Healthcare equity: What can doctors do?

Although COVID-19 and other current events have shined a light on healthcare disparities, this issue is nothing new. Major recognition in the United States started about 20 years ago with Surgeon General reports documenting inequities in tobacco exposure and mental-health care among minorities. And yet, two decades later, many disparities have either persisted or worsened for people of color, LGBTQ populations, and other minority groups compared with White populations.

“[N]arrowing health disparities is key to improving our nation’s overall health and reducing unnecessary healthcare costs,” wrote the authors of a Kaiser Family Foundation (KFF) brief that discusses healthcare disparities, how COVID-19 has affected them, and current federal efforts to advance health equity.    

The issue is also a top concern for the AMA, which wrote “Recent studies have shown that despite the improvements in the overall health of the country, racial and ethnic minorities experience a lower quality of health care—they are less likely to receive routine medical care and face higher rates of morbidity and mortality than nonminorities.”

With systemic solutions lacking thus far, the AMA is encouraging doctors to examine their own practices to ensure equality in medical care.  

Let’s take a closer look at healthcare disparities and what can be done.

Defining healthcare disparities

The term healthcare disparities refers to differences in health and healthcare secondary to broader inequities that are experienced between groups. 

The CDC defines the term as follows: “Health disparities are preventable differences in the burden of disease, injury, violence, or in opportunities to achieve optimal health experienced by socially disadvantaged racial, ethnic, and other population groups, and communities.”

On the other hand, the term health equity refers to individuals attaining their peak health via elimination of disparities in health and healthcare. To attain health equity, everyone must be valued equally, with social effort focusing on countering avoidable inequalities, historical and contemporary injustices, and healthcare disparities. 

According to KFF, “[S]tudies suggest that health behaviors and social and economic factors, often referred to as social determinants of health, are the primary drivers of health outcomes and that social and economic factors shape individuals’ health behaviors. Moreover, racism negatively affects mental and physical health both directly and by creating inequities across the social determinants of health.”

Although race first comes to mind when considering healthcare disparities, various demographics experience them. These disenfranchised populations represent differing age, language, gender, socioeconomic status, geography, language, disability status, citizenship status, and sexual identity and orientation. 

Examples of healthcare disparities include people of color experiencing worsened rates of infant mortality, pregnancy-related deaths, prevalence of chronic disease, and physical/mental health as compared with these measures in White populations. Disconcertingly as of 2018, Black people exhibited a life expectancy of 4 years less than did White people. Click here to read more about how racial bias affects patients’ lives and doctors' careers. 

Outside of race, another prominent example of healthcare disparities involves low-income people exhibiting worse health status than the rich, and LGBTQ people experiencing various health challenges.

Big-picture efforts to achieve health equity

The mission of the AMA “is to achieve health equity by mitigating disparity factors in the patient population.”

On a societal level, the AMA has developed evidence-based chronic disease programs that proffer toolkits that help quantify healthcare disparities in ambulatory care centers nationwide. Based on this data, resources are then allocated as needed. Another way that the AMA is addressing healthcare disparities involves changing admissions at medical schools to ensure a diverse workforce, and changing curricula to reflect concerns about healthcare inequity. The AMA also funds programs geared at public health prevention.

With respect to research, the AMA examines how diabetes, high blood pressure, and other chronic health conditions disproportionately impact minorities. The AMA is also looking into juvenile justice measures that facilitate healthcare disparities, as well as the “school-to-jail-to-prison pipeline” which disproportionately affects racial minorities.

What can you do?

As a compassionate and community-minded physician, there are steps you can take to help contribute to equitable healthcare and reduce healthcare disparities. Although geared toward a family physician audience, the American Association of Family Physicians (AAFP) provides useful guidance in the form, The EveryONE Project, which is part of the AAFP's Center for Diversity and Health Equity. This resource offers education to help advocate for health equity, which can be of use to all physicians,

First, the Association encourages physicians to recommend a career in medicine to students in disadvantaged communities. Second, the Association encourages physicians to advocate for policies addressing health inequity at local, state, and federal levels. Third, they encourage physicians to engage the community and pursue opportunities to enhance public health and health equity. Lastly, they encourage physicians to further educate themselves about health inequity and associated social determinants.

Read more about other determinants of health at MDLinx.