Senior Manager, Abbott PhD Student
Meharry School of Global Health

Amy Boelter reflects on a career spanning direct service, healthcare operations, clinical research, and inclusive trial strategy - and on what she has learned about making equity part of how organizations actually make decisions.

“The people furthest from institutional power were consistently
the least visible in the data meant to represent them.”

Where it started

It started in direct service, not a classroom

My path into health equity didn't start in a classroom; it started in direct service. Early in my career, I worked as an intake specialist and case manager in behavioral health, sitting across from people at some of the hardest moments of their lives and watching how much their outcomes depended on things that had nothing to do with their diagnosis: insurance access, transportation, whether a system was built with them in mind at all.

That experience never left me, even as my career moved into healthcare operations, research quality, and now enterprise research strategy. I kept noticing the same pattern at every level: the people furthest from institutional power were consistently the least visible in the data meant to represent them.

What shaped me

Through every layer of the health system

My path has been shaped less by a single mentor and more by moving through nearly every layer of the health system: direct patient support, healthcare operations at Humana, research compliance across eight centers at HealthPartners, clinical trial operations at Beckman Coulter, and now enterprise inclusive-research strategy at Abbott.

My board service with Pregnancy and Postpartum Support Minnesota and MENTOR Minnesota has shaped me just as much as any job title; those communities keep me honest about the gap between institutional equity strategy and what people actually need day to day.

And returning to school for my PhD later in my career, after over a decade in the field, has shaped how I think as much as any workplace has. It forced me to slow down and ask why the disparities I'd been observing operationally kept persisting.

A turning point

Keeping equity work from dying quietly

One period that changed how I approach this work was watching a piece of enrollment-transparency work I'd built lose momentum after leadership pulled back on socializing it broadly; the rationale was that the FDA guidance remained in draft and had not been finalized.

It taught me that having the right data or the right framework isn't enough; equity work dies quietly in organizations when it isn't re-championed cross-functionally and tied to decision-makers who have a reason to keep it alive.

Since then, I've approached every initiative I lead, including Abbott's Inclusive Trial Design Guide, with governance and cross-functional ownership built in from the start, not added later once something stalls. I tie each item of equity work to existing business processes and present it as a business solution rather than equity work because, unfortunately, not everyone values equity alongside their other demands. It requires diplomacy to speak the language those in industry speak and make it something they care about in their function, solving a problem they have in a way that allows equity in.

How I work

Rigor and humanity at the same time

I carry forward a conviction that equity work has to hold both rigor and humanity at the same time; that a framework or metric is only as good as its connection to real community experience.

I try to resist treating equity as either a pure data problem or a pure advocacy problem. In practice, that means I pair data-driven tool - GIS mapping, representation metrics, cascade-based analysis of where disparities emerge - with ongoing community relationships that keep that data honest.

I also carry forward a bias toward decision-making over endless discussion: shared efforts move forward when someone is willing to design the process that turns a room of differing expertise into an actual decision.

What I’m building

Measuring where representation erodes

I'm currently building a research methodology, an "Equity Cascade" framework and a Trial Representation Equity Score, to measure where representation erodes across the clinical trial lifecycle as part of my PhD work at Meharry Medical College.

At the same time, I'm building enterprise infrastructure at Abbott meant to operationalize inclusive trial design in practice, not just in policy language.

Increasingly, I'm also thinking about how this kind of stage-level equity measurement could translate beyond clinical trials into broader health-equity data gaps, like inconsistent SVI/ADI adoption and underused Z-code documentation of social risk factors in everyday care.

To the next person

None of it is wasted

I hope someone earlier in their path, especially someone without a traditional research background or a linear career, takes from this that health equity expertise can be built cumulatively, from direct service work all the way up through executive strategy and doctoral research, and that none of those stages are wasted or lesser.

I also hope it's reassuring to know that setbacks, work that stalls, and initiatives that lose institutional momentum aren't evidence you're on the wrong path; they're often the moments that teach you what actually needs to change about how you build things, not whether the work matters.

Beyond the work

Candid about the tradeoffs

I try to hold career ambition and family life as equally protected priorities rather than treating one as the cost of the other; my daughter, my marriage, and my faith are as much a part of why I do this work carefully as any professional goal is.

I mention it because I think health equity work is more honest when the people doing it aren't pretending it comes free of tradeoffs. I'm still figuring out that balance in real time, and I'd rather be candid about that than present a tidier version of the story.