A different kind of melting pot:
Tomás León has been leading the Institute for Diversity in Health Management for less than a year, but he has a deep understanding of the challenges facing America’s many different minority communities. | Interviewed by Jon Asplund
How did your upbringing teach you about diversity and that all people have an equal chance to succeed?
León: I grew up pretty poor in a barrio of Tucson, Ariz. Tough neighborhood, humble beginnings; there were eight of us in a two-bedroom house. I was youngest and my bedroom was the living room floor, I graduated to the couch and then eventually I got my own room when I got to high school after everybody moved out. We didn’t realize how tough it was because we had all the basics. My parents were very loving and supportive and we had food and a roof over our heads. We just learned how to be resilient with very little and to make the most of what we had.
I have four children, the oldest is 27. I am 47 so, if you do the math, I was a young teenage parent. It was one of my earlier challenges of overcoming labels and discrimination and having people look at me as just a statistic. I have a son who is 20, and two daughters, 16 and 8. So it’s almost like my wife and I raised four generations! They keep you young, they keep your feet on the ground and they keep you aspiring to do more.
I call my story, “From the Barrio to the Boardroom.” It’s been my path, my journey.
How did you make it out of the barrio in the first place?
León: One of the things that was instrumental in helping me make my way out of the barrio was athletics. I was a baseball player. It took me all around the state, the region and the world. It paid for my education. It introduced me to coaches who were mentors to me and helped me to stay away from bad influences in the barrio. It helped me learn how to work with a team, set goals, how to come back from adversity — all of the leadership skills that are essential for success. I led our American Legion team to the championship as a teenager and we went to regionals in California where I met kids from all over America. I was recruited by a team to play in the Goodwill Games in Australia.
So, at age 16, here I am flying halfway around the world to go live with Australian host families for a month. It exposed me to traveling, to other cultures, to living with other families, and it gave me a sense of independence as well as a connectedness to the larger world around me.
One of the most memorable experiences was not on the baseball diamond. It was when my friend from Hawaii and I walked in to the Sydney Opera House to hear a youth choir perform. Here are two kids who grew up in different parts of America in tough conditions and poverty standing in this world landmark, listening to other kids our age performing in a symphony and chorus. It made me realize that anything was possible for us. It really is key to where I am today.
How will you help health care increase minority representation in its highest ranks?
León: I’m working on prioritizing in this new position in the ways I’ve learned to set priorities over the years. You need to be resilient and to work with the changes going on and to see them through. It’s not for the weak in the knees. You have to be creative and develop strategies that will be innovative and will respond to what’s going on around you.
My priorities are, one, focus on assessing the organization, streamlining operations and scale up our programs so we can have greater impact and scale across the health care system.
The second priority is the 123forEquity Pledge to Act campaign. It’s a national call to action for hospital and health care leaders to accelerate progress in several goal areas: (1) increase the collection and use of real data about race, ethnicity and language to improve quality, safety and patient experience, and satisfaction; (2) increase cultural competency training at all levels to improve the mindset and skillset of the workforce to deliver more culturally competent care; and (3) increase diversity in leadership and governance structures.
The Institute and the American Hospital Association can’t do this alone. My third priority is strengthening and diversifying our partnerships across the country. We’re all trying to change the way the health care system works. Payment models are changing, how we deliver care is evolving, and we’re all trying to achieve the Triple Aim.
We can’t achieve the Triple Aim if we don’t eliminate health disparities. If you have overall great survey results, but you dig deeper and your data tell you that some patients still experience disparities, you haven’t transformed the health system. It’s a coalition; we can only do that through partnerships.
Is the challenge to show how disparities hurt the health care system, or to make changes to eliminate them?
León: There’s no more debate, it is an imperative. We need a more equitable health system that delivers culturally competent care — because the population is diversifying. [People of color] are going to become a majority population by 2044, according to the Census Bureau. We’re already at 37 percent minority. So we’re no longer debating the rationale. When you adjust for economic status, age and other factors, there’s still tremendous disparity. So the debate is: What strategies are going to be most successful in eliminating the disparities?
How does a health care system go about changing the makeup of its leadership?
León: It all starts with what’s the priority of that hospital or health system. They need to understand how they are defining diversity and how they make sure they are reflecting the community they serve. Leadership needs to be intentional about saying, ‘Hey, it really is important for us to reflect the community, because we want to relate and connect and understand what community needs are so we can better deliver culturally competent care.’
And the makeup of the board is very important to reflect the community. So, the board needs to first be very intentional about setting this as a priority, then it needs to set some metrics for diversity and evaluate the way it recruits board members and who it partners with to find board members. It is all about changing the mindset and the way board members are recruited.
We would like to see, through the national call to action, a marked improvement by 2020 when we do the benchmark survey. We would like to see, at minimum, 20 percent representation at the governance level and 20 percent representation at the leadership level.
We’ve tried to make the pledge and the goals real clear, simple and actionable. And by the time we survey, it’s an easily remembered 20/20 for the year 2020.