With both public health and community engagement experience, Kiana Trabue has a unique perspective on how we define health in our community. Since we last talked to her in June 2017, she’s taken on a new challenge as executive director, Gen-H, at The Health Collaborative, where she’s leading a project with the “simple” goal of transforming health and healthcare through collective impact. We caught up with her to see how it’s going, and among her reflections on this rainy April day: what it’s like to make career transitions, diversity and inclusion in the healthcare sector, who she’s seeing in concert this summer, and how reading will save your life one day.

And with that…ahem, we suggest you read on.

Interview by Becca Cochran. Photography by Kali Robinson.

What drew you to the role at The Health Collaborative?

I was at a point in my career to make a different type of impact on health in our region. At the Y we focused on programming and providing resources to individuals to help them with their health, so what drew me to The Health Collaborative was the focus around systems change and looking at opportunities to create change for an entire population, rather than at individuals.

Do you find there was an evolution/progression?

Absolutely. I started my career in public health at the Cincinnati Health Department, and from there worked at Hamilton County Public Health, so it seems circular to me. I was working on policy systems and environmental strategies in previous roles, took on a new challenge with the Y, and so now I’m back to my root and my passion for public health.

Who is Gen-H?

Gen-H is our region’s population health agenda – and really, it is all of us: individuals providing care, paying for care – insurance companies and Medicare and Medicaid – and receiving care, working together to improve health for our region.

It’s more than writing a prescription; it’s about improving the conditions in which we live, work, and play, which will ultimately have an impact on our health.

I’ve heard you describe the work of Gen-H as “going beyond healthcare.” What does that mean?

There’s been some research that’s been out for quite some time that shows that clinical care really only contributes about 20 percent to a person’s overall health status. So that other 80 percent is a combination of genetic factors – as well as social and economic factors – that impact our health. Really health is not just a diagnosis – it’s not how much you weigh or what your blood pressure is – it’s about the places where we live; it’s about whether or not we have adequate housing, whether or not we have adequate access to healthy foods; what our social and economic status is. All of those things work together to impact our health even more than clinical care. So that’s what Gen-H is all about: going beyond those things that we can do in a clinical setting. It’s more than writing a prescription; it’s about improving the conditions in which we live, work, and play, which will ultimately have an impact on our health.

So you’ve been working on this, from different angles, for awhile now. Do you feel like Cincinnati is making progress toward that goal?

I definitely think that we are. I think that Cincinnati is a leader in collective impact strategies – so we see things like Strive Partnership which focuses on education; we have Cradle Cincinnati that focuses on infant mortality; we have the Child Poverty Collaborative, which is looking at bringing individuals into financial stability – all those things work together to create this opportunity for Cincinnati to be a leader in this space. Gen-H fits right along with those organizations – we know things like income impact our health; we know education impacts our health – so there’s huge opportunity for all these organizations to work together. In addition, we have some really great health systems and healthcare providers in this region that have been working with Gen-H to do strategies like looking at social determinants for individuals when they present in the clinical settings and then connecting those folks to resources to address those needs. Also place-based strategy: looking within our neighborhoods in Cincinnati to determine what things are already happening, what leaders are already working on, what initiatives and how can we lend our expertise and support to these neighborhoods.

When you think of Gen-H and what it could be, what are you most excited about?

I think I’m most excited about the opportunity to collaborate with other organizations and agencies to really work together to find solutions to the health issues we have in our community.

What concerts do you have on deck this summer?

I love music. First up this summer is Cincinnati Music Festival – which comes around every year – and I’m really excited about seeing Boys II Men and Fantasia at that. And in August I’m going to see JayZ and Beyonce, and in September I’m going to see Justin Timberlake. So, it’s a summer of concerts.

You’re about to drive home. You turn on “your playlist.” What’s on it?

Earth Wind and Fire – which is my all-time favorite band. I can thank my dad for that. Huge Beyoncé fan, huge Jay-Z fan. I really like this gospel group – it’s a group of four siblings called The Walls Group. Snoop Dogg actually just came out with a gospel album. I love it – it’s really good. And Justin Timberlake.

I’ve heard you say one of your favorite quotes is, “Reading will save your life one day.”

I had a supervisor at Hamilton County Public Health that would say that all the time. And it’s another way of saying “knowledge is power.” We have a responsibility to continue to learn throughout our life. Not only here locally, but in the state and throughout the nation, internationally, to really stay in tune with what’s happening. And literally, something you read could save your life. I think that, especially now in social media – where people have an opportunity to get on and write their opinion about things that can go viral – that a lot of times we misinterpret opinion from fact, so I think it’s really important to continue to stay in tune with what’s happening in the world.

When Gen-H is successful, we will have greater opportunities for health systems to work together to solve problems, outside of the clinical setting – working with communities and within communities.

Is there a connection between what you just described with reading, and Gen-H and healthcare literacy?

I think that’s critically important. I think when folks are accessing healthcare or engaging with providers, they don’t always understand what’s happening. I think that’s why it’s important to have navigators and patient advocates and help individuals understand that responsibility is both on the patients accessing those services, but also on the providers to make sure folks understand what’s going on.

Part of Gen-H includes connecting the medical/social service sectors. Why is that beginning to happen in our community?

It connects to that statistic I mentioned earlier. If 80 percent of our health comes from those social and economic factors, and if an individual does not have adequate housing because of poor ventilation or smoking, and that person has asthma, that can continue to be why an individual is having asthma attacks. So if you can tackle the housing issue, then essentially that person will not have to access those medical services as often, which will then lead to lower cost of care.

There’s a lot of uncertainty around healthcare across the federal landscape. What are some ways – and it sounds like Gen-H is an example – where our Cincinnati community is taking a local approach to healthcare?

Gen-H is definitely an example of that. I think one of the others is Cradle Cincinnati, which focuses on infant mortality in our community. I think that’s important, again, to be in tune with what’s happening on the national level and be informed about those things, but I don’t think that is an excuse to not do anything at the local level. I think that it’s even more important to stay activated here at the local level and to drive solutions that will impact our community versus waiting for the government to provide some sort of resource or funding. How do we align the resources that we already have at our disposal to make the changes that we need?

If you’re successful with Gen-H, what will Cincinnati look like in 10 years?

When Gen-H is successful, we will have greater opportunities for health systems to work together to solve problems, outside of the clinical setting – working with communities and within communities. I think that technology will play a huge role. I think that we’ll be better connected to one another, including actual residents being connected to each other and being able to share resources, much like we do now, but more specific to health. I think our systems will be able to connect with other agencies to share data so that they can really get a full picture of the patient that they are working with. I think that we will have a more diverse workforce in our healthcare; we have examples of research and studies that have shown that having a diverse workforce will help us to reduce health disparities and create a more equitable society.

In your first interview with Women of Cincy, you talked a lot about diversity and inclusion and the importance of that. Why is it particularly important in the healthcare sphere?

Unfortunately, we suffer from health disparities, particularly as it relates to race and ethnicity. So I think that it’s really important for our health systems who are providing care to be very intentional about recruiting a diverse workforce. And prior to that, I think the most important thing to do first is create an inclusive environment, because what you don’t want to do is hire diverse folks into an environment that doesn’t make them feel included. I think that starts at a much younger age. And so I see things like the STEM programs that are starting with elementary students and getting them exposed to careers in STEM – really for women and women of color because that’s a field that is highly dominated by men. So I think if we continue to do things like that in healthcare, that will help us with the next generation that’s coming in to provide those services in our community. And I think, again, that’s really important when you think about eliminating health disparities and creating health equity. There’s tons of research out there that shows individuals feel more comfortable when they have a provider that comes from a similar background as them – they’re more open; they feel like their provider understands their situation a little bit better, and because of that, they’re more open to communicating and asking the right questions in order to get the care that they need.

I think that we all have a responsibility to speak up and speak out about the state of our community and the things that are going on, but I think we need to take a step further and figure out what our particular role is in changing that outcome.

Part of the purpose of this series is to get a retrospective look – on where you were in life when you were first interviewed and where you’re at now – so I’m going to read you something you said in the original story:

“I think that there are plenty of issues that we can talk about and plenty of complaints that we could have about the way things are, or the state of our community, our state, our country. But I believe that action is the only way to make things happen. So we can talk about it; we can tweet about it; we can Facebook about it. But if we’re not actually out there doing the work, then it really doesn’t matter.”

Looking back, has your perspective on that changed?

I still feel the same way – I think action is what gets things done. I think that we all have a responsibility to speak up and speak out about the state of our community and the things that are going on, but I think we need to take a step further and figure out what our particular role is in changing that outcome. Often times we talk about injustice and we complain about things that we don’t like, but that doesn’t get us anywhere. I think about just last week being the 50th anniversary of Martin Luther King Jr.’s assassination and just think about, “What if all he ever did was go out and give these great speeches – ‘I Have A Dream’ and others – but if he didn’t do the March on Washington, or he didn’t do the march in Selma across the bridge, where would we be? How would anything ever change?” So they go hand in hand.

Now, looking forward: What advice do you have for all those future Women of Cincy, wondering what their potential might be, how they can plug in and change the world?

As women, we need to debunk this myth of frenemies. I think we need to band together; it’s so important to have a good girlfriend, or a couple of good girlfriends, that can help you along the way – mentors, or people that can sponsor you and speak up for you and open doors for you, and then you also being that for someone else. It’s really important to develop those relationships at a young age and I think it’s important for the women of my generation to model that behavior for those coming behind us so that they know and understand how critically important that is.

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On Second Thought: Catching up with Kiana Trabue