Briefing on “Pursuing Health Equity”

The Health Affairs www.healthaffairs.org briefing at the National Press Club on June 6, 2017, discussed the results of the 2016 Health Affairs multi-year project that examined many of the factors contributing to disparities in health and healthcare. The results of the first phase of this work is included in the June issue of the Health Affairs journal “Pursuing Health Equity”.

Alan Weil JD, Editor-in-Chief for Health Affairs moderated the discussion with a number of the authors that submitted articles on topics related to equity in healthcare. Paula Braveman MD, Professor of Family and Community Medicine and Director of the Center on Social Disparities in Health at the University of California, San Francisco, School of Medicine www.ucsf.edu, commented, “Not only do health disparities need to focus on racial, social, and economic issues, but discussions on other issues also need to take place on fairness and justice.”

Joseph Betancourt MD, Associate Professor of Medicine at of Harvard Medical School https://hms.harvard.edu, and Founder and Director of the Disparities Solutions Center https://mghdisparitiessolutions.org, mentioned how the Center works with healthcare organizations to improve quality of care and also addresses racial and ethnic disparities to achieve equity. The Center’s Disparity Leadership Program beginning in 2007, trains leaders in health plans and health centers to help eliminate racial and ethnic disparities.

The article “Emerging Trends Could Exacerbate Health Inequities in the U.S.” with Mariana C. Arcaya Sc.D., Professor of Urban Planning and Public Health, Massachusetts Institute of Technology http://web.mit.edu as co-author looked at how technological progress in developing new drugs, new ways to treat diseases, updating diagnostic procedures, and producing new devices is a positive step in upgrading healthcare in this country.

However, at the same time, technology can also widen disparities with patients on a number of levels. This wide discrepancy in care when using the newest technologies may occur especially if the patient is in the privileged group versus patients experiencing low socioeconomic status. The researchers generally found that precision medicine will generally only benefit the privileged group.

The use of new technology systems can also affect disparities in healthcare in a positive way. For example, a new kidney allocation system was established in 2014 by the United Network for Organ Sharing. The kidney allocation system changed the fact that before the use of the system, white patients were more likely than black or Hispanic patients to receive a kidney transplant.

Taylor A. Melanson Doctoral Student, at Emory University www.emory.edu  along with co-authors of the article “New Kidney Allocation System Associated with Increased Rates of Transplants among Black and Hispanic Patients” reports that the kidney system has enabled at least a temporary elimination of racial/ethnic disparities in kidney transplantation among patients on the list.

It was recently announced that NIH is also going to establish a registry to study disparities as it specifically relates to people diagnosed with cancer. On May 16, 2017, NIH www.nih.gov published a Funding Opportunity Notice titled “Leveraging Population-based Cancer Registry Data to Study Health Disparities” http://grants.nih.gov/grants/guide/pa-files/PA-17-289.html.

Specifically this FOA will study the factors that influence health disparities within the framework of population-based cancer registries by including data not routinely collected or linked to registries.

 

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