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What We’re Doing to Fix Systemic Inequities in Healthcare

As the nation calls for change to dismantle systemic racial injustice, all healthcare providers, ourselves included, must do more to create long-term change.

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George Floyd’s killing has pushed our country to a long overdue tipping point. Across the nation conversations about systemic racial injustice – that for too long were stigmatized and sidelined – are taking their rightful place at the forefront of public discourse.

The realities of racism and injustice have been the lived experience of Black Americans for far too long. To make lasting change we must shine a spotlight on inequities in all facets of society, including healthcare.

Disparities in health outcomes and life expectancy based on race are one of the greatest and most persistent challenges in U.S. healthcare today – a reality laid bare recently with sobering statistics demonstrating the disproportionate impact of the ongoing COVID-19 pandemic for Black people and other people of color. Our own recently published study of COVID-19 patients at Sutter Health found Black Americans were hospitalized at nearly three times the rate of their non-Hispanic white counterparts, and that they access care when they are sicker and more likely to require hospitalization and ICU care. 

These findings – and the zip codes determined to be at greatest risk – correlate with a study we conducted in 2017 after observing higher emergency department usage among Black patients with asthma. We discovered that 72% of patients drove up to 8 miles to a hospital to access care, even though they lived within 1 mile of a clinic because of concerns with culturally competent care. With this insight, we developed community-based programs that have connected nearly 600 Black patients suffering from asthma attacks with a respiratory therapist so they could participate in an asthma control program. As a result, very few have returned to the emergency room.

Not only can this serve as a model for trusted outreach, education and treatment in a public health crisis like COVID-19, it underscores the need for health providers to invest in robust data generation and analysis to identify specific health disparities and what’s driving them. Only then can we truly hold ourselves accountable to eliminate these gaps, and it is the only way to affect the kind of change our patients need and deserve.

As a Northern California integrated healthcare network that serves more than 3.5 million patients in one of the most diverse regions in the country, we are working to understand the unique differences and needs of our patients so that we can develop targeted interventions specifically tailored to address them. We think every provider should do the same. It is why we are widely sharing a novel metric developed by our Advancing Health Equity team called the Health Equity Index, or HEI. The index uses analytics and dynamic applications of clinical and population data to measure a variety of health outcomes among different patient populations to identify potential disparities.

Racial disparities in healthcare are undeniable. As health care providers, we have a unique role and responsibility in addressing and dismantling systemic racism, and it begins with eliminating health disparities for our patients. Health equity is a measurement of care quality and we must hold ourselves accountable to achieve it.

Looking for solutions is not new to us, but as much as we have made it a priority, we have not done enough. None of us have. As the nation calls for change to dismantle the systemic racial injustice that has led to the unnecessary deaths of countless Black Americans, all healthcare providers, ourselves included, must do more to address the shameful inequities that exist in our healthcare systems. To the extent we are able to make a difference, we have a moral obligation to do so.

Originally published in CalMatters.

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