Healthcare Equity And Inequity

Health equity remains a very hot topic these days, both here in the U.S. and globally. According to the National Academy of Medicine, health equity means “providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status.”

While there’s certainly been a lot of talk about equity in healthcare, we’ve got quite a way to go to achieve fully equitable systems that address the needs of both patients and providers. This podcast episode of Becoming Inclusive digs into the many factors that need to be considered to get there.  Co-hosts Kat and Reggie were joined by Kaleidoscope Group Healthcare Consultant Fariha Siddiquie who offered an in-depth perspective on how we can transform systems to better accommodate the needs of diverse populations in an equitable and inclusive way. 

Social Determinants of Health Equity

According to Fariha, whose parents immigrated to the U.S. from Pakistan when she was a child, there are “social determinants” that we need to consider when we talk about health equity, including, but not limited to, geography and region, race, and ethnicity, socio-economic status, environmental conditions, and even things like citizenship status in certain countries. These variables all need to be addressed if we’re really going to improve care and re-imagine our delivery systems in a more accessible, inclusive, and equitable way. 

Reggie talked about how his family when he was growing up—which included seven siblings—and how they had to rely primarily on emergency rooms for care since they lacked insurance. His family was not alone. A study by the Kaiser Family Foundation looked at trends in uninsured rates by race and ethnicity over a nine-year period, from 2010—2019, which concluded that before the passage of ACA in the US, racial minorities were more likely to be uninsured than their White counterparts. And there are multiple reasons for that disparity, including things like wage disparities that unfortunately still exist. Since the Affordable Care Act passed, we’ve seen a surge in the number of people from under-represented groups who have since gained coverage and greater access to healthcare. 

Patients First, But What About Providers

It’s true that patient-centered care is at the forefront of modern medicine, or at least it should be. But too often we forget the needs of healthcare providers, including doctors, nurses, social workers, and other allied health workers. The role they play is critical to establishing more equitable healthcare systems. Of course, it’s important that medical and care teams are diverse so they can better understand and relate to their patients, but it’s also important for them to demonstrate empathy with patients. That’s harder to do when you have a more homogenous care team that cannot relate to our lived experience. But that cuts two ways, it’s also important for patients to have empathy for providers; especially in this post-pandemic era. 

Recent studies confirm that burnout among healthcare providers is a real threat to our system here in the U.S. and abroad. One study indicated one in five (1/5th) physicians plan to exit the profession within two years, presenting an added challenge to an already stretched system here. 

How We Get To Equitable Healthcare

Truth be told, there’s no easy or one size fits all solution to the challenge of creating more equitable healthcare. It’s going to take a lot of time, a lot of work, and a great deal of change before we arrive at a more responsive system of healthcare delivery and care that addresses the needs of everyone—regardless of their background, economic status, gender or race. 

And the work has to be done on multiple levels, not just within the healthcare industry—but at every level of society. That includes patients, educators, and policymakers as well. The question is, are we up to the challenge? And based on the conclusions of the hosts and guests in this edition of our podcast, we know where we need to go, but how fast can we get there depends on how seriously we take it. 

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