Ep 41: Operationalizing Health Equity

Sanjula Jain  0:03  

Women make up 70% of the healthcare workforce but only 20% of its leadership. On Her Story, we’ll explore the careers of bold and influential women from Silicon Valley to Capitol Hill and learn how they’ve overcome the odds. I’m your host, Sanjula Jain and this is Her Story, a program where we explore what’s beyond the glass ceiling.

I’m delighted to welcome Dr. Lauren Powell, President and CEO of The Equitist and Vice President of Health Equity and Community Wellness at Takeda Pharmaceuticals. Lauren, thanks for being with us on Her Story.

Lauren Powell  0:38  

Thank you so much for having me. What an honor.

Sanjula Jain  0:42  

You have a remarkable career trajectory, which I’m excited to dig into with you today. For some context, could you give us a little bit of background on exactly what The Equitist does and what you do in the health equity space?

Lauren Powell  0:56  

Absolutely. First, it is such a pleasure to be here, so thanks for the opportunity, and great to connect with you, Sanjula. The Equitist is a niche boutique consulting firm. It is focused on everything related to health equity. Having spent time working in state government, working in the federal government, now working in the private sector, I’m acutely aware of how committed the healthcare industry wants to be to health equity but, when it comes down to operationalizing health equity, people are stuck. They’re paralyzed. The Equitist exists to move people from thinking about health equity in theory to actually operationalizing health equity, so putting that into action.

Sanjula Jain  1:41  

That’s great. We’re going to talk about the origins of your career in just a minute but—as you think about the early days of studying pre-med to what you’re doing today to actually building The Equitist to also working in the private sector—do you consider your foray into healthcare leadership accidental or intentional?

Lauren Powell  1:58  

It was accidentally intentional, perhaps. I started off pre-med. I was pre-med in undergrad and went to Xavier University, Louisiana. I wanted to be a doctor, but I was also more interested in health policy, so I thought I needed an MD degree for people to take me seriously. I wanted to fix the policies that surround how healthcare is administered. As a child, I had asthma, so I was in and out of the doctor’s office. I spent a lot of time around doctors but I always intrinsically felt like there’s something wrong with the way we access healthcare and the way people are treated when they seek health care, but I thought I needed an MD degree in order to foray into that area. So I was focused on that primarily for a bit, but then Hurricane Katrina hit my senior year of college. That was completely devastating, to say the least. I think people heard a lot about how Katrina impacted the city and impacted the residents but much less was discussed about how the hurricane impacted college students. New Orleans, in particular, was a huge college town, so that impacted me a lot. What I ended up experiencing was the social determinants of health, though I didn’t know what to call it at the time. All of the broken infrastructure that led up to not only the natural disaster but the manmade disaster that happened thereafter are all rooted in racism and the social determinants of health. I didn’t exactly know how to name all those things at the moment, but they had a deep impact on me. I applied to medical school twice and I got rejected twice, which is not uncommon, but somewhere along the path I realized, “Maybe there’s something else I should be doing.” I’d been working in clinical research, so after I graduated from college I ended up working in clinical research as a research assistant, clinical research coordinator, and eventually pursued a path that was more in line with that. That took me to grad school. It was accidentally intentional. I always had some ideas of how to fix the broken healthcare system, but I wasn’t quite sure I would be a leader in this sense.

Sanjula Jain  4:18  

You and I actually have a lot of parallels listening to that. As you know, I went to college down at Rice in Houston so similarly—even though Hurricane Katrina didn’t directly affect Houston in that way—there were a lot of conversations around the impact of public health and social determinants. When you thought about being a physician, how were you thinking about the bridge between clinical medicine and those social determinants disparities you were seeing at that time?

Lauren Powell  5:01  

First and foremost, I could see there were a lot of questions being asked on the national landscape that people could have no context for unless you were local. For example, why didn’t people leave? Like, a Hurricane was coming. Why don’t people just pack up and leave? Well, if you were local and you actually understood the context of the fabric of New Orleans, you would know that there were a significant number of people who were impoverished and do not own cars. We could probably overlay a redlining map and see that the access to transportation and historic redlining probably line up exactly. The areas that were hardest hit, people were not able to live their best lives in those areas to begin with, so I was already wondering why that wasn’t a factor taken into consideration when people were being treated clinically. Why are people thinking about whether or not I can take a medicine that will control my blood pressure? It’s the fact that I may live in a neighborhood where I can’t even get fresh food and everything I’m eating is infused with sodium and lots of other additives that don’t give me a fair chance at even being able to fight back against hypertension. I wanted to think about why we don’t have policies that build a bridge out of those two things.

 

Sanjula Jain  6:36  

As you were thinking about that systems perspective, you’re also doing this clinical research. You’ve worked in a lot of terrific organizations. At what point did you decide you were going to get a Ph.D. on the population health side of things?

 

Lauren Powell  6:52  

On the population health side of things, it was because of my experience working as a clinical research coordinator. I was a research assistant and a research coordinator at Johns Hopkins, the schools of Medicine and Public Health and the Dana Farber Cancer Institute. I worked at the National Cancer Institute at the NIH. All of those were really interesting experiences because I was the one actually trying to speak with patients, actually trying to provide informed consent and answer their questions about research protocols and research studies. I got to experience firsthand just how difficult it is (1) to explain scientific jargon, to help people understand a placebo or randomization. How do you actually put that into layman’s terms? (2) I got to feel the lack of trust in participating in a clinical research study— and not just from people of color, but from a lot of different people. That led me to want to study that. I wanted to figure out if there’s a way we can build better trust. Is there a way we can increase the participation of minorities in clinical research? I was rather successful in recruiting people into my studies and that had a lot to do with the fact that I was very conversational with people, I took time to answer their questions. It was rare to see a research assistant who was a young black woman and for quite a few that was very comforting and led them to feel like, “Okay, maybe this is something I could trust.” That is exactly what led me to work on my Ph.D. People don’t really realize the National Cancer Institute’s (NIH) trials are open to the whole world. People from all over the world come to get care at the NIH. I was overseeing about 16 or 17 phase-one oncology clinical trials. We had a case of a young black male come in. He was about 16 or so, was playing basketball, was very athletic, and was randomly diagnosed with a very rare form of cancer. We had a trial that was perfect for him, but both of his parents had to consent to it because he was a minor. The parents were like, “No. We’re not putting our child in clinical trials.” At this time, there was no other course of treatment, but they were very, very resistant to it and were not okay with it. We called in a bioethics consultant and all these roles I never knew existed. I was so intrigued and also disturbed at the same time, trying to think about his quality of life. Why do his parents feel this way? Certainly, they’re warranted to have their feelings. All of that sat very heavily with me. Eventually, we were able to kind of persuade his parents. His parents gave permission, he went on trial, and it was successful, but that scene was one microcosm of what is happening all the time. That is what led me to apply to graduate school. I wanted to study those exact scenarios, I wanted to think harder about how to better communicate about clinical trials, and how to ultimately exude more trustworthiness out of our healthcare institutions.

 

Sanjula Jain  10:25  

That’s so powerful. What you’re describing is this burgeoning field of public health and it’s worth noting there aren’t a ton of Ph.D.s in public health areas. It’s a relatively newer field. There are a lot of MPH programs. When you think about the doctor programs, a lot of institutions have created their degree programs in the last 10 years or so, some a little bit longer. As you think back to the medical school path then switching over to more of a public health doctoral training, what was that like? Did you have to convince your family and explain the field to them? I went through that experience: What is public health? Or what is a Ph.D. in a public health area? Then thinking, “Okay, so how do I build a career in this with a formal education training?” How did you make that leap?

 

Lauren Powell  11:35  

I don’t know how I made that leap because I still find myself trying to pull the words together to explain to my family what I do. From a training perspective, a Ph.D. is very different, you’re absolutely right. I was looking for programs. I was kind of skimming and trying to see what’s out here because I was interested in the intersection between clinical research and population health, but most of those programs that exist are for clinicians, therefore, people who already are a nurse or are a physician’s assistant or an actual physician. There were very few programs for someone who doesn’t already have a clinical degree or credential. Those are rare, you’re absolutely right, but I’m grateful for the Ph.D. side of my training. Making the leap between medicine (something people can readily understand) to a Ph.D. (a degree that’s recognized but people don’t really have an idea of what you do with that) to public health, which was something that—even though I was living through a public health emergency in Katrina—I didn’t have a frame of reference for what public health was until I started having more exposure when I was at Hopkins. I would talk to other people, talk to students, go to lectures, and drop in and hear about things. I was like, “Wow, this is a whole different career path than I knew about,” and that’s unfortunate. I hope that’s changing. With more leaders who are black and brown, who are women, who are from native communities, who are from the LGBTQ+ community, from the disability community, I hope we’re changing the face of what people see public health to be and also opening the eyes and the realization for younger people. This is a legitimate career path you can travel down. I did not realize that, so it took some of that exposure. I did not think in pursuing my Ph.D. that I would be where I am now. I didn’t quite know where I would end up. I knew that this was a topic I was interested in. I knew very early on that I did not want to be an academic researcher, even though every one of my programs tried to get me to be. I knew as soon as I entered that academia was not for me. I actually thought I would go back and work in government, which I did, state government, but I actually thought I would return to federal government after my Ph.D., which I did not. I’m still pulling my family along the journey with me, with each role perhaps providing more clarity as to what it is I actually do.

 

Sanjula Jain  14:32  

Thank you for sharing that because, in many ways, that’s one of the core reasons we started the show, Her Story, to start highlighting these other career paths and routes that maybe aren’t as mainstream, for lack of a better word. There are these other opportunities and burgeoning fields. With that, then back to terminology for a bit. You have been navigating these different roles at the intersection of clinical medicine and public health and now you’re in this health equity space and the game of social determinants. There are a whole lot of things happening there. How do you think about health equity? How do you define that?

 

Lauren Powell  15:09  

Very simply put, health equity is ensuring that everyone can live their best life. That’s if I had to explain it in layman’s terms to someone who had no context or reference to public health. I would say that means ensuring that people have access to jobs, that people can pay their bills, that they can live in stable and clean housing, that they have access to food that is nutritious, that they can experience peace and joy, have equilibrium and your mental health, and access to a doctor when you need one, and provision of the best care when you go to seek a doctor’s help. Very simply put, we’re aiming to ensure that—just like the people who have the privilege to make sure that they’re living their best life—the people who don’t have those resources can have that same ability, that we can all live our very best life.

 

Sanjula Jain  16:11  

I love that. It’s very intuitive and not a traditional definition that you would hear in the industry today. From graduate school, you were doing your research in this space, you were trying to raise awareness, then you went to the Virginia Department of Health after grad school.

 

Lauren Powell  16:32  

This is when my family was like, “Okay, you really need to be done with school.” I was finishing my Ph.D. and I started researching. I’m a researcher, period, so I started researching: What am I going to do after this? I was in the middle of writing my dissertation the summer before I would defend it and I said, “What am I going to do when I graduate?” I started researching, doing informational interviews, reaching out to companies trying to figure out where I could fit in. This is the interesting thing because my degree was so different and so new that, at the time, people were like, “We don’t really know. It’s a Ph.D., which is great. That tells us you’re a critical thinker and stuff, but if you want it to—let’s say—come into pharma, you’d still have to do a postdoc or something because you’ve left the work world so you don’t have as much managerial experience.” All these things sort of came together and I was like, “This doesn’t really sound like what I had in mind. It’s not exactly what I think I was infused with these skills to do just yet.” I had this lingering interest in policy, so I said, “I’m not going to apply to any jobs. I’m not going to apply to any postdocs. I’m going to apply to one graduate school and get a masters in policy. That’s it. If I don’t get in, I’ll figure out what to do after that. If I don’t get in, I don’t get in.” This is when my family was like, “Okay, you’re doing the most now. You have the highest degree you could possibly get.” I was like, “Well, I have this interest in policy and I just don’t think I’m done yet.” I applied to Harvard, the Kennedy School of Government. I apply for a mid-career Master’s in Public Administration, which is specifically for people who have already worked a portion of their career and are wanting to either pivot or add a new skill or learn something deeper. I’m so blessed and so grateful I got in because I literally didn’t have anything else planned. I didn’t apply to any other schools. My academic mentor and advisor was like, “Are you sure you want to do this?” I was like, “Yeah, I am. I think this is it,” so thank God I got in. Between my Ph.D. and going to work for the Commonwealth of Virginia, I did a Master’s in Public Administration at Harvard. From there is when I went to work as the Director of the Office of Health Equity.

 

Sanjula Jain  19:08  

Wow. There’s a lot to unpack within that. To start, the Kennedy School is by far one of the best programs in policies, so kudos to you on that, but also kudos to you on going with your gut. In many ways, I can relate to that fact of where do you fit coming out of the Ph.D. training? If you don’t do the postdoc, you don’t do the traditional bench sciences route, or you don’t go into academia, where do you go within that? There’s a lot to be said about that process of researching options and creating your own path that maybe didn’t exist to find where you fit. Did that influence you to decide to get the policy degree or was it purely you chasing after just the love for policy?

 

Lauren Powell  20:05  

It definitely did influence. There was a perception—I hope we’re starting to change that—but there was certainly a perception that an academic degree only transfers academic skills. An academic degree transfers life skills. Critical thinking is a life skill. Analysis and research is something that can be applied to any industry you go into. Understanding data and how to collect data and how to analyze data, how to report on data, how to translate data for different audiences is a translatable skill. I have learned about myself and I’ve really learned about navigating this industry is there’s a way to position and brand yourself that places your skills ahead of the degrees you have, in a sense. The degrees give you credentials but it is the skills that are transferable.

 

Sanjula Jain  21:06  

That’s so important because we often fall into this trap of it being a checklist. You go get these degrees, but it’s really what you make of it and how you position it. With that said, you graduated from the Kennedy School. How did you land in the state government from there?

 

Lauren Powell  21:24  

Everything is a story. I graduated from the Kennedy School. It was so exciting. Sometimes when you’re graduating from Ivy League schools, it’s like “this is like not an experience I’ve ever had,” so I should make it clear: I’ve been at an HBCU, a state school, and an Ivy League school, all of which are very different experiences. I appreciate each one of them because they have each contributed to molding me into who I am today and making me very, very comfortable being in lots of different scenarios, around lots of different types of people. I graduated and around that time they start to prepare you. Sometimes they make you feel like, “You’re leaving Harvard, everyone will want to hire you.” That may be the case for white men, let’s just be honest and clear. That may be the case for white men, but I’m still a black woman and I still have to compete for everything I go after, so I did not necessarily find that to be the case for myself or for my colleagues who were people of color who graduated. I still had to compete for the positions I was going after. I actually applied for positions in lots of different places. I applied and made it to the first round of interviews or something for a couple of consulting firms like BCG and other top consulting firms. A social impact consulting firm, I also made it a couple rounds into that. I found them to be interesting, but not motivating, still not quite what I thought I would be doing. I applied for a couple of different states and actually had a couple of interviews for states, Massachusetts, in particular. I applied for some positions there and then I applied for a position in Virginia. I put it out there with an Office of Health Equity. I don’t remember how I found it but I was very serious about applying for jobs and networking at this time. I also had a very short stint of consulting right after I graduated from the Kennedy School, so I was doing that and applying for jobs at the same time. The Equitist didn’t exist then, so it was just me side hustling, independent, trying to make it until my next thing. I applied for all these positions. They all got whittled down eventually. I went out of the country for a week or so with classmates, we went on a trip to Nigeria, which was beautiful. I was in Nigeria and Charlottesville happened, so I was watching the coverage of Charlottesville when we were in Nigeria and we had just come from the Door of No Return, one of the ports of the transatlantic slave trade. Now, the juxtaposition of the fact that in the same day I had just come from a place that essentially originated slavery and I’m getting CNN news alerts about Charlottesville, tiki torches, and white supremacists in the same day, and this was in Virginia. I was like, “Let me withdraw my application from Virginia because that’s not my ministry,” but I didn’t. Once I got back, they reached out and said, “We would like to talk to you,” and I said, “Okay, we can talk. I’m not going to make any promises, but we can talk.” I did a couple of phone interviews and I went in for an in-person interview and they were like, “We want to hire you.” I was like, “Okay, I guess I’m going to Virginia.” I was very much like, “Should I be doing this? This is the cradle of the Confederacy.” It is not lost on me the history that is here, the ways Virginia has had a very significant influence historically on the codifying of race, on slavery. There are more millionaires per capita at the height of slavery in Virginia than anywhere else in the country. That is a deep-seated history that I had to think, “Should I do this?” Ultimately, I said, “Yes, I should do this because (1) they don’t know who I am and they don’t know what I’m going to bring to this role, but (2) isn’t this what my ancestors died for? Isn’t this what they would have wanted? Isn’t this their wildest dreams?” So I said yes and I moved to Virginia. I’m still in Virginia, bought a house in Virginia, so I’m here for a while to shake things up.

 

Sanjula Jain  26:04  

Wow. That’s incredible, where you went from saying “I’m going to withdraw my application” to taking charge of the situation in many ways. We could spend a whole hour just on this, but maybe very quickly, tell us a little bit about what it was like operationalizing some of this change from within, basically on the heels of all these national and state events that were happening at the time.

 

Lauren Powell  26:26  

Yes, there were so many events that were happening at that time, and events within the state government that were very significant as well. It was challenging and rewarding at the same time. It was challenging for me being young and a new leader. Everything you want to read about leadership is wonderful until you actually have to do it. Then you have to figure out, “What kind of leader am I?” I was like 33 or something when I started in this position, the youngest leader of this office, first black woman with a Ph.D. Everyone before me had an MD so I felt like I had a lot to prove, but I also had a lot to learn about myself, how to navigate working as a supervisor over people who were old enough to be my parents and people who were my age. How to still be the personable leader I am while creating boundaries for discipline and boundaries to hold people accountable. That was one thing I had to navigate. The other was helping people understand what health equity actually is. So much of my time and so much of my role was focused on defining health equity, helping people understand what health equity is, what it isn’t. Racism and addressing racism is a core and fundamental requirement for health equity work. If you want to skip around, if you want to walk around the perimeter of that and you don’t want it to speak about it head-on or work to deconstruct it, you are not doing health equity work. I navigated spaces where I was often the only black person in the room, at leadership tables, the only black woman in leadership spaces, and also navigating when to hold them and when to fold them. I am one person and to think that only one person could completely intercept a system that was built on oppression, that was built on white supremacy, that was built to work exclusively for white men is flawed. One person can make a difference, however, because of this experience, I’m very clear on the fact that it cannot only be one person. You have to have a movement, you have to have support, and you have to have others to see that this is an important cause to champion. Otherwise, those systems that continue to grind and work perfectly, will grind you up in the process as well.

 

Sanjula Jain  29:26  

A lot of what you’re describing is a common challenge that a lot of leaders face. You can have all these ideas and maybe know how to fix the problem but it’s about execution, it’s about education and bringing people along. You have to start there. You may have this wish list and agenda of all the things you want to do and know it’ll make the difference, but you may only get one of those things done because it’s the broader movement underlying it.

 

Lauren Powell  29:51  

We did get a lot done. During that time, we hosted the state’s first LGBTQ+ health equity symposium. We did a health equity conference, think tank, and community conversations, pushing the agency to get outside of the four walls of their building.

 

Sanjula Jain  30:11  

You are so confident and realistic about the bounds of what you can and cannot do given the environment and the point of time. You were the first of many in these organizations. How did you keep yourself going through that, not seeing others around you that either looked like you or thought like you mentally or emotionally? What was that like?

 

Lauren Powell  30:34  

That’s such a great question, and I try to stop and think about this more because I’m actually asked this quite often and I don’t always feel like I have the best answer for it, but I’ve tried to think about it more. The reality is, the places that I am and the positions that I have are the things that I do, they’re not who I am. They are a part of who I am, but they’re not solely who I am. It’s very important for me to keep the balance of having other things to do outside of my nine to five, keeping a circle of very trusted confidants around me who will hold me accountable and will tell me if I’m doing too much, if I’m working too hard, if I’m going down the wrong path, that’s so important to me. Also finding an allyship and finding support where I can. Even in the most unlikely scenarios, there are still people you can find who will support your cause, who will support you, and who want to be allied with you, for whatever reason. Sometimes it’s for selfish reasons because it might make them look good, but nonetheless, I have found support in unlikely places in all of the positions I have been in. That has kept me going. Sometimes the people who I thought were in opposition of me weren’t always. They were sometimes supportive of me in rooms I didn’t know of, so that has kept me going. I’ll be realistic, though, it can be lonely. The phrase “it’s lonely at the top” is not just a phrase, it’s real. When you’re facing certain challenges at a certain level of leadership, you can’t talk to just anybody about it because there’s so much context to it that it has to be leader to leader, boss to boss. We have to talk about this, so I keep networks of people in leadership positions in lots of different industries because, at the end of the day, we may not all be working on the exact same topic, but we face the same challenges. That has helped me and then finding mentors outside of my workplace, finding mentors outside of my industry, and then talking to those who have blazed a trail much further ahead than where I am at this point definitely keeps me going, too.

 

Sanjula Jain  33:02  

What’s fascinating about your background is you’ve seen a lot of these public health and health equity issues from multiple vantage points. You’ve seen it from the government, you’ve seen it from small organizations, you’ve seen it from the large private sector organizations, you’ve seen all of it. What are some of the commonalities you’ve seen from government to education to nonprofits? What are some of the unique differences, particularly now in your current role at Takeda, a really large multinational pharmaceutical company? That’s a big contrast to where you did some of the work you did at the state government level. Talk a little about some of those nuances.

 

Lauren Powell  33:54  

All these institutions have fragility in common, a bit of fragility around recognizing how racism is such a significant factor in health equity work. Across the board, there’s no shortage of the desire to do good. Intrinsically, there’s a small percentage of people who don’t, but overall, the majority of people do want to do good. The majority of workplaces want to do good, the majority of healthcare organizations want to do good. To not recognize, call out, stand up, or work to actively deconstruct the impacts of racism in all of these systems is to sabotage your desire to do good. That is something I see across the board. Some organizations are slightly farther along than others and maybe more progressive in thinking and policies but, by and large, there is a hesitancy and fragility around talking about the impact of racism and other forms of oppression as well. It’s something the systems in these organizations are very uncomfortable with, specifically how that ties directly to health equity. We can think about the critical race theory debate that’s happening nationally right now, that somehow we should just forget about the past, that it doesn’t have any bearing on where we are now. That is totally untrue. That even goes against what America sees as being so important to our American history, so that’s something that is a form of resistance that I have to continue to recognize is going to constantly be a barrier.

 

Sanjula Jain  35:57  

Underlying a lot of what you say is this idea that in all industries, even in healthcare, we’re really bad students of history. Actually, history was my least favorite subject. Being a researcher myself, too, you think about the trends and over time what the progression has been, but the more you understand the context, the more insight you have to be able to think about that “go forward, change and what is possible and not.” COVID played a big role in highlighting a lot of these disparities and gaps that we’ve been seeing for many years and brought a lot of that to the forefront. That played a big role in inspiring the formation of The Equitist. Tell us a little bit about how you’ve been leading this tremendous career, operationalizing this change, grassroots up through various organizations, securing a job, really busy at a multinational group, to then saying, “I’m going to also start my own organization on top of everything else I’m already doing.” What inspired the formation of The Equitist?

 

Lauren Powell  37:00  

It’s the epitome of doing too much, isn’t it? I know, it is. I have known for a little while, even while I was at Harvard because right after Harvard I had a short stint of consulting. I was mad, organized, and unofficial. I only had like one client, which was really great. I had known for a while that I had an interest in eventually working for myself, it was just a matter of figuring out when that could happen. I did think it would happen soon, first and foremost. At the beginning of COVID, I was in a role that was not directly serving in public health. I was at TIME’S UP Healthcare and I was little like, “What is with this timing?” I just left a position where I would have been right at the helm, helping to make decisions and all of that. This was momentBut million masks over 900,000 bottles pan sanitizer across the Commonwealth to the doorstep, not asking people to come out to an event, not just putting it somewhere and just whosoever shall come not shipping things to localities that we’re just most comfortable with, but figuring out using data, where are those pockets where people cannot socially distance where there are multiple people living in a household where there are perhaps multiple underlying chronic conditions in communities and bring those resources to their doorstep. I’d been working with him for the duration, pretty much what the emergency is, we’re still working on things, but now have also shifted into working with specific clients to help operationalize and teach people what health equity actually is. And then how to think about infusing that into your organization. How do you do that in a legitimate and also sustainable way?

 

Sanjula Jain  40:58  

Wow, that is just incredible. Most people during a crisis would say it’s too risky to go off and do all these new things, but you just embrace the opportunity. Thank you for doing that. It’s a really important cause and has a great impact on our communities. What’s unique about your story in many ways is you’re a founder. When a lot of entrepreneurs go off to create their initiatives—whether their co-founding or founding solo—is this idea of going in full force. You have to step away from a job or you’d say, “I’m taking on this big risk code full-on go in the deep end here.” There is this idea that you can wear multiple hats and do a lot of things, so it’s so common for people to be investors and founders and teachers. They have multiple roles, which is a really interesting dynamic shaping up. What was the thought process for you in terms of when you hit this moment? This was your calling, right? What are all the things you were working towards where you always knew you wanted to eventually have your own consulting arm or whatever it may be saying, “I’m going to do this on top of what I was already doing,” in terms of taking a step back. How did you think about that?

 

Lauren Powell  42:14  

I was very fortunate working in terms of healthcare, which for your audience is an organization that is focused on equity for women in the workplace. Working in an organization like that was really divine timing because I went to our leadership and said, “I’m a former state health official, I’m a nationally recognized public health leader, people are going to need my help at this moment. I need to know if it’s okay for me to consult, if it’s okay for me to help people at this moment.” They said yes, which I am so grateful for. That helped set the precedent and foundation for me to be able to do that, to be able to not have to walk away from something altogether, to explore my passion. I hope this is more of a movement people can recognize. I was very honest and transparent about this with Takeda as well. This was part of my negotiation. I said, “It’s important to me that I’m able to continue to do this because that’s the only way I can bring my best self to this role and bring my entire self to this role, which is what you want.” I recognize that’s a point of privilege. Not everyone is at that point in their career and that is a point of privilege for me. I recognize that, but I hope this will create more of a landscape where employers can recognize you get your best employee when they can tell you everything they’re interested in and everything they’re doing, but balancing that is hard. It’s really hard. People keep asking me when the ticket I purchased is going to blow up like, “Where are you going to lead Takeda?” I’m not going anywhere. I really, really enjoyed my role at Takeda. At the same time, I’m excited about The Equitist. I want it to grow. It doesn’t have to be just me making it grow. I have a small team of people. I have a managing director and a friend, too. Well, she’s now a friend. I didn’t know her a year ago, a year and a half ago or so. She literally tracked me down and said, “I’m going to help you build this” and she has stood by and done that, so the managing director, Aaron Dowell, is such a great support. I have a very small team but, as we expand to get more opportunities, I definitely want The Equitist to ramp up to a point, grossing a certain dollar amount that I’m comfortable with, then perhaps I’ll step over, but I don’t feel like I have to be the only one in charge. It’s a matter of mindset for some entrepreneurs. Entrepreneurship scares me. It still does. Stepping away to do something 100% that is not tied to an institution that’s been around and I can count on my check coming every two weeks, that’s scary to me because I have not seen that demonstrated. I’ve not seen anyone close to me operationalize that. My boyfriend’s a serial entrepreneur, so I’ve gotten to see it up close and I’ve become a little bit more comfortable with it, but not comfortable enough to make it 100% just yet.

 

Sanjula Jain  45:47  

There are a lot of parallels between those with a Ph.D. academic training and having this entrepreneurial fire. There are a lot of parallels when you think about the research process, too, so I think you have a lot of that innate to you.

 

Lauren Powell  46:00  

Thank you very much. That makes me feel better. Thank you.

 

Sanjula Jain  46:04  

That’s such a powerful reminder though this— I don’t know if it’s a gender thing but I do know, at least in my world and network on talking to mentors, it’s very common to see a lot of male entrepreneurs dabble in multiple organizations, multiple roles. There are also a lot of women I mentor and I’ve gone through this myself where it’s like, you can have all these passion and interest areas, and we often try to find one organization or one role to try to satisfy all of that, but that doesn’t have to be the case. In some ways, your story is a reminder that we don’t have to limit ourselves there. We can get really creative about finding these different outlets. Leadership is about how deep to go and building the teams around you to carry out those visions, so thank you for sharing that. How do you think about your career arc and the confidence and your ability to trailblaze for this ambiguous, undefined career arc that isn’t a common path that a lot of people follow? What do you think has given you your edge in your career?

 

Lauren Powell  47:04  

It’s a God-given ability. My talents come from God. I stay close to God and I stay close to my faith. I also stay close to my ancestors. The wisdom and the ways so many in my family who passed away have lived their lives continues to guide me. My personal experience with loss, like an unnecessary loss because of health inequities, because of health disparities, because of racism, they’re a double-edged sword. They’re the thorn in my side, a hurtful source of pain, but it’s also what motivates me and keeps me going because I don’t want other families to experience the losses I have. I don’t want other communities to be with this void of wisdom and knowledge and love that they should have from people who passed away from conditions that could have been managed from better care if they could have received from a better life that they could have lived if we’d actually worked to create that for them. It’s a part of who I am, quite honestly. It’s just a part of my DNA. I can’t explain it, I know that. This is my purpose. I’m crystal clear on that. It is what wakes me up in the morning and gets me fired up.

 

Sanjula Jain  48:32

As you think back to the early days of your career, is there something you believed early on—whether it was told to you by a mentor or family member or just through experience—that you no longer believe?

 

Lauren Powell  49:00

The idea that you almost can’t have it all, that you’ve done enough things. I was so disturbed by that and so hurt by that. I don’t believe in padding resumes. I don’t believe in pursuing the things that interest you. Oftentimes that means other people will not understand. It’s really not your business to understand it’s not my business to have to explain it to you. It’s just what I’m interested in. I don’t believe that and I don’t tell other people that. I do not tell aspiring public health leaders, aspiring health equity leaders, aspiring med students. I don’t. I would never tell anyone that because I know how that feels. It can be very demoralizing that I don’t go after things just for the sake of merit. I go after things because they’re important and interesting to me.

 

Sanjula Jain  50:48  

Your career has embodied exactly that spirit, so thank you for following your heart and your passion, for all of what you’re doing, despite what others may have told you along the way. I know you have many more chapters of your book to write and I’m really excited to continue tracking your career and see where The Equitist and everything else that you do takes you, but what would be the title of your autobiography?

 

Lauren Powell  51:15  

I’m gonna stick with my gut and say Hustle Hard because that is what I have always done. We could have so many other chapters of this discussion because what people also don’t know is I have worked in so many places. I have been working since I was about 13 and I have been hustling ever since then. I’ve worked at every retail place you can imagine. I’ve worked in restaurants. I had three jobs at once to graduate from college, multiple jobs when I had a full-time job, so hustle like I’m hustling but hustling for a purpose. I’m hustling so future generations won’t have to hustle as hard as I am.

 

Sanjula Jain  52:11  

That’s so well said and so beautiful. You are such an inspiration, Lauren. Thank you so much for being so candid and open about sharing your story and we’re really excited to see what’s next for you. Thanks for being with us.

 

Lauren Powell  52:24  

It’s been such a pleasure. Thank you for having me.

 

Sanjula Jain  52:28  

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