Opportunities for Physicians to Promote Health Equity

The COVID-19 pandemic and a renewed focus on social justice have combined in recent years to bring health equity to the forefront of conversations about healthcare. Even though the biggest push may be on policy and societal changes, physicians and other frontline healthcare workers have important roles to play in promoting access to care and improving health outcomes for all patient populations.

What is health equity?

According to the World Health Organization, health inequities are systematic differences in the health status of different population groups. Evidence suggests these discrepancies can result from social factors related to employment status, education, income, gender and ethnicity.

Health equity, on the other hand, according to the Centers for Disease Control and Prevention (CDC), “is achieved when every person has the opportunity to attain their full health potential,” and no one faces health disadvantages due to socially determined circumstances.

How physicians can help combat health inequities

While healthcare providers alone cannot erase health inequities, they can make a significant impact in reducing them. To promote health equity, the CDC recommends healthcare organizations:

• facilitate access to chronic disease management;
• provide patient support in the form of reminders and self-care programs;
• increase vaccine availability and testing for populations that are disproportionately affected by COVID-19;
• partner with outside organizations to form relationships with local communities;
• provide culturally appropriate COVID-19-related services; and
• train employees to disrupt discrimination.

Physicians and healthcare organizations can also combat inequities by ensuring their facilities are compliant with ADA regulations. Established in 1990, these rules require healthcare facilities to provide reasonable accommodations for individuals with disabilities to promote access to care.

As described in a Patient Engagement HIT article by Sara Heath, one third of physicians admit they do not have a strong understanding of their ADA responsibilities—an issue that could perpetuate health inequities and disparities. The article also cites results from a survey revealing that an alarming 68.4% of physicians believed they were at risk for an ADA-related lawsuit due to poor accommodations. As healthcare organizations seek to make improvements in this area, Heath says that they should follow ADA recommendations, but also seek patient input.

The field of maternity care is another area where physicians can impact health disparities. The U.S. Department of Health & Human Services reports that two out of three pregnancy related deaths are considered preventable. In addition,

• “Each year in the U.S., approximately 700 women die from pregnancy-related complications, and over 25,000 experience severe complications of pregnancy.”
• “Black and American Indian/Alaska Native women die from pregnancy-related causes at a rate two to three times higher and experience severe complications at a rate nearly two times higher than their white, Asian Pacific Islander and Hispanic counterparts.”
• “Pregnant people who live in rural communities are at higher risk for severe maternal morbidity and about 60% more likely to die from pregnancy-related causes than those living in urban settings.”

To address this, CMS recommends that hospitals incorporate preventive strategies into their procedures and protocols. Incorporating “maternity safety bundles” (a structured group of three to five evidence-based practices) has been shown to improve results and narrow the racial disparity gap in certain outcomes.

MLMIC has several resources available that may help physicians in the larger effort to promote health equity, including guidance on communicating with patients with low health literacy and implementing patient-centered care. For further developments and support specifically related to COVID-19, please visit MLMIC’s dedicated resources page.