Was Health Equity Just A 'Hustle'? A Path Forward
The last five years ushered in a wave of performative urgency across the healthcare industry—a tidal surge of press releases, C-suite appointments, and purpose-driven campaigns declaring a new era of commitment to diversity, equity, and inclusion (DEI). For many who have spent their careers in the trenches of health disparities work, it felt like a long-awaited reckoning—a rare window to push real, systemic change.
But now, with the political winds shifting and legal uncertainties clouding the DEI landscape, many of the loudest voices have gone eerily quiet. Initiatives are quietly being sunset. Equity teams are being dissolved. Former champions have disappeared from panels and podiums. What once appeared to be a movement now feels more like a marketing cycle that expired.
It's fair to ask: was health equity just the latest healthcare 'hustle'? Another badge for visibility? A convenient way to be on trend?
Many of the early warning signs were there: initiatives announced without infrastructure, funding that never materialized, and leadership roles created without authority or resources. DEI professionals were invited into rooms—but too often not given a voice. They were handed lofty titles, yet asked to color inside predetermined lines. Meanwhile, their organizations basked in applause for appearances, not results.
What happened? The generous interpretation is that legal and political pressures forced a change in strategy. But even that framing lets too many leaders off the hook. Because you can alter rhetoric without abandoning values. You can evolve your messaging without walking away from your mission. The truth is more uncomfortable: some organizations weren't ever serious about this work to begin with. They were renting values, not owning them.
Let's not sugarcoat this moment. Many health equity leaders feel betrayed. They feel used. And they're right to feel that way. Because what's at stake isn't just credibility—it's people's lives. Vulnerable communities that experience the harshest disparities in health outcomes don't have the luxury of waiting for politics to stabilize or organizational priorities to realign. So, where do we go from here?
1. Stay the Course—Even If the Spotlight Is Gone
Now is not the time to back down. In fact, real leaders will show themselves in what they do now , when the noise has died down and the easy accolades are gone. Organizations that meant what they said should continue to drive toward health equity goals however they are described—if necessary, under new language or frameworks. Call it quality. Call it population health. Call it patient-centeredness. But don't stop doing the work just because the branding changed. Leadership is not about doing what's popular—it's about doing what's right, even when it's uncomfortable.
2. Demand Accountability—for Past Commitments and Present Silence
We cannot normalize the kind of strategic amnesia now unfolding across healthcare. When organizations made bold pronouncements in 2020, they weren't just symbolic gestures—they were public commitments. And commitments matter. It's time to ask the uncomfortable questions: What happened to your health equity agenda? Why are your equity leaders gone? Where did the funding go?
Accountability can't just be a checkbox either. It must come from within—employees asking hard questions, boards demanding metrics, and media keeping score. But it should also come from the outside: regulators, ratings agencies, and partners should continue to weigh equity when evaluating organizational performance. We've long accepted metrics for financial health. Why not ethical health?
3. Integrate Equity into the Broader Healthcare Fix
The biggest opportunity we've missed is also our most urgent one: integrating the health equity conversation into broader healthcare reform. The same systemic issues—misaligned incentives, fragmented care, access barriers, clinician burnout—that fail everyone fail the most vulnerable people first and worst.
Equity isn't a separate issue. It's the canary in the coal mine .
Fixing equity and fixing healthcare are not competing goals—they are convergent ones. If we design a system that works for the most complex, marginalized patients, we design a system that is better for everyone.
A Final Word
So yes, some of what we saw over the past few years was performative. Some of it was opportunistic. Some of it was a hustle. But it wasn't for everyone and we can't afford to let our cynicism dictate the future. Because while some leaders may be done with health equity, health equity isn't done with us.
The disparities are still there. The patients are still suffering. The trust is still broken. And our obligation remains—especially if we want to call ourselves a just and compassionate healthcare system.
Real leadership in this moment isn't loud. It's consistent.
It's not in the spotlight. It's in the follow-through.
And it doesn't waver when the applause and recognition stops.
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