Addressing health inequities: Community efforts and root causes

By Chris Reddick, Head of U.S. Health Equity

While COVID-19 propelled many people across the health ecosystem to examine and address the health inequities that surround them, these inequities are not new. They largely exist because the systems relied on to deliver care weren’t designed with inclusion and equity in mind.

The impact of health inequities is tangible, driving an economic burden of at least $421 billion among historically marginalized racial and ethnic groups in the United States, according to research recently published in JAMA. The root causes of health inequities have deep historical ties, and so do the solutions that will help close these gaps. Throughout the history of the U.S. — from emancipation in 1863 and some women gaining the right to vote in 1919, to the desegregation of public schools in 1964 — advancements toward equity have been intentional, collaborative and community-centered to address the injustices that have hindered everyone from experiencing the American dream.

Similarly, ensuring that all people have a fair and just opportunity to experience the best health possible requires collaboration with community-serving organizations that are closest to the nuanced challenges and innovative solutions.

Getting rooted in the causes of health inequities

People in racial and ethnic groups experience higher rates of disease and poorer health outcomes for a wide range of health conditions when compared to their white counterparts. The average life expectancy among Black or African American people in the United States is four years lower than that of white people and Black women in particular age 7.5 years faster because of stress and trauma. These disparities sometimes persist even when accounting for other demographic and socioeconomic factors, such as age or income. A recent report on health inequities in the Boston area showed that largely because of COVID-19, the average life expectancy decreased even further among Latinx, Black and Asian residents compared to white residents.

Health care leaders recognize that the complex root causes of health inequities and centuries of compounded acts of exclusion contribute to deepening medical distrust and exacerbate barriers to care. This may prohibit marginalized people from accessing quality care, being included in innovative clinical trials, and accessing life-changing therapies and treatments, but things appear to be changing.

Community collaboration drives equitable innovation

One of the most obvious lessons that the response to COVID-19 highlighted is that solving health inequities takes collaboration. It requires breaking down silos between government, industry, NGOs and community-serving organizations to address multifactorial health inequities.

However, collaborating with communities must go beyond philanthropic efforts. Consistently working in lockstep with trusted community-serving organizations is vital to making decisions based on local needs and priorities.

Organizations like the Health Equity Compact, a group of over 80 leaders of color who aim to eliminate systemic barriers and create new processes that will lead to equitable health care and health outcomes, are helping to drive change. The group takes a multi-pronged approach to work towards their vision through advancing governance policies to move the needle in creating community-level impact.

This includes prioritizing representation in state health-focused agencies, standardizing health equity data metrics, investing in diverse public health and health care workforce programs, reducing gaps in health insurance coverage, and increasing funding for programs that address social determinants of health. By working with organizations like the HEC, and other community focused partners including the National Urban League (NUL), Remote Area Medical (RAM), the National Minority Quality Forum (NMQF), and Xavier University, Takeda is engaging with trustworthy experts who are as determined to understand the complex needs of a population as they are to implement the solutions.

Within Takeda, it is believed that to continuously fulfill the company’s purpose of bringing “Better Health to People and a Brighter Future for the World,” health equity must be embedded into every aspect of work and business — a priority that is actioned daily on behalf of the patients and communities that Takeda serves. This approach will better equip the organization to create more inclusive practices that lead to the development of innovative medicines, therapies, and services that best reflect the needs of patients and communities.

Although the finish line remains far, the steady drumbeat of sustained efforts is leading community serving organizations and public sector partners in the right direction — further upstream — to address the barriers that hinder optimal health for all.