Building Health Equity

“Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” – Dr. Martin Luther King, 1966

I believe that everyone deserves their best chance at being healthy. Unfortunately, our country still has a long way to go. How healthy we are and whether we can get the type of health care we need differs greatly based on our income, race, sexual orientation, and other factors like the language we speak and where we live.  Social determinants of health – where we live and work, what we eat, how much stress or education we have – have a huge impact on our health and deserve attention. We also have to be able to answer why health equity matters. Watch Dr. Joan Reede, Dean for Diversity and Community Partnership at Harvard Medical School, discuss health equity, privilege, and the role of health care providers in a video from the Institute for Healthcare Improvement here. While not the only factor in determining health, part of building a healthy Washington State is high-quality, affordable health care that meets our needs, that is aligned with our goals of care, and that sees us the patient as a partner within the care team. I think these values are inherent in the Bree Collaborative’s work and deserve a constant focus as we build a health care system to serve our diverse population.

I like looking to bright spots across the country, the state, and locally – to highlight organizations that are building an equitable health care system. One of the American Public Health Association’s core values is health equity. The Center for Disease Control and Prevention focuses on health disparities and inequalities – releasing a report in 2013 that outlines how some populations are more likely to have certain diseases like heart disease and what our health care system can do to address these disparities. Healthy People 2020 tracks how well we are doing as a country on specific health indicators like oral health and diabetes. The information is available to everyone and allows researchers and policy makers to look at different diseases by sex, race, educational attainment, and family income. Work is now starting to develop goals for Healthy People 2030.

Our Washington State Department of Health has prioritized health equity and undoing inequality. Learn how to get involved and look at available data on their website. The Governor’s Interagency Council on Health Disparities was established by our State Legislature in 2006 to create an action plan and other reports for eliminating health disparities by race, ethnicity, and gender. They also convene advisory committees to focus on specific topics such as adverse birth outcomes, work to improve availability of culturally and linguistically appropriate health literature and interpretive services, and regularly meet. The Accountable Communities of Health aim to promote health equity within their nine regions. The Washington Patient Safety Coalition is also focusing on health disparities.

At the Bree Collaborative, we develop recommendations around health care services like hysterectomies that have variation in where or how they happen. The Washington Health Alliance showed us that whether you have a hysterectomy varies based on where you live and also releases disparities in care reports showing our state where to focus. Our Collaborative has been working to develop recommendations to address this potential overuse and poor outcomes and have found research showing that when compared to white women, black women are more likely to experience complications from hysterectomy. These differences in outcomes by race must be addressed and must be part of our conversations.

As Dr. Reede said, “together we are making a difference,” and together we are making a difference in Washington State.

Ginny Weir, MPH
Program Director, Bree Collaborative