Health equity isn’t just a phrase that healthcare executives like to throw around — in fact, the issue is about as serious as it gets. It’s no secret that U.S. patients often lack the healthcare resources they need or face discrimination when seeking care, often as a result of their income level, race, ethnicity, sexual orientation, gender identity or ZIP code.
Bringing attention to the inequities pervading the nation’s healthcare system is imperative, as this is the first step toward the fair distribution of healthcare resources and reduction of health disparities. However, some healthcare organizations seem to have reduced health equity to a buzzword, using the phrase superficially without a genuine commitment to dismantling systemic barriers that contribute to health inequities.
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During a webinar held by HLTH this week, two industry leaders discussed why this approach must be avoided and explored how healthcare organizations can do better.
American Medical Association President Jesse Ehrenfeld named a foundational step that healthcare leaders shouldn’t ignore: acknowledging the past.
“We’ve been quite outspoken on a lot of these issues over the past few years and brought attention to past practices and frankly, decisions by previous AMA leaders that were exclusionary. And in some cases, decisions were outright racist and certainly have contributed to a lot of the inequities that we face today in our healthcare system — not just for patients, but for doctors as well,” he declared.
When it comes to the work needed to reverse health disparities, Ehrenfeld said the AMA’s vision is “pretty simple” — that the industry needs to prioritize resource allocation for solutions that are meaningfully advancing social justice in healthcare.
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The current models for health innovation resource allocation — meaning how evidence is generated, how solutions are designed, how markets are selected and so forth — do not incorporate an equity lens, he noted.
“If we don’t fix the foundational problems in technology design and development at the front end, and if we’re not intentional about eliminating bias and incorporating better datasets at the very beginning of the process, we’re simply going to perpetuate these long-standing biases and widen already existing inequities,” Ehrenfeld explained.
Investors pour billions of dollars into health startups each year, with last year alone resulting in more than $15 billion in venture capital. While healthcare investment has been increasing over the past couple decades, data shows that Americans’ health outcomes have continued to get worse than any other high-income nation, Ehrenfeld pointed out.
The groups that have been most affected by the industry’s inequity problem include women and those who are Black, Latino and Indigenous. People with these demographics make up about 70% of the country’s population, but are vastly underrepresented in digital health investment and purchasing decisions, Ehrenfeld noted. He argued that the demographic makeup of the investors and innovators developing new healthcare technology ought to mirror that of the nation.
“The health innovation sector has such incredible potential to advance health equity, with $135 billion per year in estimated economic gain associated with reducing racial health disparities. Think about that — $135 billion a year in economic growth if we can finally do the right thing for all of our patients,” Ehrenfeld declared.
His fellow panelist — Amaka Eneanya, Emory Healthcare’s chief transformation officer — agreed and added that while she is pleased that more leaders are talking about health equity, she fears that the importance of the issue might be overlooked now that it’s a buzzword.
Oftentimes, people don’t truly understand what health equity means, as the issue has become politicized, Eneanya stated. Sometimes people have a visceral reaction when they hear that phrase, immediately writing it off as another just another woke practice, she explained.
This makes intentionality all the more critical for health equity initiatives.
“You have to be a bit nuanced when you’re thinking about who you bring to the table. Sometimes it’s just a checkmark — you just pick one person from that marginalized group, and then you fix everything. That person is going to be the person that solves all of the equity issues in whatever area that you’re trying to advance in? I don’t think that’s right,” Eneanya said.
Healthcare organizations should bring diverse leaders to the table because they have deep expertise in the problem at hand, not just because they are part of a marginalized group, she added.
Photo credit: Andrii Shyp, Getty Images
