39 health systems in 45 states and Washington, DC have committed to addressing racism and the public health disparities caused by racism. Read the full statement below or download the PDF.
As members and leaders of many healthcare organizations across the nation addressing the disproportionate Black and Brown mortality of the COVID-19 pandemic, we say without hesitation that Black Lives Matter.
No person of decency can look at the images of George Floyd’s killing without feelings of rage, horror, shame, and grief. The deaths of George Floyd, Rayshard Brooks, Ahmaud Arbery, Breonna Taylor — and too many others — are unjust and unconscionable.
We must double down on our efforts. Systemic racism poses a real threat to the health of our patients, families, and communities. We stand with all of those who have raised their voices to capture the attention of people across the nation with a clear call for action.
The health systems we represent are deeply woven into the fabric of the communities we serve, live, and work in, and we stand united as frontline organizations against racism, injustice, and inaction.
Systemic racism results in generational trauma and poverty, while also unquestionably causing higher rates of illness and death in Black and Indigenous communities and communities of color. We have seen — in its rawest form — how the trauma of systemic racism adds to the historical injustices that have disproportionately affected communities of color. Health systems across the nation work to provide high-quality, compassionate care in the face of health disparities and poor outcomes resulting from social and economic inequities. In rural areas, where resources are spread out across larger geographies, we have seen healthcare organizations and community partners adapt to the shifting conditions with ingenuity and purpose.
These social determinants of health include poverty, inadequate housing, underperforming schools, police brutality, mass incarceration, food deserts, joblessness and underemployment, poor access to healthcare, and violence. All of these factors contribute to health inequities in our communities. And they serve as a recipe for pain, suffering, premature mortality — and civil unrest.
In our communities, there is also resilience, innovation, a tradition of faith, and a spirit of unity that manages to thrive even under the weight of this systemic burden. Imagine the potential for our communities with dramatically improved social and economic conditions and health outcomes.
It’s time to fully realize this potential. It’s time for action. We will work more intentionally with community-based partners in building and sustaining the sweeping change that is needed to ensure health equity across the country, and particularly in our most under-resourced communities.
As healthcare organizations, we are committed to being part of the solution, both within our organizations and in partnership with local community groups. We are focused on improving access to care and eliminating systemic racism, which contributes to poor health outcomes.
We have come together as health systems from all across the country as part of the Healthcare Anchor Network, a health system-led collaboration working to improve community health and well-being by leveraging all our assets, including hiring, purchasing, and investment for equitable, local economic impact. Here are some of the steps we are or will be taking to help overcome the healthcare disparities in the communities we serve:
- COVID-19: We are providing testing and direct care while also partnering with city and county health officials to provide educational programs, services and personal protective equipment to under-resourced communities, and advocacy for personal practices that flatten the curve.
- Inclusive, Local Hiring: We are implementing inclusive, local hiring and workforce development programs to remove barriers and build community hiring pipelines for people of color to find careers in healthcare.
- Inclusive, Local Procurement: We are directing spending to diverse and locally owned vendors and building the capacity of local minority-owned businesses to meet supply chain needs.
- Place-based Investment: We are leveraging investment assets to address the racial, economic, and environmental resource disparities that create poor health outcomes.
- Tracking Progress: We are measuring key processes and outcomes related to inclusive, local hiring, procurement, and place-based investment initiatives with a racial equity lens. We seek to understand this data in order to inform our institution’s internal and external response to the inequities embedded in our systems.
- Listening: Many in our organizations are learning about or becoming increasingly aware of the ways in which systemic racism has impacted our colleagues at work and members of our communities. Our institutions are committed to actively engaging and listening to our patients and colleagues of color, modifying our behavior where needed, and learning from their experiences. We seek to better understand and educate ourselves about this legacy of injustice and the institutional and systemic racism that persists in all areas of our society today. In that process of continuous learning, we can become better allies, advocates, and partners in dismantling systemic racism, evolving our anchor mission approaches appropriately to meet the needs of our communities.
We also are committed to continue working to address racism and the healthcare disparities it creates.
We commit to …
- Re-examine our institutional policies with an equity lens and make policy changes that promote equity and opportunity.
- Improve access to primary and specialty care.
- Continue to focus on helping our communities overcome chronic conditions like diabetes, heart disease, and asthma.
- Continue to advocate for investments that create innovative solutions to achieve enduring improvements in access, quality, and health outcomes for our communities.
- Continue our commitment to hiring locally and promoting and retaining leaders of color.
- Renew and expand our organizations’ commitment to providing anti-racism and unconscious bias training for our administrators, physicians, nurses, and staff.
- Advocate for increased funding for social needs, social services, and programs that promote social justice.
Our society only truly thrives when everyone has an opportunity to succeed and live a healthy life. We are committed to moving forward together. By harnessing the collective strengths of our organizations, we will help serve our communities as agents of change.
The healthcare systems that have signed onto this statement are: Advocate Aurora Health, Alameda Health System, AMITA Health, Baystate Health, BJC HealthCare, Bon Secours Mercy Health, Boston Children’s Hospital, Boston Medical Center, Children’s Hospital of Philadelphia, ChristianaCare, Cleveland Clinic, CommonSpirit Health, Cone Health, Dartmouth-Hitchcock Health, Denver Health, Einstein Healthcare Network, Franciscan Missionaries Of Our Lady Health System, Gundersen Health System, Kaiser Permanente, Lurie Children’s, M Health Fairview, Maimonides Medical Center, Mass General Brigham, Northwell Health, ProMedica, Providence St. Joseph Health, Rush University Medical Center, RWJBarnabas Health, San Mateo County Health, Seattle Children’s, Spectrum Health, The MetroHealth System, Trinity Health, UC San Francisco, UMass Memorial Health, University Hospitals, University of Utah Health, VCU Health, and Yale New Haven Health.
We are two months into life in the age of COVID-19 and it’s getting more complicated. Right as many of us were getting used to staying distanced, staying home, and staying in, some states and areas are relaxing restrictions. It isn’t life as it used to be, and it’s inconsistent across the nation. As we all try to figure out what relaxing measures means and what we are comfortable with, we’ve also embraced full on what life via video chat and living six feet apart can be like. Like normal humans, we all have questions, concerns, pet peeves, opinions and of course mute buttons that malfunction.
Before we dive into Etiquette in the Age of COVID-19 we would like to start by saying:
The threat of the novel coronavirus is still present. Until we have a vaccine or until we’ve gotten a handle on this virus’ impact on us, we are going to see requests, and requirements to physically distance ourselves and use personal protective measures like masks and hand washing regularly. It has changed our social behavior and it will continue to change our social behavior as communities find ways to interact safely. These new social measures can feel incredibly awkward and at times impolite, but you are not alone in feeling that way about them. Everyone is learning and figuring this out as we go.
Safety is the guideline right now and measures that we take to protect ourselves and others are right in line with the Emily Post principles of etiquette: consideration, respect, and honesty.
To find more information about the virus, it’s spread and what precautions and measures to take please visit:
As well as your state or local department of health.
When we think about what advice to give, we think first about safety and then about how to be kind and considerate and respectful when trying to be safe. Safety comes before etiquette. This doesn’t mean we toss consideration, respect, and honesty out the window. Far from it, we’ve seen how doing so can lead to tragically bad and completely unnecessary things happening. What it means is that how we interact and what is deemed “polite” or “acceptable” behavior will change during this time. Let’s look at some of the basics to consider here and for specific topics see these articles:
Zoom/Video Call Etiquette for Socializing (coming soon)
Zoom/Video Call Etiquette for Work (coming soon)
Navigating Hanging Out Together Apart (coming soon)
We are all familiar with the term “social distancing” by now. And many are encouraging the use of the phrase “physical distancing” instead which helps people to imagine a less isolated solution. Our goal for physical distancing is that when out and about in public or when socializing with those we don’t live with, we keep ourselves – or our family group – at least 6 feet away from others when possible.
It’s not as easy as it sounds. We’ve all navigated a tight aisle at a store, an elevator or stairwell, or a friend leaning in too closely despite feeling awkward. But what is the right thing to do?
We get asked, more than anything else through our podcast and media interviews, how do you speak up when something is wrong, or bothering you? It’s not an easy thing to do. How you do it makes a huge difference to how well it’s received, but it’s not a magic key. You can never predict someone else’s reaction, especially that of a stranger. So our first piece of advice is and always will be to seek the help of someone in charge if the scenario provides such a person. A manager, usher, flight attendant, host, or whomever is in charge, can have the authority to help you and can also ensure that you aren’t dealing with someone alone. That being said, you don’t do this as a way to punish someone else, it’s to make sure a concern is raised, or that help or safety can be achieved.
If someone at a store hasn’t given you enough space to pass or reach the item you’d like, then a friendly “Mind giving me just a little more space so I can pass [or grab that item] safely?” You want to have an upbeat tone to your delivery, no edge whatsoever (think that person you know who is always upbeat, or sounds cheerful and if no one comes to mind think: how would Glinda the Good Witch, Dr. Martin Luther King, Mother Teresa, the CW’s Superman say it?). If the person scoffs at you, you can either pass anyway keeping as much distance as possible, wait until they move farther away, or go get something else and come back later.
Other phrases that are being heard and used when out and about to manage distancing:
Excuse me Sir, the line starts back there, everyone’s just distanced.
(while stepping back) Sorry I’m trying to keep 6 feet away.
Excuse me, I was next.
I’ll wait and catch the next elevator.
After you, please. (said genuinely)
Do you mind giving us just a little bit more space please, (hopefully followed by a: thank you so much)
A little space please.
Flow of Traffic
While following the guidance of the arrows and directions through stores is always important, it’s not worth getting into an altercation over. Either pass, doing what you can keep your distance, or go back the other way if the aisle isn’t crowded. Don’t make a stand when there are other safe options.
Public Outdoor Spaces
When it comes to public outdoor spaces it’s important to respect any distancing guides that have been put in place whether it’s marked areas to lounge or workout in, or directions for flow of traffic. Remember that even though you’re spaced apart from others, covering your mouth when you cough or sneeze as well as not coughing, sneezing, singing, or yelling in the direction of others is helpful.
When trying to create physical distance on sidewalks, recreational paths and trails, you’re still trying to aim for six feet (about two adult arm lengths) apart. It’s really thoughtful if you’re a group or family out together to consider dropping to single file when passing others to help make room.
If it’s easy for you to be the person to step off the path or into the street (because you aren’t, using a walking or mobility aid, managing a frisky dog, balancing a toddler and a baby carriage or are on foot rather than wheels) to create space by all means make the move and do so early so that the other person doesn’t even have to guess at it.
Greetings continue to feel lacking during this strange time. Despite wonderfully bright and cheery waves, mini dances, hops, and skips when we meet, we miss hugs and solid handshakes, high fives, and fist bumps. Greetings that involve touching are still not recommended at this time, so perfect your waves (you know your “professional wave”, your “zoom-meeting wave”, your “I-love-you-Grandma wave”, your “I-haven’t-seen-you-and-I’m-trying-so-hard-not-to-hug-you wave”) and use your tone of voice to match the occasion.
While masks are causing a lot of divisiveness, when combined with physical distancing wearing a mask in public can greatly reduce the risk of spread. Wearing masks may be around for a while so it’s best to try and get used to what it’s like to interact with them on. Since most people are wearing cotton or medical masks and few have clear plastic ones allowing their full face to be seen we are more often than not without many facial cues.
Smiling (anyway), and using your eyes (cue acting skills from every medical show ever for inspiration) and hands to gesture will be the way to connect while wearing masks.
Masks unfortunately also muffle the sound of our voice and so it’s important to get comfortable speaking up, especially when in a noisy store or on a loud street. While you don’t want to shout to the point of sounding unnatural or making the listener uncomfortable, you do need to literally speak up to be heard. If you don’t, often the other person will lean in to hear you, and then you end up stepping back to recreate some space. It’s a odd dance but it happens often.
As we move into figuring out dining indoors and patio dining scenarios be prepared to see people storing their masks in a paper bag or envelope while eating. Some places may place plastic shields between tables or even at tables depending on the restaurant and local requirements.
Wearing masks outdoors is not a bad idea if you’re passing frequently while out on rec paths and trails or in the park or on the sidewalks of your neighborhood. Many choose to “mask when they pass” and let their mask down while on long stretches without others or when there’s more than enough room to pass without any worry. (According to this article in the New York Times, you’re more likely to encounter an issue for yourself if you have prolonged time indoors without masks on than if you pass someone outdoors without a mask on.)
If you’re uncomfortable when you encounter someone without a mask on resist the urge to glare or tsk at them. Do what you can to keep yourself physically distanced and avoid interacting instead. Remember you can only control yourself as best you can. There will be times when it doesn’t go perfectly and even though that can cause stress and anxiety, which often lead to rudeness, arming ourselves with kindness and avoiding judgement of others is good etiquette.
Contact tracing – tracing the virus’ spread through individuals who have tested positive or been around those who tested positive for COVID-19 – is happening at different rates throughout the country, but early indications show that contact tracing by businesses and through events that we attend may become commonplace. Many places already use your phone number or email address to contact you about tickets or a reservation or even a purchase so it’s not unfamiliar. But to have it be connected to our health when visiting a restaurant can feel very different. While we don’t know yet exactly how contact tracing will impact our personal social gatherings (birthday parties, showers, weddings…) or our public socializing (bars, sports, groups, restaurants…) we are considering the possibility that in the future a host’s to-do list list, or advice for making a restaurant reservation for a work lunch might involve contact info for potential contact tracing follow ups.
We cannot emphasize this enough right now. These are extraordinary times and there are so many ways this virus is impacting all of us. Especially when it comes to how we are mentally handling the longevity of this pandemic. You don’t know what is affecting someone’s life making the current threat even worse (financially, emotionally, physically). It’s important to respect people where they are at, and not blow off their concerns or drive fear where it doesn’t need to be.
Many of us are so fortunate to have so many ways to connect to help get us through this crisis together, but loneliness and anxiety are still huge concerns. Reaching out to one another. Being patient and kind with each other. Listening to one another. Respecting one another. Helping those in need. These are the kinds of attitudes and actions that will carry us through. They often cost us nothing, and yet they can make an impactful difference.