In my hometown of Washington, D.C., an infant born in 2020 was expected to live around 75.3 years. However, if you cross over to Bethesda, Maryland, a wealthy suburb north of the city, life expectancy increases to around 88.3 years.
The journey from Bethesda to the Capitol is under 10 miles, but those fortunate enough to be born in the suburbs can expect to live an average of over ten years longer. The gap widens even further when comparing the life expectancies on the east and west sides of the city, with a potential difference of up to 30 years.
Understanding Health Equity
Washington, D.C. is not the only city facing this issue; Chicago, Buffalo, Baltimore, New York City, New Orleans, and Columbus, Ohio also have significant disparities in life expectancies between different neighborhoods. This trend can be seen in many other cities across the United States as well.
Life expectancy disparities are not limited to urban areas, but also exist in rural regions, particularly in the Deep South and Appalachia.
How can this be happening? And why are we letting it happen?
Social and political factors play a role in these inequalities, but further investigation is needed. People born in certain areas of the capital city and rural regions are more likely to experience issues like unstable housing, lack of food security, transportation challenges, and disparities in education and finances. Additionally, lower-income urban and rural areas often lack an adequate number of doctors, especially specialists, to meet the community’s needs.
Closing the health disparities divide will necessitate a change in the incentives within the existing healthcare financial system, which has frequently hindered access, favored certain individuals over others, and upheld biases. Our current system prioritizes managing diseases rather than preventing them, often providing financial incentives for treating illnesses rather than promoting health and wellness.
Three Tools for Addressing Health Equity
The current system is rooted in a history of racism, classism, and sexism, and it’s important to acknowledge that these biases still impact decision-making today. It’s crucial to address misleading political language, broaden communication platforms, and highlight the significance of private funding. It is imperative that healthcare providers, insurers, business executives, and government officials actively work together to reform the system at both a population-wide and individual level.
Is this task intimidating? Without a doubt, but it is crucial. Here are three resources that will aid us in this process.
Data
Many discussions surrounding population health and health equity emphasize the importance of utilizing data to make informed decisions. However, there is a lack of consensus on the best methods for measuring outcomes and impact in this field.
Using data to evaluate the results of different treatments, medications, and technologies is becoming more and more crucial for getting paid back and making investments. In my course at Kenan-Flagler Business School at the University of North Carolina, we talk about how using outcomes-based pricing and real-life evidence can influence what is created, utilized, and reimbursed. Knowing the outcomes of a product or service on a larger scale is essential for financial prosperity and the well-being of a society.
Implementing and Evaluating Interventions
Certainly, we must acknowledge the potential for bias in data, and therefore we should conduct a thorough review or audit of the data.
How does this appear in real-world situations? Ernst & Young Teamed up with a health data startup to gain a deeper understanding of chronic kidney disease (CKD), the study revealed that Black CKD patients often receive a diagnosis in the later stages of the disease due to irregular or delayed care. Ernst & Young suggested that this model could be used by healthcare companies to address obstacles faced by underserved patient populations and preventable chronic conditions. For life sciences companies, this data could lead to more equitable healthcare and enhance commercial success.
Communication and Respect
I will admit that doctors can sometimes be critical and struggle with effectively communicating with patients. Our training often focuses on quickly assessing information and making decisions. However, individuals from marginalized groups, such as people of color, those who did not complete high school or college, and women, may feel unfairly judged by their doctors.
If this occurs, they are less inclined to seek treatment from us.
Building a Movement for Health Equity
report, there has been a significant increase in unemployment rates due to the ongoing COVID-19 pandemic.Survey on Well-Being and Fundamental Needs Over 75% of adults who felt criticized by their healthcare providers said that it affected their ability to get medical care. This included 39% who postponed receiving care, 34.5% who searched for a new provider, 30.7% who did not receive necessary care at all, and 11.4% who did not adhere to their doctor’s instructions.
Tools like the CDC’s Guiding principles for inclusive communication in health equity. paragraph emphasizes the importance of using language that is inclusive and does not make assumptions about a person’s identity or background. This approach aims to create a more welcoming and understanding environment for patients of all backgrounds. Rural Health Information Hub advises providers to:
- Use person-first language
- Avoid using gender-specific terms
- Use plain language
- Do not use oversimplified beliefs or assumptions to describe people or groups.
- Be aware of words or phrases that assign a hierarchy or importance to individuals or groups.
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Private-Sector Partnerships
Increasing government initiatives such as Medicaid is clearly crucial for promoting health equity, as is a growing presence of private donations and funding.
private sector extends beyond just healthcare corporations, it also has the responsibility to contribute to the enhancement of public health. World Economic Forum The statement suggests that every organization has the ability to contribute to better health outcomes and increased life expectancy within their local areas by investing in healthcare initiatives. Harvard Business Review last year, options include:
- Leveraging human resources professionals to assist employees in gaining a clearer understanding of their healthcare plans and benefits, and to determine the most suitable option for their individual needs.
- Ensuring that employer-sponsored health plans cover expensive out-of-pocket costs that low-income families cannot afford, but have been shown to decrease health inequalities.
- Investing in non-traditional healthcare services such as nutrition programs that are not typically included in medical insurance coverage.
- Increasing access to primary care and mental health services through virtual platforms and collaborations with community organizations.
Achieving health equity is a difficult task that involves changing the way we structure and operate our healthcare system. It requires strong leadership to address the existing inequalities that can significantly impact someone’s lifespan based on where they live.
