Changing health equity at Mass General Brigham and beyond

November 14, 2022

Tom Sequist, MPH ’04, is leading equity change at Boston’s Mass General Brigham health care system and supporting better care for Native American populations in the Southwest.

During the summer of 2020, Mass General Brigham faced a reckoning, and Tom Sequist saw an opportunity. Staff angered by COVID-19’s disproportionate impact on Boston’s minority neighborhoods and the murder of George Floyd were demanding the hospital system use its clout to tackle structural racism in health care. Sequist, at the time chief patient experience and equity officer, was asked to take a lead role in this effort, a responsibility he embraced. As he saw it, the moment called for more than virtue signaling on social media. Instead, Mass General Brigham needed a robust response built around goals and accountability.

After months of meetings, employee surveys, and listening sessions, the system launched United Against Racism in October 2020. The long-term, multimillion-dollar program is focused on improving health equity for patients, improving health in local communities, and creating workforce equity for the more than 80,000 employees across the system and its 12 hospitals. In the two years since the program’s launch, Sequist and colleagues—including Elsie Taveras, professor in the Department of Nutrition at the Harvard T.H. Chan School of Public Health, who was hired as the system’s first chief community health and health equity officer—have eliminated inappropriate use of race as a data point in clinical decision tools, increased translation services for patients, sent a mobile health clinic into underserved neighborhoods, and developed new systematic approaches to respond to internal reported instances of racism.

Sequist says that since the start of his career in medicine and public health, he’s been driven to help people who have suffered for too long. “That’s what motivates me every day,” he said.

After graduating from Harvard Medical School, Sequist began his residency at Brigham and Women’s Hospital in 1999. Three years later, while maintaining a primary care practice at the hospital, he started pursuing an MPH in clinical effectiveness at Harvard Chan School. Sequist wanted to explore health policy research and needed training in vital areas such as large database analysis and clinical trial design.

“It was really a foundational experience for me,” he says. “It provided me with knowledge that I’ve used in every part of my career.” His subsequent research on quality of care, health care equity, and Native American health paved his way to becoming professor of medicine and professor of health care policy at Harvard Medical School, and earned him election to the National Academy of Medicine last year.

Sequist has had less time for research since moving into management at Mass General Brigham in 2019—in February, he was appointed its first chief medical officer—but Native American health care remains close to his heart. He is a member of the Taos Pueblo tribe, and although he grew up outside of New York City, he often visited the reservation in New Mexico where his mother grew up. Alongside its rich culture, he was struck by the poverty, unemployment, and chronic disease that he saw. He was particularly shocked to see that many people lacked electricity and running water…..

Written by: Michael Blanding

Photography by: Kent Dayton

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