Dignity Health CEO: How Homelessness and Race Affect Healthcare

Dignity Health CEO: How Homelessness and Race Affect Healthcare

Lloyd Dean is at the helm of Dignity Health, the largest hospital provider in California, and the fifth largest health system in the nation. As one of the few CEOs of color in the U.S., Dean’s commitment to healthcare isn’t just business—it’s also personal.

“I have eight siblings and we grew up in Western Michigan, where our community didn’t have access to reliable healthcare,” said Dean. “I didn’t realize that other communities were different until I was bussed to a neighboring town that was more economically robust. In a bigger sense, we know that only a small percentage of your health is due to genetics. That means that our health is largely based on where we live and social determinants of health.”

Another factor contributing to healthcare inequity is homelessness. Coincidentally, Dean is fighting to reduce homelessness in San Francisco, one of the more expensive cities to live in the world, which also has one of the most severe housing problems in the state of California.

“In the United States, there are more than half a million people who are homeless on any given night; 41% of whom are African American,” said Dean. “It keeps me up at night, knowing that so many Americans of all colors and backgrounds are forced to choose between paying for rent, food, or healthcare just because they don’t have insurance or the ability to pay for their care. That is why I’ve dedicated my life to reducing inequity. We live in a first world country, where access to affordable housing shouldn’t be as big of an issue as it is. It is difficult to be healthy, if you don’t have a home. Homelessness, mental illness, substance abuse, and chronic health problems are all interrelated, and we know that we can’t tackle each issue in isolation.”

Lloyd Dean

To reduce healthcare inequity, Dean believes communities must form partnerships to address each person holistically.

“I believe that healthcare is a right and not a privilege. In many cases, mental health and homelessness go hand-in-hand, which is why we work with many multifaceted partners. For example, at one of our San Francisco hospitals, St. Mary’s Medical Center, we started the San Francisco Healing Center in partnership with the University of California, San Francisco (UCSF), the San Francisco Mayor’s Office, San Francisco Public Health, and San Francisco Behavioral Health to provide mental health services to homeless patients in need. Helping people get into more stable environments is one of the most important ways we can help one another, which helps the overall health of our communities,” he says.

“Last year, we invested $1.65 billion in charitable care and community services that allow us to develop and support programs across the continuum of care. As only one example in Stockton, we provide psychiatric and chemical dependency disorder treatment to patients. We also recently committed $1.65 million to benefit the homeless in the Sacramento area. Of that, $1.2 million continued operations at the city’s triage shelter serving about 200 people. The remaining funds will go to other projects, including the City of Sacramento’s Whole Person Care program with Dignity Health Mercy General Hospital piloting coordination and transition of care from the hospital into the community. We are working on efforts all across our communities, especially to address the needs of our most vulnerable patients.”

Hospitals are another solution to improving access to healthcare and getting homeless people off the street.“ As anchors in communities, hospitals are in a unique position to help the populations they serve, said Dean.

“One of the primary problems in healthcare today is that, too often, emergency departments are used as a primary care source. We must instead look at care more holistically with the goal of keeping people well before, during, and after a medical encounter.

Dean continued: “We know that making progress isn’t always simple, but by staying in tune with the individual needs of those we serve and the communities where they live, we can continue to find sustainable solutions—this is especially true for the homeless population. We have seen that people are more likely to reach their full potential when they have community support, the security of a home, and access to health services. This is true of a small community or a large city.”