Q & A with Kaiser’s Head of Equity

Kaiser Permanente has a deeply rooted commitment to diversity. Dr. Ronald L. Copeland, MD, F.A.C.S., senior vice president of National Equity, Inclusion and Diversity strategy and policy for Kaiser explains what this means to the organization.

Q: Could you explain Kaiser’s history in diversity?

A: Our organization started in the Kaiser shipyards, with women and men, including those of historically underrepresented groups and individuals with disabilities, working as equal members of industry-leading teams. In the 1940s, Dr. Sidney Garfield and Henry Kaiser committed to building a unique health care system that would deliver the highest standard of care and be accessible to everyone without discrimination. This was a bold approach at a time of rampant racial segregation and gender inequities in America. When many other hospitals were segregated, we had integrated wards, built diverse teams of employees and physicians, and treated all our patients equally, regardless of race.

During the Civil Rights movement of the 1960s, Kaiser Permanente modeled racially integrated hospitals and an ethnically diverse workforce. In 1989, Kaiser Permanente created a Minority Recruitment and Promotion Task Force to add impetus to efforts to recruit, develop and retain minority managers. Since 2001, Kaiser Permanente has been an industry leader in coverage for gender-affirming surgeries/treatments for transgender individuals.

Our organization continues to reflect the diversity of the communities we serve, with representation across all categories of race, ethnicity, age, gender identity, sexual orientation, disabilities, veteran status, and religion working together for a shared mission. In 2020, nearly 67% of our total workforce were members of underrepresented and historically marginalized groups, and 75% were women. Research shows that highly diverse teams in inclusive environments optimize productivity, innovation and business results.

We know that having a diverse and inclusive workforce reflective of the communities we serve also builds trust and makes Kaiser Permanente a better place to receive health care, and the data supports that. Forty percent of our members are from historically underrepresented groups, underlining the trust they have in our care.

Our work in this area is ongoing. We know it is essential to ensuring equity, inclusion and diversity are woven into the fabric of everything we do — something we recommit to every day.

Q: How have the health disparities exposed by COVID-19 affected Kaiser Permanente’s commitment in this area?

A: COVID-19 has been felt more deeply in underrepresented communities, underlining the longstanding health disparities in this country. Equity has long been a priority of Kaiser Permanente, and we are committed to providing high quality, culturally responsive care to fully address the needs of all populations we serve. We continually look for ways to address the social drivers of health that lead to poorer health outcomes for our most vulnerable populations.

The pandemic has demonstrated, however, that we all must do more. The social gap present even before the pandemic has widened still further, underlining disparities in health and healthcare in underrepresented communities. Kaiser Permanente isexpanding our work to address health disparities and inequities and their root causes, including the history of systemic racism inhealth care and the resulting mistrust that some members of underrepresented and historically marginalized communities have forthe health care system. This includes acknowledging and addressing access issues related to geographical barriers and ensuring that telehealth and new virtual access solutions are deployed equitably.

In 2020, we reaffirmed our commitment to advance equity and address systemic racism through a series of actions acrossour communities, our care delivery and our workforce. This included investments and grants to address systemic racism and lack of economic opportunities in communities of color. And we established a health equity advisory council to expand our identification of care disparities beyond our current quality measures, to ensure all performance measures will be viewed through an equity lens. This council is researching COVID-19 health outcomes and vaccination data by race and ethnicity to design solutions for improving member and community health equity.

Q: Could you tell us more about how Kaiser Permanente is addressing bias in the workplace?

A: We are continuously working to maintain a highly inclusive, engaged and psychologically safe workplace so that our people can contribute at their highest level to support Kaiser Permanente’s mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve.

We are ensuring equitable and inclusive practices across the employee life cycle with the intention of identifying, recruiting, developing, mentoring, retaining and advancing diverse talent. Last year, we introduced an enterprise- wide training program that helps us recognize bias and racism in our own thinking and actions and gives us tools to think and act more inclusively.

That program, Belong@KP, is designed to foster inclusion and social justice in everything we do. It was built on foundational principles, habits, and a common language that support an anti- bias, anti-racist work environment. We believe all our employees and physicians have the right to a fair and equitable career experience in an inclusive, safe, respectful environment. And we want to ensure we all feel we matter and are valued — that we are recognized for our unique perspectives, lived experiences, and there is personal accountability to disrupt bias and racism.

Q: How is Kaiser Permanente addressing health disparities in its care delivery?

A: We believe in equity, inclusion and diversity in all aspects of our mission — among our staff, in our exam rooms, emergency departments, operating rooms, hospitals, partnerships and communities.  We institutionalize practices to identify and eliminate inequities contributing to health disparities.

Kaiser Permanente has used quality of care data, broken down by race, gender and ethnicity, for over 10 years to drive health care innovation and priorities. When data indicates a disparity in care, we strive to create and implement comprehensive plans to address those disparities. We have made great strides, for example, in addressing health disparities and inequities since we implemented tracking measures more than 10 years ago. We have used that quality data to drive health care innovation and priorities, and, in doing so, have eliminated care gaps in many areas — most significantly in the areas of colorectal cancer screening and controlling high blood pressure (hypertension).

From 2010 to 2020, the gap between colorectal cancer screening for Latinx members and Whites was reduced more than 75%, from a high of 5.9 percentage points to 1.4 points. From 2009 to 2020, the gap between controlling high blood pressure for Black or African American members and Whites was reduced more than 80%, from a high of 8.6 percentage points to 1.5 points.

We are committed to looking at all our care from an experience, outcomes and equity perspective, and systematically working to improve our performance. This includes ensuring that all clinical performance data and measures will be viewed through an equity lens, incorporating the need to address social predictors of health, and systemic and structural racism in outcomes.

Q: Why is Kaiser Permanente focused on the health of its communities?

A: Not only is it core to our mission to contribute to the health of the communities we serve, but we believe the health of the community in which one lives contributes to the health of its residents. And the health of a community stems primarily from economic and environmental conditions.

In other words, economic opportunity is foundational to healthy communities; it supports housing stability and food security, as well as physical, mental and social health. We know that support for under-resourced business owners of color, for example, can change the trajectory for individuals, families and entire communities.

Kaiser Permanente invests in programs that create equitable economic opportunity for underrepresented communities and works to dismantle racist systems that create barriers to success. We promote these shifts to help close the racial wealth gap. Accordingly, we are using our purchasing power to build healthy, equitable and sustainable economies. This includes providing support to more than 2,000 businesses owned by people from underrepresented communities.

This work builds upon our longstanding commitment to support the social needs of our communities, with programs providing access to housing, food and healthy living. We also ensure diversity among suppliers. And we provide good jobs to individuals facing barriers to employment through high impact hiring efforts.

RONALD L. COPELAND, M.D., F.A.C.S., is senior vice president of National Equity, Inclusion, and Diversity strategy and policy and chief equity, inclusion and diversity officer for Kaiser Permanente. He leads Kaiser Permanente’s efforts to ensure our strategic vision for equity, inclusion, and diversity is successfully implemented to drive strategic business and mission outcomes and results in all Kaiser Permanente members achieving health and health care outcomes that are high quality, equitable, and increasingly more affordable.

A recently retired board-certified general surgeon, Dr. Copeland joined Kaiser Permanente in 1988 after a six-year honorable tour of duty in the United States Air Force Medical Corps. Dr. Copeland served as president and executive medical director of the Ohio Permanente Medical Group prior to assuming his current role in 2012.

He earned his bachelor’s degree from Dartmouth College and medical degree from University of Cincinnati Medical College. In the fall of 2016, Dr. Copeland was appointed to the board of Kaiser Permanente’s School of Medicine (opened in 2020).