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No state has fallen further than Kansas in America’s Health Rankings. We used to be 8th in 1991.
Why did we slip so far down in the rankings? The answer might surprise you; it’s based on a leadership challenge.
At the Kansas Health Foundation, our bold vision is to make Kansas the healthiest state in the nation and to do so, this movement must be powered by Kansans in positions of authority and influence to shift Health outcomes.
Starting with the launch of the 2025 publication, Leading Health, written by President and CEO of the Kansas Health Foundation, Ed O’Malley, this podcast aims to break down key concepts of this leadership challenge and actionable ways that we can work together to make a real impact on Health in Kansas.
In each episode, Ed O’Malley, and Senior Advisor at Kansas Health Foundation, Susan Kang, will highlight a chapter in the book and discuss with Kansans who are actively engaged in expanding our definition of Health.
Leading Health is an invitation to move the needle on Health in Kansas, and we invite you to join us in leading the way.
Ep14
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Series Recap Setup
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[00:00:00]
Ed O'Malley: All right, we're back for another episode of the Leading Health Podcast. It's the podcast where my colleague Susan Kang, and I go through this book, leading Health, how You and 30,000 [00:01:00] Kansans. Help communities thrive. We've had quite a journey so far. We, we are now into chapter 14 of the book we'll be discussing today, but we've come a long way.
We spent the early part of this podcast series talking about part one of the book. Which Susan, as you remember, was really laying out the foundation around capital H Health versus lower H Health, the role of the 30,000, those Kansans with authority in civic life, the role they have to play in improving.
Capital H Health, and of course we lifted up America's health rankings as a rallying point as a North Star for Kansas, and we highlighted the fact that no state has fallen further in the rankings. Part two was the, Hey, it's a leadership challenge, it's not a health challenge, and we explored that part three.
We've been diving into the nine mindsets. We need Kansans, especially the 30,000 to [00:02:00] hold if we're gonna make more progress.
Mindset Three Preview
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Ed O'Malley: And the first mindset was, you know, working further upstream. The second mindset was working systemically. And today we're gonna talk about the third mindset, which is that race and racism really do matter.
So I'm excited to get into the conversation. Susan. Of And, and of course the big picture is we're trying to change the conversation among the 30,000. That's why we wrote the book, it's why we're doing the podcast. We want a different conversation about health. So that's the big picture. But really excited to get into this conversation today.
Susan Kang: Yeah, I'm really looking forward to this different conversation and really excited about having Kari Buffett, president and CEO of the Kansas Health Institute who was with us in to discuss our last chapter, chapter 13.
And so Ed, before we bring Kari on and start asking her some questions, land the chapter for us.
Ed O'Malley: Yeah. You know, there's a, there's a lot in this chapter. This chapter is only a few pages long and clearly we are not encompassing [00:03:00] everything there is to say or know about the topic of race or the topic of racism.
But we felt this chapter was very important.
Tulsa Run Story
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Ed O'Malley: And I, I wanna start by just telling a story about a an early morning run. I had a, a few years ago, I was down in Tulsa. Mm. Oklahoma, and I was out for an early morning run and the day before I had been to the Tulsa Race Massacre Museum.
Susan Kang: Yeah,
Ed O'Malley: which is an important experience and one I would highly recommend that the listeners.
Participate in, and I was very moved by it. So the next day I woke up very early and I, I want to run back down to that part of Tulsa, the Greenwood District. The museum is in the Greenwood District. That Greenwood District is also what was known as Black Wall Street. Okay. And Black Wall Street was a thriving, [00:04:00] thriving economic success.
It was the heart of black economic prosperity in America. Okay, and at at, at its heyday. I hope most of the listeners know the story. There was a horrible race massacre. Yeah. And it, it was horrendous what happened there And that museum highlights that. Well, the next morning I ran back down there.
It was early in the morning. The sun was just coming up. There weren't cars on the road yet, and I, I just want to soak it in again. So I, I stood there at an intersection right in the middle of what's left of Black Wall Street, and I was overcome with emotion. Thinking about picturing what literally happened there, but I was more overcome when I had this realization because if you've been there, you'll know there's not a lot of Black Wall Street that exists anymore.
And the reason why is because [00:05:00] of Interstate 2 44, which cuts right through that area. And I sat there. I was standing there at this intersection, sweaty from my morning run, sun coming up, standing in the middle of the intersection looking down towards Black Wall Street, and there's only about a half a block of it left before the interstate.
And I had this realization that.
Systemic Racism Explained
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Ed O'Malley: While it was explicit, disgusting, horrific racism that led to the Tulsa Race Massacre,
Like actually the heyday of Black Wall Street came after the massacre. It came in the thirties and forties. Hmm. So this realization that as horrific and awful as the Tulsa race massacre was, it was a different type [00:06:00] of racism like, like the people of Greenwood, the people there could overcome.
A massacre and they did. But locating Interstate 2 44 right through the heart, that's a type of systemic racism. That's what destroyed Black Wall Street. So this chapter, I tell that story in the chapter, but I think that story is important because explicit racism. Is horrible and real and still exists in America, and systemic racism exists, and it's often the result of explicit racism of the past, the lingering effects of that.
Mm-hmm. Mm-hmm. And the chapter is attempting to shine a light. On the fact [00:07:00] that race and racism matter when it comes to health, and if we are going to climb the health rankings, we're gonna have to eliminate the inequities, the barriers that are creating health disparities. And if we want to do that, we need to understand the role that race and racism play in that journey.
Susan Kang: Thank you for sharing that really powerful story. And also I, I actually actually learned something new just now because I think most of us who are familiar with Black Wall Street and its demise, we attributed to the massacre. Which is explicit racism. Right, right,
Ed O'Malley: right.
Susan Kang: But what I'm hearing from you is that really, that happened later as a result of something seemingly innocuous as a highway, A road being put in EE except for the choice of its location.
Right.
Ed O'Malley: Yeah, yeah. You know, and, Most of us know that in lots of metros, there are other examples of the placement of things [00:08:00] like interstates
Susan Kang: and whatnot in Wichita. That also happened too, didn't it?
Ed O'Malley: Yeah. Yes, it happened in lots of different metros and, and things like that. And, and I think the, but it, it's a good example because, you know, I don't know the mindset of the highway engineers.
The construction teams that built that interstate system in Tulsa, you know, and they certainly did not manufacture a horrific, horrific situation like the Tulsa race massacre.
Susan Kang: Right.
Ed O'Malley: But the effect was even worse. That's what trying to help people understand, like in some ways it's too simple of an interpretation to think Tulsa Race massacre destroys Black Wall Street.
Like in some ways that's actually, this is gonna sound really weird, but in some ways, especially for those of us so many years later. That in some ways, that is a more comfortable interpretation if there can be such a term for this, [00:09:00] because it is in essence saying horrific people manufacture a race massacre resulted in this bad thing happening.
But again, the massacre didn't do it. What what? Decimated, decimated the wealth of the black population there was something that was much more benign to, I think most of the population.
Oh, a highway. It's gonna increase efficiency. You're gonna help us get around, help Tulsa become, you know, this great new first class city with this, you know, so on and so forth. And I know we're using a non Kansas exam example, but it's such a relevant one. So this chapter explores a lot of those ideas.
Books Common Ground
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Ed O'Malley: It also tries to bring some focus to the fact that. I act, I know this is a hot topic. I actually think there's a lot of agreement. I think there are a lot of people who realize there are issues here. I mentioned this in the chapter. I keep copies of three books on my desk. Mm-hmm. And I reference them often.
I give copies of them away often. And one of 'em is by Ian Rowe. It's book is called Agency. [00:10:00] And it talks a lot about the the challenges. That are being faced and, and, and, and the effects of race and racism. And it's written frankly, more from a political right perspective. But I also, I love that book and I also love the book, the Sum of Us by Heather McGee.
And it's maybe more from a political left perspective, but it's also talking about the dangers of race and racism, and especially when the effects of explicit racism get embedded into systems. And then George Yancy's book, it's called Beyond Racial Division, is maybe more of a kind of a, a centrist perspective on the topic, but all of 'em are kind of saying a version of the same thing that this matters.
Mm-hmm. It's a problem. And if we want to improve things overall, we have to understand the relationship between race and racism. So a lot to get into today.
Welcome Kari Buffett
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Ed O'Malley: I'm so excited to have Kerry Buffett back, you know, former secretary of a state agency. Formally worked with the University of Kansas Health System now is [00:11:00] the amazing CEO of the Kansas Health Institute, a very close partner of ours.
She was with us on the last episode. She was also with us in an episode way back in part one when we were talking about what life is like in Kansas at number 29. So let's get this conversation going and we'll explore where it goes.
Susan Kang: Welcome Kari. It's really great to have you back. Thanks for letting back for this episode. Yes, thank you. So, you know, we're, today we're talking about a, a truth that is. Kind of uncomfortable to be talking about, right? That race and racism shape, health outcomes. But I wanna make sure that we understand that our discussion today isn't about blame. It's really about understanding and taking responsibility and looking at what leadership looks like if we're really serious about closing the health gap. Mm-hmm. And so in that vein, I'm gonna ask you my first question, which is, so you work with a bunch of researchers.
You are way more of a researcher than Ed or me put together. so you know a lot about data, [00:12:00] right? Do you remember a time when you first came to understand that race and racism weren't just social issues, but a health issue? Health with a capital H issue?
Kari Bruffett: You bet. Absolutely. And thanks for inviting me to this conversation.
Data Reveals Disparities
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Kari Bruffett: It, it really hearkens back to some of the discussion we had a few weeks ago talking about tough interpretations. Mm-hmm. You know finding alternative interpretations of data. So sometimes as researchers, and as you said, I work with researchers and sometimes fancy myself one, but I primarily work in policy world and, and work in have always been interested in data and use data for decision making.
Sometimes because the data. That we're looking at is smaller populations. So we're a smaller state in Kansas, and then we've got smaller subsets of populations, maybe children of a specific race or ethnicity, and we start to see differences in perhaps their insurance coverage status. For example.
We see big differences and they look like [00:13:00] differences, but then when you run some statistical tests on 'em, this is for all the. The data folks listening it's not statistically significant. So we find, well, there's these changes. They look like they were big, but they didn't match these, you know, they didn't have the low enough P value.
So we have to be careful about how we phrase it. And then that builds year after year that we're like, well, we think we see something there, but we don't. We're, we use caveats and everything to. In a way to try to explain the data, but actually makes it a lot harder to understand.
But the reality is that per, there are persistent patterns in data, in health data. Mm-hmm. Not just insurance coverage data but in health outcomes data. Mm-hmm. That, that we see. So some very stark examples. Infant mortality in Kansas and across the country is much higher for African American babies than it is for Kansans as a whole.
Much higher maternal mortality and morbidity as well. And Kansas has particular challenge that even [00:14:00] compared to some of our, our surrounding states that might have some demographic similarities to Kansas as well. So those, those are differences that, that go far beyond any statistical significance test.
And we see it really in the data. Sometimes the challenge too though, is that we only, we think of, of the health outcome as being a medical outcome. And it, it can be certainly access, equal access to services and to pro protective services like a, like the women infant and children's program for example.
It's really important. That's really important to health outcomes. But we see even with. Some of that, some folks who can go to the same hospitals and so on. There's, there are persistent disparities that exist, that continue. So even we, we try to control for a lot of other factors like the zip code where somebody's from, we still see some of the persistence and we have to ask why. So the challenge for us as a, a team that's looking at data to really [00:15:00] inform policy and try to provide that for policy makers defined very broadly, to be anybody who wants to be really part of the policy process in Kansas is to look beyond just the disparities and get to the why.
And for us, that's when we start. You talk about the inequities that lead to the disparities. It's the disparities are the differences and the inequity is why, and it understanding why can also get us on the road to, to equity.
Disparities vs Inequities
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Ed O'Malley: Kari, I, I think that what you were touching on there at the end there is so important.
I just want to hit a emphasis button on it. So the dis the disparities. Is the difference.
Kari Bruffett: Right.
Ed O'Malley: Okay. So there are disparities of health outcomes. So for the non-health people, what we're talking about is people like you, your team, what they know is different. Kansans are having different health outcomes.
Kari Bruffett: Right.
Ed O'Malley: And going back to the book, we, early in the book, we talked about how. The health outcomes, [00:16:00] for example, comparing like the 30,000, like Kansans and high levels of authority. I think it was Michael Mamet his book called The Health Gap, talked about how people with more authority mm-hmm. Like the, the, the, the more important the job, the better health they have.
Mm-hmm. And so like the 30,000 are some of the healthiest people if we want to go by that standard. And. The Alice population, the working poor. Right. You know, like their health outcomes worse. So there's, there are disparate health outcomes. So the disparity is the difference, but the inequities is the why, right?
Is what you were just saying? Yeah, absolutely. The, the inequities are like the systemic and structural, like the way we've organized society, all that type of stuff is what's creating. The disparity. Am I getting it right?
Kari Bruffett: Yeah, absolutely.
Ed O'Malley: Yeah. It's a huge concept,
Kari Bruffett: right?
Ed O'Malley: It's kind of simple on one hand.
Kari Bruffett: Yeah.
Ed O'Malley: But it's a really important concept.
Kari Bruffett: It was a big shift for KHI certainly before I was in my current role at KHI, we started [00:17:00] to we did a report a few years ago, so my colleagues did about disparities in Kansas. It was like a big data book. Mm-hmm. It had pulled data and looked at the health outcomes, education, outcomes, income outcomes.
A, a lot of different factors, the capital H Health but it really was focused on disparities. It was kind of telling the story. It was like it was the chart book that showed you like where, where the numbers are, but it didn't really answer why or, or necessarily the relationship between all those factors.
And so that's the work that we try to do now. And I think we can only do effectively when you work in community and with people that, that are experiencing, potentially some of those impacts the, those, the, the, the different systems that have create different protective factors and really get to a true understanding.
So we, that's to, to us it's less about, you know, sometimes the word equity for some implies a specific meaning that might shut them down. And to us it just means trying to understand why there are [00:18:00] disparities in what we can do systemically to tie to the previous chapter what we can do systemically to change.
The playing field in a way that, in the long term, we think will have an impact on those outcomes for everybody at the population level. Yeah.
Equity Opportunity Frame
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Ed O'Malley: You know, Susan, I know you've got other questions, but I, I just wanna hop in with another thought you, you just mentioned, mm-hmm. Equity. So, so we, we do, we offer a definition of equity in the chapter.
And I think what the chapter is really trying to do in a lot of ways is to say, Hey, look, if Kansas is gonna climb the health rankings, we're gonna have to be a place in America that can have better discourse about all kinds of things. But this chapter is saying, especially race and racism. Like if, if we don't become a place where we can have better discourse about those things, this is gonna be tough.
It's gonna be tough. Sledding, you know, I like tho those three authors I mentioned earlier like it would be really fun to have them on a panel. I think they would argue like crazy with each other [00:19:00] about all kinds of aspects. But I also think they're each coming to this with an understanding that yes, like the outcomes are not what they should be.
Right. For populations in our country, and especially populations delineated, delineated by, by race, one of the things we offer in the chapter as a way to help people have better conversation is a, a definition of equity that might be useful. And there'll be folks who I think disagree with this and, and that's fine.
But what we found is if we define. Equity as a quality of outcomes like in the here and now that immediately kind of subconsciously for a lot of people, leads to a zero sum game. There are gonna be winners and losers, and we're gonna take some of the pie away from this population and give it to another part of the population.
Okay? [00:20:00] If we define equity as a quality of opportunity. What I've noticed is people don't get triggered by the, the word equity. Like, they're like, yeah, let's give everybody an equal shot. Mm-hmm. And I think what we're really trying to do with that suggestion in the book, but also with this chapter overall, is in essence say, Hey, 30,000.
We gotta have better conversations about race and racism and understanding that there actually is some common ground. Understanding that there is a connection between the explicit racism of the past and the systemic outcomes today matters. Mm-hmm. And understanding how to talk even about a word like equity.
Mm-hmm. Act actually matters. So there, there's a lot in here that we're unpacking.
Susan Kang: There is a lot. We're un unpacking here, many different ideas. I so, you know, to your point about the disparities, right? Mm-hmm. Are, are the differences and, you know, in order to get to the why you have to start mm-hmm.
Doing the, you have to ask you a question. Mm-hmm.
Systems Thinking Data Walks
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Susan Kang: So in doing that, how does systems thinking come into play?
Kari Bruffett: One of the [00:21:00] examples I was thinking about, hearkens back to the conversation we had in one of the earlier episodes about data walks. And this was a different data walk.
So if you, if, if you didn't listen to a previous episode I'll describe 'em really briefly. So, the idea of a data walk is you bring in some key data points, let's eight to 10. You create big old posters that really describe data that we know around a system or an issue. And then. Convene a group that, groups that have different backgrounds and different experience, and then they interpret the data.
So the data is a chart that doesn't have a bunch of exclamation. It tells people how they should think about it. It's a chart that says, Hey, there's something here. So you can understand what the data is actually telling, it's saying, but you tell us what it actually means.
Redlining Maps And Disadvantage
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Kari Bruffett: So the Wichita Business Journal for a summit they had in December of.
23, I think. 2023. Brought leaders together around topics like demographics and education, really trying to understand how some of the historical [00:22:00] issues that you talked about earlier, Ed, you talked about some of the systems that frankly, some of the outcomes of systems that were, were steeped in racism, that did have racism, that have long impacts even after decades and decades after.
They were no longer in place like redlining. Started in the thirties, but we still see the impact of it today. In the last episode you talked about. You know, the, the government incentives to take out mortgage. Well, here is a, here is a system that was in place that made it difficult to, to get a loan to build or buy or renovate in communities that had higher proportions of people of color or immigrants and that sort of thing.
And. That persists today, your impact on the wealth and and families. And so that was part of the discussion and there was an interesting set of posters and these were folks from the business community employees that were really interested in, in diversity in the workforce and really building an equitable Wichita as well.
They were to discuss these posters and together, and there were two posters, [00:23:00] one that was a. A picture of something that's called sort of neighborhood disadvantage. It's like a, it's a economic index basically, and it was put on the map of Wichita and it showed sort of where some of there are some really stark differences with neighborhoods with some of the highest economic advantages in Wichita right next door to neighborhoods that have some of the most disadvantage.
But if you juxtapose that with the next poster, which was a map of the historic redlining. It was maybe not one to one, but a very close mapping of where the impact of something that happened now almost a hundred years ago, that started as a policy that in, as part of the New Deal around that time, actually has this super long impact in our communities.
But. That was interesting for us to see, but it was more interesting to hear people who live in those neighborhoods and live in Wichita really discuss those impacts. So I think that's the kind of conversation that we need to have too, is for people to think about those [00:24:00] systemic impacts. Not only think of them as something that is in the past that we got rid of in the 1960s or something, but instead we see those impacts till today.
And I hopefully that helps people understand. It helps me. Understand the impacts of, of historical policies that were, frankly, they had explicitly racist elements to them that were in place that still have impacts today. And we, if we only talk about just our data today, we might say, oh, I wonder why those neighborhoods are different.
Let's look at the income background of those neighborhoods. And that'll explain. Or, or, well, income is what you're measuring, but maybe look at some other factors. You have a historical factor that is driving a lot of those, the differences in those communities and those neighborhoods.
Susan Kang: Yeah. It's,
Kari Bruffett: and health is impacted by that.
Absolutely.
Susan Kang: Right. Those communities. It's the remnants Yeah. Of explicitly racist Yeah. Policies. Yeah. That were in instituted. Yeah. Hundred, you know, hundreds of years ago. Yeah. Right.
Racism Remnants And Health
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Ed O'Malley: Susan, let [00:25:00] play with that for a little bit, so. Yeah. So what we're really after is, hey, we Kansans, hey, we gotta have better conversations about race and racism.
Right? So that's what the chapter's about. That's what we're talking about. And what you just mentioned, Susan, is making me think that, yeah, I mean, what we, I think we even said in the book that we, systemic racism today is often the remnant of explicit racism of the past. Mm-hmm. Right? And my guess is most people would agree that explicit racism.
Like a racist mob coming after you in Tulsa or in in wherever. That's bad for health, right? Everybody's gonna agree on that, right? I think everybody would probably agree that explicit racism is not good for the way we've defined health capital h. Health And my guess is people would agree that if somebody did that explicit racist thing yesterday, the [00:26:00] lingering remnant of that racism still exists the next day.
Right. And maybe even the next week. The next year, maybe the next decade. And what we're really talking about sometimes I think in our society is debating how long is the remnant of a society that was literally formed around explicit racism. I mean, you can't get more explicitly racist than a system of slavery.
Right right. How long does that remnant continue to have an influence on something like capital H Health? And I think if we think about it that way, we can disagree. Like people can have differences of opinion, but I. Think it's not logical to say there isn't a remnant or that it doesn't stretch beyond the explicit behavior of the past.
And I don't know if that reframing helps anybody else besides just me as I'm thinking out loud right now on this podcast with you all. But it, to me, it's, it's a helpful way of thinking [00:27:00] about it. These actions do leave a trail and how long that trail. Is having influence on current day outcomes is kind of something we should be talking about and having healthy discourse about.
Susan Kang: Mm-hmm. And Right.
Leading Brave Conversations
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Susan Kang: So, and speaking of healthy discourses mm-hmm. Mean, so in your position of authority mm-hmm. Sometimes formal, sometimes informal, depending on what situation you're in. Right. What, what do you, how do you, how do you use that to mm-hmm. Help foster discussion around race and racism, that, that doesn't lead people feeling silenced.
Kari Bruffett: Mm-hmm.
Susan Kang: Or blamed.
Kari Bruffett: Yeah, so I, I have in some of our other conversations, talked a little bit about the Pathways to a Healthy Kansas project, which is sponsored by Blue Cross Blue Shield of Kansas. So there is, there are some specific actions that our team that works with Pathways communities takes to, to elevate this kind of discussion [00:28:00] in the community and, and, and lean into what can be uncomfortable.
And as you, as you said this, it doesn't have to be about, and it is not about blame, but it, it's not about avoiding the discomfort or what's uncomfortable or or facing, you know, really stark realities that are, that are realities in our communities. So whether we were talking about them or not, you know, we think about, we talked about in the last chapter about systems too.
Systems don't have to be like explicitly. Built by something to yet systems are designed to produce the outcomes they get. So even if the systems weren't, some of those systems were explicitly designed in ways that have that long impact over time on it that come from a place of racism.
Others that were designed to have other impacts that maybe were intended to benefit certain populations, maybe not explicitly with racist. Purposes, but yet have some of those outcomes as well. They were designed for some of those outcomes, so one of the things that they work on with the [00:29:00] Pathways communities is really starting out with a clear purpose.
They're not looking at individuals in the room saying, this is your fault, but it is to strengthen those out the systems and improve the outcomes. So they actually ask each community to look at specific populations. Now it's not always defined by race, but often or can be defined by race that they want to focus on and helps ground the conversations.
And really thinking of the, of Populations and not making it an abstract debate, but really thinking about, okay, where do we wanna focus our work? They want to also create that shared space or the expectation of norms of how we communicate. And instead of saying things like, who makes this decision or who created this system?
Although that can be a good question to ask. Mm-hmm. But in this environment, they ask who benefits or who is harmed? Intentionally or unintentionally in the current systems or who's burdened by how this policy operates. And then that little bit of reframing focuses on the system even though somebody designed it at some point probably, but, [00:30:00] but it's focused on what is the impact right now.
And then we try to model, and I try to do this to our own vulnerability and, and curiosity and knowing that we don't have all the answers, and in fact want to listen in the communities that. Tell us the, of the impact. So what are those intended or unintended consequences? There are consequences regardless of the intention, right?
And that creates a, some level of safety too, hopefully. So we try to do that. It, it does require courage to sometimes name something that can be that can be hard for folks that you're talking to, to, to talk about. But it requires more courage for folks who are experiencing the impacts of, of unequal systems and unequal access to systems to be able to talk about the impact on them too.
And you have to recognize that as well. So yeah, leaning into the conversation. Not assigning blame, but not running from the difficult interpretation, the tough [00:31:00] interpretations.
Susan Kang: I love one of the elements that you guys consider which is. Who benefits.
Kari Bruffett: Yeah.
Susan Kang: Who, who you know, and who is potentially harmed by this.
Yeah. And so it feels like a mindful reflection on the potential intended or even, I mean, most of us, we don't know what our intended, you know, there's so many unintended outcomes or, or consequences of some of the things that we do unwittingly. Right. I think staying mindful around that by asking those types of questions Yeah.
Is helpful. And maybe fostering a a conversation that is actually meaningful.
Kari Bruffett: Yeah.
Susan Kang: I appreciate you sharing those things.
Ed O'Malley: What's going through my mind right now is like, we all know that there have been times in our country recently where it's just really hard to talk about race and racism and.
It's heated, it's hot. A whole lot of people just want to avoid the conversation. Like it might feel safer to some people to not be in that [00:32:00] conversation. There are people who are incredibly passionate about. The about their understanding of how race and racism are affecting outcomes of people today.
Mm-hmm. And that passion brings the heat. And, and so it's, we all seen it and it's all great and it's all like hard and it leaves my experiences, it leaves many people. Really wanting to be incredibly careful about how, like, I think I'm even trying to be careful during this podcast episode, right, of how I'm talking about this to make, because I want to do the topic justice.
And I also know that this can be a tricky thing to talk about in America in the year 2026, right? And.
Advice For Better Discourse
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Ed O'Malley: I, so I just, I just keep going back to this chapter doesn't have all the answers. This [00:33:00] podcast, podcast episode doesn't have all the answers, but the heart of what we're saying is Kansas has gotta become a place that can do this better.
Do this, meaning have discussion about this better. One of the things that we write in, in the chapter is that, and this is, you know, the type of thing that's gonna. Maybe anger everybody, I don't know. But it says, those who believe they see systemic racism need the forum and the space to share their experience.
But then we go on to say, those who have contrary thoughts about whether something is systemic racism also need that same opportunity, meaning a forum and space to share their experience. And then we end that chapter by saying, a culture that cancels dissent is no better than a culture that assumes our race issues are all in the past.[00:34:00]
And. I, my mind just keeps revolving around like, we've gotta be a place that we can talk about this stuff. We can bring more people into this conversation. And so, like, the question on my mind is like, what, what advice do we have for the 30,000 for like, how to have this conversation a little bit better?
Like a wee bit better because it's gonna pop up again and there's gonna be. High heat moments that occur again in our country that focus attention on the tensions that exist related to race in our country. So what advice do we have for the 30,000 on how to do this discourse better?
Kari Bruffett: Don't shirk from it And invite the, you said people need a forum to speak invite. And create settings where, where there's not a penalty to talk about whether that's a social penalty or something else, to be able to talk [00:35:00] about the real impacts on, on individuals or on communities. And I, I think by framing it, by framing some of the discussion around what are, you know, the who benefits and who's who's, who doesn't benefit who's negatively impacted, we can, maybe moderate the heat a little bit by focusing on systems. I, I don't know that that is, has to be the, the goal, but I think in some ways that that helps focus it. And it's also the reality of where we're most likely to make the biggest difference is systemically not really at that individual level.
Data Disaggregation And Access
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Kari Bruffett: So making the opportunity, the setting and know, from a data, you know, from a very 1 0 1 version, going back to the beginning of our conversation reporting out outcomes by disaggregated data that by race and ethnicity and income and education and zip code and rurality, everything that helps us understand the impacts of systems on our populations.
We need to do that [00:36:00] and be really committed to that. That means sometimes we have to demand. Demand seems like the wrong word, but yeah. We have to ask very strongly for access to data that allows us to do that. Mm-hmm. And partnering, you know, during COVID-19, there was a effort early on when some of the data was being released about how COVID was, where COVID was in our communities in Kansas, but we didn't have any specificity about race or ethnicity. We had sort of geography only, and there was a group of folks from researchers and foundations who wrote a letter to the state that said, Hey, can we get the, the data released with some.
Demographic factors as well so we can understand the impact of COVID-19 and then later on vaccinations and so on as well. So part of the work is, even though that sounds like nerdy data work or something that's important for us to really understand impacts, we have to have the data to be able to help get to the understanding of disparities before sometimes, before we can really even start to think about how we address those inequities as well.
So [00:37:00] I'd say that's one of the things that we. Have, and our, we've had our strategic plan for a while as well, is to really sort of whenever possible and when it's appropriate to disaggregate the data, sometimes you have to sort of add the data back up together because of the small populations to still understand sort of those impacts as well.
To be very intentional about how we report on data and, and the meaning. And then very collaborative with folks in communities that want to help us explain the why in ways that probably numbers alone won't tell us.
Facilitators And Preparation
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Susan Kang: Here's a really practical suggestion for our 30,000 before engaging in this kind of conversation, I would say is get a really good facilitator.
I think also, you know, set out. The framework of what that discussion is gonna look like. Have people understand that the heat will be raised, and that it has to be a safe space for people to be able to actually say the things that are on their mind without being pilled on [00:38:00] either end of the spectrum.
Right? Mm-hmm. So I think there's nothing wrong with trying to get some help around these, the really difficult discussions and also being very honest about what what types of things might happen as a result of this conversation and, and giving people a little bit of an advanced signal.
In terms of what they might, what they might experience. So I think that's one, that's one concrete thing that I might, I might recommend to our 30,000.
Ed O'Malley: I love that idea of, of using a facilitator. I also think, like, just prepare yourself.
I'll go back to those three books, like they're really good books and you know, Mo if you're, if you're listening and you go by those three books and you read all three of 'em, my guess is that there's gonna be one that you love, that you're like, yes, this is the correct one from your perspective. But I think it's important just to think of it as it's, it's the one you most align with.
The other two have valid points, and if we can prepare ourselves to understand the valid points from [00:39:00] across the different kind of ways of thinking about these issues, and if we can understand that there are people who are passionate about all the different points, it helps like prepare ourselves to go into those maybe more formal conversations.
Yeah. At some time. A lot here, a lot more to talk about. These mindsets are really, really important.
Takeaways Fair Systems Thrive
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Ed O'Malley: Susan, I know you like to have us end with thinking about a, a, a takeaway that's on our mind. And of course there are many more mindsets to come, but should we shift to the takeaway?
Susan Kang: Yeah, I mean, you know, my, my takeaways really, really think very deeply about what's a conversation you've been avoiding, because it might raise the heat because it might make people angry. And really start to hone in on the fact that you should have that conversation and how you might have that conversation.
So I, that's, that's what I encourage people to do.
Kari Bruffett: I would encourage people to keep in mind that the goal is to create systems that are better for everyone. [00:40:00] Something that's more fair is going to create the opportunity for equity. Mm-hmm. And that's hard for anybody to argue against.
Ed O'Malley: Kerry, I love that.
Let's just make it fair. Make it fair. I love it. Like systems that are fair, better for everyone. I love that. I think what's on my mind is we know because of a report that the Kansas Health Institute did about a decade or more ago, that all the population growth in Kansas, if I remember this study correctly.
Mm-hmm. Yeah. All of the population growth in Kansas, the last 10 or 20 years has come from a growth in Kansans of color. Right,
Kari Bruffett: right.
Ed O'Malley: That, that's what's helping our population grow. All right. And now the, the capitalist in me, right. now, like. I'm gonna say, say like, we gotta grow, like Kansas has gotta grow.
Everything is harder if Kansas is shrinking. Mm-hmm. Okay. We have to grow and while we're growing, we're not growing at a fast enough rate. Like we will likely lose another congressional seat in [00:41:00] the future at some point because we are becoming a smaller and smaller share of our nation's population. So why am I bringing this this up right now as my takeaway?
My takeaway is we need the 30,000 to understand that the states or the state that figures out how to help all of the populations inside it thrive, and especially the populations that are facing these disparate outcomes.
Okay. Which does connect with populations of color. The state or states that figure that out. How to create that equality of opportunity which will lead to eliminating those disparities in time. That state or those states are gonna be the ones that grow and thrive and growing and thriving is so critical.
So it's the right thing to do to eliminate the inequities. It's the right thing to do, to create fairness. And it's just the smart thing to do, to be the state that figures this out when it comes to race and [00:42:00] racism. 'cause that's a key way Kansas will thrive.
Final Thanks And Sign Off
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Ed O'Malley: Kari, this is the last time you're joining us during this current series.
Kari Bruffett: Yeah.
Ed O'Malley: Thank you for being a conversation Catalyst. Thank you for what you do for Kansas. We love our partnership with you. Anything you wanna sign off with?
Kari Bruffett: Uh, no, I really appreciated all, um, all of our chances to, to talk and the book, I think it is a catalyst for conversation too, across the state.
So I really, you know, the framing of leading health has helped us at the Kansas Health Institute. Also think about some of our work. I I mentioned in an earlier, episode, the work, what happened to Health in Kansas where we dove in with a hundred. We define 'em as experts who wanted to understand what did, what's behind the decline in Kansas' Health ranking and what could, could reverse it as well.
That work was inspired by that vision of Kansas leaving the nation in health. So I'm excited for what comes next.
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