Over the past few years, I’ve had the opportunity to lead programs focused on helping our partners increase their capacity to reach underserved patients to help them prevent or better manage their chronic conditions. As an organization that regularly sits at the intersection between direct service, policy and evidence, we have an imperative to make equity a primary lens through which we do our work. In the spirit of this goal, here are a few strategies I reflect on regularly when trying to design a meaningful approach to programs.
- Understand the benefits and limitations of data. Population health data can give us a great baseline for understanding significant health disparities. However, it is important to acknowledge where our data falls short either due to population-size limits or inconsistent reporting. These blind spots can lead us to overlook important disparities in our local communities. The Institute on Medicine’s report "Race, Ethnicity, and Language Data: Standardization for Healthcare Quality Improvement" (2009) offers helpful guidance on collecting more meaningful data sets that reflect our local cultural and linguistic make up at a more granular level.
Another consideration when responding to the limits of readily available population-level data is to be sensitive to its limitations and work closely with local partners to better understand the makeup of the communities we seek to serve. Also, I believe strongly that it is important to give data shared with us by partners back to them in a format that helps advance local improvement goals.
- Increase “on the ground” capacity to address disparities locally through investing in the communities we seek to serve. I have seen firsthand the impact of investing directly in the organizations comprised of individuals from the communities we are trying to reach. By working with these organizations, we can become better bridge builders and strengthen our capacity to identify effective solutions in addressing the burden of chronic disease on disproportionately affected groups.
- Increase representation of underserved populations in the workforce. According to Health Professionals for Diversity coalition, diversity in the workforce increases access and patient satisfaction among underserved racial and ethnic populations. In addition, increasing access in training programs leads to broader improvements in the workforce’s ability to meet the needs of all Americans due to cross-cultural exposure during school and increasing capacity to empathize with people from different backgrounds.
- Include dedicated relationship builders on your team. We should all think of ourselves as relationship builders, regardless of what our role is on a team, but it is important to recognize that to do this work meaningfully at an organizational level, we need dedicated staff who can ensure the quality and continuity of relationship-building approaches. Recently, we have seen benefits from the broader attention and investment in community health workers and community care coordination pathways that rely on employing staff whose job is to spend their time effectively bridging the divide between health care and communities who may have greater barriers to accessing quality care.
- Find ways to overcome health literacy barriers. According to the National Action Plan on Health Literacy, some groups are significantly more likely to experience limited health literacy, including adults over the age of 65 years, specific racial and ethnic groups, recent refugees and immigrants, people with less than a high school degree or GED, people with incomes at or below the poverty level, and non-native English speakers. Finding opportunities to support partners in providing information, written and verbal, in plain language and in multiple languages can go a long way in helping to address this barrier.
We’ve known for years that to address disparities, we need to look differently at how we approach health along the continuum of care. I love working for an organization whose mission it is to connect policy to action and foster transformation in the health care system. I challenge all of us to remain mindful about the impact of our efforts on the communities we strive to serve to ensure we are heading in the direction we intend to go.