Harnessing Current-State Diversity and Inclusion to Advance Health Equity
The pandemic has taken a toll on U.S. lives, but Black Americans and other Americans of color have been disproportionately affected. Nationally, Black Americans have died of COVID-19 at 1.4 times the rate of white Americans. Responding to health inequities, healthcare systems have taken steps to advance diversity, equity and inclusion (DEI) efforts across their organizations.
“A lot of organizations have brought in chief diversity officers to reset the conversation and the programming around diversity, equity and inclusion,” says Mardia Shands, Chief DEI Officer at Swedish. “But more than that, organizations are now starting to focus their efforts on health equity.”
A health system’s diversity and inclusion (D&I) initiatives have a distinct impact on patient health outcomes. Here’s how to leverage your current D&I program to advance health equity in your community.
Focusing on internal D&I builds a platform for equitable care. You have to provide the training and resources around prejudice and implicit bias to help clinicians and staff see your patients as whole people — not stereotypes that they treat based on assumptions. “D&I expertise needs to come in and break down those structural barriers that are created by bias,” Shands says.
Black women, for example, often don’t receive the pain medications or pain management resources they need because clinicians make assumptions about their pain tolerance. A recent study reveals that, compared with white patients, Black patients are 40% less likely to receive medication for acute pain. To achieve health equity, clinicians have to be more aware of the biases they bring to their practice.
Current institutional and environmental challenges must be taken into account. Understaffing and overcrowding have necessitated speed in patient care. Workers have to move fast to keep up, but doing so can affect health equity. “Unconscious bias comes out the most when you move fast,” says Deloria Nelson, President of Authentic Culture & Engagement Solutions. Interactions with patients have to be thoughtful and intentional to minimize bias.
Practicing intentionality helps clinicians account for their patient’s lives outside of the doctor’s office. “Rather than just writing the prescription and divorcing themselves of the person,” Shands says, “the physician or clinician has to first understand the whole person and everything that comes along with them to provide a treatment of care that's equitable.”
Equitable care accounts for social determinants of health, like access to transportation or housing. Medicaid and insurance companies are trending toward a managed care model, and healthcare systems need to prepare now by expanding cultural competence among clinicians.
The steps healthcare systems are taking now will foster an environment where questions and continuous learning are encouraged. Education on microaggressions can help individuals see the impact of their words and actions despite their intentions. “People spend so much time talking about what they intended that they haven't even considered the damage they’ve caused to their co-worker or the patient,” Nelson says.
Expand your outreach to the larger community by working with local nonprofits to provide care to marginalized populations. These groups also offer opportunities to get involved with local legislative decisions that affect patients in the community.
The events of 2020 reminded us how interconnected internal D&I is with health equity. We have to commit to maintaining our momentum by becoming an ally to marginalized communities. “‘Ally’ is an action word,” Nelson says. Take action now to minimize bias and microaggressions, and support more equitable patient care in the future.