Only culture change brings lasting progress

We are now well into the new century but the health and health care inequities that became prevalent during the previous one are still firmly among us. ZIP code is more important than genetic code has become an axiom of our times. The global events of the past two years (the COVID-19 pandemic), and the social unrest rekindled by the murder of George Floyd, have exacerbated the wounds of a society that continues to struggle to live up to its own declaration of "life, liberty and the pursuit of happiness." The oft quoted words of Dr. Martin Luther King Jr. strike directly at the heart of our challenge: "Of all the forms of inequality, injustice in health is the most shocking and the most inhuman because it often results in physical death." There is no way to disguise the consequences of inequalities in health; those involved in health care stare at this reality on a daily basis.

In my many years of work in medical education, I was guided by two principles: first, diversity in the physician workforce is critical to address long-standing inequalities in access and outcomes of care, and secondly, achieving equity must be everyone’s job, not just a few with "equity" in their titles.

To address the first principle, we developed pipeline programs to encourage Black and Latinx youth to pursue careers in medicine and other health professions. We exposed them to the important role they could play in improving their community’s health status. With the second principle in mind, I taught all medical students about the social determinants of health, or SDOH, convinced that I would open their minds to things not explained by biology or genetics. I sincerely believe that students appreciated the importance of those factors until the reality of medical care showed them that SDOH are difficult to control from the confined, "elegant" space of clinical care.

There is significant research that shows that racial/ethnic equity in the health care workforce can, and does, support equity issues in the delivery of care. Individuals with different lived experiences bring an invaluable perspective not only to patient care, but also to research and administration. Their presence in the leadership ranks is a crucial first step to bring about lasting change. That said, those who understand the predicament of bringing the two worlds—health care institutions, and the communities they serve—to align and achieve benefit for both, know that leadership and its culture is key in making it happen. It takes only a quick scan of the landscape to know we are far from that alignment.

via Crain’s Chicago Business

December 17, 2021 at 08:38AM

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