Paula Houston: Taking on the weighty issue of healthcare equity

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Paula Houston, director of healthcare equity
Credit:
Clare McLean
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Paula Houston recently joined UW Medicine as director of healthcare equity to help us make progress in achieving diversity, inclusion and equity within our organization. We asked her some questions about her life, career, and goals for this work.

Q: Why are these efforts so important? Do you feel a personal connection?

A: Wellness and well-being have always been very important to me, not only through my work in healthcare but as a professional personal trainer. I’m a breast cancer survivor, with my third recurrence last year. I’ve had personal experiences in the healthcare system and while I haven’t felt like I’ve been treated inequitably, I think that’s only because I am very assertive, have educated myself, have a good care team, and have made it clear that I was going to be in charge of what was happening to me. I realize that not everyone has that. I'm appalled when I hear how many African-American women and other women of color are still treated in our healthcare system, that they’re not getting the type of treatment that is warranted.

To still hear women in 2017 say they had to be the ones to tell their doctors they needed a mammogram or MRI, it made me even more determined to get into a professional situation where I felt like I could make a difference. I want to do my small part to change a gigantic system, not just at UW Medicine, but the healthcare system. Being a cancer survivor has helped influence who I am as a person and as a leader. I look at things differently when I walk into a healthcare or social services provider and think about the person who isn't educated, who doesn't have a support system, who is worried about money because they don't have insurance. What's that service provider doing to make sure this person is going to have a good experience and is going to have the same opportunity or outcome as someone else who has more privilege or more resources?

Q: Tell us a little about your background and why you were interested in this role at UW Medicine?

A: I’ve been in health and human services for over 20 years. I went to graduate school at UW School of Public Health and worked with Public Health-Seattle & King County. After a short stint running my own fitness business, I became clinic manager at Carolyn Downs Family Medical Center and then executive director of the Meredith Mathews East Madison YMCA. While there, I started my doctorate in educational leadership at Seattle University. My dissertation was on the use of complementary and alternative medicine among African-American breast cancer survivors. Reading literature on institutional racism and health literacy and their effects on cancer treatment and outcomes for African-American women and other women of color reignited my thinking about equity, inclusion and diversity.

Throughout my career, I have provided diversity, cultural competency and equity and inclusion leadership in my organizations. As CEO of Sound Generations, which provides services to seniors and disabled adults, I was attracted to their strong mission around undoing institutional racism, disrupting all forms of oppression and providing services that affect social justice. Over the last three years, I began guest lecturing at UW. I wanted to get back into healthcare and liked being in front of students and talking about leadership. I thought a job in a university in healthcare with a focus on equity and inclusion work would be almost the perfect job. And then this opportunity appeared. It’s allowing me to continue to follow what I really feel is my vocation.

Q: Healthcare equity is a pretty big task…what are your priority goals?

A: I was pleased to see our healthcare equity blueprint objectives: 1) Increase workforce diversity, decrease implicit bias, increase cultural humility; 2) Engage our communities as partners; 3) Deploy targeted quality improvement and healthcare services to marginalized populations. I believe these are the right priorities to affect sustainable transformation in service delivery and health outcomes. My goal with the UW Medicine workforce is to work with system leaders to provide training and tools to help us understand why a diverse and inclusive workplace is important to improving healthcare equity—how each of our own backgrounds and cultures influences how we lead, provide patient care and relate to co-workers. A critical piece is increasing diversity in system leadership to represent the communities we serve. I want to really see if we can turn this giant ship in the direction of healthcare equity. I know it's going to take a long time but I plan to be here for a long time.

Q: How do you spend your time when you’re not at work?

A: I’ve been a competitive powerlifter for 20 years and have been fortunate to do very well in that. I spend a lot of time powerlifting and doing Pilates, yoga and aerial/circus arts. I’m also on a variety of community boards, including the board of the Seattle Rotary and the Alzheimer’s Association. Seniors are certainly a marginalized population that frequently experience inequities in our healthcare system, so it’s been really rewarding to be on that board. I'm also on the Seattle Housing Authority Board of Commissioners. And I spend a lot of time with my two Rhodesian Ridgebacks, Holly and Issa. There’s nothing better when you’re having a hard day than coming home and snuggling up with two 100-lb dogs.

Paula Houston powerlifting
Houston is a six-time International Powerlifting Federation Masters Champion, 12-time USA Powerlifting National Champion, 2012 USA Powerlifting Hall of Fame inductee and 20-year volunteer for Special Olympics Powerlifting. Her personal best records are: squat 424lbs; benchpress 238lbs; deadlift 429lbs.
Holly and issa
Houston's two Rhodesian Ridgebacks, Holly (left) and Issa (right).

Q: Is there anything you’ve taken from powerlifting that affects how you lead and get through challenges?

A: Absolutely. Powerlifting has always been my mental health therapy and part of my spiritual practice. In good and tough times, it keeps me grounded, balanced, centered and connected to my support system. Throughout my cancer treatment, I worked out six days a week. They weren't particularly intense workouts sometimes, but it was really important to me to continue going to the gym to do my lifting, yoga, etc. There were days I was really tired but I made myself just show up. Even when workouts were not very long, I'd sit and talk to teammates. Or at aerial class, if I could climb the rope only once before I was exhausted, I stayed and videotaped the rest of the class. It was just important to be there, to be around that energy and keep myself moving. I credit that with being able to get through the treatment with very few side effects and keeping my mental outlook pretty positive.

The discipline that goes along with powerlifting has influenced my leadership, from knowing how to stay focused on something to knowing when and how to ask for help. I tell people that you have to stay very focused when you have 400 pounds on your back! And if you think you’re going down and feel like you’re going to need help, you can have that help standing by even before you start. That applies to business too — there are people there to help you. I had to learn that because I was raised to be very independent. Both powerlifting and being sick made me realize that you have people around you who want to help. I think good leaders know their weaknesses, know how to surround themselves with people who have different strengths and know when to reach out to them.

Q: Who are some of your role models and inspirations?

A: I have good friends who have been mentors and motivators and who inspire me. I've been a Seattle Rotary member for almost 10 years and I always get inspiration from that group. I've met accomplished, caring people who've become mentors and part of my support system. There are people from all backgrounds with opinions that are both similar and very different from mine. I learn about topics there that I would never hear about or pursue on my own. This also heightened my interest in equity, inclusion and diversity work. Diversity has lots of different dimensions. It’s not just race, ethnicity, gender and sexual orientation, but it’s diverse thought or experiences, too.

Q: What tips do you have for people facing challenges?

A: Don’t be afraid to ask for help — find a support system. Believe that there’s a higher power, however you define that. Be the captain of your ship. It’s your body — be in charge, educate yourself, don’t take what you’re told at face value, do your own research. Have a good sense of humor — look at the lighter side of things. If I could make my breast cancer funny, I can make anything funny.

As told to Paula Gottlob

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