Health equity: We still have a lot of work to do
A new report explores eight steps that should be taken by 2025 to improve health equity in the United States.
There is still much to be done in the area of health equity, a new report finds, despite some areas of progress.
The Status of Health Equity Report, released recently by the Root Cause Coalition, outlines ongoing health equity issues in the U.S., and recommends eight steps that should be taken by 2025.
The report examines a widely acknowledged flaw in the U.S. health system—that an American’s access to care, and the quality of that care, can be greatly dependent on where they live or their economic or racial status.
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“In its examination of the underlying socioeconomic factors that influence health and well-being, today’s report also reminds us of a very simple reality: where you live – what we call your ZIP Code DNA or ‘ZNA’ – matters,” says Randy Oostra, President and CEO of ProMedica and chair of The Root Cause Coalition Board. “As national health care costs continue to rise, we’ve outlined a bold Call to Action to improve our nation’s health care delivery model through addressing social determinants, engaging in community partnerships, and striving for greater cultural competency.”
Identifying the problems
The report surveyed front-line health providers: primary care physicians, nurse practitioners, and physician assistants, and asked them to identify top socioeconomic factors that influence health care outcomes.
The results showed that “Not enough time during an office visit,” “limited resources to provide help effectively,” and “community resources are not integrated with clinical resources to provide help effectively,” were the top answers.
From this data, the report concludes that health care equity will require a change in the way health care is delivered, as well as support for things like housing, transportation, and economic security.
“Primary care providers including physicians, nurse practitioners and physician assistants agree that there is a need to address health disparities, but they feel it will require increased access to resources and more effective integration of clinical and community resources for the primary care provider to feel their involvement will be productive,” the report said.
Eight strategies to reduce inequities
The report focused on eight key points to help reduce inequities in health care. These include:
1. Reform payment processes. The report called on payment reform that rewards providers and health systems for addressing inequities caused by social determinants of health.
2. Create a standardized integrated health benefits technology platform. This strategy calls for connecting patients, providers, payors, and community organizations through a technology platform that consolidates currently fragmented programs and services.
3. Increase health plans/systems that focus on health inequity. The report said there should be a 50 percent increase in the number of commercial health plans and health systems nationwide that embed social determinants of health, as well as health inequities goals, into their strategic plans, programs, and services.
4. Strengthen education and training of providers. This recommendation calls for creating a more robust system of educating and training providers about health equity, the role health care providers play, and how to effectively integrate that role into their current practice.
5. Establish a national target for healthcare expenditures. I.e., set a target percentage of the national GDP for health care spending.
6. Develop a plan to address health care deficits. The report calls for developing a comprehensive plan to address the nation’s deficits in infant mortality, mental health services, and substance abuse disorders.
7. Strengthen education at health care organizations and corporations. The report also calls for strengthening workplace education in the areas of racial equity and cultural competency.
8. Improve metrics for measuring outcomes. This step would establish clearer, standardized metrics for measuring health outcomes related to racial disparities and the social determinants of health.
“Factors such as the lack of low-cost housing, access to affordable, nutritious food and transportation, as well as isolation and economic instability, all hinder health and well-being along with economic mobility,” Oostra said. “The solution to creating a healthier society does not rest on the shoulders of one sector, but requires all sectors – business, social services, health care, government, education and more – to work collaboratively.”
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