HDG #027: My Health Equity Story

Read time: 10 minutes

Where did you get your start? If you’re anything like me, you could have all too easily fallen through the cracks too.

Let me back up a bit: I spent the last month co-facilitating a program for healthtech founders and one of the exercises was to examine our “why.”

Why do I do what I do? Why am I so obsessed with the concept of “health equity?” I’m not especially fixated on health, or especially fixated on every single aspects of social justice writ large, though both of these topics are important to me. But why is it that when these two things come together, I get beyond fired up?

I thought about it deeply, long after that day’s session. And it unearthed three big realizations:

1. Health equity can mean something quite different to everyone, for quite different reasons. I believe it is shaped by your background and experiences (both immediate and generational), paired with professional and academic learnings. I’ve asked myself, and others, “what does health equity even mean” and written about it here, but that means everyone’s “why” when it comes to this topic is very different.

2. My “why”—not surprisingly—is deeply nuanced.

3. A series of events this year amplified and cemented my inclinations on the topics of both health and equity, furthering my resolve and reminding me of a gift I never realized I possessed.

As someone who self-admittedly came out of the womb asking “why,” these three realizations were quite intriguing… and I just had to explore this.

And so, this week’s issue was born.

I’ve shared bits and pieces of this story before, but not in the detail that I will today.

Let’s start again: if you’re anything like me, you could have all too easily fallen through the cracks, too.

I’ve never appreciated the gravity of this statement until recently. Through my data work, I was acutely aware of how COVID-19 put a spotlight on major gaps in our communities — exacerbating some that we already knew existed and revealing others we didn’t even know about yet.

As people were disparately impacted by the droves, it frustrating but unsurprisingly illuminated major gaps in our data, our policies, our healthcare system, and most noticeably, among our most vulnerable communities— just to name a few.

And these are major gaps that we NEED to understand to drive change in policy and systemic structures that perpetuate the status quo.

COVID was frustrating for me as a data practitioner because the data to identify these risks earlier was there all along, but no one had really looked at it until something catastrophic happened.

Upon deeper reflection, I realized the magnitude of this phenomenon—these gaps, if you will—in the context of my own life.

Those gaps (and data oversights) are how people like myself, and so many others, can fall through the cracks of society in a very major and, frankly, scary-easy way.

This is a big part of my personal “why,” but certainly not all of it.

Hi, I'm Stefany (Thongvilay-Ferraraccio) (Pickin) Goradia, and I showed a lot of promise as a youth.

I was an eager little learner and highly artistic kiddo growing up in Jacksonville, Florida. In elementary, I was effortlessly top of my class. Straight A’s, gifted programs, always the first to volunteer, ask a question if something didn’t make sense, or answer the teacher’s question when posed to the class. I was inquisitive, curious, the first student to finish all the homework or tests (though I didn’t scramble to do so intentionally).

But it turns out this mostly annoyed or warranted weird looks from the other students. Equally as early in my life, I developed shame around both my confident, outspoken nature and my intelligence. As early as 5th grade, I can remember throwing the Spelling Bee.

I previous wrote an article about how your neighborhood as a kid shapes your opportunities as an adult and the community that I grew up in, which is decidedly middle-class (and I’m quite proud of that, as I shared on this podcast how Blue Collar Roots are a superpower).

But it also means my parents weren’t always home when I got home from school; demanding work meant that also we didn’t have a ton of lavish vacations or physically active weekend activities. In fact, I have always been (quite literally) last in gym class and overweight. This wasn’t surprisingly or abnormal, as my entire Italian-American maternal lineage has struggled with obesity and diabetes for generations.

As for my paternal lineage, my biological father has been absent from my life since I was 3 years old—so the extent of what I know is that he immigrated to the States from Laos before I was born and that he had, or has, struggled with alcohol addiction his entire life.

As you can infer, I was already not off to a great start, but not a terrible one either.

Fast-forward to my tween/teen years.

🏌️My extremely hard-working mom was a "housekeeper" (that was her job title) at a Top 10 TPC Golf Resort, and the highlight of my week was when she brought items home from the Lost+Found. She was up at 4am and home by 4pm, managed a tight ship🚢, and still made dinner every night and kept an impeccably spotless home (not sure how??). My unrealistic strive for perfectionism was subconsciously reinforced here.

📫 My [step]dad was a USPS postman and ALSO worked in the laundry dept of said TPC resort to make ends meet (where he met my mom) after 20 years in the US Navy; still grapples with severe depression and PTSD. My fear of blurting the wrong thing, upsetting someone, and not learning a healthy sense of self-expression (but rather bottle everything), was was subconsciously reinforced here.

Still, I was never for want of anything.

My family modeled hard work through adversity, challenges (mental or physical), and though I experienced a lonely childhood and showed signs of depression since elementary, there was always a lovely roof over my head, I was safe and cared for, and food abounded.

But unsurprisingly, I grew withdrawn as a teen.

🅰️ So I was this effortlessly Straight-A student and yet… I grew withdrawn in my teens and after skipping out on most of my 7th and 8th-grade years (until the school finally noticed), and I ended up dropping out at 16. I was working at Taco Bell then, with a pretty bleak future ahead.

📝 I did start to get my diploma equivalent at a community college; my teacher there accused me of plagiarism (but I didn't understand until much later in life that is why she was so incredulous that "[YOU] actually wrote this.....???")—ended up getting my GED instead. I was working at McDonalds by now.

While everyone around me was starting to have kids and work in the major industries there—food, retail, trades—I randomly found my way to New Mexico through another series of misguided choices.

I wish I could say something inspiring happened to motivate me back to school, but it didn’t. Through happenstance, I did end up going back, after changing majors quite a few times and adding two years to an undergrad, I graduated with a B.S. in Statistics/Economics—with $90,000 in student loan debt—right into the recession of 2008.

Why Statistics? It was a mathematical way to quantify all the “what-if” scenarios I was always running through my head and to answer “why” with some level of certainty (early signs of a future Analyst).

My first job after graduation was making $18 an hour, or about $38,000 a year, working at the State as a labor market economist. I was ecstatic but my ex, an engineer, was quite appalled by its pay, and reminded me often. Fairly, no way I would have paid off that student loan as a public servant without loan forgiveness programs.

Two years later, I landed in healthcare analytics. It also meant a $20,000 pay increase. When informing my boss of resignation he asked, “wow, how did you find someone to pay you that much?”

I’m still unclear if that was because he had made a career on State pay, or some other reason, but I didn’t ask. It didn’t matter. I fell in love with healthcare, coding, and analytics. So much so that I dreamed about it at night.

Healthcare was the most impossibly complex problem I had ever seen, I learned something new about healthcare literally every day (still do), and it meant something—even though I could never actually be a nurse (one of the majors I tried), I could help people understand patterns and help people with Medicaid receive better care, access, and value. In a state where we are 40%+ Medicaid, that is important to a lot of people, for many reasons.

From here I had a few different roles in similar contexts, but always expanding my knowledge and skill set. I loved it. There is always a deeply nuanced question to solve for or ponder, and I’m damn good at it.

I only share all of this detail now to show you just how easily my life—my outcomes—could have been much different.

Now pull a Sixth Sense and go back through my story looking for each instance that was an early indicator/data point that could have tipped someone off to any one of the potentially-life altering things (that I narrowly avoided) proactively.

The data to intervene earlier was there all along, but no one was looking at it that way.

I share this story now, as an example of how easily people like me can fall through the cracks, even though all the signs — and what I understand now to be DATA — were there as early as age 5.

My datapoints are a few of millions of datapoints that — if leveraged together — we can use to be more proactive, deploy targeted and meaningful programs with precision, and even predict in real-time the risks or behavioral trends of an individual or community.

Luckily, this is what happened instead:

⏩ to 2017: first-time co-founder thanks to Angelica Maestas who convinced me to take our skills to the masses, and we worked across the nation supporting various stakeholders across the healthcare ecosystem.

⏩ to 2023:
- 2x startup exec
- Health Equity Advocate
- Health Data SME
- Still dismissed for my tone and outspokenness

Recommitting to healthcare and the fight for equity

Perpetual curiosity led to starting a small company at the urging of my colleague and then co-founder, and our company was later acquired by a larger technology company.

In March 2023, I found myself on a new path entirely, which gave me time to recuperate and think about what I really wanted/who I really was. It was the best thing that has ever happened to me.

Not only did I gravitate immediately back to healthcare, which re-energized me, but it gave me time to think really hard about the experiences I’d had over the past few years as an entrepreneur and intrapreneur. I’d seen inequity, microaggressions, implicit and explicit bias, and I’d seen it happen to myself and others. I’d finally started practicing using my voice, like a wee baby learning to express anger. It went about as well as you’d imagine.

But it re-awakened my spirit to fight for what is just and fair. And as I’ve grown to care a little less about saying the wrong thing, I realized I’m still here at the table, advocating for those who aren't and for those whom it doesn't come naturally to 💪

More importantly, I realized this gift has been inside me all along, I just squashed it as a kid. It is a divinely-given superpower that enables me to not be afraid to speak up, connect with others who this means something to, or something for. It is a gift to rally people and gain momentum, to inspire, and rally around integrity. I still have to focus on learning healthy and productive expression, something I never learned as a kid. But I’m not afraid to embrace it now.

I’ve learned so much that will help me try to impact the world for those who will never find themselves at the tables I’m am at, all because of their unique circumstance. Hell, I almost didn’t make it here either.

There are others who will fall through the cracks because no one is looking.

Everything we experience shapes how we interact with the world, the opportunities we do/don’t have, and the roads taken. I’ve narrowly avoided very different fates.

Never be embarrassed to share your experience of it can help others who don’t realize that they “can,” too.

There are many who need people with outspoken voices like mine to advocate for them.

Throughout my life, I’ve felt like I’ve had to try really hard to prove my worth, and I’ve been consistently dismissed because of my tone, interrogating nature, and outspokenness.

Never be embarrassed to speak up if it helps others who don’t have the voice or position in life to do so.

We now have the data, technology, and public platforms to speak up for what is right—and we have the data to back us up.

All of this defines who, what, and why I am who I am, and write what I write.

While my story isn’t related to “health,” per se, the systemic and personal barriers that we face impact not only equitable access to healthcare, but equitable and obtainable economic, educational, social, and literally every other kind of opportunity in this nation. It impacts how a person rises (or doesn’t) out of their economic class, how they are regarded by others in the world, how they are (or aren’t) provided equitable promotional/advancement opportunities, how they handle and bounce back from setbacks, how they approach life, how they interact with one another, and how they make decisions every single day that cumulatively impact their physical health, mental wellbeing, and livelihood—and how others make those decisions for them or affecting them in a very real way.

That is why health equity is so important to me on a deep level, and I am so grateful that I was able to finally figure out and articulate the “why,” despite the rather painful path it took to get here. And I can’t wait to continue to learn and grow in this field.

. . .

Actionable Idea of the Week:

Figure out your WHY.

Once you figure that out, and it will help you drive everything you do with more conviction, confidence, passion, and it will help you to inspire more people to effect more change. Decisions will become easier and connections with people who are “your tribe” will become easier ro find. Connection to and meaning of your work will deepen—or it will guide you to work that is.

This I promise you.

That is my story, and I’m sticking to it.

. . .

See you next week!

-Stefany

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