Healthcare companies are ramping up health equity efforts. However, many are still missing the mark, one executive recently said.
“When we talk about health inequity, when we talk about social determinants of health, that’s been reduced to this checklist of unmet social needs,” said Dr. Shreya Kangovi, executive director of the Penn Center for Community Health Workers. “Where on that checklist does racism fit in? Where on that checklist does lack of power fit in? That has to be part of the equation. People’s individual circumstances are so much more nuanced than, ‘Here’s a referral to the food pantry’ or ‘Here’s a referral for a ride.’”
Kangovi made these comments during a panel discussion last week at the MedCity INVEST conference in Chicago. She presented data on the Penn Center’s IMPaCT program, which helps organizations plan, build and run community health workforces at scale. Community health workers are community members who work in the healthcare system and provide assistance including translation services and culturally appropriate education and guidance.
To demonstrate the effect community health workers can have in advancing health equity, Kangovi told the story of a community health worker in Philadelphia and one of the worker’s patients. The patient, named James, was referred to the worker by a local hospital care team and was struggling with addiction. James was initially described to the worker as a “difficult patient.”
“[The community health worker] came to find out that James was a big teddy bear,” Kangovi said. “He was a big burly Black man and the team was intimidated by him. But she said he wouldn’t hurt a fly. She got to know him and found out that he was involved in a tragic incident where he and his sister … had been using and she overdosed. [The community health worker] asked James, ‘What do you think you want to do to improve your life and your health?’ That’s what a transfer of power looks like.”
Ashley Perry, chief strategy and solutions officer of Socially Determined, also spoke during the session and discussed how the company is leveraging data and analytics to determine barriers that impact patients’ access to care. These barriers include finances, food and housing. Based on these insights, organizations can better create tailored strategies to improve health outcomes.
Perry emphasized that health inequity isn’t just a Medicaid or uninsured issue.
“[For] a lot of people, when you talk about social determinants of health, when you talk about health equity, they think this is a Medicaid problem, this is an uninsured problem,” she said. “We have seen unequivocally that it’s not. We work with a lot of payers in the commercial lines of business and we see as strong a signal — if not stronger — for the impact of social risk and social determinants of health on commercially-insured populations as we see in Medicaid and uninsured populations.”
What will the conversation around health equity look like in 10 years? Perry hopes to see more of an alignment among stakeholders in the healthcare industry.
“We’ve made a lot of strides, but we still have a long way to go,” Perry stated. “My hope is that 10 years from now we’re all on the same page and can align both our language and definitions.”
Kangovi, however, is a little less hopeful when it comes to the future of health equity conversations.
“I am perhaps a little more cynical as a Brown person,” she said. “I don’t know if we’re going to be talking about health inequity in 10 years. We’re already seeing the window closing on the conversations and the exuberance that we had around post-George Floyd. But what I am hoping is that the issues that drive health inequity have gotten baked into the fabric of care delivery in the U.S. Because I think there are … seismic shifts that will not be going away in the next 10 years.”
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