Here’s a look at where things stand with health equity and root causes that are being addressed.
By Tamara Lobban-Jones, Founder of DHH. Board of Director at Lazarex Cancer Foundation
The root causes of health disparities must be examined by individuals, government organizations, and patient advocacy organizations to make real progress toward health equity. With this in mind, National Healthcare Quality Week (HQW) is celebrated each year during the third week of October. HQW is a dedicated time to acknowledge the progress made by healthcare and quality professionals toward improving patient outcomes and to prepare themselves for the many challenges and opportunities that lie ahead. Here’s a look at where things stand with health equity and root causes that are being addressed.
What Is Health Equity?
Health equity is the goal for all people to achieve optimal health no matter social determinants or other barriers to care. Examples of barriers to health equity include lack of health insurance, living in rural areas, low socioeconomic status, racial discrimination, and language barriers among others. These types of barriers to health equity lead to many health disparities including issues like higher maternal death rates for Black women and later diagnosis of multiple types of cancer. The U.S. government and patient advocacy organizations are making commitments and taking action to work against health disparities and toward improved outcomes and health equity for all patients.
Organizations Committing to Health Equity
With the U.S. government and Biden Administration pledging to work toward health equity, funding and actions have been undertaken. The U.S. government organization Centers for Medicare & Medicaid Services (CMS) created an initiative called the CMS Framework for Health Equity to address health disparities. Five priorities are identified in the initiative including improvements in working with standardized data; assessing and addressing causes of disparities and inequities; building capacity of healthcare organizations to reduce disparities; advancing language access, health literacy, and culturally tailored services; and increasing all forms of accessibility to health care coverage and services.
Lazarex Cancer Foundation is committed to work and actions toward health equity; creating the Cancer Wellness HUB concept as a safe space for community members to talk about their health concerns across the continuum of cancer care. The hub brings together resources and services to help cancer patients to manage their cancer journeys. USC Norris Comprehensive Cancer Center has been one recipient of a Lazarex grant to fund Cancer Wellness Hubs. Another organization involved in equitable healthcare is Allies for Reaching Community Health Equity (ARCHE). ARCHE provides thought leadership, collaboration, resources, learning opportunities, and innovative solutions that advance health equity. And the National LGBTQIA+ Health Education Center supplies resources, educational programs, and consultation to healthcare organizations to work toward optimizing quality, cost-effective healthcare for LGBTQIA+ (lesbian, gay, bisexual, and transgender) people.
People Committing to Health Equity
Many medical researchers, scholars, and patient advocates have continued efforts to raise awareness and to motivate changes toward health equity. Authors Brian D. Smedley, Adrienne Y. Smith, and Alan R. Nelson of the report Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, released their systemic racism findings to the medical community in 2003 — a report that was met with shock and disbelief by many. And though some thought and hoped that the report would serve as a wake-up call to healthcare professionals, positive changes are progressing too slowly in some data areas and imperceptible in more areas than healthcare advocates had hoped.
Confronting racial issues is still viewed as an uncomfortable topic by many people, but some key individuals are working for the changes that they want to see come to fruition. A Black cardiologist at the Ohio State University College of Medicine named Quinn Capers IV initiated changes at Ohio State by testing 140 admissions committee members for implicit racial or gender biases. After up to 70 percent of the committee members were found to harbor such biases, training was instituted to help diminish their biases. The next year’s class was the most diverse group in their history at that time and had 17 percent of students from underrepresented groups. Clearly, Capers’ decisive action took courage and initiative, and his action can be used as a model for other medical schools and healthcare facilities.
Health policy researcher and director Daniel Dawes from Morehouse School of Medicine’s Satcher Health Leadership Institute has advocated for more data collection to hone in on racial, ethnicity, and other biases. As more data is collected, issues can be identified on a more granular level to get the attention and resources they deserve. Professor emerita from the University of Pennsylvania Risa Lavizzo-Moureys served as a committee co-leader of the Unequal Treatment report and points out that healthcare clinics can take initiative to address their own clinic biases by examining if there are longer wait times by provider or by race. The clinics that really want to foster change can take action right away while they also work to start collecting additional data to analyze and address issues that take longer to work through.
Quality healthcare and health equity are important for all no matter race, gender, socioeconomic, or other impeding factors. Everyone — whether patients, healthcare professionals, or otherwise — must examine root causes and work to correct the issues. Not giving these issues due attention keeps us in the exact same place. Below are some ways that everyone can assist in diminishing health disparities; and learn about organizations conducting research on health disparities.
- Support patient advocacy organizations
- Write to your congressperson about continuing funding support toward health equity
- Understand your rights under HIPAA
- Share your story if you experienced discrimination in healthcare
Committed organizations conducting research on health disparities in the United States:
- Center on Health Disparities — Adventist HealthCare
- American Hospital Association
- Center for Advancing Health
- Center for Health Equity Research & Promotion Collaborations
- Henry J. Kaiser Family Foundation
- National Center for Cultural Competence
- National Quality Forum
- New York Academy of Medicine
- Prevention Institute
- RAND Corporation
- Robert Wood Johnson Foundation
- The Commonwealth Fund
- The Cross Cultural Health Care Program
- The Dartmouth Atlas of Health Care
- The Urban Institute
- The Joint Center for Political and Economic Studies
- Allies for Reaching Community Health Equity
- Asian and Pacific Islander Health Forum
- Berkeley Media Studies Group: Health Equity
- Center for Health Equity and Place
- Health Equity Project (Society for Public Health Education)
- National Collaborative for Health Equity
- The Praxis Project
- Prevention Institute: Health Equity
CMS Framework for Health Equity. Centers for Medicare & Medicaid Services website. Accessed September 29, 2022.https://www.cms.gov/About-CMS/Agency-Information/OMH/equity-initiatives/framework-for-health-equity
Usha Lee McFarling. 20 years ago, a landmark report spotlighted systemic racism in medicine. Why has so little changed? STAT website. Accessed September 29, 2022. https://www.statnews.com/2022/02/23/landmark-report-systemic-racism-medicine-so-little-has-changed/
Usha Lee McFarling. The nation hasn’t made much progress on health equity. These leaders forged ahead anyway. STATE website. Accessed September 29, 2022. https://www.statnews.com/2022/02/24/little-progress-health-equity-these-leaders-forged-ahead-anyway/
USC Norris Comprehensive Cancer Center to establish the Cancer Wellness HUBs with Lazarex Cancer Foundation grant. Keck School of Medicine at USC website. Accessed September 29, 2022. https://keck.usc.edu/usc-norris-comprehensive-cancer-center-to-establish-the-cancer-wellness-hubs-with-lazarex-cancer-foundation-grant/
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Importantly, this information is not a substitute for, nor does it replace professional medical advice, diagnosis, or treatment. If you have any concerns or questions about your health, you should always consult with a healthcare professional.