• Family’s Immigration Experience Shaped Health Equity Champion

    January 18, 2022, 11:32 a.m. David Mitchell — J. Nwando Olayiwola, M.D., M.P.H., began her path to primary care leadership in the United States on a village road in southeastern Nigeria.

    Headshot of Nwando Olayiwola, M.D., M.P.H.

    Olayiwola’s parents immigrated to the United States for higher education after the Nigerian Civil War but returned to their native country regularly during her childhood in the 1970s and ‘80s. There, she and her older brother, L. Okey Onyejekwe, M.D., J.D., would accompany their aunt — a general practitioner who had trained in England and returned to care for the people in her family’s rural village — on house calls.

    Olayiwola and her brother both later became family physicians.

    “She was very much an inspiration,” said Olayiwola, the inaugural chief health equity officer and senior vice president for Humana Inc. “People would be so excited when she came, and because we were with her, they would give us juice, cookies and sweets. In a very young-minded way of thinking about it, we were like, ‘This is a great job.’ People were not feeling that great when she arrived, but they would seem to feel better when she left. We didn’t know exactly what she was doing or saying, but there was this healing power that came from her presence. And there was a gratitude that people expressed. That was my earliest visual of primary care.”

    The Nigerian Civil War, also known as the Biafran War, lasted nearly three years, resulting in famine, devastation of Nigeria’s academic institutions and other infrastructure, and the death of more than 1 million people. Olayiwola said her father came to the United States before she was born with “one suitcase and $15.” She grew up around many other immigrant families and developed a passion for helping people settling in the United States, which later translated into clinical care for refugees and asylum seekers as a primary care physician.

    “I was very much shaped by the immigrant experience,” she said, “so I definitely empathize with people who are finding a new life. I love hearing my parents tell the stories of how they first came here. One issue that ends up being a common thing among people who resettle here from other countries, regardless of what brought them to America, is that they need to have good health and health care to survive.

    “Immigration is such a leveler, particularly if you’re coming as a refugee or seeking asylum in America. I’ve had patients who were doctors or judges in their countries, and they come here and have such a humbling experience. You have people who go from having prominence, status and resources in their home country to trying to figure out how to make ends meet, practically invisible and impoverished here. Many are ridiculed or dismissed. But inside, they are still that person who left their country. That’s still a core part of who they are. I see the role of a doctor who is caring for patients in those circumstances as getting them health care, but also restoring their sense of self-worth and dignity.”

    Olayiwola joined Humana in April 2021 after spending nearly two years as a professor and chair in the Department of Family and Community Medicine at The Ohio State University College of Medicine. She remains an adjunct professor in the College of Medicine and College of Public Health. She will also continue to see patients one day a week at the Heart of Ohio community health center in Columbus, where she will help launch a clinic for refugees and asylum seekers this spring.

    At Humana, Olayiwola is leading the development and implementation of a health equity strategic plan and coordinating the integration of health equity into multiple business segments. She is responsible for defining health equity measures, setting related goals and coordinating efforts to achieve equity for Humana’s patients, members, communities and associates. The company is one of the nation’s largest health insurance companies and also provides primary care to seniors at nearly 200 clinics in nine states under its CenterWell and Conviva banners.

    Employer-sponsored health plans cover more than 180 million Americans. Other large insurers also created positions for chief health equity officers in the past year, she said.

    “It’s definitely an emerging role in the in the large health plans,” she said, “and I think it is really timely because of the work that needs to be done. If we can collectively figure out how our position in the health care ecosystem allows us to remove barriers to health, create systems of equitable care and address social justice and health-related social needs for people in our health plans, that’s helping millions and millions of people. I think we have a great opportunity for the health plans to all come together and do this.”

    Olayiwola’s work in health equity goes back nearly two decades. She was a Commonwealth Fund/Harvard University Fellow in Minority Health Policy at Harvard Medical School/Harvard School of Public Health from 2004 to 2005. After completing her training, Olayiwola served as a practicing family physician, chief medical officer and director of health policy for Community Health Center Inc., Connecticut’s largest community health center. In her eight years there, her roles included practice transformation, physician leadership and using health information technology to improve care and reduce health disparities.

    She later worked in various clinical and teaching roles at the University of California, San Francisco, where she served as the director of the Center for Excellence in Primary Care. During that time, she cared for underserved patients at the Zuckerberg San Francisco General Hospital, including patients in the San Francisco County Newcomer’s program for refugees and asylees.

    Along the way, Olayiwola emerged as a leader in work related to health systems reform, practice transformation, health information technology and primary care redesign. She founded an international consulting company, Inspire Health Solutions LLC, focused on health systems redesign and also launched a conference and professional development program for minority women — Minority Women Professionals are MVPs. She later served as chief clinical transformation officer for RubiconMD, a health technology company with an e-consult platform that aims to improve access to specialty care for underserved patients.

    Although Olayiwola has been an entrepreneur, author, educator, department chair and recognized leader in health care innovation, she said she was proud that work related to health equity played such a large role in her election to the National Academy of Medicine in October 2021.

    “I’m really excited that I was elected on the basis of work that I care deeply about, and that’s largely my work that’s been focused on health disparities; health equity; public health leadership; community health; and diversity, equity and inclusion,” she said. “My career trajectory has afforded me many other skills, but it’s really for this work that that I was actually elected. That really makes me feel proud and also hopeful for other physicians who choose a career path in which they focus on some of these more challenging issues like tackling structural racism, championing social and health justice, forging community empowerment and partnerships, and leading diversity and inclusion efforts. My election to the Academy is a signal that they, too can build a career centered around health equity, and that work is as credible and valuable as other areas in medicine and science. Though it can be tiring, under-resourced, professionally difficult and frequently under-appreciated, this work will be acknowledged, appreciated and, ultimately, honored.”

    October was a big month for Olayiwola. In addition to her National Academy of Medicine honor, she received recognition from outside the medical community when she was featured in Essence magazine’s “Eight Black Women to Watch in Corporate America.” Olayiwola said she has been reading the monthly lifestyle magazine for Black women since childhood.

    “That provided some of my early imagery of strong, highly successful, high-achieving African American women,” she said. “I would look at the magazine and the women featured and say, ‘One day, I want to be in there.’ It’s probably one of the most full-circle moments I can imagine because I went from admiring the women in the magazine when I was younger, to being in it. And now, there might be some Black girl out there who is looking at her parents’ magazine and sees me, as a health care leader, primary care physician and a fighter for health equity. Maybe she will draw some sort of inspiration from that. Honestly, that’s what it is all about.”