The legacy of racism manifests itself in harmful ways every day, but in the medical space it can have drastic consequences. âOften people of color aren’t believed when they complain of pain, so they don’t get pain relievers,â says Dr Nwando Anyaoku, Health Equity Manager at Swedish Health Services.
A pediatrician by training, Anyaoku heads the Swedish Office for Equity, Diversity and Inclusion in Health (OHEDI) with Mardia Shands, Head of Diversity, Equity and Inclusion. Their goal is to provide equitable and high quality healthcare to all their patients, regardless of race, ethnicity, language spoken, disability, gender identity or expression, sexual orientation. , socio-economic status, religion or age.
And validating each patient’s pain is only part of it. When healthcare organizations don’t value fairness, Anyaoku says, it results in “clinical decisions that are not based on science.” It outlines criteria for glomerular filtration rate, a measure used to assess kidney function. It was only recently that clinicians stopped a common practice of using two different sets of criteria for black and white patients.
âThe result of this policy was that African American patients presented with more advanced disease, kidney failure, and therefore had worse outcomes,â she says.
This speaks to a larger issue of equity in health care a clinician like Anyaoku is working to change. “Maya Angelou said ‘Do your best until you know better. Then when you know better, do better, âshe says. “And that’s what we’re trying to do now.”
To promote health equity, âdoing betterâ means fostering culturally competent care, a diverse workforce and a culture of inclusion in partnership with the local community, which can lead to better patient outcomes. and stronger communities.
Much of the job is to identify and address health inequalities, which are different from health disparities. “People often say ‘I treat everyone the same’ and what I’m trying to communicate is that there is a difference between health disparities and health inequalities because health disparities can arise for no particular reason, âsays Anyaoku.
She takes breast cancer as an example: more women than men are diagnosed with it, but the reason is biological. Health inequality, on the other hand, “tends to stem from a variety of preventable causes, often social determinants of health and problems of structural racism,” she says.
Hospital systems can address these disparities by educating employees; Swedish, for example, recently hosted a webinar on birth inequalities, manifested in disproportionate rates of maternal and child mortality and morbidity among black and indigenous women.
Senior management can promote âa diverse pipeline of clinicians,â as Anyaoku describes it, so that hospital staff reflect the communities they serve. At OHEDI, this involves partnerships like the one with Meharry Medical College, a historically black medical school in Nashville. OHEDI has also partnered with community organizations such as the Seattle Jobs Initiative.
But Mardia Shands says it wasn’t enough to recruit diverse recruits. Healthcare organizations also need to retain and develop diverse employees, which means building avenues for promotion and leadership. Anyaoku agrees. âIf you recruit diverse people and they don’t see a path to growthâ¦ then you don’t ultimately keep them,â she says.
And keeping a diverse workforce is crucial because it can alleviate health inequalities. By creating routine organic interactions among employees from all walks of life, a diverse staffing promotes cultural competence, Shands explains.
“Diversity of thought plays a huge role in how you solve problems, and [brings] innovation and creativity because not everyone is in group thinking, âshe says. In healthcare organizations, creative problem solving can be especially important. When that doesn’t happen, Shands says, “innovation is stifled.”
There is also a business incentive, Shands says. âWe just know fromâ¦ research over decades that the more diverse an organization, the more it outperforms more homogeneous organizations. “
Yet, she says, some organizations choose not to promote diversity and inclusion. And it’s hard work, because âyou are asking people to change their mindsâ.
She has some advice for organizations ready to take the plunge: âHealthcare organizations in particular should be aware that when they embark on this work, they [diversity, equity and inclusion] that it must be intentional. It will stretch your organization; it will stretch your people.
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