Off the Charts: Examining the Health Equity Emergency

City of Saint Paul's Diversity and Equity Efforts

Episode Summary

The murder of George Floyd and summer of 2020 intensified the equity work of businesses, organizations and government. It was an urgent wakeup call for some but reaffirmation of the work already being done by others. Toni Newborn, human resources director and the first chief equity officer for the City of Saint Paul, discusses cultural and systemic change, the city’s focus on equity as a pillar, and meeting people at their level of success.

Episode Notes

The murder of George Floyd and summer of 2020 intensified the equity work of businesses, organizations and government. It was an urgent wakeup call for some but reaffirmation of the work already being done by others. Toni Newborn, human resources director and the first chief equity officer for the City of Saint Paul, discusses cultural and systemic change, the city’s focus on equity as a pillar, and meeting people at their level of success.

Hosts: Kari Haley, MD, and Steven Jackson, MD

Guest: Toni Newborn

HealthPartners website: Off the Charts podcast

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Episode Transcription

Kari Haley:

He's a rehab doctor from Chicago.

Steven Jackson:

She's an emergency medicine doctor from the Twin Cities.

Kari Haley:

Together we're examining the health equity emergency.

Steven Jackson:

Inviting voices for change without the cue cards.

Kari Haley:

I'm Dr. Kari Haley.

Steven Jackson:

I'm Dr. Steven Jackson.

Both, together:

And this is Off the Charts.

Steven Jackson:

Welcome to the show. And we have a treat for you guys today. Almost said this evening, it depends on when you're pressing play. We have Toni Newborn who is gracing us with her presence. She is the chief equity officer as well as the human resources director for the City of Saint Paul. That sounds heavy.

Kari Haley:

That sounds like a big title.

Toni Newborn:

It is.

Steven Jackson:

Dang. Maybe we should get your autograph before we start.

Toni Newborn:

No, not yet.

Steven Jackson:

Not yet, but soon. I hear that. How are you doing today?

Toni Newborn:

I'm doing well. It's a Wednesday, an afternoon for us, almost a Friday. Things are good.

Steven Jackson:

Friday.

Kari Haley:

So let's hear more about you. What's your story? Where are you from? How did you get here?

Toni Newborn:

Let me rear back in my seat right. I am originally from Birmingham, Alabama, born and raised. And I grew up in Birmingham proper. My family still lives in Birmingham now, my parents and my oldest brother. And I came from a family of six, so two boys, two girls, and then my parents, and I lived in Birmingham, deep South, until I moved up to Minnesota. So Minnesota has been my second home for 19 years, which I can't believe.

Kari Haley:

So now you're basically a Minnesotan.

Toni Newborn:

No. I still have my Alabama cell phone number, area code 205. I'm not changing it. Not changing it. People all the time, they're like, "You've been up here for a while." That's OK. It's not changing, so keep it saved.

Steven Jackson:

Well, you went from Alabama to Minnesota. I mean, they're pretty similar anyway, so.

Toni Newborn:

Oh, yeah.

Steven Jackson:

That's probably an easy transition, right?

Toni Newborn:

Oh, yeah. The closest family that I had lived in Detroit, Michigan, and I had never been to Detroit. It was a prayer that this was going to work here. So I graduated from Birmingham Southern College in Birmingham, of course. And I knew I wanted to go to law school, and I had applied to a ton of schools, mostly in D.C. I wanted to be in Washington, D.C. Still do sometimes. It's one of my favorite areas of the country. But I didn't get in, and D.C. is saturated with attorneys. So I started applying to random schools based off of my LSAT score, which was somewhat low. So I needed to be creative about the schools that I applied to. William Mitchell was the school that I applied to and didn't know anything about it. It looked pretty from the website, and I knew that it would accept my LSAT score.

So I didn't know anything else about Minnesota except for the Mall of America. And I knew it was going to be cold. And I got accepted first school that I was accepted into, and I told my parents, I'm like, "I'm not going to Minnesota. That's crazy." And my dad said, "You need to think about this. You want to go to law school? You should think about it. Let's go for new admitted students day." So in June...

Kari Haley:

Oh, that's a good time to come.

Toni Newborn:

My whole family, minus my oldest brother, flew up to Minnesota. And in June, Summit Avenue, there are babies everywhere, people walking.

Kari Haley:

Beautiful.

Toni Newborn:

The grass is green.

Steven Jackson:

Oh, they got you. They got you.

Toni Newborn:

They got me. Oh, my gosh, picturesque. They hooked me. So we signed on the dotted line, and I started in August of 2004.

Steven Jackson:

That's great. And now you're the Human Resources Director for the city. How was that?

Toni Newborn:

I am not an HR professional by trade. I am an attorney by trade, and I started out doing investigations, civil rights investigations for the Minneapolis Department of Civil Rights. And I sort of stumbled into HR. And I left the City of Minneapolis to go to the City of Saint Paul, which is a big deal in this.

Kari Haley:

Oh, yeah, you crossed the river.

Toni Newborn:

I crossed the river. And that 12-mile difference it's like a big deal and decided to work in HR, not knowing really what this was going to be about. And I would argue that it was a little bit of a stretch as to how this role was explained to me and what I would be doing because I don't think I would've signed up for it. And that was my first sort of stint in HR. I quickly realized that I did not like working in HR, not the job that I wanted to be in. And I was planning to leave the city, I was done.

And I wasn't thinking about Mayor (Melvin) Carter (III) running for office, being the first Black, potentially Black mayor for the City of Saint Paul. And then maybe I should stay, and see how this is going to work out. And it all just came together. The mayor asked me to serve on the transition team for his administration, and I started out as the first chief equity officer for the City of Saint Paul. Fast-forward, I had a whole bunch of different other jobs, the city, including the chief equity officer. And then two years ago, our HR director at the time left and I miss her, wish she'd come back sometimes. She left and the mayor asked, he's like, "Toni, do you want to be the human resources director?" I said, "No, I do not. Thank you. I want to stay in my role." Well, we got to a good place. And I realized quickly that at the level of the director that the things I hated about HR, I could influence and change.

And I brought the chief equity work into the space and quickly realized that Human Resources, this is a really important department, and they're the main people and department that needs to be driving the equity work, if not the primary. And so I got to a good place somewhat with being in HR, and I have to now because I'm the boss. But it's been tricky in this industry. And human resources is one that is oftentimes compliance driven. So when you talk about equity and inclusion and belonging, we're supposed to be thinking about those things and including embedding that into the work. But oftentimes because it's compliance and rule focused, it's not. And that's been a challenge for me in this role and just understanding the industry.

Kari Haley:

You kind of spoke that there's been challenges. What has been some of those biggest challenges that you've faced and what kind of changes have you brought to the role and brought into the industry?

Toni Newborn:

Sure. The biggest challenge, so working in the public sector in government is a challenge, a bureaucracy in itself. That's a challenge because the rules and the laws and the policies were all, I think they had good intentions around trying to better the residents experience, our employees experience, and just people in general, but require post bring about challenges because you have to go through so many hoops to get things done. So if I said, "Hey, I want..." Currently, we're trying to change a policy and a rule related to hiring, which has been in existence for 50-something years. We're talking about like Al Capone.

These rules were put in place because of organized crime, in part, organized crime being a part of the city. I'm trying to tweak these rules because these rules weren't made for people that look like me. And they're merit-based rules. So the intended, it's supposed to be, well, you get hired based off of the skills that you bring for the job, but it doesn't actually happen that way as it was intended. And so I'm trying to tweak these rules. I have to meet with the attorneys, I have to meet with my staff, I have to sell it. Then I have to go through several processes to get the rule actually officially change. And we've been working on that for the last year. So I think the goal or the intent or purpose of these rules and processes was to make sure that we have fairness and equality, in some shape or form equity, but they end up being hoops that we have to jump through. So that's definitely a challenge. People are a challenge.

Steven Jackson:

And HR is all about the people.

Kari Haley:

That's a lot of people.

Toni Newborn:

A lot of people. People are a challenge because you're talking about people's livelihood and their sense of value and respect, and it's all housing their jobs and the job titles. So when I talk about one of my strength is being futuristic when you do the strength finder assessment. And I'm always thinking about what's next? What are we going to change? Why don't we do that? And people, they get scared of me because they're like, "Wait a minute, you're telling me that I need to change something and something's wrong with what I'm currently doing?" I'm like, "No, I'm just saying it could be better."

Steven Jackson:

It can be better.

Toni Newborn:

And so the people tend to be those challenges. And when you add that with the process that we all have to go through and the laws, it tends to be burdensome. It tends to be overwhelming. But it could happen. And we've been able to make some success. I talked about the civil service or I talked about those rules, and it's our civil service rules. We've been able to make some changes into those rules. And I won't say I'm the first one ever. I don't know that, first direction.

Steven Jackson:

First one ever, you heard it here.

Toni Newborn:

But definitely in a long time to make changes to those rules. And for any government employee who understands who has personnel rules or civil service rules, that's a big deal. And my team now realizes that this is part of the equity work in the same way that hiring more Black and brown folks or BIPOC community into our workforce is a part of the equity work. And so they're starting to see that it's the systems work that we need to do, not just the feel good stuff and the representation. So that's been an accomplishment that I'm proud of.

Steven Jackson:

Definitely a big job. And well, first of all, May of 2020 changed the world probably forever and got us all having conversations that maybe we needed to have a long time ago. And number one, how did that affect you personally in terms of your view of say, that commitment and almost that imperative to infiltrate the space of DEI? And also from a City of Saint Paul perspective, how have things changed and how was that affected in the inner workings of what you guys do in that space?

Toni Newborn:

Sure. I appreciate this question. After March of 2020 was a soup of mess. We had COVID. And first time ever, it's OK for government workers to work from home. For most of us, we had our first responders and people who had to be in person. So that was going on, and never could you work from home. Never could we have any type of flexibility. And then all of a sudden it's like, oh, we got flexibility. We don't want you breathing the same air, so we have to change ASAP. So you had that, we had two months of that March, April, and then May. Personally, May is a hard time for my family because my sister passed away in May, and a day before day, day after George Floyd was murdered. So that was on my mind when that was happening. And then you have the murder of George Floyd.

We were living off of Park and 18th in South Minneapolis, so thick in it. So we heard the protests. People would come down Park because it's a one way into the downtown to get to do the protest. We'd heard all of the, it sounded like bombs going off. So my husband and I were in a two bedroom, two bath apartment condo on Park. And we were like, we don't have any outdoor space. So that was a issue for COVID. But then now we wanted to be indoors because all of these things were going on. We had made plans to head down South and see our family, and we were going to drive. So if you've ever taken those trips, it's 17 hours.

Kari Haley:

It's a long drive.

Toni Newborn:

It's a long way. But we were trying to time how we were going to get out. And I have a cousin who's in the military and she's in the National Guard, and I texted her and said, "Do you think we should leave now?"

She was like, "Leave before the National Guard comes, because when they come, they may shut down borders. And you may not be able to get out." So we did. It was a lot going on, a lot going on both personally and then trying to get home, trying to be safe. We were worried about "traveling while Black" down South because of all the protests and things that were going on. And then the COVID stuff, where were we going to stop? Being safe and not getting COVID, it was just so many things happening.

Steven Jackson:

That's a lot.

Toni Newborn:

And then professionally, for work standpoint, we're dealing with COVID, now we're dealing with the public outcry. I know some people call it civil unrest, insert all of those names and titles. Where on the St. Paul side, while we didn't have as much damage as Minneapolis, it was quite a bit of damage of our businesses.

So we are dealing with that, reassigning employees to different work because we had librarians making facial masks because the libraries were closed. We had our rec center staff passing out food to families. So while from the outsider's perspective that looks like, "Oh, well, just reassign people to a different job." We have 25 unions at the City of Saint Paul, and they have a say about who does what and when. And we have to pay folks. I'm proud to say we didn't have to lay anybody off during that time because we reassign them, but you don't just reassign an employee to work at any government structure. So it was a lot happening, a lot.

Steven Jackson:

Wow. And I would imagine that maybe perhaps the urgency to look at the equity work that was being done was intensified. I mean, you have conversations, particularly around that time. There are people who lived in St. Paul-Minneapolis area, they didn't even know racism existed or they didn't know it was that bad. And then for something like this to happen in Minneapolis, it was a wake-up call. And as tragic as that is, and it was a good wake-up call because people need to know, yeah, this is real, and it's happening. As we speak, it's happening. And Minnesota is not immune to tragedy. And so can you speak a little bit about maybe the urgency now that maybe we all have and having conversations like the one we're having now on this podcast?

Toni Newborn:

I think the urgency from a broader perspective with the state of Minnesota and just kind of the nation and world, Minnesota was put on a map in a way that was...

Steven Jackson:

We didn't want to be.

Kari Haley:

Not the way that we wanted to make ourselves known.

Toni Newborn:

No. And a lot of folks were, Minnesota? But the last, what, 10, 15 years we've been on the top list or bottom list or whatever you want to say for the worst cities, Twin Cities Minneapolis and Saint Paul for Black and brown folks, and specifically for Black. So one could argue that this was brewing. And for me, people often at times ask me the same question as you all did. Wow, such difference between the deep South and Minnesota. Actually, when I go down south, I know exactly where I'm going to go and not go because people got the Confederate flag up or I don't know the environment. I don't know anyone there. So I know I'm not going to go there. Whereas here, you don't know. And the culture here is just kind of the passive aggressiveness.

Steven Jackson:

Passive-aggressive, yep.

Toni Newborn:

All of those things doesn't allow for you... For me, it's actually more uncomfortable because I don't know if you want me in your home or if you're just being nice. And there's a lot of, different from the south, multiracial, biracial relationships here that's very prevalent. And it's starkly different from down south, and you would think like, oh, that's cool, but it's not.

Steven Jackson:

Must be all right.

Toni Newborn:

But it's not. And so the studies and stuff that have been around for decades now have showed that Minnesota was like a hotbed. Just unfortunately it took this situation, this murder that took place to bring attention to that in a way that I would say was heightened. And for the City of Saint Paul, I mean, try not to let my ego show and the mayor's ego show. The mayor ran on a campaign that centered equity. And yes, first Black mayor, yes, of course.

But we've been able to do that. So from day one, it's been the Office of Financial Empowerment that we started and the Mayor forum, minimum wage was passed in the first year. The college fund and college bound, all of those initiatives are equity initiatives. We eliminated fines, library fines. And if you talk with the mayor, people thought that it was crazy to eliminate library fines. Well, how are they going to learn about social responsibility? But as the Mayor would say, "By reading a book about it, because they can go to the libraries now." So equity has been at the core and pillar of our administration. So how we pivoted, and it wasn't even a pivot, it was more about, OK, how do we lift up? We have the pillars of this administration already, and we've been doing what we do now.

Now, how do we respond to the needs of our employees and our residents in a way? So the Bridge Fund, a lot of cities and states across the country just had set up funds to help peoples survive and families survive during the transition with COVID and also whatever public outcry or civil arrest took place. So there were initiatives that we lifted up. Guaranteed income is another that we lifted up in response to both COVID and just the changing world and environment and were all centered in inequity. So we didn't have to do a lot to pivot or to respond, but we needed to just do it. And so I think the work and effort in the sense of urgency was OK, we just need to do it, right?

Steven Jackson:

Yeah, execute now.

Toni Newborn:

Yeah, absolutely.

Steven Jackson:

That's awesome.

Kari Haley:

I think it's awesome the City of Saint Paul and the administration with Mayor Carter has been able to do in St. Paul. What are some of the things that are still on your wishlist? What are some of those top two, let's say major initiatives that you're hoping to still get out there, get going and light the fire under?

Toni Newborn:

Sure. So I'm going to say something that I think the mayor would say, and then what Toni's going to say, right? Sometimes it's aligned, sometimes it's different. The mayor and I have talked about the need to hire more residents in the City of Saint Paul. About one-third of our workforce are city of St. Paul residents. And we have roughly about 3,000 employees. So the mayor's talked about, I want to bet on our residents. I want our residents to be, these are good jobs. And one could argue, maybe not as competitive as we used to be, but it's good benefits.

You can still get a pension. Pension is unheard of. We have excellent benefits. And it used to be coveted positions like, oh, you need to get that government job. And I think the mayor wants to lift that up more and create pathways for our youth, create pathways for our folks for entry level positions that we have and moving and navigating up through the city. So developing programs and initiatives throughout our enterprise to hire more residents. For Toni in the world of HR and inequity, one of the things, and this is aligned with what the mayor wants as well, what the administration wants. My theme for HR and for my team this year has been and is cultural and systemic systems change. And I really want to dig into, because I'm very internally focused with the equity work in HR, and I want my staff to be as big of an ambassador as I was as a chief equity officer in the work that they're doing day in and day out.

In order for us to embed this work, we have to change our systems. We have to change the culture in the city and to be one that's inclusive, that's welcoming, that's intentional around wanting people to meet whatever their level of success, both as employees and as our residents. So what I'm excited about, and not just like a system from a technology standpoint, but I want to chip away and break down some of these systems that have just been in place for years and years just 'cause that's what it makes us feel good to know that that process is there, and challenge us with asking the question of like, well, why do we do that? And who does this impact or does this best serve? And if the answer to that question is one demographic and not all in some shape or form, then there's an opportunity for us to make changes. So I'm excited about this opportunity with my 41-person team to help lead the effort in changing our culture and breaking down systemic racism. That's huge.

Steven Jackson:

Yeah, that's very significant. And what I'm happy about is that's so in alignment with what we're doing here at HealthPartners. We created the Equity, Inclusion and Anti-Racism Cabinet. And in an attempt to not only change a culture and affect a culture, but to simply be the best we, so we can serve the people that we serve. And even in terms of we have something called the equity framework where we're examining our practices and our policies and are they conducive for equitable practices across the board, or do they just help one person or two people? Can they help everyone? And so I think what you're saying is it's universal from governance to health care, to education to law, you plug in the industry, what we're talking about is where we need to be. This is where we need to be, and we need to answer the question, how can we make things better for everyone to be successful? And I think that's essentially the definition of what equity is.

Toni Newborn:

Absolutely.

Steven Jackson:

That's brilliant. Brilliant.

Toni Newborn:

And we have a similar framework. It's got to be funded. And so budgets, and that's another piece that I'm getting into. I talked to the finance director, I'm like, I'm coming.

Steven Jackson:

OK, I'm coming.

Toni Newborn:

I need to get into how we're spending our money, open up the purse strings. And I think you asked a question earlier around how has it changed the equity work? And we're starting to see so many organizations lift up chief diversity officers and chief equity officers and come up with our equity statement, which is great, and what we should have been doing, right. It's great. But are you funding the work? Because if you're relying on one person or a team of people to be able to lead this work and make this cultural change, you are on the wrong path. It's got to be embedded, and you need to fund it, and you need to pay people for this stuff. And you need to recognize that there's going to be turnover because this stuff is hard. It's hard work. So that budget piece, that financial sponsorship, that investment into this work needs to take place, and it needs to hit people's purse strings.

Steven Jackson:

Well, we need people that are committed and not just talking about it, but being about it and sticking around when it gets hard. Because this work is not for the faint of heart. It's not.

Kari Haley:

So we just started this podcast. It's been a work in progress that we launched last year. I hear you also have some connections to another podcast. Love to hear more about that.

Toni Newborn:

Yes. My husband, Pleasant Radford Jr., has started a podcast within the last year, and it's called The Heart of Equity. And he's in health care. And so this has been his passion project. And I've been on only one episode. He only allowed me to go on one episode, but he is increasing subscribers as we speak. So it's been great to see him in this space and role.

Steven Jackson:

Well, he just gained a few subscribers just a little bit ago.

Toni Newborn:

Awesome.

Steven Jackson:

Definitely. I'm looking it up now. Sorry everybody.

Toni Newborn:

Awesome.

Steven Jackson:

That's great.

Kari Haley:

I was going to say, just hearing some of the things that you've already dealt with and are continuing to fight for, I'd love to hear maybe in closing, how do you stay motivated? How do you keep doing the hard work?

Steven Jackson:

In closing, that's a whole nother. That's a wellness...

Kari Haley:

That's the next episode that you come back for.

Toni Newborn:

It's hard. I went to a place where I was starting to lose sight of my purpose in this role and in this space. And how do I make change? I struggle with in being an equity, racial equity advocate and leader, do I need to be protesting? Where do I need to fit? And what I found after some, and I'm still doing some soul-searching around it, is that I'm where I'm supposed to be. Being internally focused is going to be just as helpful as being externally focused.

And I needed to settle and rest in that space. But it took me a while to get there and having friends to help motivate me, having my parents to help motivate me, my husband, even my 2-year-old baby, to help motivate me to stay focused on the work because it's still important. And I don't think of it from an ego standpoint of if not me, then who else? There are plenty of people who are passionate about the work, but while I'm here, I need to stay motivated for me because I need to be purpose driven and purpose aligned. And so it's taking breaks when I need to. It is reaching out to friends when I need to, go into those conferences and getting inspired and then rest and sleep so that I can regroup.

Steven Jackson:

Beautiful.

Toni Newborn:

Mic drop.

Steven Jackson:

I mean, seriously. I don't even know what to say except thank you.

Toni Newborn:

Thank y'all for having me.

Steven Jackson:

Yeah, this was wonderful. And listen, you're in our thoughts. As we sort of matriculate through this year and beyond, the race is not given to the swift nor the strong, but to the one that endures into the end. And so it's going to take some endurance, but I think if we work together, and we continue to uphold each other, I think we can move that proverbial needle. Thanks so much for your time.

Kari Haley:

Thank you for being on our podcast and for all the work that you're doing in the city of St. Paul. I think that it's wonderful that we have people in positions like yourself who are really motivated and committed to making change.

Toni Newborn:

Thank you all for having me and keep up the good work that y'all are doing as well.

Steven Jackson:

And come again.

Kari Haley:

Yes, come back. Come back.

Steven Jackson:

Thanks.

Toni Newborn:

Thanks, y'all.

Steven Jackson:

Off the Charts is a production of HealthPartners and Park Nicollet.

Kari Haley:

It is recorded by Jimmy Bellamy, with creative by Peggy Arnson, Tina Long, Tim Myers and Jeff Jondahl.

Steven Jackson:

Production service is provided by Matriarch Digital Media.

Kari Haley:

Our theme music is by Ryan Ike.