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The United States spends more money than any other industrialized country in healthcare. Yet, the nation is still known to have the highest poverty rate, most significant wealth disparity, and some of the worst health outcomes among developed countries.
Despite the expansion of healthcare coverage in the last decade, one in 10 Americans still lacks health insurance, a burden that falls disproportionately on communities of color. People without health insurance are less likely to have a primary care provider and be able to afford the health care services and the medications they need. Perhaps most troubling, people who identify with racial and ethnic minority groups are less likely to receive routine medical care as well as medical interventions for a broad range of conditions, even after taking a patient’s disease severity into account.
Expanding access to high-quality healthcare and delivering it in a way that addresses systemic barriers to healthcare delivery is critical to making large-scale gains—having a positive impact on communities and the economy.
Building on contributions of 30 health equity experts published in An Action Guide to Disrupt Inequitable Health Outcomes, here we offer distilled actions and resources for those delivering healthcare in hospitals, clinics, or other healthcare facilities who wish to close gaps in care.
Promoting Patient-Centric, Culturally Humble Care
Healthcare disparities are often exacerbated by biases established in the healthcare system itself. Addressing these issues requires not only acknowledging their existence, but actively working to disrupt them.
Healthcare providers and facilities can take concrete steps to address inequities by utilizing a patient-centered, value-based healthcare approach that centers on individuals and ensures that the preferences, values and needs of those most impacted are considered. For example, this includes involving patients in decision-making, offering flexible scheduling options, and considering how their needs beyond the medical setting drive their care plans.
Cultural humility, or the ability to maintain a stance open to others in relation to aspects of cultural identity most important to the person, is also necessary to changing established disparities in the healthcare system. This concept complements cultural competency – the ability to understand and respond to the beliefs, values and needs of patients from diverse backgrounds.
By integrating both ideologies into healthcare provider trainings, healthcare providers will be able to better recognize that there is no one-size-fits-all approach and act accordingly by tailoring care plans.
Addressing Social Determinants of Health
Because most healthcare occurs outside of medical care, it is essential that healthcare facilities and delivery systems consider the social determinants of health when developing their care-model. Understanding how these factors impact individual lives is imperative to ensuring equitable access to high-quality care as well as the opportunity to adopt a healthy lifestyle.
Expanding telehealth, for example, can increase access to healthcare services for people who live in rural or remote areas, those who have mobility issues, lack transportation, or who have limited time off from work.
Looking beyond the clinic walls, health facilities and delivery systems can also prioritize the role of Community Health Workers (CHWs). As members of the communities themselves, CHWs recognize the impact of social factors on individual health and often connect patients not only to health information, but to a range of social services that can help expand access, such as facilitating transportation, expanding nutrition access, and providing digestible health education.
To aid in the development of CHWs, Morehouse School of Medicine has developed a CHW training program for high school students that serves as a pathway to healthcare related fields. The National Association of Community Health Workers has also developed The Six Pillars of Community Health Workers, which can help health advocates develop position papers for supportive policies.
The bottom-line is that social determinants of health are core drivers in disparate health outcomes. Strategies that address these factors need to be embedded into healthcare delivery approaches to ensure patients receive a high standard of care that reflects their unique needs.
Investing in People
In areas with pronounced health disparities, healthcare workers navigate a greater range of resource constraints and social stresses, which can lead to frustration over systemic barriers that prevent them from providing the level of care their patients deserve. This emotional exhaustion can compromise quality of care and result in higher job turnover rates, which again disproportionately impacts marginalized communities.
By investing in the well-being of healthcare professionals through team-based care, mindfulness training, and promoting work-life integration at early stages of healthcare providers’ careers, we can equip those at the forefront of patient care with useful tools to avoid burnout.
Looking Ahead
Health equity in health facilities can help improve overall health outcomes and reduce health disparities. While these resources and the many others included our community-developed Action Guide do not encompass all aspects of what is needed to advance health equity, we hope they offer practical tools to help us move closer to a future where healthcare systems serve the needs of all patients.
This post highlights a key driver for advancing health equity as outlined in An Action Guide to Disrupt Inequitable Health Outcomes, published by the Pfizer Multicultural Health Equity Collective and its partners. Learn more at Pfizer.com/TheCollective
