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Hospitals and Health Equity

Core to the mission of Genesis Health Consulting is our belief that every child deserves the opportunity to thrive. For children to thrive in our society, they need healthy, supportive relationships with adults and healthy, safe, enriching environments in which to learn and grow. Increasingly though, our children experience different opportunities for health based on where they live, which sets them – and our society as a whole – on a path for disparities in health outcomes that continue to challenge our nation. Inequities in healthcare are a burden to our society. In addition to the significant costs associated with treating poor health conditions, inequities also impact one’s work productivity, ability to engage in society or even participate in the military. It is hard to be healthy and fully contribute to society when you don’t have access to good schools, safe neighborhoods, healthy foods, good jobs and stable homes.

While achieving health equity will require active participation from a host of community-based organizations and governmental entities as well as individuals, hospitals and health systems play a uniquely important role.

For the past few decades, hospitals and health systems have championed the pursuit of personalized/ individualized medicine, recognizing that individuals require clinical care and supports that meet their unique needs and reduce the likelihood of harm. The same approach holds true for health equity. Achieving health equity means that everyone has a fair and just opportunity to be healthy, and to achieve that, health systems can ensure that children and families receive the right type of services and supports based on their unique needs. The image from the Robert Wood Johnson Foundation provides a helpful illustration of what equity looks like – when everyone has what they need to thrive. This is not synonymous with everyone having access to the same resources. In fact, in the top picture, providing the same resource to everyone results in only one person having the exact resource that they need; whereas providing the right resource for each person (bottom image) results in an optimal outcome for all.

For many reasons, hospitals and health systems have a responsibility to address health equity.

Population management The primary function of health systems is to help people be well. In that regard, addressing health inequities is fundamental to the mission of healthcare organizations. Health systems that have contracted for value-based care are incentivized to deliver the right type of care in the right setting to improve outcomes. Given that health outcomes are driven by many factors other than clinical care, and that these factors often disproportionately impact the health of certain groups more than others, health systems must determine how to mitigate these influences on health in order to measurably improve health outcomes. The same challenge exists for hospitals operating in fee-for-service arrangements – in order to improve the health of their patients, these systems must identify institutional practices and societal policies and norms that contribute to health inequities, and work to develop meaningful solutions.

Employer Hospitals and health systems are often one of the largest employers in their communities, recruiting talent for all levels of work needed to make hospitals function. In many cases, hospital employees – particularly those in lower-paying hospital jobs – struggle with meeting basic needs, and live within environments which challenge their ability to be healthy. As an employer that benefits from a healthy, productive workforce, hospitals can leverage their significant economic and political influence to promote long-term strategies for building healthier communities and pursing efforts to eradicate some of the root causes of poor health. Not-for-profit health systems should use their community health needs assessments (CHNA) to guide investments of community benefit dollars in ways that address key barriers to health identified in the CHNA. Furthermore, employers can save significant dollars in medical expenses and missed work by eliminating disparities in healthcare treatments such as asthma management and mammography screening, which can improve employee health.

Another critical perspective in the search for health equity is that of the health care consumer. All hospital employees and their dependents are also consumers of healthcare, and as such likely have certain expectations of their health care provider and system relative to health equity. As consumers, we expect to have providers and systems that are structured and trained to listen effectively to our needs, to be readily accessible to provide the right level of care and support that we need when we need it, and to do so in a manner that respects our culture, background and current realities. In other words, consumers want their health care systems to support them in achieving optimal health; that is, health care consumers want systems to support health equity.

The Institute for Healthcare Improvement (IHI) outlines several steps hospitals and health systems can take to improve health equity:

  • Make health equity a strategic priority;

  • Develop structures and processes to support health equity work;

  • Deploy specific strategies to address the multiple determinants of health on which health care organizations can have a direct impact;

  • Decrease institutional racism within the organization; and

  • Develop partnerships with community organizations to improve health and equity.

A number of health systems have been working to implement strategies to eliminate health inequities and promote a culture of health. The National Academies of Sciences released a report highlighting health system efforts to promote health equity, and another that spotlights several cross-sector partnerships to promote health equity. Achieving health equity is not just an inspiring goal. It is essential for the health and well-being of our children, and our country, and it is achievable with leadership from hospitals and health systems in partnership with the communities they serve.

Genesis Health Consulting has deep experience facilitating cross-sector collaboration to improve health, and expertise in developing and evaluating practices and policies to promote health equity. We welcome the opportunity to learn about your particular challenge, and to share more about our experiences. Please contact us at:

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