For over a decade Bronx Health REACH has been working within underserved communities to eliminate health disparity. In that time, government agencies, hospitals, and health systems have become more willing to address health disparities and work toward solutions to achieve health equity. This partly stems from ethical obligation, but it also enhances performance and makes good financial sense. (Chronic diseases account for the largest health gap among ethnic and minority populations and are responsible for 75 cents of every dollar spent on health care in the U.S.) Even so, the Call to Action to Eliminate Health Care Disparities, issued by leading national health care organizations last week, is notable for its commitment in providing a foundation to accelerate efforts to achieve health equity.
Led by the American Hospital Association (AHA), the “Call to Action” brought together five major health care organizations, including the American Association of Medical Colleges (AAMC) and the National Association of Public Hospitals and Health Systems, to focus their efforts on eliminating health disparity. “We’re in a new era of health care,” says Dr. Maulik Joshi, senior vice president of the AHA. “Collaboration is a key part of the process.” The group will focus on three building blocks: increasing the collection and use of race, ethnicity and language data; increasing cultural competency training for all staff; and increasing diversity in leadership and governance. The organizations will pool resources and tools and have created a website (www.equityofcare.org) as a portal for information on how to implement these initiatives within hospitals.
A main impetus for joining this effort, says Dr. Marc Nivet, chief diversity officer at the AAMC, was the recognition that medical schools and teaching hospitals need to do a better job in communicating the importance of health disparity. “We’re creating future physicians and we’ve known for a long time that we’re not providing a workforce that is culturally competent,” says Dr. Nivet. “We need to have the concept and understanding of health disparity woven into the curriculum.” Collecting and sharing data is also a key component so that people understand the issues and better policy can be made. The goal, says Dr. Joshi of the AHA, is not just systematic data collection, but a better understanding of the community and how the right data can be used achieve equity of care.
The importance of integrating the entire hospital structure with the community is also a key part of this effort. “Community organizations have been in the right place for decades in terms of trying to improve health by not just paying attention to health care, but paying attention to other social determinants of health,” says Dr. Nivet. “It’s important that all of that knowledge is transferred through shared learning between major medical institutions and community groups to figure out how we can all work together more closely going forward.” Dr. Joshi agrees, saying that hospitals are often role models in the community and collecting better data allows hospitals to know their communities in a more comprehensive way. “We need to move away from this mentality that we sit in the community to that we are part of this community,” concludes Dr. Nivet.
The chasm between public health and medicine is a frequent roadblock in collaboration between community groups and hospitals, but the “Call to Action” may be the crucial opportunity needed to bridge the gap. We applaud these health care organizations for taking a decisive step forward in outlining steps to achieve health equity and providing resources so that hospitals can implement better practices. As a community-based initiative, Bronx Health REACH looks forward to increased collaboration with hospitals and hopes that this effort galvanizes hospitals across the country to heed this Call to Action and become active in the national effort to eliminate racial and ethnic health disparities.