How to achieve health equity on a population scale
While U.S. health systems strive to offer quality care, systemic inequities perpetuate challenges that cannot be ignored. During a Nov. 2 webinar, four expert panelists — Tomi Ogundimu, Vice President of Research and Education at The Health Management Academy; Dr. Ann-Gel S. Palermo, Chief Diversity, Equity and Inclusion Officer in Education and Research for the Office for Diversity & Inclusion at Mount Sinai Health System; Dr. Tshaka Cunningham, Co-founder and Chief Scientific Officer of Polaris Genomics and Executive Director of Faith-based Genetic Research Institute; and Emily Richmond, Strategic Advisor for Helix — discussed possible solutions for tackling health inequities, including how population genomics could help support more equitable community health.
1 Health equity means ensuring everyone benefits
Representation is critically lacking in research, science and other areas of medicine, causing certain communities to be excluded from the benefits of innovation. However, with the rise of population genomics, there is significant potential to actually achieve system-wide goals of improving diversity, equity and inclusion. By improving representation in research and genomics, healthcare can effectively serve the broader population with preventative healthcare learnings.
2 Inaction is not an option
For health systems, the consequences of failing to address research inequities include furthering discrepant mortality rates, higher costs from increased rates of avoidable readmissions, and missed revenue because staff are too overwhelmed to accommodate patient volumes. Therefore, health systems must advocate for conducting research and collecting data in ways that are much more representative of the entire population.
3 Acknowledging history is a starting point
Healthcare’s first challenge regarding health equity is grasping the legacy of scientific racism. While disparities were further illuminated by the pandemic, racism has long been deeply embedded in research norms and practices. The ideas of racial superiority and inferiority have manifested in metrics, tools, methods of study design and more. Ultimately, these systemic issues contribute to premature illness and death among diverse communities.
Health systems can begin to advance health equity by auditing their own representation gaps, calling out inequities for what they are, and investigating ways in which they might be perpetuated, intentionally or unintentionally. Once gaps are identified, goals for improvement should be identified and clearly measured for optimization, progress and accountability.
4 Leadership must help drive change
To elevate health equity, it’s important to appoint leaders at the board and C-suite levels who will be held accountable for progress. These leaders need to be willing to embrace disruption but also prepared for the emotional nature of conversations about racism and bias in the scientific learning community. While difficult, these conversations are necessary to build trust in communities that have been harmed in the past. Beyond active leadership advocacy, ongoing progress will require organizations to have clear short and long-term goals, a designated budget, and dedicated resources and staff.
5 Health systems must actively engage communities
It is vital to include diverse communities in all levels of research by authentically providing relevant opportunities through targeted community outreach that meets people where they are, leveraging community organizations and leaders that they trust. Rather than expecting historically marginalized communities to participate, researchers and healthcare advocates must engage community
members in the conversation. With better understanding of which populations have historically been excluded from or fearful of genetic testing and why, healthcare providers and ambassadors can focus on personally communicating the benefits of community health research programs and how they can not only impact each individual’s health, but also the future health of their family and generations to come.
Due to varying levels of health literacy, it is important that messaging remains simple and digestible. This could be supported by engaging a local community advisory board, or hiring external consultant groups with expertise in more customized messaging.
Ultimately, whether it be ongoing health initiatives or making genetic screening more accessible, nothing that impacts specific communities should be done without the involvement of the people within those communities. And conversely, health benefits that are offered to one community, should be offered to all communities.