Issue link: https://beckershealthcare.uberflip.com/i/1372822
88 88 THOUGHT LEADERSHIP Poverty, depression and domestic violence aren't just 'social determinants of health' to Northwell CEO Michael Dowling — they're part of his remarkable past By Molly Gamble M ichael Dowling's childhood home in Knockaderry, Ire- land, was a thatched-roof cottage made of mud and stone. It lacked electricity, indoor plumbing and running water. To obtain peat to heat it, he traveled an hour with his father in a borrowed donkey cart to a bog. is might sound like the colorful sto- rytelling the Irish are known for. But, the details of his upbringing in 1950s and 1960s Ireland at times resemble those of life in the 1800s. "Sometimes when I talk about the way I grew up, people have a hard time believing it was only in the '60s," said Mr. Dowling, president and CEO of New Hyde Park, N.Y.-based Northwell Health. Mr. Dowling's new memoir Aer the Roof Caved In hardly romanticiz- es the challenges he confronted as the oldest of four children in Ire- land, as well as his immigration story to the United States in the 1970s. In it, the reader comes to see how the longtime leader of New York's largest integrated health system has a unique relationship to many of the circumstances and factors that are referred to as "social determi- nants of health" in the industry: inadequate housing, substance abuse, domestic violence, depression, poverty and classism, to name a few. When Mr. Dowling finds himself in a board room discussing any of the aforementioned with corporate executives and leaders, his per- spective is oen unmatched. Here, Mr. Dowling reflects on what got him to put pen to paper, how he squares privilege with his past, his assessment of care for mental health in the United States and more. Question: Your new memoir is a very honest account of your childhood, family and upbringing in Ireland. In it, you share some painful experiences and memories. How open have you been throughout your career about the less-than-perfect parts of your past? Does this book mark a departure from norm? Michael Dowling: I've always been pretty open. I've never been shy talking about my past, or embarrassed by having grown up in poverty. In fact, sometimes I think it's a good thing. is is the first time I've ever written about it, however. I resisted writing a book for many years, but many people told me I should aer the debates about immigration in the United States. As an immigrant, I finally decided at the encouragement of others that it could be an interesting story and important to write it. ere's a part of everybody's history in this book. We all have an immigrant story, whether it's our own or our predecessors'. Q: The book touches on housing, substance abuse, do- mestic violence, depression, poverty, classism and other themes that many accomplished CEOs may speak about as corporate citizens, but have not experienced firsthand. How has this influenced your leadership and communica- tion style, especially toward stigmatized issues? MD: Having lived through them, you have much better appreciation of their impact. You can empathize more. People have oen asked me, "Why did you decide to work in health and human services?" Well, it directly emanates from my past. My mother was deaf and my father was very ill. I've always had a direct personal interest in those issues, and I've always tried to figure out how I can have some kind of a role in making things better for people who suffer from those concerns. On the other hand, I'm a very strong advocate that you should never reduce the incentive for people to work and do things for themselves. It's that fine balance. In the book, I discuss when I worked in child welfare for the state of New York. I helped initiate a lot of innovative programs to help create less disincentive to work because I think peo- ple have an obligation to help themselves. But for those people who legitimately cannot, we have a social and moral responsibility to help them the best we possibly can. Growing up the way I did has made me pretty passionate about what I do. If someone talks to me about not knowing where the money for their next whatever-it-might-be will come from, I know that. And I get upset with people who take advantage, but I also get upset with people who do not fully appreciate the inconvenience of being in a very difficult circumstance. Q: One thing that stood out when you talk about grow- ing up in Ireland is the tension around class, money and opportunity. You describe a "cacophony of no" that con- stantly reminded you of your plot in life, as did many peo- ple in your village. A priest would read off families' dona- tions to the church, and embarrass your father when the Dowlings were able to afford a smaller contribution than other families. Nonprofit healthcare isn't exactly the most lavish of sectors, but corporate leaders do have privilege. How do you square that and not feel like you're turning your back on your roots? MD: I remind myself that I today have a very fortunate life. I live in a beautiful community, have a nice home and have everything I need. A model of the house I grew up in is in my home now, because I like to look at it and remember how fortunate I am. It's important to stay grounded, be a decent person, do the right thing, treat people well, keep your feet on the ground and remind yourself that everybody, whether rich or poor, puts their pants on the same way every morning. All of us who have done relatively well and have kids, I think my kids are fortunate and don't fully understand. I want to make life easier for them, but not easy enough where they don't understand what it's like to have it hard. Know where you come from, but try to understand where other peo- ple are coming from. In any discussion or policy debate, you can only