all people VCU serves have a fair chance to live a long and healthy life. The initiative has been instrumental in establishing the structure that allowed for the development of the History and Health program, Harris said.

Acknowledging what has shaped the organization’s 180-year history through the History and Health: Racial Equity series will help VCU and VCU Health “engage people in all parts of our mission,” Garland said. The series is intended for team members, students, faculty and staff to use an equity lens to advance teaching and research practices and provide even better care for all of the communities VCU serves, she said.

“We really need to understand and learn from our history because it will be important to inform what we do going forward. It will be important to shape our policies, our practices, our culture,” Garland said. “It is important for us to utilize this History and Health initiative as our framework for ensuring intentional progress towards achieving health equity.”

Harris said he hopes team members, students and staff will learn and become more sensitized to the fact that their experiences today are being influenced by this history and that it motivates them to cultivate change in their own lives and in the organization.

“We want this to spark action and to create a culture of wanting to actively write our new history because it’s not going to happen without effort and without forethought,” Harris said. “We want the community to build competencies around this so, even when we act, we want to make sure we're acting appropriately and we’re acting in a way that moves us forward. That’s going to require some literacy for some of us. For many of us, that’s going to require some new skills or maybe dusting off some old skills that we haven’t used often.”

Community engagement is a vital component of the History and Health program — and in advancing efforts to make health more equitable for all, said Harris, who also serves as interim senior associate dean for diversity, equity and inclusion at VCU School of Medicine.

“We have a mission that centers us as an important resource in partnering within our community and, particularly in our patient care setting, that community engages us, and they come to us with narratives (of our history),” Harris said. “Someone said in a recent event that, even though we might not fully appreciate the importance of our history, our patients do. They bring that to us, and it creates a response to us. It could create a response of hesitancy or a lack of trust if we haven’t fully embraced them and helped to navigate these challenges (related to these narratives).”

Part of the process of building greater trust is gathering input from the beginning on how the organization can support community members in the ways most valuable to them, Harris said.

“We want to make sure that we take that information, we engage the community, and they can help us co-create so that we’re not doing this in a vacuum,” Harris said.

Confronting the country’s history of slavery, segregation and racial discrimination must be part of the process of offering the fullest understanding of what has influenced historical practices in health care. But if the community within and outside VCU is intentional about reflecting on this challenging history and taking action toward achieving health equity, students, employees and the community have an opportunity through this series to decide what that future looks like, Harris said.

“Our history shapes us, but it does not define us and it does not confine us,” Harris said. “We get a chance to write this next chapter. That’s what we’re hoping with this initiative, and that’s what I would want my fellow community members to understand. We will do this as a collective, and we will break out of whatever we feel that history has presented us with.”

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