Second installment of a series on health equity
As a health equity strategist, I know this much for sure: Our health circumstances are as unique to us as our fingerprints.
Though two individuals may have the same or similar medical conditions, their socioeconomic and racial backgrounds — as well as their family histories, personal habits, and even access to transportation — significantly impact their experiences with healthcare.
At Belong Health, we embrace this complex tapestry of influences whenever we commit ourselves to whole-person care. It’s that deep investment in understanding the individual, in fact, that sets our work apart and keeps our members engaged.
But even a focus on the individual can’t pull our attention from a troubling nation-wide pattern: for countless Americans, healthcare has become a “nice-to-have” — something to get around to only when time and money allow.
That pattern, if left under-resourced or misunderstood, only widens health disparities in catastrophic ways. So let’s get to the root of it.
What are health disparities?
The Centers for Disease Control and Prevention (CDC) identify health disparities as preventable differences, experienced by socially disadvantaged populations, in the burden of disease, injury, violence, or opportunities to achieve optimal health.
But a bird’s-eye definition won’t quite suffice here. So let me instead tell you the story of a former patient of mine. We’ll call him Alex*.
When I met Alex, he was a taxi driver with uncontrolled diabetes. While he clearly wanted to get a handle on his condition, he simply didn’t have the means or time to do so. After all, Alex had a multigenerational family of six at home, relying on his solo income.
That meant a lot of time spent behind the wheel, caring for everyone but himself.
As might be expected, Alex’s work was sporadic and his hours were chaotic. On any given day, he was lucky to find time for breaks to take medication, to eat healthy, to stay hydrated, or to attend medical appointments.
Additionally, his healthcare coverage was poor, a fact which made accessing medications and blood sugar monitoring supplies a frequent challenge.
Still, Alex kept driving. He had to. “Every time I pass up a ride,” he told me, “that’s time I might have spent supporting my family.” For Alex, family was everything — and yet, ironically, his job and health risked stealing him away from the very same people he was working to protect.
Combined, Alex’s stressful job and heavy demands at home created a health disparity that impacted not only his own life but those of his five other family members, too. He was looking after them — but who was looking after him? Alex’s circumstance is all too common. For many members of socially disadvantaged populations, it’s a story that cuts especially close to the bone.
Reducing disparities, championing equity
Across America, numerous factors, from employment status to disability to ZIP code and gender identity — congeal to create health disparities that unfairly shorten lives or keep people just like Alex in a constant state of uncertainty.
Health equity work, where I’ve dedicated so much of my life, proactively addresses each of those barriers, head-on, first by seeking to understand their roles in an individual’s life — then, by guiding that individual towards their fullest potential.
As one might imagine, this field of work is as deeply rewarding as it is profoundly challenging. Just as inequity is multifaceted and persistent, its solutions must be, as well. They often must tackle a multitude of big issues — including income inequality, job and food scarcity, and community violence — at their roots.
If they are to be successful, those solutions must be innovative. And they must never let up.
The case for care coordination
Though so many of the challenges of inequity are deeply intertwined, the focus of this blog — and the core of my work — is equitable delivery of care coordination, a baseline requirement for health equity, in general.
At its best, care coordination delivers quality outcomes and reduces cost by shifting healthcare away from a one-size-fits-all approach. Simultaneously, it sets out to shift the common mindset from...
...treating everyone fairly with standardized care...
...to treating them equitably, according to their specific strengths, needs, and circumstances.
For someone like Alex the taxi driver, strategic care coordination would be a game-changer. While many people with uncontrolled diabetes are given prescriptions and are then instructed to eat nutritious foods, stay hydrated, monitor their blood sugar, and attend preventative screenings and follow-up appointments, that’s hardly an achievable game plan for someone like Alex — someone whose life has already stretched them thin.
Imagine, instead, a health strategy that truly took Alex’s daily experiences to heart. Imagine the multitude of ways in which providers, and a dedicated care management team, could change his life by simply:
- Connecting him with medication and supply assistance programs
- Reviewing testing and medication regimens, to increase the likelihood of adherence to a plan
- Providing aid in completion of government food assistance applications
- Offering referrals to local food pantries for his large family
- Anchoring exercise to family events
- Proactively scheduling appointments during his off-peak work hours
For Alex, and in recognition of the unique specificities of his life, this is what equitable health looks like. For you, or for me, it might look a bit different.
But that, after all, is the nature — and the beauty — of health equity. It treats people not as paperwork but as partners, with a clear dedication towards affording them agency and individuality across their own life and care.
In my next blog, I’ll illustrate how best to apply this powerful lens to broader care coordination strategies.
Until then, take a moment to assess the complexities, challenges, and joys of your own life — and to reflect on what health strategies leave you feeling like your best and most capable self.
Are you tailoring your life and health in ways that best suit you?