Starbucks – Missing It By A Latte

Written by Dr. Heather Hackman

There has been quite a kafuffle about Starbucks closing for a whole day to do implicit bias training in response to the racial incident in Philly last week. To be clear, I do not doubt the intent and level of concern expressed by their CEO, Kevin Johnson. Nor am I questioning the knowledge, both professional and through personal experience, of the “consultants” they brought in to lead the day-long discussion. What I take issue with are three critical things: leadership, training, and time.

As a consulting group, we do not train front line staff unless the leadership of an organization has a) gone through extensive training itself, and b) done this training before the front line staff. The former is critical in that you simply cannot lead around issues you do not know, and the more power one has, the more in-depth the training and application needs to be. We meet many CEOs and organizational leaders who have read one piece of information or had one emotionally moving experience and are suddenly “motivated” to “go do something”, but in actuality are nowhere near being able to lead from an equity and social justice frame. Connected to this is the need for the leadership to be out in front of staff so that they can actually lead around these issues. It is often quite difficult to have the leader(s) of an organization going through their own “ah-ha’s” simultaneous to those that they supervise. The nature of training around race or gender or class or other social justice issues is such that there must be time to internally process, to lean into one’s edges, and to do the personal work necessary to change behaviors and apply a more socially just lens to their vision for the organization. This is almost impossible to do if the staff is having the same sets of experiences as leadership at the same time; the logical question from staff, “what are you going to do about it right now!?” cannot be answered if both are going through it together, and this can lead staff to doubt leadership’s ability to really do anything about racial issues within the organization.

Starbucks’ choice to send everyone through a training is good optics and will provide an opportunity for everyone to have together. But, with respect to a system of racial oppression that has been in place for 400 years, there is absolutely no way that one day of “implicit bias” training will do much of anything in terms of deep and substantive organizational change for Starbucks. This brings me to my second critique of this “day of training” – it’s not really training. I meet thousands of folks a year (mostly white, but also some people of color and Native peoples) who are badly educated about issues of race, racism and whiteness (RRW) in the U.S. It’s not surprising. I have spent enough years in teacher education and training P-12 folks to know that what we are taught in mainstream education (both public and independent) in terms of race, racism and whiteness is not just bad, it is explicitly false with the intention to avert our nation’s gaze from the racial tragedy of its past and present. Thus, the Starbucks employees for whom the U.S. is their first nation have been exposed to years and years of explicit and intentional lies about RRW and no one-day training en masse is going to make even a tiny dent in the deep and calcified socialization folks have received about RRW.

So why train like this? Because it “looks” like the organization is doing something. Most private sector organizational leaders have become profitable by learning how to maximize their performance in transactional spaces where solving problems and addressing issues is about decisiveness, taking charge and “doing something about it now”. That works well with phenomena that are themselves transactional. But, RRW are sociological phenomena and absolutely cannot be addressed in quick, transactional, check-list ways. This does not stop leaders form choosing this approach because the illusion of quick and strong action = effective solutions is a powerful one in the private sector. In white dominant spaces, this “rugged individual” and transactional manner actually serves to reinforce the dynamics of whiteness and in the end leaves the influence of the Racial Narratives, the systemic targeting of people of color and Native peoples, and the systemic advantaging of white people firmly in place because it has actually never been addressed.

Additionally, Starbucks did not choose actual racial equity trainers to lead this training. Rather they chose big names to match their desire to look like they’re doing big things about race. I’m not dismissing the incredible knowledge and life experience of former Attorney General Holder, for example, I’m simply suggesting that while brilliant, he is not best qualified to train on racial justice issues. Why? Because to be an effective trainer on this content one needs to know something about the art and science of teaching. Moreover, they need to be exceptional at training (not quite the same as teaching) – meaning they need to know exactly how to lead a racially complex group of people through the process of identifying RRW and uprooting it at its core. While the trainers chosen for this day-long are all knowledgeable with respect to their various sectors, none of them have the extensive experience training necessary to make real change at Starbucks. To the lay person who might also not have experience teaching and training on this content, however, the big names will likely be equated with “big action” and Starbucks will be let off the hook.

Connected to the above need to have long-standing experienced trainers do this work, is the fact that one day is absolutely not enough time to cover anything of substance. The mainstream corporate media has reported on the financial losses for Starbucks (roughly $12 million) taking this “bold” move of closing their stores. In so doing, the media reinforces the erroneous notion that one day is really going to change racial dynamics in Starbucks. I often encounter folks who say that HCG’s three-day training is simply too much time. I then suggest, however, that 400 years of racism compared to 24 hours of training time is really not much of a comparison. In addition to being steeped in that long national legacy, however, I remind participants that they have individually been miseducated (to varying degrees, depending on their identities) about these issues and therefore, again, 24 hours is actually nowhere near enough to counter that.

Ignorance about what is really at the heart of this nation’s racial reality leads companies like Starbucks to make misguided, and in the end unhelpful, choices about how to address RRW issues internally. But, if this is not the answer, what is an appropriate response? Here is a general outline of the approach we suggest for large organizations: 1) make sure leadership understands what RRW issues actually are and be sure that they are on board with the level of organizational change necessary to more fully address them, 2) work with an internal team to identify a strategic approach for training layer after layer of the organization beginning with the top levels of leadership and working down to the ground, 3) implement various forms of firm-wide assessment to know where participants are starting, and 4) once a critical mass has been trained, support them to apply that lens to organizational changes that will support the front line folks in also being able to be trained and rewarded for engaging with customers differently. Of course, there is much more to all of this than what is mentioned here, but the general outline of work stands – be sure the organization is ready to commit to this work, assess them, train them as extensively as possible, begin the organizational change process, and then do that work for the next layer down and so on. If Starbucks had chosen the path of real organizational change, they would still be taking immediate action, but it would have a very different look and feel, and would be over the long haul. Most importantly, perhaps, they would spend a little less time in the headlines and more time committing to the actual work of racial equity within their organization.

Racial Health Care Disparities: How Do We Move Forward?

I have been practicing Pediatric Hematology in Minnesota for 20 years. For the bulk of that time I’ve had the distinct honor and privilege of caring for children with sickle cell disease. Sickle cell disease is one the most common inherited genetic disorders, and is the most common abnormality detected on nationwide Newborn Screening tests. There are 100,000 Americans living with sickle cell disease. It is a disease that affects the red blood cell and has multiple complications including severe pain, stroke, lung disease, infections, and early death (http://scinfo.org/). Although sickle cell disease is a global issue that affects people of all races, in the United States patients are predominantly black.

As a white man, trained by mostly white faculty and white mentors, I never really gave this much thought. Physicians strive to provide quality health care to all of our patients and families and race shouldn’t be an issue, right? Well, then I stumbled into a workshop on White Privilege given by Heather Hackman at the Rainbow Families Conference in 2008. Only then did I begin to consider how my identity as a white male physician might affect the health care delivery to my patients of color. This consideration was long overdue and since that moment, I have been on a journey to better understand racial health care disparities and, with Heather, develop an action plan to address this inequity.

While many factors affect health care equity, disparities based on race that target communities of color are consistently reported in the management of many diseases. For example, blacks receive a lower standard of care than whites when being treated for breast cancer, orthopedic problems, cardiovascular disease, pain, and end-of-life care. According to the 2009 National Healthcare Disparities Report produced by the Agency for Healthcare Research and Quality, many of these discrepancies are not decreasing. Blacks receive worse care than whites for half of the core measures studied, and only about 20 percent of measures of disparities in quality of care improved over the study period of 2000–2007. Being uninsured was the single strongest predictor of quality of care. However, when correcting for uninsurance and socio-economic status, blacks still eceive worse care than whites (www.ahrq.gov/qual/qrdr09.htm). At the local level, a recent Wilder Foundation study reported similar results. Blacks and Native Americans in the Twin Cities have a significantly shorter life expectancy than whites, even after correcting for socio-economic status. (“The unequal distribution of health in the Twin Cities: a study commissioned by the Blue Cross and Blue Shield of Minnesota Foundation,” October 2010 available at www.bcbsmnfoundation.org/objects/Publications/F9790_web%20-%20Wilder%20full%20report.pdf)

Barriers to racial health care equity include the health care system (insurance, funding, white-domination in provision of care), the patient (poor health literacy, fear, mistrust), the community (awareness, advocacy), and we the providers (bias, attitudes, stereotypes, expectations). The combined magnitude of these factors can seem overwhelming, and yet there are points of entry for each of these major variables. As providers, I believe we have the greatest potential for changing racial disparities by working on our own biases. There is much published evidence that our behavior contributes to race/ethnicity disparities in care and that patients and providers perceive race as an issue in health care delivery. Heather and I recently published some of our work in this area (http://hackmanconsultinggroup.org/wp-content/uploads/Race-Matters.pdf). So, what can we do about provider attitudes and biases?

Stay tuned…..Heather and I have developed a training module for health care providers to address race, racism and whiteness and how these affect health care delivery. We hope to present data from our initial pilot training at the 7th Annual Sickle Cell Disease Research and Educational Symposium & Annual National Sickle Cell Disease Scientific Meeting April 14-17 in Miami (http://fscdr.org/).

Similar to Heather’s blog from January 13 Racial Justice Work: A Spiritual Imperative, I strongly believe that racial justice work is also a Health Care Imperative. In the words of Martin Luther King, Jr: “Of all forms of inequity, injustice in healthcare is the most shocking and inhumane.” National Convention of the Medical Committee for Human Rights, Chicago- 1966 (http://www.standupforhealthcare.org/blog/martin-luther-king-jr-a-civil-rights-icon-s-thoughts-on-health-care).

 

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