On this Juneteenth holiday, we have a great opportunity to reflect on what is needed to create more equity and diversity in our world. As we look to build an Institute that will accelerate the transition to value-based care, we must think about what role we can play in improving outcomes for all.
Population health research shows us that the American health care system is not immune to institutional racial discrimination. African-American patients tend to receive lower-quality health care, including treatments for cancer, HIV, prenatal care, diabetes, and preventive care. They are also less likely to receive treatment for cardiovascular disease, and they are more likely to have unnecessary limb amputations. African American men, in particular, have the worst health outcomes of any major demographic group in the country. Health disparities also affect African-American women leading to increased death rates from breast cancer, threefold risk of dying during pregnancy, and significantly greater chance of dying needlessly from preventable diseases. In this current pandemic, communities of color are also being hit disproportionately hard by COVID-19 due to inadequate access to testing in African-American neighborhoods. For those that are able to obtain tests and get treated, there is a much higher death rate among African-Americans revealing even further inequities. Research has been able to irrefutably show that if you control for all variables that may contribute to health disparities (e.g. education, income, access to health insurance), African-Americans still get the worst quality health care of any demographic in the country.
In our Accountable Care Atlas, we identified a specific competency to “understand the unique cultural characteristics of the population served to implement changes in the organization to provide high-value care”. This cultural competency failure is reinforced by research that shows that care for black patients is better when they see black doctors. Routine medical practice continues to treat black and white patients differently, and this must be changed if we are to truly transform our health care system and improve outcomes for all. While we can’t do anything about the diversity of the workforce to mirror the demographics of patients served, we can do our part to raise awareness. Addressing racial disparities are of paramount importance in value-based care. As President Pulsipher stated in a recent Townhall, ““Let us take this moment to individually and collectively reaffirm our commitment to serving and uplifting our fellow humans, and not let our “silence become betrayal”. Now is the time for the ACLC to join this national conversation…we cannot be silent.
Eric Weaver, DHA, MHA, FACHE, FACMPE
Executive Director, ACLC