As health equity takes center stage for new policies – with the CDC and HHS unveiling a tool to track health effects of environmental issues and NCQA updating guidelines to address disparities – health systems nationwide are ramping up their own efforts.
Becker's asked leaders what their health equity priorities are for the remainder of the year. This compilation features guidance from nine leaders at nine systems who shared insights.
Editor's note: Responses were lightly edited for clarity and length.
Avonia Richardson-Miller. Senior Vice President and Chief Diversity Officer at Hackensack Meridian Health (Edison, N.J.): Addressing disparities in health outcomes is a major strategic priority for Hackensack Meridian Health. We have created a network-wide plan to reach our goals which focuses on five domains: cultural competency; data collection, stratification and use; dimensions of physician and team member well being; diversity, equity and inclusion in leadership and strengthening community partnerships.
The priority for the remainder of this year is focused on data and cultural competency. It is critical that we have good foundational data to support our efforts to identify and effectively address gaps in health equity. Recently we created and launch a training course on the collection use and stratification of race, ethnicity and language (REaL) data & sexual orientation and gender identity (SOGI) data. Our EPIC fields have been updated accordingly for full alignment and for the remainder of the year we are focused on creating health equity dashboards. Additionally, we are currently implementing an unconscious bias training pilot with plans to train our entire workforce by mid 2023. A third priority we are focused on is the American Hospital Association's (AHA) health equity roadmap assessment. For the remainder of the year, we will be focused on each of our hospitals completing the Health Equity Transformation Assessment (HETA) and based on those results creating Transformation Action Plans (TAP) to advance our progress along the health equity continuum.
Carrie Bridges Feliz. Vice President of Community Health and Equity at Lifespan (Providence, R.I.): The Lifespan Community Health Institute is focused on addressing barriers to healthcare and mitigating social determinants of health through expanded navigation support services, food distribution and nutrition programs, transportation and housing resources, and by delivering hyperlocal, culturally-sensitive community outreach and education experiences. We are also working to empower more Rhode Islanders to be active partners in managing their own health and the health of their loved ones through skill-building programs and strategic partnerships with complementary community-based organizations.
Dan Roth, MD. Executive Vice President and Chief Clinical Officer at Trinity Health (Livonia, Mich.): One of Trinity Health's top priorities to advance health equity is integrating clinical care and addressing social needs into a singular, connected model for health. We have seen the impact a patient's social and economic needs can have in creating health inequities. We are focused on supporting the work of care teams to identify the needs our patients may have and utilizing community health workers solely focused on addressing and minimizing those needs. Listening to our patients and community members to learn more about all the factors that impact their health and engaging with them to find solutions that resolve or lessen the impact of those factors is the most effective step we can take to improve health equity.
Gbenga Ogedegbe, MD. Director of the Institute for Excellence in Health Equity and The Dr. Adoilph and Margaret Berger Professor of Medicine and Population Health at NYU Langone Health (New York City): The role of the Institute for Excellence in Health Equity (IEHE) is to advance and operationalize health equity across every spectrum of NYU Langone Health—including in clinical care, research, medical education and community engagement. On the clinical side, we are analyzing and correcting a number of medical algorithms with built-in racial biases known to cause poorer outcomes for Black and other minority patients.
Our team is working with leaders across the health system to correct these algorithms and eliminate race from calculations, when appropriate, so that racial bias no longer factors into patient care such as measuring kidney function or deciding whether or not to perform a caesarian section. We have examined at least 15 algorithms so far and will continue to add more.
Another priority is leveraging our community-based partnerships to launch new programs that improve health outcomes for underserved populations. Recent examples include a new hearing loss screening program for low-income immigrant children run through community centers and faith-based organizations in Brooklyn and Long Island, as well as the upcoming launch of a new evidence-based addiction recovery program adapted for use in Black and Latinx churches.
Being a leader in advancing health equity across a health system as expansive as NYU Langone means that we also need to recruit, develop and train leaders in this arena, particularly individuals who are underrepresented in medicine. Building a culture of inclusivity and excellence is key to fulfilling our mission and vision, as we continue to onboard new faculty and clinicians with expertise in addressing racial disparities in medicine.
Jason Purnell, PhD. Vice President of Community Health Improvement at BJC HealthCare (St. Louis): BJC HealthCare designated "community health improvement" as one of its four strategic priorities for the organization and in 2020 created a new system-level department with dedicated leadership and resources to improve the health of the communities it serves. BJC Community Health Improvement is working alongside community partners and stakeholders to advance health equity through a collaborative, holistic approach that emphasizes physical, mental, social and financial well-being. Strategic efforts have begun in a 22-zip code area in the City of St. Louis and North St. Louis County.
BJC’s top health equity priorities for the remainder of the year include the following:
- As part of its financial well-being strategy, BJC is working with financial institutions and community-based organizations to address the racial wealth gap. Through the deployment of capital, the system is making it possible to expand lending for individuals and small businesses. These partnerships also support business development, loan refinancing, access to affordable rental housing and homeownership.
- The system is partnering with trusted community organizations with high-traffic locations to establish behavioral health and wellness hubs. These hubs will offer respite from daily stressors and will include behavioral health programming tailored for youth, teens and adults. Programs will focus on resiliency, self-care, mindfulness and social connectedness.
- BJC is working with doulas to provide continuous support throughout the birthing process to improve prenatal care, birthing outcomes and assist with the postpartum transition. The Community Health Improvement team is partnering with community-based doulas to host workshops on the doula model of care for BJC care teams, those giving birth and their families. There are also plans to convene key stakeholders to advocate for Medicaid reimbursement for doula services.
Jonathan Jaffery. Chief Population Health Officer at UW Health (Madison, Wis.): UW Health prioritizes health equity across several ongoing initiatives. The top health equity priority is to eliminate disparities in low birthweight births between African American and white families in Dane County. As part of a collective impact model, we have implemented ConnectRx alongside the members of the Dane County Health Council. ConnectRx is a bi-directional, closed-loop referral system that connects Black birthing families with community-based organizations that can fill any identified gaps in social determinant of health needs and provides community health worker and doula support.
Julia Andrieni, MD. Associate Professor of Clinical Medicine at Weill Cornell Medical College and Senior Vice President of Population Health and Primary Care at Houston Methodist: Our top priorities for health equity within our population health programs include mining data to identify patient care gaps for preventive health (cancer screening), chronic condition management, behavioral health and medication adherence. Our patient outreach is focused on identifying individual barriers such as cost of medications, transportation difficulties to appointments and lack of healthy foods in order to address these important factors in overall health.
Our focused nursing outreach includes a social determinants of health assessment to identify barriers to care matched to community resources. Our goal is to equitably provide individualized, culturally-sensitive care for all people to promote healthy diverse populations.
Kevin Slavin. President and CEO of St. Joseph's Health (Paterson, N.J.): We have several. One of our top strategic initiatives is bridging the gap in social and health equity.
[We're] doing a lot of education internally to understand two things: structural racism and how we can turn that around in our community as well as internally working with a nationally known consultant, Tony Chapman, to do unconscious bias training throughout the organization. We'll be launching a new supportive housing project adjacent to the campus. [We're] doing that in partnership with two great groups in New Jersey: NJ Community Development Corporation and New Jersey Community Capital. This will be a 55-unit, supportive housing facility dedicated to two groups: one a special needs population, which are families that are experiencing behavioral health, psychiatric issues and need stabilization in the facility. And also our own employees who have their own social determinants of health challenges, whether it be transportation housing or food insecurity so that they can have a secure, supportive facility adjacent to where they work.
We're excited to be expanding our hospital-based violence intervention program, where we work with another community partner, Patterson Healing Collective, to assist victims of violence. We're going to be moving into food injustice. Our city has been designated by the state of New Jersey as a food desert. And there's a number of different initiatives at the state level that will support really going beyond just food pantries (which is important work) and really getting into the whole issue of grocery stores and the availability of fresh and affordable foods in our neighborhood.
Sherri Neal. Chief Diversity Officer at HCA Healthcare (Nashville, Tenn.): HCA Healthcare‘s Health Equity Council oversees the advancement of our commitment to health equity. The council analyzes data related to patient outcomes, identifies opportunities to reduce disparities and explores opportunities for cross-sector collaboration and community engagement to address root causes of health inequities. Our scale enables us to address health disparities in a way that will positively impact patient quality, safety, and satisfaction outcomes for our patients. We are also leveraging partnership opportunities and collaborations with payers, government partners and community organizations, including March of Dimes and Johnson and Johnson, focused on measurable outcomes related to health equity in communities we serve. In addition, we continue to strengthen our culturally competent education to ensure the care experience for all of our patients is equitable.