Dr. Dwayne Proctor is the president and CEO of Missouri Foundation for Health, an independent philanthropic foundation committed to changing systems and removing barriers to health for all Missourians. He assumed this statewide leadership position in 2021 after nearly 20 years with the Robert Wood Johnson Foundation, based in New Jersey, the largest American philanthropic foundation focused solely on health.
The adjustment, he told The American, is “one of scope, not mission.”
“What we at MFH are doing is just as critical as my work at RWJF, and just as complicated,” Proctor told The American. “I’ve realized that Missouri has consistently been a reflection of and a flashpoint for what is happening in the nation, which means any solutions we find here can and will have a national impact.
We spoke to Proctor about the work he is leading at Missouri Foundation for Health, what Missouri needs to hear from a candid transplant, and what he learned touring with Ray Charles as his road manager. This interview orginally appeared in The St. Louis American’s Diversity Equity and Inclusion Special Publication.
The St. Louis American: Missouri Foundation for Health partnered in a recent study that found that 25% of Missourians do not believe or do not know that birth control pills are legal in the state, and more than half (53%) do not believe or do not know that emergency contraception is legal here. Both, in fact, are legal. What can be done to increase awareness of these basic facts?
Dwayne Proctor: All birth control is legal in Missouri. It’s important we keep that drumbeat going, reminding our communities of this fact while also recognizing that these are complex and confusing issues for anyone. People are making potentially life-altering decisions and evaluating them against their cultural, religious, and socioeconomic realities. Knowing what birth control treatments are right for you is a personal decision, but we want people to be aware of their options. That’s why we partner with health clinics throughout the region, increasing access to and improving information about the full range of contraceptive services through our The Right Time initiative.
The St. Louis American: Missouri Foundation for Health recently co-hosted free public screenings of the documentary “Birthing Justice,” which explores the high rates of Black maternal death rates in Missouri. What can be done to improve the health outcomes of Black women going through pregnancy?
Dwayne Proctor: That’s a big question. Let me first say that we were excited to partner with Denise Pines of Women in the Room Productions, the movie’s executive producer and co-writer, to bring this thought-provoking film to audiences across Missouri. Our moderator Erica Dickson, founder of the Mid-Missouri Black Doula Collective, crisscrossed the state and fostered audience conversations at the five screenings, in collaboration with Ragtag Cinema.
As to how we improve health outcomes for Black women, it’s a multi-pronged approach. In Missouri, there are three things we’ve learned should really be addressed to improve health outcomes for pregnant Black women.
First, we need a more skilled and diverse birthing workforce. This means integrating more Black doulas, midwives, and community health workers onto care teams and paying them fairly for their skills.
Second, providers must assess and treat pregnant women living with mental illness.
Third, we should address behavioral health issues related to drug use disorders. The biggest underlying cause of death (33%) in the last Pregnancy-Associated Mortality Review was mental health conditions, and substance use disorders were a factor for all the deaths in that category. Extending postpartum Medicaid coverage from 60 days to a year was a huge step in the right direction, but we can do more. If we don’t support Black moms in all areas of their lives, we’re dropping the ball.
The St. Louis American: The foundation partnered in another recent study that found that 33% of people of color reported skipping needed medical care due to distrust of or feeling disrespected by health care providers, compared to 22% of white respondents. What can be done to address this disturbing situation?
Dwayne Proctor: That Altarum survey said a lot about the many reasons people deferred care during the pandemic. We know that some made the decision to put off procedures for safety reasons, while others couldn’t access care because hospitals were filled with people fighting COVID-19.
As we transitioned out of the public health emergency, people who deferred care contended with a shortage of medical professionals, which was worse for folks in rural areas. This is why Medicaid is critical to Missourians; it helps ensure maximum access to available health care personnel. In 2024, diagnostic breast exams will be fully covered by insurance in our state. That means people who put off getting a screening because they were afraid of added costs are more likely to access testing. Adding coverage and removing economic barriers makes people feel it’s safe to resume their care.
Our community partners work with families across the state who are experts on how systems need to change for them to be healthy. We treat that wisdom with respect.
The St. Louis American: Earlier this year, the foundation announced a new type of financial partnership with a $10 million deposit in St. Louis Community Credit Union (STLCC). Five months later, can you report any positive returns on this investment?
Dwayne Proctor: We signed on with the many corporations supporting the Community Impact Deposit Program. STLCC is one of the largest Black-owned credit unions in the country, and it’s right here in Missouri. We don’t yet have reporting for 2023, and we are excited to support the nonprofit’s stellar work.
Removing obstacles to home ownership is key to building generational wealth. If you don’t have financial access, everything is harder – building your savings, buying a car, starting a business. The credit union is committed to improving the financial health of their members and the surrounding community. Our investment fits perfectly into our work to achieve health equity and help break down a long-standing racial wealth divide.
The St. Louis American: Is there anything else new coming from MFH?
Dwayne Proctor: I have to talk about our food justice initiative, which we launched this year. The foundation has made a 20-year commitment to build collaborative efforts that strengthen local food systems and help Missourians get the foods they need to live active and healthy lives. We know that we’ll work to bring together safety net advocates who have in-depth knowledge about the Supplemental Nutrition Assistance Program (SNAP), Woman, Infant, and Children Food and Nutrition Services (WIC), and school meals to push for policy changes that remove roadblocks to access.
For example, Missouri just turned down millions in federal food aid for children because of administrative hurdles. That’s a systems issue. Long-term, we want to help communities who have been disproportionately affected by food insecurity reclaim power and resources. This is a generational effort to build an equitable and just food system that nourishes us all.
The St. Louis American: You spent nearly 20 years with the Robert Wood Johnson Foundation, based in New Jersey, before coming here in 2021 for the top job at MFH. Talk about your adjustment from a national platform on the East Coast to a statewide agency in the Midwest.
Dwayne Proctor: The adjustment is one of scope, not mission. My career has focused on changing systems so that everyone has what they need to live a healthy life regardless of who they are or where they call home. What we at MFH are doing is just as critical as my work at RWJF, and just as complicated. I’ve realized that Missouri has consistently been a reflection of and a flashpoint for what is happening in the nation, which means any solutions we find here can and will have a national impact.
The St. Louis American: You toured with Ray Charles – which is just too cool. Tell us something we don’t know about the great man.
Dwayne Proctor: Mr. Charles taught me that no matter your platform, you can use it to advocate for justice and equity.
I remember that he agreed to perform in South Africa, which could have undermined an international boycott against apartheid. I was surprised at first, but I then learned his performance was conditional. He agreed to play three shows if one of them was racially integrated.
He was a generous elder and teacher who shaped me in fundamental ways. He taught me the value of listening, which sounds simple. But listening deeply allows me to engage with people with all types of lived experience, trust their wisdom, and bring their voices into the rooms I occupy.
I learned that collaboration is the heart of any achievement. I watched him lead a 33-piece orchestra with five background singers who had to work together to pull off spectacular shows. Nothing I’ve done or hope to do can happen without collaboration. What Mr. Charles taught me helped me to better understand my identity in the workplace and in the world, and to lean on collaboration when the task ahead is hard.
The St. Louis American: A Fulbright Fellowship took you to Senegal, West Africa, to investigate how HIV/AIDS prevention messages raised awareness of AIDS as a national health problem. Do you maintain any professional or personal contacts back there?
Dwayne Proctor: During my time in Senegal, I connected deeply with the land and the people. It was a life-altering experience that will always be with me. The people I met, especially my hosts, are family now.
The St. Louis American: You have spoken about taking risks to be outspoken. What is something you see about St. Louis as a transplant that we need to hear?
Dwayne Proctor: Missouri has an abundance of kind, curious people who show up for their neighbors and their communities. It’s laudable – and we need to take it further. I’d challenge us to expand our definition of “neighbor” and erase the historic divides that don’t serve anyone. From the Bootheel to Rock Point, rural and urban, across ethnic and socioeconomic lines, we must learn from those facing the most challenges and the biggest obstacles to thriving in all aspects of their lives. When we do that, everyone benefits. Cornel West said that justice is what love looks like in public. We can love people we don’t know.
Learn how MFH defines system changes at https://vimeo.com/811389637. Visit https://mffh.org.