Oxford Languages define progress as “forward or onward movement toward a destination.” It’s action that leads us to our intended goals and ideals. When we speak to progress, we spotlight the steps we take to advance us into better and brighter futures. Medicine has seen and experienced an endless stream of advancements. In 2022 alone, the medical breakthrough list housed a surplus of life-altering innovations such as mapping the human genome, delaying type 1 diabetes, and performing the first pig-to-human heart transplant.
With the field evolving from so much improvement and gain, one area appears to suffer from slow to no progress—healthcare disparities. We struggle as a medical community to bring an end to the gaping hole in care and accessibility that impact a myriad of patients. Demographics and social factors, from geography to gender to race, are all facets influencing the ricochet caused by healthcare disparities.
Last year, the Pew Research Center surveyed African Americans in the United States (U.S.) to learn more about their views and experiences regarding healthcare. Forty-seven percent felt improvements had been made in the last twenty years, while 51% said care and outcomes either remained the same or declined in the same period. Those who saw no change or a reduction in care attributed it mainly to less access to quality healthcare, with fewer mentioning that the well-being of the African American community is a lower priority.
The U.S. Census Bureau also provides numbers, highlighting the disparities African Americans experience in healthcare. The statistical agency estimates that the life expectancy for non-Hispanic Black Americans is 71.8 years. This is the lowest rate since 2000 and below that of other racial and ethnic groups. The COVID-19 pandemic spotlighted this issue as Black communities in the U.S. suffered in ways other groups did not. According to an essay published in the Health and Human Rights Journal, “poor social policies and programs, unfair economic arrangements, and bad politics” aid in widening the disparities between Black Americans and other patient groups during the pandemic.
African American women stand out among the race as they seem to be impacted at egregious amounts. In the same survey conducted by the Pew Research Center, they noted that the experience of Black women ages 18-49 showed that one out of seven reported having adverse medical experiences. African American mothers even experience higher preterm-related infant mortality ratios, 491 deaths per 100,000 live births. Comparatively, the 159 deaths per 100,000 live births ratio was attributed to white mothers.
With all these stats alarming our medical community, the question becomes, what can we do to change the healthcare narrative for African Americans and other patient groups impacted by healthcare disparities? Well, let’s look at what has been done in recent years. U.S. Congressional leaders fought to address the maternal health crisis in this country. Ensuring critical policies, such as the 12-month postpartum Medicaid coverage that makes certain all moms have access to full postpartum care, has been one effort deployed. Additionally, the Black Maternal Health Momnibus Act of 2021 was passed to address the causes and impacts of the maternal health crisis in America.
Further, after witnessing the devastating events surrounding George Floyd’s death, many organizations stepped up and began addressing the blaring issues encompassing equity. PhRMA, a biopharmaceutical research company, developed the PhRMA Equity Initiative “to put renewed focus on DEI” in medicine. This initiative aims to reduce and eventually eradicate barriers to equity while destroying systemic walls that prevent real equity from being realized.
Even with groups like PhRMA doing some heavy lifting for the long term, there’s room for all to elicit change today. Many insist that one of the greatest immediate solutions to healthcare disparities is access. Increased reachability to medical care coupled with raising awareness of the challenges faced by the underserved and the overlooked would drastically shorten the distance between various patient populations. The University of Southern California notes that the low-income region of rural Appalachian has fewer mental health (35% less) and specialty physicians (28% less) compared to the rest of the country. This limitation creates wellness hardships for residents. However, providing Telehealth as an option may open the doors to care in a new way. Modifying and concentrating on delivering medical services can place help within reach and, in turn, elevate the community’s overall well-being.
In a recent article in Healthcare IT News, Dr. John Martin, Chief Medical Officer at Butterfly Network, advocates for the training and growth of point-of-care ultrasound (POCUS) for addressing health equity concerns. The affordability, portability, and usability of the device hold great promise. The “use of handheld ultrasound can introduce a care modality that otherwise does not exist … POCUS closes information gaps faster, improves the accuracy of timely diagnostics, and simply put, can save lives,” Dr. Martin describes. The idea is to improve community access to medical imaging, specifically a tool that can be used for prevention, diagnosis, and procedural guidance.
Lastly, knowledge is power. There is strength in awareness and education. Discussing African Americans’ healthcare issues is vital if we want to see change. Where disparities exist, so should conversations delving deep into the causes and effects. Real time and attention to researching the problems at hand and sharing resources on findings must be prioritized. We must turn with open eyes towards what’s presently broken, pierce past the progress that has been made, to see what is still yet to advance forward. Now, with new lenses, we must be willing to contend for equal advancement for all.