Achieving Health Equity for All:
A Solutions Roundtable
May 21, 2021
By Bloomberg Live
Long-standing health inequities were both exacerbated and exposed during the Covid-19 pandemic. The disproportionate health impact on people of color cannot not be ignored. Neither can the lack of access to care, biases that exist in health care, or the role of one’s environment and its effect on health. Improving health and well-being for everyone is both a moral and economic imperative. Stakeholders must innovate and collaborate to close the gaps.
The pandemic coupled with the ongoing reckoning on race and racism forced by the killing of George Floyd and other Black Americans have encouraged overdue conversations on systemic racism and bias throughout society. The health care industry is not immune and can also play a huge role in addressing health equity.
This virtual roundtable convened leaders from health care and life sciences businesses, government, philanthropy and academia to share strategies for improving health equity and actionable steps being deployed today.
Kulleni Gebreyes, MD, Director of the Deloitte Health Equity Institute and US Consulting LSHC Health Care Sector Leader, Deloitte Consulting LLP
Aletha Maybank, MD, MPH, Senior Vice President and Chief Equity Officer, American Medical Association
Julie Morita, MD, Executive Vice President, Robert Wood Johnson Foundation
Kyu Rhee, MD, MPP, Senior Vice President and Chief Medical Officer, Aetna
Sally Saba, MD, MBA, Chief Inclusion and Diversity Officer, Medtronic
Pat Schou, Executive Director, Illinois Critical Access Hospital Network
Kevin Sowers, MSN, RN, FAAN, President, Johns Hopkins Health System and Executive Vice President, Johns Hopkins Medicine
Bobby Watts, CEO, National Health Care for the Homeless Council; Member, Biden Covid-19 Task Force
Moderator: Duane Wright, Senior Research Analyst, Health Care, Bloomberg Intelligence.
Click here to view the video of the full discussion.
Here’s what they had to say: Participants shared the challenges and opportunities of achieving health equity for everyone. Lack of trust, access and technology remain key barriers. The economic consequences are substantial. Kulleni Gebreyes, MD, Director of the Deloitte Health Equity Institute and US Consulting LSHC Health Care Sector Leader, Deloitte Consulting LLP put a number on the toll that the trio of racism and bias and health inequity has had: $16 trillion of opportunity costs over the last 20 years. Citing the W.K. Kellogg Foundation, Gebreyes said over $135 billion of spending in healthcare could be reduced by closing the gap on healthcare disparities.
Role of Housing in Health
Bobby Watts, CEO, National Health Care for the Homeless Council discussed the role of housing status as a social determinant of health. “There is so much in where people live that affects their lives. And so much of that is driven by systems that have inequity baked into them,” he warned. However, housing status is rarely asked at the point of care. “How can you as a clinician be sure that the care plan that you’ve developed is appropriate if you don’t know the housing status of your patient. And the answer is you can’t,” he argued.
Partnering with the Community
The Covid-19 pandemic’s disproportionate impact on vulnerable and marginalized communities highlighted the importance of engaging with the communities you serve before a health crisis, according to Julie Morita, MD, Executive Vice President, Robert Wood Johnson Foundation. “And so when the pandemic struck, Chicago had these relationships ready and were able to mobilize these connections to do contact tracing, to do testing, to help with vaccine distribution to make sure that it was more equitable overall.” She warned engagement should be ramped up to ensure the community is part of the solution.
Kevin Sowers, MSN, RN, FAAN, President, Johns Hopkins Health System and Executive Vice President, Johns Hopkins Medicine discussed how data helped to identify communities with the greatest need during the pandemic. Leveraging zip code data of Baltimore, Maryland identified a significant Latinx population. Sowers said they partnered with a Catholic church to set up testing sites. Cultural awareness is also essential. A quarantine space was created to contain the spread of Covid-19. “We know from a cultural standpoint, that it’s not uncommon to have multiple generations living in one household,” he said.
During a crisis competition is an afterthought when care is prioritized. “We partnered with University of Maryland, our city and our state to develop public private relationships,” he explained.
The rural community is not a monolith. Challenges of delivering care in a rural community varies greatly if you are in Maine versus Alabama or Wisconsin, for example. Pat Schou, Executive Director, Illinois Critical Access Hospital Network discussed the loss of 136 small rural hospitals over the past decade. Transportation availability and geography play big roles. With 20 percent of the U.S. population living in rural areas, Schou weighed in on the importance of funding to care for vulnerable populations.
Reflecting the Community
It is of utmost importance that care providers reflect the communities they serve. Kyu Rhee, MD, MPP, Senior Vice President and Chief Medical Officer, Aetna emphasized the critical role of pharmacists and pharmacy techs during the pandemic. Having significant representation of nonwhite pharmacists and pharmacy techs makes a difference. “Making sure your workforce represents the people you serve, plays such an integral role in addressing issues like vaccine confidence, vaccine equity, vaccine hesitancy,” he added.
The medical community must also deal with its past in order to move forward in advancing health equity. Aletha Maybank, MD, MPH, Senior Vice President and Chief Equity Officer, American Medical Association said apologies have been issued for the historical exclusion of black physicians, but that is not enough. “We need to quantify and qualify what are the costs of that harm,” she asked.
She urges health care providers and institutions to do the self-reflective work. “We can’t do equity work on the outside of our organization if our own teams and staff don’t even understand how to define it,” Maybank argued.
Saba, MD, MBA, Chief Inclusion and Diversity Officer, Medtronic said her company had a wake up call and recognized social, political and economic issues are not left at the door. “They bring them in and companies are needing to work through them and have a voice and a purpose in delivering against societal change that is meaningful,” she cautioned. Companies must also amplify their impact via their supply chains yet supplier diversity if often forgotten. “Wealth and health are inextricably linked and economic impact creates jobs and therefore enables people to have better access to health,” Saba said.
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