3 Questions to Ask While Fighting Healthcare Inequities
- May 4, 2021
At the end of 2020, Coker did what most of America did this year—we took stock of how much had changed this year. We asked questions like,
What had changed our organization and our employees?
What had changed our communities?
What had changed our clients?
In reality, the question we should have been asking was—what hadn’t changed? Our clients were facing entirely new challenges and patient concerns, and many strategic plans from 2019 seemed laughable in the face of everything that had occurred in the past nine months.
One item in particular that came to the forefront of discussions was the spotlight on health disparities in our communities. While the problem is not new, COVID-19 made it glaringly problematic and shed light on the situation. Further, coupled with the racial issues and divides that our country faced in 2020, organizations finally were coming to terms with their roles in this issue and were eager to respond.
Now, we pose the question:
How can your organization play a role in bettering your community from the ground up?
What Are Health Disparities?
Health and healthcare disparities refer to the systemic inequities in healthcare delivery closely tied to socioeconomic, race/ethnicity, gender, age, environmental/geographical, disability, and sexual orientation factors. Specific social determinants of health create these divides and contribute to the vast differences in healthcare, including, but not limited to, access to care, quality of care, availability of resources, access to education, social norms and support, language barriers and literacy, and health patterns in communities.
Thus, we see communities with vastly different opportunities to receive healthcare and manage health conditions, creating the potential to build upon comorbidities and exacerbate these issues. When we consider population health initiatives, this becomes critical as we have to consider these subsets of our society independently as we try to address community-wide health.
Further, these issues create complex health issues that result in additional, unnecessary costs that adversely impact those populations. Studies estimate that disparities amount to approximately $93B in excess medical care costs and $42B in lost productivity per year. The studies project that people of color will account for over half of the population (~52%) by 2050. As our population becomes more diverse, this will only increase our awareness of these issues and the associated economic impact.
As previously stated, this is not a new problem. Instead, this has been a historical issue in our nation that is just getting the adequate attention it deserves. COVID-19 brought these discussions to national attention, showing how ignoring health inequities can have a significant impact.
Early on, physicians and infectious disease experts saw that COVID-19 disproportionately impacted ethnic and racial minorities, now a proven theory. Counties that reported an above-average proportion of Black residents (13% or more) had an infection rate 1.4 times higher than the national average and a mortality rate that is 1.2 times higher. Meanwhile, counties with above-average proportions of Hispanic residents (18% or more) had 14% higher COVID-19 case rates.
Many of the social determinants of health indicated above influenced these cases, with risk factors including health care system discrimination, underlying comorbidities, higher uninsured rates, higher rates of employment in essential work settings with minimal or no paid sick days, increased likelihood of reliance on public transit, and crowded housing situations.
Again, all of these issues existed pre-COVID; however, communities were confronted with the severe implications of the concentrated nature of the virus.
What Do We Do?
Many of these issues feel overwhelming in their complexity because a single policy or initiative cannot address the problems. They inherently involve the most basic of our community structures. With that said, healthcare organizations have a unique opportunity to begin making real change. Thus, as you start developing your strategic plans (or revisiting plans developed pre-2020), it is important to ask some specific questions:
This is an uphill battle with levels of complexities. Still, it is critical to our nation’s health to begin addressing these as part of our dedication and commitment to the populations our healthcare organizations serve. Thus, we encourage thoughtful consideration of these questions and honest communication about how you can begin driving change in your community.