Why health equity is important in cardiology
While it has been known for years there are wide divides between the access to healthcare in America prior to COVID-19, the pandemic laid bare these massive inequities. COVID statistics disproportionately impacted minority and low-income communities because of they did not have the same access to care or the same level of service as white and more affluent communities. This trend was consistently seen across the country and medical societies highlighted these issues at their conferences during and post-pandemic. These calls to action led many health organizations to change the way they do business to try and address these issues.
Not only were the issues of race and health inequality magnified by COVID in 2020, but that same year the Black Lives Matter movement came to the forefront of national news on the heels of several high-profile police murders of unarmed Black people.
During the pandemic, Mass General Brigham in Boston was one of many healthcare organizations that created policies and programs to address these issues. Its "United Against Racism" diversity, equity, and inclusion policy statement was backed by appointing staff members to serve as chiefs for diversity and equity in each department.
The Mass General Brigham statement outlines that systemic racism is a public health issue that impacts the hospital's patients, workforce and the communities they serve. MGH is now taking action across the health system to dismantle racism and the barriers inside and outside of the hospital walls to provide better medical care and equity for everyone in the community.
"Mass General really has taken a hard stand on its United Against Racism Campaign, and we all recognized that for many reasons, 2020 was a devastating year," explained Malissa J. Wood, MD, associate chief of cardiology for diversity and equity, and co-director, Corrigan Women’s Heart Health Program, Massachusetts General Hospital.
She explains the MGH program in the video above and the article below.
"Once our eyes had been opened, you cannot shut them. I think COVID shined a light on inequities in communities. And when we looked at people infected with COVID and saw they were more likely to be Black or Hispanic," Wood explained. "We also saw a lot of these patients had established, but undiagnosed, heart disease, or risks for heart disease. We also realized that these patients really had not been seen in our health systems before and only started coming in when they were so sick that they really needed to be on a ventilator. So I think it really made every one of us take a hard look at the patients in our communities and start looking at our own data dashboards and we started asking where are these patients and how can we make our services more available?"
Wood said there is now a big effort across healthcare to figure out how to address inequities and help provide better access to care for all patients.
An issue realized during COVID was that many minority communities have a mistrust of the healthcare systems because they do not see people that look like them in the ranks of clinicians treating them. Wood said the MGH equity effort includes not only ways to expand community based care, but also ways of recruiting a more diverse workforce in cardiology.
"Cardiology is really under-represented in terms of Black, Native American and Hispanic physicians," Wood said. "That has been part of a really big push here at MGH, to recruit a more diverse cardiovascular team. We know that concordance matters, and we know that cardiology has been a fairly non-diverse specialty."
She noted even the number of female cardiologists remains very low. When she was a fellow 35 years ago, 12% of cardiologists were women. Wood said the needle on recruiting more women has changed little since then, because the number is still only around 16%.
But, Wood said the changes that are being made are helping to move things in the right direction.
"I think it is incredibly awesome that we are now looking at health equity as a major feature of quality in our cardiovascular service lines. I also think there is going to be an increasing amount of attention and focus on health equity benchmarks in the way we get reimbursed, and I think it is high time that we look at our data across the board to make sure we are taking care of everyone, regardless of their ability to pay, or their sex, ethnicity, or race and that we are really trying to do the best we can for everyone," Wood explained.
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: dfornell@innovatehealthcare.com