Addressing Inequity in Healthcare – Marcus Whitney LIVE with Ivelyse Andino

MW

what's up have you Monday another

episode of Marcus Whitney live we're 24

hours away from the launch of the book

and I cannot be more excited to not talk

about it I have a much better topic

today we have the wonderful wonderful

innovator in health and advocate

activist and person who I just recently

met but as soon as I connected I've

realized everybody in the world adores

her miss IVA Lee Santino

I've Elise how are you 

 

IA

I'm doing well

this is it's it's mutual it's mutual

like we feel the same way about you

everyone like this is an honor and a

pleasure to be here and I'm excited so

it's a chop you today

 

MW

yeah it's so great to have you on the

show and it's basically David Dee's who

was our mutual our friend in common he's

a bunch of people who he introduced me

to over the last couple of weeks but he

was like you and I've at least have a

lot to talk about and we haven't even

really had that time to talk yet but

obviously we both work in health care

we're both like people we're you know

we're in this world experiencing all

this craziness today and we're both

innovators and you are you know sort of

knee-deep in an incredible company that

we're gonna ask you about but before we

we get into that just a quick couple of

minutes on on your back story 

 

IA

yeah so I

think for me it's always leaving it's

like I'm from the Bronx I am born and

raised here but that really colors a lot

of like even how I got here today so I

started my career I wanted to be a

doctor didn't realize that you actually

need to prep a lot to become a doctor I

thought you go to college and tada turns

out there are a lot of steps involved in

getting there and somehow find my way

and working for healthcare I ended up

still working in healthcare I worked for

a large biotech company and my job was

to help doctors understand new drugs as

they came out of the FDA so to train

them all doctors and researchers and it

was great so this girl from the Bronx I

made it tada we're here and in that

moment while I was working on an ecology

suite and working on cancer drugs my mom

had cancer

it was a wildest thing to go through an

experience where I ran you know millions

of dollars in budget all the researchers

and doctors FDA at my fingertips but my

mom's in a Bronx Hospital and I have no

idea how to help her support her help

her navigate that world and it was

horrific and so it really forced me to

see just you know the but it's just not

it doesn't matter how much money you

make doesn't matter how smart you are

does matter who you know sometimes these

things are just not fair

so I transitioned a bit from the pharma

world left that and got into tech and

specifically health check where again

led the first platform that let doctors

prescribe apps to patients they needed

someone who had that like how to talk to

doctor feel they also had the tech lane

and so got to do that about ten years

ago and again it was phenomenal cuz here

I am this young you know after left

being up in the Bronx in these rooms and

while I'm doing that uh it became really

clear the folks who could afford these

technologies again did not represent

home towns and home towns like mine but

beyond that I was often the only woman

in the room by far the only person of

color in that room and always the

youngest and it became really crystal

clear to me that in that game right at

those tables like I mean I made it

through but then it was my honor and my

duty and my responsibility to shift the

game which kind of led me to starting

radical health right a space where it

wasn't enough to be at other people's

tables but we really wanted a center the

experiences that you and I have lived

through that you and I have seemed but

to do that with community and to really

shake this help game right on its head

and you know radical health means

radical to get at the root to really get

at the root of people of who we are

personally right and so we started

started there 

 

MW

so but before we get into

what radical health does I want to ask

you a question that people sometimes ask

me and I always wonder like why they

asked me but then as you were talking it

was like oh now I know why they asked me

this so yes you're in this room you're

the only woman of color there and you've

now had this these personal experiences

and now these these power dynamic

experiences around

in healthcare for many different aspects

of it what gave you the belief that you

could go do something about it right I

mean like the this 

There are

 systems that feel unmovable, and 

 healthcare, I feel like the more you're in it,

 the more it can feel that way, right. It's

 such a large, Byzantine system... most

 people have no idea how complicated it

1. What gave you the confidence, you know,

 that you could do something about this?

 

IA

Yeah. I think that for me, I got to you

 know -if we're playing a video game- like

 I wasn't just, I just have the

 controllers in my hand, I was actually

 programming the game as we walked, right.

 So I was in an industry -health tech- you

 know 10-12 years ago, no one knew what

 this was.

 And I got to witness folks in

 positions of power making decisions. And

 at that time right, there literally -what

 we see today did not exist- so I saw

 people making it up as they went along.

 And, more than that right -because I was

 like oh okay, that's how that game’s played- I

 was on the ground doing the work of like

 designing a product, speaking with

 clients, getting by, and understanding

 what that was. And so for me, it really

 came down to like... if I could do this

 labor for someone else -someone else who

 is making billions of dollars on the

 backs, right, of like insurance and

 companies- like oh hell no. And then it

 became like like not only can I do this

 -because I wrote the book for my other

 companies, I wrote the book right in in

 terms of what we can be doing- so not

 only can I do this, I can do it

 differently. I can do it in a way that

 elevates that is not just.. um like

 extractive, that we're not just taking

 from communities or people, but we’re

 putting back in. Do so with a conscience.

 And really, I mean really, flip the script

 is what I was going for.

 

MW

Yeah and...

 one more thing. I relate to, I

 relate to you so much. You know... how do

 you embrace that moment where this,

 there's a possibility and there's an

 excitement, and at the same time, there's

 this sense of obligation because you

 also know you are -as far as you know-

 uniquely qualified and capable

 with the access to be able to do that.

 Like how do you, how do you live in that

 moment? I feel like I'm spending a lot of

 time in that moment right now. How, like

 how do you everyday, and how did you at

 that moment, I just...

 

IA

Yeah, I mean at that

 moment, it was... I mean it literally was my

 duty.

 It was my, you know Assata Shakur says you

 know “it is our duty to fight for our

 freedom. It is our duty to win.” And in

 that moment right I was actually... I

 started Radical Health, I was on

 maternity leave. So I just had my son, and

 my best friend from high school

 was also pregnant. And what happened was

 I had just seen cycles of this where I

 have a little bit of leverage or

 privilege, first with my mom, then in my

 own pregnancy -where I still ended up

 with a c-section even though I did all

 the right things- you know. But it became

 a point where was like this is my duty.

 And it is far bigger than me right. I'm

 part of the 0.01% right

 of black CEOs in health tech um. But like

 this is not even about me anymore. The

 work that I do... this is a movement. This

 is almost like a calling, I would imagine

 like Angela Davis right isn't like “I'm

 doing this work just for me, this is a

 movement work.” Um, and so the way that I

 settle with that is like everything that

 I do, right, serves a greater purpose. And

 it's, it is one to honor the folks who

 have come before me that allowed me to

 be here, but to like knock down walls so

 that everyone else could come behind me,

 and and and turn this turn this mother

 up.

 

MW

 yeah yep I feel you okay cool

now now talk to me about radical health

what what is what what is radical health

 

IA

so radical health we consider ourselves

a public health tech company essentially

we believe in health equity and we

believe that that happens through

meaningful conversations for us those

conversations happen in person online

and in a really hyper local way so

through these conversations we use

indigenous circles where we talk with

people in community not just about what

they might need so when we talk about it

like that extractive model like what do

you need what about what they want what

resources they have it really goes down

to to trust so helping people trust

themselves individually

trust their communities in this

collective way and our ultimate goal is

to create some restoration with the

systems that have hurt us and harmed us

we layer that with some tech and

Chopra's were a people first company and

we use tech as a supportive tool and we

built out chat bots and platforms that

help bright individuals with agencies so

we have know your rights for maternal

health and giving people questions to

ask before they go in for an appointment

we're doing kovat support now so what do

you need to know and this again spans

like the breadth of a person's

experience right so we get questions

from where can I get tested to I don't

have any sick days and my employers tell

me that I have to come in and really

helping people navigate this system that

is built on power and hierarchy but

doing so in a way that is relevant it is

like talking to your best friend or you

know your your sister who might be a

nurse right and helping them do that in

a way that feels authentic but really

shares in that power 

 

MW

what what is the

point of introduction between the the

individual and radical health is the is

the is the health system or their

primary care physician introducing them

to radical health or as radical health

getting to them directly through

marketing or through word-of-mouth how

does the individual find and engage with

radical health 

IA

yeah so we operate in two

ways so one folks come directly to us

whether they're coming in through a

program we host right now we're posting

online circles or whether they're coming

in through our text message or whatsapp

but the way that we traditionally work

is with partners so we usually have

partners who say I have really ever

really hard time reaching X community

right this specific community in

Brownsville Brooklyn or in Tacoma

Washington and we want to be able to

reach them and serve them in a way that

is authentic and really gets at health equity

and so we partner with

organizations who then bring us on and

we reconnect with them we connect

locally wherever they're physically

located hire locally and then deployed

either our services or our tech solution

so it's a meet Oaks 

 

MW

And and you decided

 to set it up as a public benefit

 corporation. First maybe just quickly

 explain to people what a public benefit

 corporation is.

 

IA

Yes so a public benefit corp... it has the

 same structure as a c-corp -technically

 right, a for-profit organization- but

 within those bylaws, we have a public

 benefit. For us, it's to address health

 equity, which means that, while we can

 make a profit, right, we still have a

 purpose and a legal obligation to

 fulfill that purpose.

MW

Right, which is

 really important because... A) people will

 try to say that corporations exist for

 the benefit of the shareholders, and it's

 really... corporations exist to do whatever

 the bylaws and the operating agreement

 says they exist to do, right. So it's

 it's not... these conventions are not

 laws, they're conventions, right. So that's

 that's super cool. And I mean I think

 I know why you did that,

 but how has that shaped the way that you

 run the business?

 

IA

Yeah, so I think you know

 early on when I first started... I'm the

 first Latina-owned and operated public

 benefit corp in all of New York.

 

MW

Wow. Wow.

 

IA

Yeah. When I

 started doing this you know health tech

 equity work, I went to funders. Cuz I was like

 alright, we need to raise some capital.

 And when I told folks that I was a

 benefit corp, I got that door shut on me

 so fast. 

 

MW

Really? 

 

IA

It was like oh man, yes.

 This is you know 2015. It was... like no one...

 was like they were like I had one

 investor say “why the hell would you do

 that? That is like... why would you do that?

 No one's ever gonna invest in you.” And

 for me right, it forced me 1) to like

 double down on the work. Like okay that's

 fine,

 in fact I actually don't need your

 capital anymore. I'm gonna bootstrap this

 company and make it profitable.

 Which I did.

 

MW

Good for you, good for you.

 

IA

What it's done for

 me is it allows me to have a better

 vision. It allows me to attract folks

 that are committed to the cause. It also

 kind of is a screener, right. So if you

 don't understand why I did my company, why I

 structured my company this way... like

 then we're not gonna do business. And

 more so now, we're on the trajectory

 really to create generational wealth in

 our communities, right. And to invite

 folks to join in so we can all... we still

 can have shares, we can still have equity.

 But my method now, as

 run my company, it forces me to create like a

 much bigger vision, and to do so in a way

 that benefits, right, all the people that

 I work with. So to the extent that my

 communities are shareholders in my

 company like. And we all benefit

 financially when we do this good work,

 has kind of been like this full circle.

 So not just on the the work that we do

 with community, but on the corporate side,

 on the economic side that there's also

 impact there as well.

 

MW

amazing so we're we're now at the

halfway point of the show and it's

probably a good time to segue into the

topic you wanted to talk about right

which is the the role of black women in

in healthcare in power structures and

sort of how that how meaningful that is

in the work that you do but also how you

think that there is a larger message

about this that needs to get out

especially in this moment in time so I

think with that I'll cede the floor to

you to introduce the the conversation

however you want I'm happy to sort of

follow from here 

 

IA

I mean I

 think that we're in a unique

 moment. We had covid which made us focus right on on health right.

 Everyone in this country -in this world-

 is considering their physical health and

 what that means. We saw then -right- that 

 folks who were disproportionately

 affected were black and brown people

 who had covid right. Those are the folks

 that died at a higher rate than others.

 And then we have the brutal murders of

 black men across this country -of black

 people across this country I'll say- by

 police brutality. That kind of then

 layers on an additional component to

 what we're seeing, and so we're in this

 middle... we're in the middle of like

 health equity -health being all the

 things that we experience, whether it's

 social, emotional, environmental, right the

 structures- and our personal lives. And I

 think that I've been talking about this

 for a very long time.

 And the piece that we're missing is that

 this isn't necessarily new. Might be new

 to some folks who are just kind of

 understanding, and we welcome you. Thank

 you. But this is a historical thing. This

 has been happening for years. We can go

 all the way

 back to slavery, right, where women -black

 women, black men- were used for breeding.

 Where black women were used to perform

 tests -gynecological like tests- and and

 surgeries without anesthesia.

 Moving a little forward right we

 experienced that, we you know we ended

 slavery, in a sense. you know to the

 recent history 1950s where we have

 Henrietta Lacks -black woman- who without

 her consent, her cells were taken from

 her. So without her consent, there was a

 physician who went in, performed exams,

 and she was basically experimented on.

 And Henrietta Lacks is really important

 because um you know, what we saw there

 was really the the trust that we put... the

 trust that people -black people, brown

 people, indigenous folks- put into the

 health care system... Henrietta Lacks went

 to get care, and instead she was

 experimented on. Her cells taken from her.

 And if you look at that

 today, we benefit we still benefit from

 her -I can't even call it a sacrifice

 because it wasn't willing- but with the

 her cells, the HeLa cells, we have the

 polio vaccine, we have genetic cloning, we

 have in vitro fertilization due to her

 cells which are still alive, and being

 used, and tested on. And there was no

 sense of compensation. There was no even

 just acknowledgement of what

 contribution she gave into health care,

 and still gives today. And so from that,

 right, we owe a lot of our current

 medical benefits -that we are all

 benefiting from today- to women. Birth

 control pills... so in 1970 about third of

 Puerto Rican women were sterilized in

 order to test and create what we have as

 birth control pills. And you know, I was

 born in ‘84... like 1970 is not that long

 ago. And so when we look at the history

 of health, when we look at the history of

 of both science, health, the

 social-emotional, where we are today... it's

 really to the credit of the black women

 that were used… that were experimented

 on... that I mean really, again unwillingly,

 you kind of sacrifice their lives

 theirselves, their families, to have what we

 have today. And then beyond that right,

 we're now like at this present ish

 moment, you know, the the experiences that

 we are carrying. I can speak for myself

 and and for my friends around me; we are

 in this moment where black women are

 still working, right. We're still taking

 care of families, and being support, and

 building communities, and being right

 creative, and starting companies to solve

 the challenges that we've seen. And the

 call today is that we need to

 acknowledge right just the historical

 piece, but also now support and protect

 and understand the role of black women

 in our future. We've talked about, you

 know, the the other piece that I want to

 add is when we look at maternal

 mortality rates today, where black women

 die 3-4x more likely than

 their counterparts, regardless of

 socioeconomic status. Doesn't matter how

 much money you make, doesn't matter how

 smart you are.

 We are literally dying today. And in a

 day where we we can say that we can look

 at black men who are dying at the hands

 of police brutality, in many ways black

 women are dying at the hands of our

 medical industrial complex. And the

 advocacy the fight isn't the same 

MW

thank

you I'm glad you I'm glad you mentioned

that last part because that is kind of

the that is the the it's so sad when

when you talk about all of the I'll use

the word contributions because that is

the that's the at least I know that that

it's not an adequate word but it's the

word I'm trying to use to honor

the where they were not recognized for

for what they did you know when you talk

about these these unrecognized

uncompensated unjust contributions that

all of society benefits from today in

that at the same time in parallel to

that the system hasn't even managed to

repay black women in terms of equal care

right that is you know it's really it's

really sad because I have felt very good

about being in the health care space for

the last five years prior to this I was

in digital marketing and you know it's

just sort of like a really vapid space

you know for the most part it's like

people doing terrible things you know

all these ads and like it's like a lot

of bad things happening in digital

marketing and I felt like wow I'm

working in health care there's all these

like great people and people who care

but it's like I have gotten to this

point now five years in where it's not

that the people aren't good but the

system damn sure is not good you know

what I mean

the system is not good and it's it is

sad you know it's it's it's really sad

so you know and the thing I've been sort

of attacking and I've been I've been

saying it i I've been saying this for

black people but everything I say for

black people is like you can to exit

when when you're just focusing on black

women right which is the absence of

power in the system the absence of power

in the structure right this this was you

know you know about the post that I

wrote a couple weeks back I mean this

this is the part that I am trying to

focus on this is not to say that the

disparity and outcomes is a pure symptom

of the power but there is no way you can

disconnect the - there's no way you can

look at the lack of

presentation at the center of power and

not know that there is a lack of

adequate advocacy happening there for

these disparities there is acceptance

that these disparities are just the way

it is and when you say things like

regardless of socioeconomic status that

is like the biggest indictment right

like that's the part where you start

realizing holy shit this is this is not

this is just racism that's it that's it

it's just racism and sexism like that's

it it's just black women don't matter to

this system that this would be allowed

so okay I'll see you the floor again

because I think that's like right you

talk there's there's power right but

there's there's concentrated power right

so who's who's at the seat and we're

having this conversation over and over

who's on your board who's on your

c-suite but when you look at who makes

up the rest of those seats for each of

your organizations especially if you

work in health care who cleans your

floors who serves your food right who's

at your front desk right and when you

look at that right especially I'll say

here in New York City across the

healthcare system majority of those

employees are black women right who are

doing the work who are your CNAs

who are your home health aides who are

these folks and the power and so I want

to be really clear this is not that

black women don't have power right cuz

we that's not that's our same is right

right and it's just that who's in

control right who is who is there

talking about the system not about

inherent right god-given power we're

talking about the system right and what

I'll say is that for all of those black

women who are on that ground like that

is an incredible amount of information

of power right a source of resources to

not only have like to live through an

experience in life but then to work

through it and I think that we get to a

point where like you know I I'm

frustrated because I'm like the history

of health care is based on the facts and

bodies of black women and you trusted us

you know to nurse your babies

to create scientific you know revolution

with ourselves

you've trust us to be the front face of

your companies to be out on the ground

to run this but you you don't trust us

to lead to have power to have

self-determination right and authority

over over I mean both like companies

over or our future and I think that you

know you made a really great point about

if you will take this and and you know

think about if you if you look at the

dynamics right and you can exponentially

like apply some of this challenge to

black women

I'd say the reverse is also true when

you think about what happens when we

need and create resources my favorite

analogy is the curb cutouts on sidewalks

right those were created for folks with

disabilities maybe who needed who are in

a wheelchair and needed a ramp to go

down but by creating those curb cutouts

I will say for my kid on his scooter

we've used it with a stroller the days I

might have worn to high heels to walk

through or here on crutches we all

benefit from those curb cutouts and in

many ways as we think about the future

of health as we think about the future

of this world we need to be solving for

those who have been the most ignored and

as a way that we all then benefit

exponentially as well I love it I love

that example that's that's that's so

powerful so alright let's let's leave on

an optimistic note your your company is

doing really well yeah yeah yeah we're

doing good yeah and you're you're

growing you just trying to like manage

growth but things that things are going

well right well it's going really well

you know what started out you know it's

a wild idea where we had people coming

together we layered with tech and and

this you know unique model and folks

said that's never gonna work is working

and now more than ever people need to be

connected we are really forced to be

connected really locally so the idea

that we get to do that that we get to

hold space we're the first to say like

we're not the experts on anything but we

believe people who lived experience are

the experts we get to do that layer in

some tech and then do that in in health

really for me is a dream

and even with the challenges of koban

the current state of events it is a

beautiful thing to witness this wild

idea blooming into something that I

think will and it already is radically

transforming healthcare what can people

do lots of people are you know we've

we've now been having this conversation

for enough weeks that you know I think

we went through the stage of listen

whole space educate yourself and I don't

mean to say like we're done with those

phases but I do think we are ready for

some actions right we are ready for some

actions what would you what would you

tell to someone who wants to leverage

what power and privilege they have to

contribute to lifting up black women I

would definitely say specific

specifically in health care because I I

you know I I feel like we've got it

we've got a fix health care we've got to

fix health care but we can even go more

broadly because not everybody who's

listening or watching is is in is in

health care so what is you know a

specific action that that can be taken

yeah so my my company is based on

meaningful conversations and we use

agreements when we're in space together

you might have heard like one mic one

person stop anytime one of my favorite

agreements is get your cousin and what

that means is that if my cousin is

acting a fool it is my job because I

have that personal relationship to tell

my cousin hey your your accident last

year come on let's talk about it and so

what I would encourage everyone is go

get your cousin if you are listening to

this today and you're like oh wow I

didn't realize that you know I I'm a

part of this I'm complicit I think we

all are we all have our biases and

shortages have that conversation right

so set up a group right and make sure

that it is representative right you need

to have someone there but have a

conversation have a meaningful

conversation let's talk about this what

does that look like how does that play

out and we can talk about you know we

need CEO seats we need board seats we

need we need all that but I think very

tangibly like what are the ways that we

can talk about the way that we both

uphold patriarchy and racism and the

ways that we can dismantle it sorry I

would say have that conversation

if you need help having these

conversations radical health is here we

can help you I can help you we have a

bunch of folks and and just this isn't

even to center that there are a bunch of

people around you that are ready to jump

in that was amazing perfect way to exit

the show I've at least thank you so much

and you know you're gonna have to come

back we'll have to get you back on the

show in a couple of months and I'm gonna

be talking to you offline because we

have too much to talk about so thank you

so much for spending you know I know you

have a busy day you did like another

show today didn't you tomorrow morning

okay yeah well thank you for spending

some time with me all right everybody

out there make sure to follow

I've Elise I've Elise on Instagram on

Twitter radical - health.com is the

company go check them out follow support

this incredible leader this incredible

woman this incredible innovator and yeah

tomorrow's the day create new

orchestrate finally done and out in the

world it's not anticlimactic but I'm

just I'm just bracing myself for all the

feedback so thank you thank you you can

follow me also by subscribing to the

podcast Marcus Whitney's audio universe

on Apple Google Spotify all that good

stuff and everywhere online I am at

Marcus Whitney so that is it tomorrow it

will just be me I'm gonna be on here

probably reading a chapter from the book

and talking about it so I look forward

to seeing you back here tomorrow until

then have a wonderful rest of your

Monday peace