How are health care disparities a barrier to health equity and what can be done to address these disparities?

The COVID-19 pandemic has laid bare the myriad health equity challenges we face in the United States and highlighted the roles of racism, geography, and other social determinants of that drive the health care disparities (HCDs) we see today. The past two years have made it clear that our individual well-being is intrinsically linked to the health of those around us. Addressing DDH is critical to achieving health equity and optimizing health for all.

What are DDH and what is health equity?

In a seminal report, “Unequal Treatment”, the Institute of Medicine defined HCD as “racial or ethnic differences in the quality of health care that are not due to factors related to access or clinical need , preferences and appropriateness of the intervention”. He found evidence of lower quality of care for minority patients in many areas, including cancer, diabetes and cardiovascular disease. Another notable area of ​​HCDs is pain management. The literature documents that black patients, including children presenting to emergency departments with acute pain, were prescribed pain medications less often and in smaller amounts than white patients. A study showed that medical students and residents endorsed biased beliefs about the black body, and these biases predicted pain processing accuracy. Eliminating HCDs can help us achieve health equity – the highest standard of health for people of all backgrounds.

How has COVID-19 contributed to HCDs?

Many minority groups have different social determinants of health, due to past structural racism. Factors such as being frontline workers, relying on public transportation, and living in larger households have made these groups more susceptible to COVID-19.

What is the impact of HCDs on rural communities?

According to a Health Disparities in Rural America report, 20% of the US population lives in rural America, but is served by only 10% of physicians. The shortage of providers has led to a lack of preventive care, which likely contributes to rural Americans’ increased morbidity and mortality from the five leading causes of death, such as heart disease, cancer, and accidents. cerebrovascular.

How can medical schools approach these HCDs?

Medical schools have a responsibility to train health care providers to care for culturally and socioeconomically diverse populations, as well as medically underserved communities. Through UNR Med’s See It To Be It initiative, future physicians from underrepresented populations are encouraged to consider a career in medicine. At UNR Med, we also recruit medical students from rural communities because we know that these students are more likely to serve these communities after graduation. Training future health care providers to fight HCD includes teaching the history of structural racism and how it has led to health inequities and passing students implicit bias assessments to know where their blind spots may exist. More importantly, medical students learn strategies to mitigate bias. At UNR Med, students follow a program to help them recognize and mitigate bias. Students also learn to provide culturally competent and humble care and to address the social determinants of health.

Medical schools also have a social responsibility to improve the health of the population in the communities they serve. UNR Med Student Awareness Clinic provides free services for uninsured or underinsured patients, including clinics for rural patients. Additionally, Project ECHO connects academic faculty specialists with primary care providers in rural and underserved areas that would otherwise have limited access to care.

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