The U.S. Health Resources and Services Administration defines health equity as “the absence of disparities or avoidable differences among socioeconomic and demographic groups or geographical areas in health status and health outcomes such as disease, disability or mortality.” In other words, it’s the principle that health care should be equally available and accessible regardless of race, age, gender, locality or economic class.
Creating health equity among these disparate groups is a complex proposition, ranging from how medical students learn about differences between ethnic and socioeconomic patient populations to addressing payment models that are barriers to medical care.
“The health care system is just yet another example of how racism operates, specifically in this country, but even generally,” says Keon Gilbert, co-founder of the Institute for Healing Justice and Equity at Saint Louis University. “You could look at any system, any set of institutions, and see the same patterns and also link them to the broader social conditions or determinants that structure inopportunity for people to access not only health care but also education, etc.”
He adds that once people gain access, they often face challenges in actually receiving and navigating services.
Striving to help the metro area attain a higher level of health equity, both SSM Health and Mercy joined a Catholic Health Association of the United States initiative. Participating health systems pledge to work on “examining and changing hiring, promotion and retention practices to ensure diversity and inclusion; forming stronger partnerships with communities of color to improve health outcomes; and leveraging their united and powerful voice to advocate for policy changes that address the root causes of racism and social injustice,” according to the CHA.
Working toward achieving these goals, Mercy established a Physician Diversity Advancement Council, focused on “advancing culturally competent care and equity for all Mercy patients,” says Ursula Wright, vice president of clinical care redesign and optimization. “In addition, this council focuses on developing and attracting minority providers, with recognition that this contributes to cultural competency and equity in the care we deliver.”
Beyond the hospital walls, “listening and responding to the needs of the community, with particular attention to persons who are economically poor or underserved, is part of our faith-based heritage,” explains Takisha Lovelace, executive director of Mercy’s community health operations. Mercy community health workers identify patients with unstable social circumstances and redirect them to a primary care provider, help locate community and financial assistance, and assist with social needs, such as utility assistance and food resources, she says.
These types of initiatives are a good start, but there is much to do in order to bring health equity to the region, Gilbert adds. “We know where the pockets and concentrations in our communities are where there are high rates of chronic diseases and other illnesses,” he says. “Our hospitals and health care systems, as well as other institutions, have to think about the investment into those communities to actually change and reverse the trends that we see and the social conditions where people are living and working.”
It’s a proposition Mercy was already working on, says Danielle McPherson, director of managed care contracting and payor relations. “The CHA initiative was already in line with Mercy’s core values,” she says. “Prior to the pledge, Mercy was committed to the work and will continue to commit to the work – because it’s the right thing to do.”
Saint Louis University Institute for Healing Justice and Equity, slu.edu/research/research-institute/big-ideas/institute-for-healing-justice-and-equity/index.php
Mercy, St. Louis, 615 S. New Ballas Road, St. Louis, 314-251-6000, mercy.net
SSM Health, ssmhealth.com/st-louis