Alexis Taylor understood the reality of medical inequity when she experienced it firsthand in a life-or-death situation. Since then, she has channeled the activism of two previous generations of her family by devoting her professional life to repairing inequitable outcomes by catalyzing structural change. At HealthBegins, Alexis manages a groundbreaking initiative to support community-based organizations across California in securing Medi-Cal contracts to expand the services provided to the most marginalized communities, from housing to respite to food security—thereby redefining health care. She came to HealthBegins from a position at the City of Pasadena, where she oversaw support for CBOs in Northwest Pasadena. Alexis holds a master’s degree in public administration and was a select scholarship recipient at the USC Gould School of Law for a second graduate degree in law. She has also worked for FEMA overseeing hurricane relief and for Senator Bernie Sanders. Here she illuminates the truths she learned from the generations before and after her.

You’ve spent a lot of your career working on equity. In the course of your life, when did you first recognize the reality of health inequity?

As a kid, I knew that there was something that wasn’t right. We faced severe food insecurity. We faced housing insecurity. We lived in a redlined district in South Central LA. And it wasn’t until adulthood that I realized the factors that influenced that. The moment of realization for me was when I was diagnosed with cancer. I was 25. I was nine weeks pregnant. And when I received that diagnosis from an oncologist, who told me I wouldn’t survive if I didn’t terminate the pregnancy, I wasn’t immediately provided with remedies. And when I went to have my first mammogram, the radiology staff laughed at me and said that I did not have cancer, maybe I was mistaken. After overcoming that obstacle and having both breasts removed, my medical pump failed. So I did not have post-surgical anesthetic. There was a series of failures that I experienced that could have cost me not only my life, but the life of my daughter. So that experience has galvanized something. 

So when you went through that experience, what did you see in a way you hadn’t seen before?

At that time, I think that I was hyper-aware of individual racism. But at that moment, I realized that there was something more structural going on, because those encounters were not just happening with an oncologist or a surgeon, they were happening across the sphere of services that I had to receive. When I went through chemo, I started to talk to other patients, and there was obviously a disparity between patients that were of color and patients that were not. That was very monumental for me.

So once you saw this systemic bias of discounting the experience of a Black patient, then what did you understand about your childhood experience? 

There was a painful period of reflection, trying to figure out what you could have done differently to make life easier for your family. You almost internalize it. Or as a mom, trying to think back on ways that I could have maybe better shielded my son from systemic racism. It’s almost like Stockholm syndrome, where you start to blame yourself. There was a healing period of needing to grow out of the self-blame to move into a place of action. And I wouldn’t say that the pain is completely gone. I think that in a very interesting way, it is part of what drives the work. Because our lives are quite literally on the line.

Your family did not always have health insurance when you were growing up. Did you have insurance when you received your cancer diagnosis?

I ended up appealing to Medicaid, and I was able to get insurance because I was pregnant, and they were able to cover the vast majority of the cost. But once I went back to work and transferred over to private employment, and having copays and deductibles, I racked up almost $100,000 in medical debt, and that was devastating. It dilapidated my credit, removed any buying power that I had. It was difficult even to rent an apartment. And that is another way that the healthcare system at large can really devastate families.

Are you in remission?

I am in remission. My daughter is eight years old now. She came out, she was only four pounds because we had to go through all of the chemo. I had a lumpectomy during my pregnancy without anesthesia, because we did not want to compromise the pregnancy. And my daughter came out with this huge head of hair, and she’s just gorgeous and just full of life and crying. And there I was, frail and bald and just—it was amazing. She is just a reminder of all of the blessings that we have despite the experience. Me and my husband want other Black mothers that potentially experience such a harmful situation to be able to hold their children as well.

Tell me about the people who shaped your values.

My civil rights hero is my grandmother, Zella Mae Payne. She was just hardcore. And because my mother died when I was very young, from end-stage renal disease, my grandmother took me in when she was already in her sixties and I was only six. She was an educator for LAUSD for almost 30 years. And because she was a Black woman that was born in 1923, living in South Central LA, she had experienced so much. She didn’t hold back when she was raising me, and she let me know that the only thing society would not be able to take away from me was my education. And this was someone that had two master’s degrees from prestigious universities and still lived in poverty. I don’t think my grandmother ever made more than $30,000 a year. So for me to have received all of those life lessons and motivation and discernment and encouragement from her has definitely shaped me into who I am today.

How would you state the values that your grandmother gave you?

If I think about the core of my grandmother, it was: you don’t let anybody stand in your way. You always do the right thing. And even if there are people that are telling you that you are not going to be successful—because that was something she constantly heard—my reaction to that should be: I’m going to stand (which was one of her words) steadfast. And I can just call upon my ancestors to trust that I’m doing something that is going to incite change whether I get to live to see it or not.

What brings you meaning in your life outside of work?

My kids. I think it was because I gave birth to my children at very difficult times in my life. When I gave birth to my son, I had literally just lost my grandmother. And because my family is already so small, giving birth to my son just reignited something in me that I just didn’t know was possible to have. And then five years later, to receive that diagnosis when you were trying so hard to bring another little human into this world, and to see my daughter survive this pregnancy, come out so strong, so resilient, so healthy—I could not have asked for anything that could bring me more joy in my life than my kids. 

What’s a fun fact about you that people may not know?

I’m an anime fanatic. Like I can watch hours and hours of anime, nonstop. Don’t mess with me and my Demon Slayer or my My Hero Academia or my Promised Neverland. 

When you were a kid, what did you want to be when you grew up?

I did not know if I wanted to be a paleontologist or a hair stylist or an astrophysicist. I kid you not. It was those three, consistently, nonstop. I saw Jurassic Park. I wanted to dig up dinosaurs. I saw some hair movie that was just making people really pretty. And I was like: oh my God, I wanna do that. And then the last one was because I had a cousin that worked at NASA for years. 

What was your first job and what did you learn from it?

My first job is actually a really funny one. I met my husband at my first job. I worked at Food for Less, and I was one of the people that pushes the carts out of the parking lot. I was 16. And within one week I got promoted to be a greeter. That was a big deal back in the day. And so everyone else that had been hired before me that was still pushing carts, they were mad. 

What was your husband doing at Food for Less?

He was pushing carts.

Oh, so was he mad at you when you got promoted? 

He talks mess about it ‘til this day.

What are your favorite films?

One movie that just really sat with me was American Son, the film adaptation with Kerry Washington, where her son did not make it home that night and come to find out it was because he was murdered by the police. I know that that does not sound like it should be one of someone’s favorite films, but I just think it gives causation to wake up. And that is super important for me, because in my life that is actually one of my greatest fears. My son is 14, and he walks to school, he walks to Starbucks, he walks to the grocery store, and he’s the greatest kid in the world. He’s just so sweet and so loving and so full of life. And I know that society is going to look at him as a threat. And unfortunately we have to have that conversation every time he walks out the door. So I think why that film was so important to me was because when my counterparts had the opportunity to watch the film from a parent’s perspective, something shifted within them. 

Looking 10 years into the future, describe what you hope to have achieved and how you hope the world will be different.

Ten years from now, I want health care to be a human right. I do not want anyone to have to pay out of pocket for health care. I want there to be an overhaul of what is considered health care. Similar to what we’re working on with the Medi-Cal initiative, I want there to be an expansion of services that are covered, but I want there to be an expansion of these services at no cost. I don’t want there to be the in-between gap where you don’t make enough, but you make just too much, so you’re stuck there with the cost of these critical services that families need in order to survive.

Lastly, what advice would you offer to others who are striving to advance health equity?

Remain steadfast. Don’t waiver. This is hard work. This is lifelong hard work, at that. And something that really resonates with me that one of my former colleagues stated was that we are a beautiful rebellion. We’re not maintaining the status quo. And when you’re not maintaining the status quo, you’re always going to be in the face of opposition, and that’s okay. We need to just, as they say in the Black churches, keep on pushing on. And that has been a crutch for me, to be able to take some of the disappointment and take some of the pain that comes out of this work sometimes and to be able to realize that it’s okay, because the greatest have gone through it.

I heard your grandma there, in the steadfast. 

Yeah. Steadfast.
 

Grace Rubenstein is a journalist, editor, and podcast coach specializing in health science. She is the Editorial and Communications Director at HealthBegins.