In this series of articles, The Cancer Letter invites conversations about diversity, equity, and inclusion in recruitment and mentorship at academic cancer centers.
The objective is to help disseminate best practices for diversifying the oncology workforce of the future.
If you’d like to take part, reach out to Matthew Ong (matthew@cancerletter.com), associate editor of The Cancer Letter.
Two academic health systems in Cleveland are creating programs and faculty positions to direct institutional initiatives on health equity—at the executive level.
As sister campuses that share a network of affiliate hospitals, Cleveland Clinic and Case Western Reserve University School of Medicine compose one of the largest health systems in the Midwest.
Cleveland Clinic, with its worldwide reach, logged more than 8.5 million outpatient visits in 2020. Case Western Reserve employs more than 7,000 basic science and clinical faculty.
How are these behemoths addressing health equity issues post-2020, and how do these initiatives affect patients with cancer?
At Cleveland Clinic, an Executive Diversity Inclusion and Racial Equity Council has been established to examine and promote policies to eliminate racism, bias, and health disparities across its health system.
“As Cleveland Clinic takes steps to address and eliminate racial disparities and cultivate a culture that embraces diversity, inclusion, and equity—transparency is important,” the organization’s leaders said in a statement, in response to questions from The Cancer Letter. “As an anchor institution in the community, Cleveland Clinic is leading by example.”
These activities, including hiring and recruitment decisions, are primarily made at enterprise-level, which means they apply to Cleveland Clinic’s Taussig Cancer Center, a spokesperson said.
Case Comprehensive Cancer Center—a mere mile away from Taussig—named Blanton Tolbert associate director for diversity, equity, and inclusion, starting this month. The cancer center is a consortium of Case Western Reserve University, Cleveland Clinic and University Hospitals.
“Tolbert was also appointed as vice dean of diversity, equity and inclusion for the Case Western Reserve University School of Medicine,” Stanton Gerson, director of Case Comprehensive Cancer Center, said to The Cancer Letter.
Executive-level appointments and initiatives are essential for re-imagining an institution’s community outreach and engagement efforts—to improve access for underserved communities as well as to ameliorate underrepresentation of racial and ethnic minorities in medicine, experts say.
The latter has been well documented:
- An analysis of NCI’s workforce and grant recipients shows that Black and Hispanic scientists are dramatically underrepresented across key metrics (The Cancer Letter, July 2, 2021).
- A leadership pipeline survey conducted in 2020 by The Cancer Letter and the Association of American Cancer Institutes found similar disparities across North American academic cancer centers (The Cancer Letter, Oct. 9, 2020).
- A recent study of leadership teams at NCI-designated cancer centers by a team of Memorial Sloan Kettering Cancer Center researchers reached kindred conclusions (The Cancer Letter, June 25, 2021).
“I think one of the easiest ways—this is something that can only come from leadership—is to just say, ‘Hey, this is a priority of our cancer center,’” Fumiko Chino, senior author of the MSK study, said to The Cancer Letter. “And it’s amazing how much things can happen if leadership has said X is a priority.”
In 2019, Cleveland Clinic increased its “Community Benefit” budget—which is used for an array of public service efforts, including outreach programs and subsidized health services—by 12% to $1.16 billion.
Over the past year, Cleveland Clinic leadership said they focused on expanding the network’s portfolio of efforts to improve the health of the communities it serves:
- Expanding a mobile, full-service pediatric school-based healthcare program; providing high speed internet to surrounding neighborhoods;
- Expanding the ASPIRE Nurses Scholar Program;
- Investing in the JobsOhio initiative;
- Delivering Thanksgiving dinners to the community; and
- Connecting patients with health and social organizations across Northeast Ohio which reduce barriers to care through the Unite Us program.
“On June 3, 2020, Cleveland Clinic publicly supported Cleveland City Council in its declaration that racism is a public health crisis in our community,” officials said in a statement. “Since then, the healthcare system has worked to reaffirm its commitment to diversity and inclusion through new programs and partnerships.”
Recent hires at Cleveland Clinic include:
- Kiersten Kanaley, executive director of talent acquisition, who joined Cleveland Clinic earlier this year after leading that function at Scripps Health, a non-profit healthcare system in San Diego.
- Melissa Burrows, who serves as director of talent acquisition workforce diversity. On June 1, she joined Cleveland Clinic from the City of Cleveland where she served as director of the office of equal opportunity. A key responsibility will be to advance hiring efforts from the City of Cleveland by building and connecting caregivers from entry level positions to career pathways.
“Cleveland Clinic has been recognized as a healthcare leader in diversity and inclusion and that recognition carries a responsibility,” LeJoyce Naylor, executive director of Cleveland Clinic’s office of diversity, said in a statement. “We are proud to provide rewarding jobs that open up opportunities for all skill levels and serve to support the health of our communities.”
Cleveland Clinic will have recruiters and coaches working in neighborhoods, such as at the Langston Hughes Community Health and Education Center, to help remove challenges related to job applications and interviewing.
In December, Cleveland Clinic joined OneTen, a coalition of 37 top U.S. employers to train, hire and promote one million Black Americans into family-sustaining jobs with opportunities for advancement over the next 10 years.
OneTen has started working with Cleveland Clinic and other partner employers to accelerate hiring, retaining and promoting Black talent. The focus is on reducing exclusionary hiring practices, identifying robust and new talent sources, and ensuring adequate and equitable career pathways for all, Cleveland Clinic officials said.
“The values of Cleveland Clinic, specifically our value of inclusion, aligns directly with OneTen’s mission,” Kelly Hancock, chief caregiver officer at Cleveland Clinic, said in a statement. “Our partnership and participation in this coalition is an extension of Cleveland Clinic’s commitment to the lives of our current and future employees and the communities that count on us.”
Gerson’s remarks on Case Comprehensive Cancer Center’s efforts to grow the training pipeline and improve access for underserved communities follow:
Director, Case Comprehensive Cancer Center
What best practices in hiring and recruitment—or in pipeline programs—do you use at your institution to elevate potential diverse leaders? How effective are these strategies?
Blanton Tolbert, PhD, was named associate director for diversity, equity and inclusion for the Case Comprehensive Cancer Center, commencing July 2021. Tolbert was also appointed as vice dean of diversity, equity and inclusion for the Case Western Reserve University School of Medicine.
Our center has two successful pipeline programs. The R25-YES program is funded by the NCI Center to Reduce Cancer Health Disparities. This program is focused on middle and high school URM students, specifically those in the City of Cleveland, along with their teachers and families.
The R25- Cancer-focused Summer Undergraduate Research (CanSUR) program is funded by the NCI, with ~30% URM in the first 2-years.
In your experience as a member of your center’s executive leadership, how has increased diversity among your faculty improved patient outcomes, as well as your ability to reach and engage underserved communities in your catchment area? Could you provide a few examples?
The Dean’s Scholars is a career track supported by the Case Western Reserve School of Medicine/Case Comprehensive Cancer Center for 2-3 current graduate students per year as postdocs with support towards faculty appointments.
The Diversity Career Development plan has a Junior Faculty focus that includes mentoring, grant development and pre-submission review.
What programs have you led that are directly contributing to greater equity i.e. a reduction in disparity of outcomes or disparity of access in your catchment area? What is the nature of those disparities and what have you learned?
We have had an actively engaged Community Advisory Board (CAB) since 2012 that has shaped and informed the programs of the Case Comprehensive Cancer Center, particularly with regards to addressing racial and ethnic disparities in our catchment area.
In partnership with our CAB, some programs addressing disparities in our catchment area include:
- On the recommendation of our Committee on Disparities in Clinical Research, we have provided financial support for culturally concordant Clinical Trials Navigators to improve recruitment of African Americans into clinical trials.
- The Cleveland African American Prostate Cancer Project, funded by Bristol Myers Squibb Foundation, aiming to address prostate cancer disparities by increasing awareness and access to prostate cancer screening.
- Partnership with local federally qualified health centers (FQHCs) to facilitate access to high-quality cancer screening services.
What are your next steps?
Some of the next steps of the Case Comprehensive Cancer Center in addressing disparities in our catchment area and promoting diversity within our center include:
- Enhancing our current training pipeline, including students from high school through post-doctoral training, with the inclusion of training in Community Outreach and Engagement principles.
- Strengthening relationships with federally qualified health centers (FQHCs) to increase access to quality cancer screening and care.
- Expand initiatives to help reduce the barriers that impact clinical trial accrual of African Americans.
This story is part of a reporting fellowship on health care performance sponsored by the Association of Health Care Journalists and supported by The Commonwealth Fund.
