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Equity of Care Begins With Us: Tell Someone

Equity and inclusion are basic human values, important to most people in many cultures. A group of physicians, other health care providers, communicators, students and researchers at the University of Michigan have joined together to catalyze a national conversation on health care equity and how it can be attained across all segments of U.S. society and the globe.

Spurred by evidence of inequities and disparities in health care driven by social, racial, ethnic, gender, economic, and even geographic status, the University of Michigan Health System is focusing national attention on how health care equity must be a national priority.

The University of Michigan Health System (UMHS) Office for Health Equity and Inclusion (OHEI) launched a three-month campaign “Talk Health Care Equity” on March 25 to engage people across the United States in talking about health care equity. This national conversation will take place in many venues including the Web, face-to-face, via social media, in policy arenas, in classrooms, and in the media.

According to Carmen R. Green, MD, associate vice president and associate dean for Health Equity and Inclusion at UMHS, “In order to develop policies and procedures and to provide care that is patient centered, appropriate, respectful and compassionate for everyone, we must first understand the roadblocks to health care equity from the patient’s perspective. Only then can we take action to eliminate factors like income, gender, geographic location, racial/ethnic/religious affiliations and age as barriers to optimal health.

“What does health care equity mean to the mother of a newly born low birth-weight baby or to a heart patient or to a person with a disability?" adds Green. "Is it the same for me and you? It’s time to connect and engage people in a healthy conversation, giving everyone the chance to be heard by contributing their unique short narratives about how health care equity looks and feels for them.”

But health inequities exist. They can be found in differences in lifespan; quality of life; rates of disease; disability and death; severity of disease; and access to treatment. Poverty, for example, has long been associated with poor health outcomes. In 2012 the poverty rate for African American children was 36.7%. The rate for Hispanic children was 33.8%. For non-Hispanic, White children the rate was 12.3%. Such children and teens are at increased risk for asthma, diabetes, obesity, and other indicators of poor health. Health inequities exist for those who are affluent as well.

“No matter who a person loves, where people live, what they believe, or what they look like, all citizens deserve access to the right care in the right place at the right time in an environment that is inclusive and welcoming. In a country as wealthy and democratic as the United States, exceptional health care should not be a luxury. It should be a right. This campaign is a chance to be engaged, to join voices in an important conversation that affects us all,” says Ora Hirsch Pescovitz, MD, executive vice president of medical affairs for the University of Michigan.

Since March 25, people on the University of Michigan campus and throughout the nation can raise their voices to help the Office for Health Equity and Inclusion start a national conversation about health care equity.

“Once everyone has the opportunity to tell their health care story, we can begin to work together, to celebrate the good news and find solutions for those things we can do better so that we promote health for all. The Talk Health Care Equity conversation allows us to address unequal burdens by hearing frequently unheard voices,” says Green.

OHEI staffers began distributing cards on March 25 across the U-M medical campus and health science schools for anyone interested in providing an eight-word impression of the phrase “health care equity.” Participation is not limited by geography or physical access, though. People can connect about health care equity by participating online at www.healthyconversation.org through June 30. The website will accept submissions in English, Spanish, Chinese, Arabic, Japanese, Korean and Russian. Engaged tweeters who wish to increase the dialogue are encouraged to use the hashtag #talkhealthequity.

“Through these eight-word stories, we can get a better understanding of what both consumers and providers of health services think about health care equity and amplify their voices to affect change where it may be needed. We have the opportunity to hear their hopes, frustrations, or whatever they want to tell us. We will be listening,” says Green, a professor of anesthesiology, obstetrics and gynecology, and health management and policy at the medical school and the School of Public Health.

According to Green, changes in how health care is delivered sometimes can be as simple as measuring each patient’s body mass or asking for a pain score—not just for the select few—to begin a conversation on diet and exercise or pain management, or by asking each patient about barriers at home to following hospital discharge instructions.

Green has a long-standing interest in health policy and health equity, particularly in the area of disparities in pain care access, assessment and management among minorities, women, elders, and those who are socioeconomically disadvantaged. Her research has uncovered inequities in pain access assessment and care, and variability in decision making based on age, race, ethnicity, gender, class, and other sociodemographic factors across the lifespan.

There are several ways to connect and join the national conversation on health care equity:

• Log in towww.healthyconversation.org to submit your thoughts.

• Encourage your friends to join the conversation via the UMHS Facebook page. “Like” the Office for Health Equity and Inclusion Facebook page: OfficeforHealthEquityandInclusion. 

• Endorse this cause. Start your own conversations through Facebook, Instagram, and Vine. 

• Tweet #talkhealthequity

• Connect with friends, family, and co-workers and host an equity and inclusion conversation.

• Complete a campaign card. Cards will be distributed throughout UMHS, health science schools, colleges and clinics.

— Source: University of Michigan Health System