![]() ![]() Like every organizational transformation effort, advancing racial justice and health equity requires leadership. STEP 1 Commit as a Health System to Do the Work ![]() “As health care organizations, payers, and others focus on social determinants and population health, we have a responsibility to ask: To what degree are our approaches grounded in a framework that addresses structural racism and equity? If we can't answer that question with rigor and candor, even our most innovative solutions might perpetuate inequity and illness, not prevent it.” 3 These recommended STEPS are part of a larger cycle of continuous learning, improvement, and accountability envisioned in the American Medical Association's Organizational Strategic Plan to Embed Racial Justice and Advance Health Equity that seeks to advance equity through transformation efforts at the patient, organizational, community, and societal levels. Recognizing that the path to equity and justice is a dynamic, long-term journey, this toolkit focuses on initial catalytic STEPS and associated resources to translate that commitment to equity into action and make meaningful improvements that can produce concrete benefits to patients, clinicians, and other colleagues in their health systems. Since health equity and racial justice are not only desirable outcomes but also ongoing interrelated processes, this toolkit adapts a practice transformation framework to offer 5 STEPS that can help motivated leaders move health systems forward to embed racial justice in their practices and advance health equity for clinicians, for patients, and for the communities served. How do internal DEI efforts for employees relate to our pursuit of health equity and racial equity for our patients and community at large? Leadership may desire to improve internal diversity, equity, and inclusion (DEI) initiatives, asking questions like:ĭo all employees feel equally welcome and comfortable at work?ĭo our recruitment and hiring practices consider diversity within our organization?Īre our recruitment and hiring practices bringing in individuals who represent the patient population we serve? Now more than ever, you and your colleagues might be asking questions like:ĭo preventive screening rates, treatment recommendations, or other measures of the quality of our patient care differ by race, ethnicity, and/or language?ĭoes everyone in our practice and health system understand how institutionalized racism shapes clinical practice, patients' health outcomes, and the health of the community? How can we better understand or deepen our understanding?ĭo all patients feel equally welcome by our employees and comfortable in our clinic?ĭoes our health system's payer mix reflect or even exacerbate institutionalized racism? How Can Health Systems Advance Health and Racial Equity?Īs the commitment to advance health equity and racial equity grows across many sectors, motivated physicians in medium and large health systems-ranging from physician groups and integrated delivery systems to hospital-affiliated outpatient practices and emergency and inpatient settings*-may wonder how best to pursue these goals through their day-to-day work. …Health equity means social justice in health (ie, no one is denied the possibility to be healthy for belonging to a group that has historically been economically/socially disadvantaged).” 2 Ultimately, health equity means optimal health for all, and is a goal all health care organizations, big and small, can work toward through their day-to-day work. Pursuing health equity means striving for the highest possible standard of health for all people and giving special attention to the needs of those at greatest risk of poor health, based on social conditions. ‘Health equity' or ‘equity in health' implies that ideally everyone should have a fair opportunity to attain their full health potential and that no one should be disadvantaged from achieving this potential.” 1 Another valuable definition comes from Paula Braveman: “Health equity is the principle underlying a commitment to reduce-and, ultimately, eliminate-disparities in health and in its determinants, including social determinants. The World Health Organization defines health equity as “the absence of avoidable, unfair, or remediable differences among groups of people, whether those groups are defined socially, economically, demographically or geographically or by other means of stratification. ![]()
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