Why has it taken so long for health care organizations to focus on health equity initiatives?
I had the privilege to present at American Hospital Association’s Health Equity Conference. I was joined by my friends and colleagues Jane Carmody, Senior Program Officer at the John A. Hartford Foundation and Ashley Atkins, Director of US Corporate Responsibility at Novartis. Our session was centered around advancing health equity by leveraging philanthropy and partnerships. The dialogue was rich….but one question remains with me. A gentleman stood up and asked the question, “Can you tell me why it has taken so long for (health care organizations) to recognize there was a problem?”
I don’t know if he had asked this question in other sessions, but you could tell from his voice and see it in his eyes, he needed to ask this question and he needed a response. He deserved to be heard, and he deserved a response. How would YOU answer this question?
It has taken a long time for us to focus on health equity, advancing health for all...
Hospitals and other organizations are focusing on health inequities in their communities by establishing partnerships with other organizations and engaging more community members that are unhoused; face environmental disparities and lack access to basic health, food and transportation. As we engage with community partners and community members, we, as health care organizations, must be prepared to answer this exact question with the acknowledgement that health care has had historical faults serving its patients and community. While hospitals have been delivering health care to communities, most have fallen short to meet the audacious needs that are present outside of the hospital walls. There have been historical system disparities and clinical biases that have exasperated the issues. Our responses need to be authentic, thoughtful and not defensive. While the overall blame is much larger than one organization or community, for individuals who face these challenges and the solutions to address them are local. There are many “excuses” we could use—historical political and system constraints, financial model of health care, limited funding, lack of true understanding of the problem and more. No matter the excuse, each excuse will fall short to satisfy those who have personally experienced inequities. I believe it is more important to absorb the question, answers and solutions that come up with another “excuse.” If we want to engage individuals with lived experiences and if we truly want to make a difference, we need to first listen, truly and actively listen to those who have experienced these health equity and access challenges firsthand. We must take accountability for our parts of these problems and, first and foremost (after listening), seek to build trust. We must understand that we are here to serve our communities and it is our responsibility to have community members trust us. We must understand and appreciate that we are asking the same individuals to trust us who continue to experience the inequities of health care. We must earn that trust through our words and more importantly, through our actions.
Suggested Actions and Takeaways:
Take time to authentically (and humbly) listen.
Recognize the historical system, racial disparities.
Do the hard work to build trust and develop relationships.
Back up your talk with action.
Realize that it will take time.
Allow the community to help create a healthier tomorrow.
Building relationships and ultimately advancing health equity can happen only at the speed of trust, and that begins with listening.
About the Author: Amy Dorrill, FAHP, is the Community Health Equity Lead and Principal Consultant with Accordant. She can be reached at Amy@AccordantHealth.com.