Upstream’s Journey and Commitment

Last week I had the privilege to participate in a convening of Upstream staff who identify as Black, facilitated by The Justice Collective, who are assisting us as part of our broader equity, diversity and inclusion (EDI) efforts as an organization. I was privileged to be a part of the visceral, raw testimonies of Black Upstreamers who spoke of the deep seated, exhausting stress of worrying if a husband, son, wife or daughter will come back home each day safe, or alive; of the extraordinary emotional toll experienced through the racial disparities highlighted by COVID-19; over policing and police brutality in communities; and the murders of George Floyd, Breonna Taylor, Tony McDade, Elijah McClain, Ahmaud Arbery, David McAttee, Rayshard Brooks, and countless others. It was 90 minutes of searing reflection on unanswerable questions and associated pain about how to exist in a world that perceives us as a threat, where Black lives are taken by the institutions set up ostensibly to protect us. To be Black in this country is to be close to pain. 

What do I say to my 24 year old daughter who feels this pain so acutely that she is contemplating participating in a collective action in Boston explicitly with the goal of getting arrested, in order to shine a light on the inequities in the Mayor’s budget? How do I balance my ever-present desire as a parent to keep her safe, particularly in this moment of COVID, with her deep-seated, searing need to block traffic, her arms linked to others, to shout, “Just stop killing us!” 

Against this backdrop, some may assume that because I’m Black, I would know enough, it would be intuitive enough, to make sure that Upstream is not just an ally in the fight for equality, but is the anti-racist organization it should be. While our work was founded on and motivated by a desire to combat and undo poorer outcomes due to racism in health care, that does not mean that we have been an explicitly anti-racist organization. We need to become that organization. We have grown too quickly without explicitly building equity, diversity, and inclusion into all of our operations in order to ensure a culture where all staff feel that they belong, and are respected, valued and safe. This is a shortcoming that I acknowledge and take responsibility. If we are to be a part of the movement to eradicate anti-Black racism, I need to do better; we need to do better. I am committed to deep internal reflection and action – structurally, organizationally, and personally – to make Upstream the anti-racist organization it needs to be. 

We have already begun our journey, but this moment demands more. Over the last year, we have significantly improved the diversity of our Board, Executive Team, and Operational Leadership Team. Under the leadership of Melanie Manning, our Chief Human Resources Officer, we have started a comprehensive review of policies and practices to address inequities and healing, including completing an organization-wide review of our compensation packages to ensure equity; increasing our family leave policy to 14 weeks and expanding eligibility; creating safe spaces for employees of color to continually share, grieve and support each other; and honoring important days of reflection like Juneteenth, now an annual paid holiday. 

While these strides are important first steps, there is still much more work to do. This summer, we will lean into this work further, beginning with organization-wide workshops to build the muscles we’ll need for our accelerated EDI journey. 

There is a deep and important through line between the work Upstream does every day, and what has always been wrenching apart this country. When you consider the intertwined strands of racism, lack of access, equity, social determinants of health, and opportunity – our work is at the heart of changing this, at scale. Because of this connection, there is an even greater obligation for us to look hard in the mirror and ensure that, within Upstream, we are creating a truly inclusive and equitable experience.

We have come remarkably far in the short five and a half years this organization has been in existence. As hard as it was to witness and experience the profound, unfiltered pain in that setting last week, I know that is the first step toward healing and improvement. It is a long road, filled with opportunities for mistakes and missteps, but we’re on that road together. I am incredibly energized by this opportunity for us to have the centuries’ overdue conversations that enable us to move forward. 

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