Health equity has always been an issue, but COVID-19 and new attention on social injustices have brought these disparities new attention.
The Biden Administration has promised to protect and expand Americans’ access to quality, affordable healthcare, and has made it a priority to tackle the issue head on. The Administration recognized that promoting health equity is essentially achieved by addressing structural problems such as laws and policies that perpetuate health injustice. In March, the National Institutes of Health launched an initiative to address structural racism in biomedical research, and in April the Centers for Disease Control and Prevention said it would lead an effort to confront the systems and policies that have resulted in the generational injustice that has given rise to racial and ethnic health inequities.
But the government isn’t the only one addressing health disparities. Healthcare providers and insurance companies are also focusing on promoting health equity. Here’s why.
What is health equity?
Health equity is the “absence of unfair, avoidable, or remediable differences in health among groups of people, whether those groups are defined socially, economically, demographically, or geographically or by other dimensions of inequalities such as sex gender, ethnicity, disability, or sexual orientation,” according to the World Health Organization’s definition.
Instances of health inequities are everywhere. For example, Black women are at least three times more likely than white women to die as a result of a pregnancy, and in states like Illinois, their risk is six times greaters. Lesbian women have an increase risk of breast cancer.
The way the pandemic has affected minorities more heavily is also telling of such discrepancies in the ways health is provided to different groups. Native Americans, Black, and Latinx people in the U.S. had about three times the hospitalization rate and twice the death rate of white people as of November, according to data from the CDC.
Why does health equity matter?
As the Kaiser Family Foundation noted in a paper published in May, “addressing disparities in health and health care is important not only from a social justice and equity standpoint, but also for improving the nation’s overall health and economic prosperity.” Health disparities are costly: The U.S. economy could be $8 trillion larger by 2025 if the country eliminated all racial disparities in health, education, incarceration and employment, which would be equivalent to a continuous 0.5% GDP boost per year, according to a 2018 report by the W.K. Kellogg Foundation and Altarum. The elimination of health inequities would reduce medical care costs and increase U.S. productivity.
How can the industry help?
The American Medical Association in partnership with the Association of American Medical Colleges (AMA) Center for Health Justice recently published a guide on health equity for healthcare professionals, encouraging them to address upstream social causes of health inequities and to avoid stigmatization of patients. The guide helps doctors understand and recognize that discrimination, structural racism, access to care, and poverty contribute heavily to health inequities.
According to the AMA guide, promoting health equity means recognizing social injustice and understanding how marginalized people and minorities are unfairly disadvantaged when it comes to health services. The way physicians and health insurance companies interact with these groups is often at the root of health inequities and changes promoting health equity must come from healthcare providers (and insurance providers, but more on that shortly). In particular, the guide suggests health equity language that doctors can use and explains why the narrative they use is essential to promote health equity.
The American Academy of Family Physicians for its part considers that family physicians can promote health equity by considering the balance of social determinants that impact the health of an individual, family, community, population and environment. Mitigating health disparities can happen by collaborating with governments, businesses, educational systems and health and social service providers.
Health insurance companies have also rallied to improve health equity. The National Association of Insurance Commissioners and the American Academy of Actuaries have created new committees on health equity. National associations including America’s Health Insurance Plans Blue Cross Blue Shield Association have also pledged to reduce disparities.
At the company level, several health insurance providers including Molina Healthcare have relied on philanthropy to address health equity, while chief health equity officers have become critical members of management teams. A year ago, Humana hired its inaugural chief health equity officer and other health insurance providers have followed suit.
Health insurance providers can promote health equity by focusing on prevention and wellness services. Just like doctors, they can also partner and engage with community leaders to understand the challenges that affect different groups and the best ways to address them.
A focus on health equity can promote social justice and economic growth, but it may also emerge as a panacea to reform the healthcare system by increasing prevention and avoiding costly healthcare-related expenses.
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