There are few silver linings related to the COVID-19 pandemic, but one that stands out is the growing recognition that health equity must be an essential guiding principle for health care organizations going forward.
The broader health care system suffered greatly due to the coronavirus outbreak that has infected tens of millions and killed hundreds of thousands nationwide, but vulnerable patient populations and marginalized communities were far more susceptible to long-term damage. For example, a Commonwealth Fund study released in November 2021 found that “deep-seated racial and ethnic health inequities” were exacerbated by the COVID-19 pandemic across all 50 states and the District of Columbia.
There is clearly room for improvement and health care executives recognize this reality. A poll conducted by the Institute for Healthcare Improvement in 2021 found that health equity is now considered one of the top three organizational priorities for health system leaders. The poll also revealed that many health care executives are emphasizing initiatives to address the social determinants of health (SDOH), which often contribute to issues related to health equity.
The industry has undergone a marked transformation since March 2020 and more elements are likely to continue to change in the months and years to come. What’s important is that while change is inevitable, it should not be dictated by clinicians, nurses, or executives. Instead, a system-wide evolution toward greater health equity will come from the patients and will be influenced by their expectations as consumers and lived experiences that affect their health outcomes.
Consequently, health care leaders must respond to these evolving, consumer-driven expectations by establishing a system that is more accessible and equitable for all patients.
A glimpse into the future
While there’s currently an abundance of uncertainty throughout health care, there is also a certain excitement to realizing that the industry will likely undergo a positive transformation in the coming years.
Consider what a redefined and realigned health care system might look like: One that empowers patients with plenty of care options that may or may not involve traditional health care organizations like hospitals or health systems. By expanding the availability and accessibility of care, while at the same time enhancing its convenience for patients, stakeholders can recreate the health care system in a more equitable way.
Some organizations may look at health equity as an aspirational goal but it’s so much more than that: it’s a crucial part of the mission. With insightful, actionable information driving health care organizations, it’s possible to decentralize the traditional care system to create one that is both more accessible and equitable to patients in need.
To that end, the Robert Wood Johnson Foundation recommends several approaches for health care leaders to take action with the objective of health equity. These include adopting new vital signs to “screen for the nonmedical factors influencing health” such as SDOH, helping low-income and non-English-speaking patients receive necessary care, and ensuring that “elderly, women, and racial/ethnic minorities” are represented in clinical trials.
Health care: a luxury item no more
Increasingly, health care in the U.S. has become a luxury item: Unless patients are insured or wealthy, they don’t receive the same level of access to care. This dynamic perpetuates a vicious cycle for low-income patients, especially as prices rise for services. Add in a pandemic, which has pushed the American public health system beyond the brink, and we are amid a disaster the likes of which the country hasn’t seen in nearly a century.
Good, quality care should not be only available to those with wealth or insurance. The health care industry should strive for an environment where all barriers are torn down and as many patients as possible can get the treatment they need. This involves understanding the SDOH affecting patients and providing ample treatment options where it’s most convenient for them.
The industry and country at large are now more aware than ever of how vulnerable the health care system is and why health equity must be a priority during this rebuilding effort.
Even the Healthy People Initiative, a federal program aimed at establishing goals and benchmarks for improving health and wellbeing nationwide, has been influenced by the increased recognition of health equity’s importance. All five of the Healthy People 2030 initiatives’ goals center on achieving health equity, including “diverse, distinct disease prevention and health promotion efforts.”
Learning from past lessons
Given all the momentum behind promoting greater health equity across the nation, it is incumbent upon health care executives to do better for their patients and recognize health care as a necessity for at-risk communities.
As the country has seen all too well during the pandemic, there are plenty of people living on the margins and in danger of being harmed when a crisis emerges. It’s promising that health equity is receiving the attention it rightly deserves but action must follow the words.
That means that the American health care system should be more focused on proactive measures rather than reactive measures, especially for those who have chronic conditions, little to no insurance, or lack consistent access to care.
Accordingly, if there is to be any meaningful chance that equity can be achieved in health care, organizations must dutifully expand access to their care offerings and understand the obstacles that stand in the way of their patients. The industry has experienced significant turbulence over the past two years but there is hope in learning from institutional mistakes and correcting course for a more promising future.
George T. Mathew is an internal medicine physician and health care executive.
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