Moving health equity from goals to reality

Several experts discussed ways to close disparities among disadvantaged groups during a panel at the HLTH Conference. They stressed working with communities and measuring data to see if interventions are working.

Since the emergence of the COVID-19 pandemic, many healthcare leaders and experts have said the pandemic has vividly illustrated the inequities in health treatment and outcomes among disadvantaged groups.

Eboné Carrington, managing director of Manatt Health, said those disparities in healthcare among minority groups and those with lower incomes haven’t exactly been hidden. The fact that so many are genuinely surprised by health inequities indicates the conversation needs to move forward, she said.

“When no one is disadvantaged, then we’ll be on the way to health equity,” she said.

Carrington led a discussion on health equity with other healthcare leaders at a panel at the HLTH Conference in Las Vegas earlier this month. They talked about ways to close disparities in health outcomes.

Health systems need to think about the conditions of health and equity in the communities where their patients live, said Bechara Choucair, senior vice president and chief health officer of Kaiser Permanente.

Efforts to improve health equity must focus on the patient, Choucair said. Kaiser Permanente engaged in a text messaging campaign to gain a better understanding of the needs of its members. The organization eventually helped 100,000 people sign up for food assistance, Choucair said.

Kaiser Permanente has made some progress by “putting the patient’s voice at the center of the table,” Choucair said. That involves visiting individuals in their homes and asking them what they needed. It’s easy to sit in a conference room and try and come up with solutions, Choucair said, but organizations need to be reaching out and engaging with their communities for human-centered solutions.

Charlotte Owens, vice president and head of health equity and patient affairs at Takeda Pharmaceuticals, said she had experience with health equity long before that phrase had become widely known.

“Most of what makes us healthy is outside of the healthcare system,” she said. “It’s about your personal ecosystem.”

“If that environment Isn’t healthy, you don’t have a good chance of being healthy,” Owens said.

Healthcare organizations looking to improve health in their communities need to partner with organizations and leaders in those neighborhoods, she said.

“If the problem sits in the community, the solution probably lies there, too,” Owens said.

Taylor Justice is co-founder and president of Unite Us, a technology company that connects health and social services providers. He said it’s important to do more than track how many people are being referred to social services. Ultimately, providers need to be sure people are getting the care they need.

“Put referrals to bed. Referral is only halfway there. The focus needs to be on the outcome,” Justice said.

It’s critical to examine the data to be sure interventions are successful, and to see where efforts are falling short.

“If we want to measure success, we need to be able to look at the good data, the bad data, and look at those gaps,” he added.

Amaka Eneanya, head of strategy and operations for Fresenius Medical Care, is leading a team working to address inequities in kidney disease.

Race is often misused in healthcare, she said. It’s useful to track race in efforts such as vaccination, to make sure that Black or Latino neighborhoods are gaining access to vaccines, she said.

But race is often used improperly in clinical algorithms and screening tools, potentially delaying some patients from getting treatment, she said. Race modifiers in algorithms used to measure kidney function have delayed Black patients from obtaining proper treatment, according to the Coalition to End Racism in Clinical Algorithms.

“Stopping with just race is lazy in your clinical algorithm,” Eneanya said. “You need to go beyond that.”

Justice also said that offering services to help individuals who have food and housing needs is actually more cost effective than having to treat more complex health conditions down the road. “Those services are usually far less expensive than a clinical intervention,” Justice said.

Addressing health equity involves coordinated effort of healthcare organizations, social services and government agencies working together, panelists said. “Health equity is really about a whole of government approach,” Carrington said.

“This isn’t on one sector to solve all of the problems,” Justice said. “This is all of us coming together.”