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To make progress on health equity, leaders must ‘play the long game’


Pritesh Gandhi, chief community health officer of Walmart, says hospitals and healthcare organizations need to work on long-term solutions, which is admittedly difficult.

Hospitals and health systems must realize one important truth when it comes to making substantial progress on health equity, Pritesh Gandhi says.

“We have to play the long game,” says Gandhi, the chief community health officer of Walmart.

In a recent interview with Chief Healthcare Executive®, Gandhi shared some perspective on improving health equity. He also talked about what hospitals and healthcare organizations can do to improve the health of their communities

Gandhi concedes that making real progress on health equity is difficult, because he says there is “profound pressure” in focusing on more short-term goals.

“There are plenty of incentives to play the short game,” he says. “And we've got to take that logic and turn it on its head. The long game is a lot harder. And there is no instant gratification of playing the long game.” (See part of our discussion with Pritesh Gandhi in this video. The story continues below.)

He cites some of the challenges for health organizations, including hospitals who only have patients for a relatively short period or managed care organizations that lose members after a couple of years.

Gandhi has spent much of his career working to improve outcomes for disadvantaged groups. He worked for years at a Federally Qualified Health Center in Austin, Texas and more recently served as the chief medical officer of the U.S. Department of Homeland Security.

He joined Walmart in January and is hoping to help develop large-scale solutions to offer more access to care in underserved rural and urban communities.

At Walmart, Gandhi says he is particularly excited about the company’s program to hire community health workers. Walmart has opened dozens of health clinics, with more on the way, and the company has hired more than 40 community health workers.

“Our community health workers have an opportunity to think broadly around health,” Gandhi says. “Investing in community health worker programs is an example of playing the long game.”

More healthcare leaders are talking about the need to raise the quality of healthcare for all patients, and on one level, Gandhi says it’s good that there are more conversations about health equity. But he says there needs to be more action.

“I think there's a concern for folks that have been in this space, that we talk so much about these issues, but it's not clear that we're actually making progress on this front,” Gandhi says.

In terms of developing long-term solutions to improve a community’s health, he points to a redevelopment project in his own city of Austin. Community groups have spent years on a plan to transform a vacant Home Depot site in a historically African-American neighborhood. After much discussion, community groups worked with neighbors to develop a plan with affordable housing and a park.

“It is going to change the entire health outcome of that community,” Gandhi says. “But it took us years to do. And it took a comprehensive approach from health leaders, from community leaders, educational leaders, city leaders to get to that point. But it's going to make a difference …. in health for that community and for families and children.”

Gandhi says that the project will still take years before the community sees the true return on its investment, but he says healthcare leaders need to think about long-term commitments.

And that’s why he says playing the long game is “the most important advice I would give to my colleagues.”

Seeing a host of troubling health indicators nationwide, Gandhi says he’s fired up to work with Walmart to try to make a difference.

“We're looking at outcome measures in our country that are worsening over the past few years, whether it's life expectancy or maternal mortality,” Gandhi says. “We're looking at very stubborn rates of poverty and economic empowerment, and challenges that working families face across this country.”

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