Advocating for Equity in Health Care

This summer, Geoffrey Roche ’08 accepted an appointment to the National Health Equity Task Force, which has begun work on developing strategies to fight the COVID-19 pandemic in racial and ethnic minority, rural, and other vulnerable communities.
By Anndee Hochman
Photograph by Matt Carr

Behind the Walmart Supercenter in East Stroudsburg, Pennsylvania, across the railroad tracks, in the woods-shadowed tent city that a dozen or more adults called home, Geoffrey Roche began to understand some things about power, inequity, and health.

Alongside the CEO of Lehigh Valley Hospital-Pocono, where he worked 
until 2017 as director of public and government affairs, Roche would visit 
the encampment of homeless adults to offer food, water, health information— and, if people were willing, even transportation to one of the hospital’s outpatient care centers.

“It was eye-opening for me,” Roche recalls. He learned, for starters, that
 the adults living in those tents were more willing to talk with him if he was not dressed in a suit and tie. He also learned that their wariness of health authorities—of any authority, in fact—was sometimes justified.

“Their hesitancy was because some of them had been patients in our very own healthcare systems and felt they had never been listened to, had never gotten the treatment they needed.”

When physicians at new clinics set up in various locations in the county occasionally resisted treating this uninsured population with its complex health concerns, Roche remembers his boss responding, “Get a heart. It doesn’t matter who you’re serving. Address their needs first and foremost.”

Collaborating on Solutions

That experience shifted the way Roche thought about health and the barriers that make it hard for some people to thrive. It made him an advocate for public–private collaborations that engage all parts of the community—policy makers, law enforcement, educators, and faith-based leaders—in the pursuit of health equity.

And it paved the way for his recent appointment to the National Health Equity Task Force, an initiative of the US Department of Health and Human Services. The 115-member task force, which began with a three-day virtual meeting in July, will develop strategies to fight the COVID-19 pandemic in racial and ethnic minority, rural, and other vulnerable communities.

The task force exemplifies the type of public–private partnership Roche champions: Partners include the Satcher Health Leadership Institute at Morehouse School of Medicine and the Centers for Disease Control Foundation. Google will help gather and analyze data to examine COVID-19’s impact on vulnerable populations, and the task force will work with community-based organizations across the country, seeking and sharing best strategies for COVID-19 response and recovery.

“Leaders noted that ‘race is not a risk factor; racism is.’
If we’re truly going to achieve health equity, we have to address economic and social policies.” —Geoffrey Roche ’08

When Roche was invited to join the task force, he worried that it might be one more group that would talk endlessly, identify problems, but “never be willing to have the tough dialogue about solutions.” But at the group’s first meeting, participants engaged in a visioning exercise called “How might we...” and identified a focus on people, the power of stories, and an understanding of social determinants of health (for instance, poverty, literacy, and citizenship status) among their priorities. That was enough to convince Roche that the group intended to have real impact.

The task force, which in September began to form committees and outline its work, plans to provide technical assistance to local and state health organizations to strengthen their COVID-19 reporting, screening, contract tracing, and data collection.

Again and again, Roche says, speakers at the July meeting emphasized that systemic racism is a threat to public health—a concept underscored recently by the American Medical Association. Black Americans are more than four times more likely than white Americans to be hospitalized for COVID-19; they are twice as likely to die of the disease. COVID-19 incidence and hospitalization are also disproportionately high for Latinx, American Indian, and Alaska Native people.

“Leaders noted that ‘race is not a risk factor; racism is,’ ” Roche says. “If we’re truly going to achieve health equity, we have to address economic and social policies.”

The Path to Social Reformer

Roche’s interest in the workings of government began early: 
He was a CNN devotee and, at 12, volunteered on a judicial campaign due to the encouragement of a close family friend. He was also influenced by his Oma, his maternal grandmother, who lost her parents at the age of 12 and was raised by her older sister in West Germany, where they had both ended up after fleeing from Soviet soldiers for a safer life. In 1963, his Oma emigrated with her husband and children to the United States. “She would always say to us that those challenges made her stronger and made her realize how her role was to never allow what she faced to be a bias toward someone else.”

During his childhood, Roche spent a lot of time with neighbors, including a multiracial family from Jamaica. He recalls numerous experiences with them facing discrimination in the schools, community, and region. “I saw systemic racism first-hand. And I’ve always, as an individual, been hungry to be part of the solution or to find a new way of dialogue.”

At Moravian, where he transferred in the spring term of his freshman year (“I didn’t get in the first time,” he says. “I didn’t do well on the SAT”), Roche wanted to study political science. He didn’t know how thoroughly Moravian would expose him to other cultures: the high school students invited to campus for discussions on diversity as part of the “Promise of the Rainbow” program; the indelible talk by Chris Gardner, the businessman and motivational speaker whose struggle with homelessness was captured in the film The Pursuit of Happyness; or the senior trip to France, Germany, Austria, and Italy to examine the destruction and restoration of cities worldwide.

“Moravian had a big impact personally and professionally,” Roche says. It’s also where he met his wife, Rebecca Angstadt—a 2008 graduate who played tennis, studied math and accounting, and shared his commitments to faith and service. They married in 2010.

Following his tenure at Lehigh Valley Hospital, Roche worked as director of legislative affairs for the Pennsylvania Higher Education Assistance Agency, then as vice president for strategic initiatives at Lebanon Valley College. He is currently the executive director of strategic healthcare initiatives and partnerships at Harrisburg University of Science and Technology.

Roche serves on numerous task forces and committees, including the Pennsylvania Department of Health’s Equity Advisory Committee, an experience that amplified what he learned a decade ago on those sojourns into the homeless encampment behind the Walmart.

“We look at different marginalized communities, and the same issues we’ve been fighting for years are still occurring,” he says. “People say there are no injustices, but there are. [For instance], Pennsylvania has so many food deserts that people truly don’t have access to healthy food.”

In 2014, Roche experienced a life-cycle joy and a tragedy in the same day: He and Rebecca learned that she was pregnant with their first child, and Roche’s brother, then 29, died of a heroin overdose. That experience also shaped his perspective on health equity and individuals’ struggles. “What it amplified for me is the mental health–physical health connection,” he says. “Addiction is a disease; we have to treat it as a disease and not rush to judgment.”

That’s the approach—understanding, empathy, humility— that he hopes to bring to his work on the task force, coupled with a career-long respect for data, policy, and evidence-based solutions. “Generally, our healthcare system is focused on addressing the need at hand,” he says. “My dream would be that it’s very much focused on prevention: What do we wrap around that consumer to make them healthier and address every need that they have?”

Anndee Hochman is a journalist, essayist, and storyteller. Her column, The Parent Trip, appears weekly in the Philadelphia Inquirer, and her work has also been published in Poets & Writers, Broad Street Review, Purple Clover, and other print and online venues. She is the author of Anatomies: A Novella and Stories as well as an essay collection, Everyday Acts & Small Subversions: Women Reinventing Family, Community and Home.