HJAR Sep/Oct 2020

HEALTHCARE JOURNAL OF ARKANSAS I  SEP / OCT 2020 53 LaShannon Spencer Chief Executive Officer Community Health Centers of Arkansas by any measure, been eradicated. Reduced in some respects, but not eliminated. It is difficult to effectuate systemic chang- es during this challenging time. Yet, we must do all we can to keep disparities fromwiden- ing, and look to address the root causes of existing health inequities. Health inequities often result in a lower quality of healthcare, and worse health outcomes for minorities, especially for minorities who are cancer patients. “As a health services researcher who spe- cializes in cancer disparities, health equity means understanding and/or reducing bar- riers that prevent a person from achieving his or her full health potential in cancer out- comes. Most times, minorities do not get the preventive care that is needed to address cancer before it gets worse because of lack of money, or simply being uninsured,”stated Dr. Michael Preston, assistant professor and assistant director of the Office of Health Eq- uity at Virginia Commonwealth University. The U.S. spends the most money per capita on healthcare compared to all other countries, but isn’t reaching its full potential to save lives. As healthcare leaders, we must be serious about developing a health equity interven- tion program to move beyond the written word into clinical practice. We must focus on ending social disparities, which refers to the unfavorable social, economic, or politi- cal conditions that some groups of people systemically experience based on their rela- tive position in social hierarchies. Social dis- advantage is based on an individual’s wealth, income, education, and professional ranking. We must develop a better measuring stick than the Federal Poverty Level. I have of- ten expressed my concerns about the FPL because of geographical variances across the United States. Health equity is an eco- nomic issue, as well as a social justice issue. Significant inequities and disparities exist between different racial/ethnic groups, socioeconomic classes, and geographical locations. Critical conversations are need- ed to eliminate the disparities in our com- munities in terms of the care that’s being delivered. We must be mindful that, as the population of the United States becomes more diverse—in particular, the increasing number of Hispanics—we must incorporate a focus on diversity in all aspects of health- care, whichmeans having a diverse group of voices with the authority to make decisions. Different perspectives boost innovation and broaden understanding of complex issues. We also should utilize proven evidence- based approaches to assist with creating our roadmap to health equity. The Robert Wood Johnson Foundation has created an impressive and compre- hensive guide for healthcare practitioners to follow to help eliminate health dispari- ties, and address health inequities. The six- step framework considers several factors, and helps integrate the process among all healthcare quality improvement efforts. Its goal is to support a thoughtful and compre- hensive approach to achieving health equity. Dr. Knitasha Washington, president and chief executive officer of ATW Health So- lutions based in Chicago, believes public health advocates must change focus from the individuals to the bigger picture of how social determinants of health impact the health of multiple populations. “We must create ways to methodically examine the healthcare system workflow process and systematic barriers,” she says. Here are some examples of how we can improve health equity: 1. Examine the data. Apply data to long- term strategies. 2. Incorporate the patients and commu- nity voice . Listen and learn to get at the root of the problem. 3. Embed health equity in quality im- provement initiatives. Public health improvements cannot be made with- out using data on race, ethnicity, and language data (REAL) data. 4. Track performance improvement. Pilot programs could be used to test results for possible further uses. There is a critical need for a multifacet- ed plan of action to increase health equity. This plan needs to incorporate the support of policymakers and payors by assisting with the development of incentives to ad- dress disparities and generate awareness. Ultimately, the challenge lies in developing strategies that would eliminate disparities and the complicated and often time-con- suming process of persuading healthcare organizations across the country to adopt these strategies. InArkansas, we have the ripe opportunity to develop equity-centered care for all resi- dents. But doing so will require us to harness data that clarifies who in our state has the highest unmet need. State Senator Keith In- gram is leading the effort by commissioning a group of healthcare leaders and practitio- ners to study and publish a report on health disparities inArkansas. The report will help enable policymakers to design policies to reduce inequities, and evaluate how public health issues affect vulnerable populations, people who reside in rural communities, and members of minority races. Working for social, economic, and health equity means a healthier Arkansas. In the coming months, residents in central Arkan- sas will see how Community Health Cen- ters of Arkansas will address health equity. This solution includes multiple stakeholders and, most importantly, communitymembers’ voices, andmost importantly, the patients. n