What is Health Equity?

Premier Pulse     June 2024

1134192644By Andre Harris, MD, chief medical officer, Miami Valley Hospital

In the United States, health care has never been equal. This is a bold but true statement that should prompt us to examine how we contribute to this continuum of care. Many might say, "I provide the same care to everyone," yet our history does not support this claim.

America’s historical blemishes, such as the Tuskegee experiment, may seem like ancient history, yet I was two years old (1972) when this U.S. Health and Human Services (HHS)-sanctioned event ended. As recently as 1985, Secretary Heckler of the same HHS declared that everyone’s health in the U.S. was doing better except for minorities. In 2003, the Institute of Medicine published "Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare." Our literature is replete with examples of disparities in infant mortality rates, maternal morbidity and mortality, cardiac catheterization discrepancies, and even immunization rates. The point is not to chastise and shame but to bring awareness so that change can happen.

At its core, health equity works to level the playing field. The concept is not about socialized medicine where everyone receives an “equal” amount of care but one of “equity” where the appropriate amount of care is given based on individual circumstances. Visualize our level one trauma center with two patients from a car accident. The first patient has a broken femur and mild breathing issues. The second patient is unconscious and has a collapsed lung, several broken bones, and a liver laceration. The second patient does not need equal care as the first but the appropriate amount of care (equity) to get her well.

How can Premier Health excel in this area of health equity? There are five areas we need to tackle including care access, cultural competency, policy and advocacy, health disparities, and social determinants of health (SDOH).

We have taken initial steps to acknowledge, measure, and start to influence SDOH. This requires a partnership between Premier Health and the community, and I believe we are on our way. Care access continues to grow in our communities. West Dayton has the most opportunity within our network and should be our focus for the foreseeable future. Underrepresented minorities in medicine (URM) will be key to addressing these needs and providing care where gaps exist. URM providers can tackle health disparities from a unique vantage point. Providers living in the communities they serve add another layer of care. Our goal is health equity. The road there requires deliberate steps that will cause lasting change.

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