Debra Farrington has stepped into a new role at NCDHHS, becoming its next Chief Health Equity Officer. She previously served as chief of staff for NC Medicaid, where she received the 2022 John R. Larkins Award for her commitment to justice and equality in the workplace and the community. She shares some of the insights she’s gained from working in public health and observing challenges to receiving health care.
Tell us a little about yourself. Where are you from?
I am originally from Chadbourn, N.C., a town in rural Columbus County with a population of less than 2,000. You may be familiar with the three-stoplight town many pass through on the way to Myrtle Beach. To those who love small town USA, I ask that the next time you drive through, stop at the gas station, grocery store or one of the fast-food places to help the local economy!
Chadbourn, which used to be known as the strawberry capitol of the world (maybe the world was much smaller then), still hosts an annual Strawberry Festival during the first weekend in May. My favorite thing to do is go to Chadbourn to visit my mom, who has 9 living siblings, and all the extended family who have remained in my hometown.
How did you get interested in public sector healthcare?
I have been blessed with good health. But I come from, and married into, a family with chronic health conditions. My mother, maternal grandmother and grandfather, and so many aunts and uncles have suffered from high blood pressure and arthritis. My mother-in-law died from complications related to kidney disease. Many family members have been on public assistance or Medicaid.
I have known too many people who rely on the emergency room for their care, meaning they don’t see a doctor until they are too sick to manage their pain or illness on their own. It is not that they didn’t want care - they did not have health insurance and could not afford to otherwise pay for care or prescriptions. In some cases, those who could access medical care received substandard care or limited information, perhaps because of their health literacy, perceived lack of understanding, or God-forbid, bias of the healthcare professional.
The policies we make, decisions about reimbursements to providers, and structures we put in place, or fail to put in place, impact the people I love, my neighbors, or others who I feel responsible for or accountable to. I think as a state agency we can do a lot to address disparities and I want to be a part of the team that does.
How will your work leading up to this new role influence your leadership in this area?
Having the opportunity to focus on health equity seems to be the perfect culmination of my life’s work. Now before I start to sound like I am old or at the end of my career, let me explain.
Most of my career I have been involved in service delivery, having worked in group homes for children and adolescents with I/DD or mental health conditions, and therapeutic foster care for children with serious emotional disturbance. In those roles I was able to support the care and impact the lives of the children and families who were receiving those services. In those roles, I was able to gain valuable knowledge about the public mental health field and understand firsthand the needs of the people we support.
Providing care at the local level enabled me to establish connections and see the immediate benefits of my work. Although I enjoyed the work immensely, the scope of impact was somewhat limited, impacting the lives of those who benefitted from the services we delivered.
In my role as Chief Health Equity Officer and even in my previous role at Medicaid, I am able to partner with caring and compassionate professionals on setting, evaluating and improving policies which impact the lives of millions of people.
Is there a specific issue or focus area you want to address as Chief Health Equity Officer?
Ultimately, I would like to see NCDHHS address health disparities by ensuring our service delivery policies, contracting and financial practices, and incentives align with our mission to improve the health, safety and well-being of all North Carolinians. We will accomplish that in part by providing tools, templates or resources divisions, programs or offices can leverage to develop and implement plans or evaluate and strengthen existing approaches for addressing whole person, equitable health care. In the near term, I will work with the Health Equity Portfolio team to build up our internal infrastructure; filling key positions and dedicating time and attention to internal DEI work while establishing connections with external partners.
What does health equity mean to you?
To me, health equity is about ensuring that everyone, especially those who are disadvantaged, marginalized or disenfranchised, have access to the health they need and want; that those who are at greater disadvantage or who have not formerly benefited from advancements in care, science, wealth or thought leadership are given a fair opportunity to attain their full health potential. The image below captures it well.