According to the World Health Organization (WHO), “Equity is the absence of avoidable or remediable differences among groups of people, whether those groups are defined socially, economically, demographically, or geographically.”
The WHO goes onto explain, “Health inequities involve more than inequality with respect to health determinants, access to the resources needed to improve and maintain health or health outcomes. They also entail a failure to avoid or overcome inequalities that infringe on fairness and human rights norms.”
Systematic variances among different population groups have been in the news for years and is once again making headlines in recent weeks. Compared to other industrialized countries, the United States has historically ranked low on measures of health equity. Additionally, a 2017 report shows a wide variation of disparity in health status by state.
The economic strain of health disparities in America is expected to increase to $126 billion in 2020 and rising to over $350 billion by 2050 if the disparities stay the same.
Health gaps among different race populations in the U.S. is due in part to decades of systematic inequality — from housing to the economy, to the infrastructure of healthcare systems.
According to the Center for American Progress, in 2017, over 10% of African Americans or Black Americans were uninsured, compared to nearly 6% of non-Hispanic whites. Additionally, over 12% of African Americans (under the age of 65) reportedly had no health insurance coverage.
Understanding the Problem
United States healthcare systems are making strides in identifying health equity as a strategic priority. Some are having success, others — not so much — as they are mostly unaware of the disparities within their four walls.
Although the healthcare industry still has a long road ahead to effectively tackle health inequities, there are some evidence-based approaches that are gaining traction.
To better understand the problem, the right questions first need to be addressed. Why are (racial) minorities in America disproportionately impacted by poor healthcare? Why are Black infants 3 times more likely than white infants to not survive due to low birth weight complications? Why does life expectancy for babies vary by decades, even though they only live a few miles apart in certain urban cities across the United States?
In order to thoughtfully address these questions, there needs to be a better understanding regarding what is the root cause of health inequity to begin with.
Health disparities are the consequence of much more than individual choices. These inequities stem from:
- Structural racism
- Structural discrimination
- Health systems’ inconsistencies with access to care & technologies for certain populations
The Role of Healthcare in Disparities
An NCBI article notes that the race/ethnicity of a patient, “has been shown to influence physician interpretation of patients’ complaints and, ultimately, clinical decision making.”
A cross-sectional analysis indicates that physicians have a bias toward particular populations that hinder their ability to provide valuable care. These biases then become institutionalized, and ultimately more difficult to eradicate.
Many healthcare organizations find themselves in a self-inflicted, self-perpetuating cycle of poor health outcomes due to these healthcare inequities.
To make matters worse, health systems can exacerbate these issues when they don’t have the right data or delivery structure in order to bring light to, and rectify these disparities.
How to Achieve Health Equity
Outlined in this Health Equity Must Be a Strategic Priority article, here are specific ways in which healthcare organizations can strive for achieving health equity:
- Put health equity on the shoulders of leaders, and hold them accountable for making it a priority.
- Create plans and procedures that embrace equity, including dedicated resources, and initiating a governing body to supervise the health equity efforts.
- Identify the health disparities and the needs of those who face these disparities, and then implement measures to lessen the imbalance.
- Identify and dismantle policies and procedures that perpetuate race-based advantages.
- Collaborate with organizations in the community with the same mission to end inequalities.
Health systems must act swiftly, strategically, and sincerely in order to demonstrate the improvement for quality outcomes and equal treatment for all populations.
In our next Auxo Medical blog post, we’ll share which apps are helping trace COVID-19 in order to slow down the spread.