BY ECRI PRESIDENT AND CEO, DR. MARCUS SCHABACKER, MD, PHD

It is a moral failure and an economic disaster to allow health inequities to persist in the American healthcare system. When certain communities face preventable illness and limited access to care due to socioeconomic status, geography, or other factors, the price is paid in human suffering and in dollars. Addressing health inequities will reduce the financial strain on healthcare providers, private and public payors, and boost the nation’s economic engine.

At ECRI, physicians, scientists, and engineers decode data, evaluate the evidence, and follow the facts wherever they lead. Time and again, the evidence points to the harsh reality that a person’s socioeconomic status, gender, weight, race, veteran status, physical disabilities, and geographic location can hinder their ability to access and receive quality healthcare.

Decades of scholarship show these inequities in stark reality, from “healthcare deserts” in rural areas, to unrecognized diseases and trauma among veterans, to insufficient maternal care.

• Rural patients struggle to access hospital care and maternal care as more rural hospitals are closing their doors.
• Women who report pain to their healthcare providers receive fewer pain management interventions than men.
• Compared to white patients, Black and Hispanic patients experience worse quality of care on 43% and 36% of healthcare quality measures, respectively.
• Black mothers face a significantly higher risk of dying during childbirth, regardless of their socioeconomic status.

Health inequities have a devastating personal as well as economic impact. It is estimated that health inequities account for about $320 billion in additional annual healthcare spending. Closing the health equity gap is among the most powerful investments we can make for individuals, the economy, and for the future of the country.

Finding solutions to these challenges is critical to making and keeping all Americans healthy. These are not problems that will go away by pretending they do not exist. Doing so will make them worse and will make more Americans sicker.

Despite the evidence that health disparities persist, at least seven minority health offices across the Department of Health and Human Services (HHS) have dramatically cut staffing in recent weeks, including the HHS Office of Minority Health and National Institute on Minority Health and Health Disparities. These offices developed policies, led research, and implemented programs aimed at improving health outcomes for underserved communities. This administration is also proposing to pull funding from equity-focused organizations and programs, leaving many healthcare leaders and equity advocates in wait-and-see mode, their work hanging in the balance.

In light of these cuts, it remains to be seen how this administration will “make America healthy again” without the insights, research, and interventions these offices and programs provided. ECRI has collaborated with various HHS agencies for decades and will continue to do so to advance safe, quality, equitable care.

Hospitals and health systems must seize all available opportunities to advance their health equity efforts. States, counties and cities can step in to fill gaps in funding, programming, data monitoring, and more. But healthcare leaders must lead the charge. It’s imperative that hospitals and health systems consider a total systems safety approach to create lasting change by:

• Increasing investments in care for historically underserved populations, including rural communities
• Identify cost savings to fund equity initiatives by reviewing your supply chain, where some health systems are unknowingly over-paying by millions
• Leverage your safety event reporting process to understand and measure disparities specific to your facility
• Overlay safety event data with patient experience, grievances and claims data to gauge the extent of inequities within the institution that patients face
• Gain insight from patients, families and caregivers to better understand the personal impact i.e. distrust and fear, and wider impact, i.e. reduced access to care, that health disparities can create
• Create a “just culture” where staff feel safe to report incidents of bias, discrimination and threats to patient safety and equity
• Evaluate artificial intelligence and other tools for potential biases that are often “baked in” without clinicians’ awareness

It begins with self-awareness among healthcare leaders to recognize that health disparities of all origins are real, pervasive, damaging and extremely costly.

ECRI is a trusted partner to health systems trying to meet the demands of this moment. With six decades of experience, ECRI is offering our expertise and voice to help eliminate health disparities and improve the health and safety of ALL patients.