Learnings from the Field: FSG CEO Greg Hills on the Work of Advancing Equity

This blog was originally posted on sharedvalue.org.

The Shared Value Initiative hosted the 2021 Shared Value Initiative Leadership Summit on November 810, 2021 which explored how companies can deliver equitable outcomes while also realizing financial success through the lenses of economic inclusion, access to health, and climate action. Featured speakers included Dr. Julie Gerberding, Chief Patient Officer, Merck; Adrian Gore, CEO, Discovery Ltd.; and Franklin Leonard, Founder & CEO, The Black List.

On the second day of the Summit, our CEO, Greg Hills, gave the keynote address to kick off a day focused on access to health.

I am thrilled to share a few thoughts today about how corporations are advancing equity—what are some lessons learned and what is needed going forward?

By way of introduction, I’ve been with FSG for the last 18 years and have served as CEO for the last 3.5 years. During that time, I helped lead FSG on our own intentional, multi-year, and ongoing equity journey. I also have had the privilege of advising multiple Fortune 100 companies on their racial equity work over the last 3-4 years. One caveat—I don’t consider myself an equity expert. That said, I’ve been in the arena doing this work, internally and externally, and learning from equity experts within FSG and from partners such as our friends at PolicyLink.

Today I’m going to focus on our work with U.S.-based companies. That work primarily emphasizes racial equity. However, many of these lessons are relevant across geographies and different types of equity.

In her opening remarks, Bobbi Silten, Managing Director, SVI, framed this “critical moment” that calls for the private sector to play an outsized role in delivering greater equity. She urged us to imagine and design a more inclusive system that delivers equitable access and opportunities.

With that framing in mind, what are we learning from the work companies are doing to advance equity?

I want to start by sharing four observations from our equity work inside companies.

First, individual equity work is imperative.

If we skip over this step, companies will be ill-equipped to advance equitable strategies. Of course, we know people are at different points on their own equity journeys. What’s important is to increase an individual’s awareness and capacity to understand and address inequities. In our work with clients, we conduct workshops where we ask folks to share when they have experienced advantages and disadvantages based on their respective identities. It’s a fascinating exercise. I’ve observed straight white men, like myself, really struggle to identify any moments of disadvantage in their lives, whereas women or people of color could fill an hour sharing stories of the disadvantages they have experienced. This tends to be a lightbulb moment for some folks who have often walked through life benefiting from the layers of privilege built into our systems and cultures.

Second, senior leadership matters.

It sounds trite, but if your CEO and executive team are not leading on equity, your company won’t take it seriously and the culture will not evolve fast enough. This requires authenticity and vulnerability from senior leaders. It requires listening and learning. It requires creating more diverse and inclusive decision-making structures. I’ve worked with companies where the CEO was deeply committed and participating in equity work. In the room. Advancing the agenda. That was so powerful and inspiring. But I’ve also worked with companies where the CEO and executive team were absent from the equity conversations—not participating, not doing the work, not advancing their learning with the internal champions. Their absence was called out by participants. Internally, this dynamic can be experienced as a form of equity washing. And we know this internal perception will eventually become the external perception as well.

Third, CEOs and companies must reckon with past harms.

Over the years, companies have contributed to inequitable outcomes in their communities, intentionally or not. In our work with clients, we’ve seen long-time employees of companies learn for the first time how their company’s business decisions have harmed historically marginalized communities. Back in 2019, FSG released a report called “Reckoning, Repair, and Change” which provides guidance to companies seeking to advance their equity work. A critical step in earning the trust of stakeholders is understanding and acknowledging the history of a company’s role in creating and sustaining inequities.

When we think about advancing health equity—the primary topic of today’s sessions—we can learn from examples of how the health care industry has been reckoning with past harms. The pharmaceutical industry, for example, is reckoning with past exclusionary approaches to clinical R&D. Marginalized populations who could benefit most from new products have often been systematically excluded from the clinical R&D process. The behavioral health field is reckoning with the role the field of psychiatry has played in supporting racist ideas and contributing to behavioral health inequities. For example, recent studies point to the continued over-diagnosis of schizophrenia and under-diagnosis of mood disorders in the Black community. And in our hospitals and health systems, providers are less likely to deliver effective treatments to people of color when compared to their white counterparts. This includes physician bias underestimating the pain Black people feel and Black patients receiving older, cheaper, or more conservative treatments.

I know from first-hand experience that these reckoning conversations are super challenging to have within a company. Excruciating, really. And it’s even more difficult to make these acknowledgments public, particularly for most companies that are fiercely managing their brands and reputations. At the same time, it’s critical that companies be honest about their past contributions to inequities as a starting point for creating a more equitable future.

Fourth, CEOs must consider the core versus the periphery.

Many companies are focusing their equity efforts in their philanthropic and CSR activities. That’s important, but change at scale will not happen unless this transformation is core to a company’s mission, vision, and strategy. FSG and PolicyLink recently published a paper titled, “Health Care and the Competitive Advantage of Racial Equity.” The report examines how leading health care companies are redesigning the ways they provide core products and services to better meet the needs of people of color and to simultaneously achieve business value.

For example, ProMedica, a large integrated health care delivery system, added a new step in service delivery by screening patients for ten social determinants of health indicators, including food insecurity and transportation challenges. Asking the patients what they need rather than relying on assumptions about them can reduce biases and in turn leads to improved health outcomes and reduced costs.

Another example is that of Cigna, a global insurance company, uses data science to identify and track disparities among customers. Cigna created a disparities dashboard to track several quality measures by race and gender which informs the development of targeted clinical interventions such as a colon cancer screening campaign culturally tailored for Latino and Black men.

Building these strategies into the core business is the essence of a shared value approach to advancing health equity at scale.

Given those lessons and what we’re observing in companies more broadly, what’s needed going forward? We all know companies are making bold equity commitments and we know they are struggling to put those commitments into action.

I want to highlight two key missing elements to advancing equity. First, a common roadmap to follow—companies have said, “We need guidance. We need best practices. What does good look like?” Second, accountability for change—companies want to know how to measure progress in a standardized way.

I am excited to share that FSG is partnering with PolicyLink and JUST Capital to address both of these elements. We have formed the Corporate Racial Equity Alliance to turbocharge the advancement of racial equity within corporations. For a roadmap, we have developed the CEO Blueprint for Racial Equity which defines what it means to be an antiracist, equitable company. It looks at this in 3 dimensions: inside the company, in the community, and in society. For accountability, we are in the process of developing common standards that companies can report on and be measured against. These standards will be piloted in 2022, working closely with existing standards bodies. This will provide transparency on equity performance for executives, employees, investors, and other stakeholders.

This is such a critical, pivotal time for the private sector to help advance equity. I am deeply energized by companies’ aspirations, by the progress I’m seeing, and by the possibilities that lie ahead.

Nobody has figured this all out, but together we can begin to glean knowledge of what’s working so we can all contribute to a more equitable future.

Learn more about FSG’s corporate racial equity work >

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