What is Health Equity?
Equitable care does not vary in quality because of personal characteristics such as gender identity, race, ethnicity, preferred language, geographic location and socioeconomic status. Quality care cannot be achieved without equity.
Despite decades of evidence showing persistent health disparities impacting populations made vulnerable by racism and discrimination, progress is slow to close the gaps. Quality initiatives measuring only outcomes of general populations may conceal widening gaps in care or disparate outcomes of minority groups. Focused efforts are needed to collect and stratify data to uncover health disparities within health systems, train staff to better understand root causes of inequities in healthcare and partner with communities to address social needs.
WSHA Health Equity Collaborative
Over 50 Washington and Oregon hospitals and ambulatory sites with strong commitment to achieving health equity have enrolled in an 18-month collaborative. Using an “all teach, all learn model,” supported by content experts and peer coaching, the collaborative focuses on implementing foundational health equity components. (informational flyer)
Topics include providing effective language access services, collecting patient self-reported race and ethnicity data, delivering LGBTQ+ affirming care, analytics approaches for detecting disparities, designing health equity dashboards, screening and addressing social determinants of health.
Collect Patient Race, Ethnicity and Language Data
One of the first steps towards identifying health disparities locally is to collect self-reported race, ethnicity and language (REaL) data. Allowing patients to self-identify their race, ethnicity and primary language is the gold standard for collecting valid data. Other demographics, such as sexual orientation and gender identity (SOGI), religion, veteran status and disabilities may also be collected consistently to help to inform culturally sensitive care and find disparities.
Addressing Health Care Disparities through Race, Ethnicity and Language (REaL) Data—a PDF overview with linked hospital case examples and resources developed by the AHA Institute for Diversity and Health Equity. Provides framing of collecting REaL in the context of responding to COVID-19.
Race, Ethnicity, Language Data Collection Best Practices – a PDF document published by the Greater Cincinnati Health Council with validated guidelines to improve data collection.
Screen for Social Determinants of Health
Social determinants of health (SDOH), or health related social needs, reflect community and environmental factors impacting the ability of a patient to access health care and prioritize healthy choices. Evidence suggests that 80% of health outcomes are related to SDOH. Screening for SDOH include housing instability/homelessness, food insecurity, transportation, education, utility needs, interpersonal violence, family and social supports, employment and income.
SDOH Screening Tools Comparison—UCSF SIREN has compiled information from several of the most widely used social health screening tools for stakeholders interested in comparing these instruments. This includes a summary table for quick reference and links to individual tool information.
Community Resource Referral Platforms: A Guide for Health Care Organizations—UCSF SIREN comprehensive study of community referral platforms to integrate with health system referral workflows to address SDOH screening needs.
Complete the Health Equity Organizational Assessment
Not sure where to begin? The Health Equity Organizational Assessment collects seven key metrics, which together reflect the level of hospital implementation underway to reduce disparities. The seven metrics align with research in the field on how and where hospitals have the most impact to reduce disparities. Upon completing the survey, review the results with a cross-functional and multi-disciplinary team to develop an action plan to improve health equity.
HEOA Metric Categories Include
- Data collection
- Data collection training
- Data validation
- Data stratification
- Communicate findings
- Address and resolve gaps in care
- Organizational infrastructure and culture
Download: Health Equity Organizational Assessment
Eliminating Disparities to Advance Health Equity and Improve Quality—PDF guide developed by the Michigan Health & Hospital Association (MHA) Keystone Center to provide practical guidance for organizations seeking to eliminate disparities in care to advance health equity. This is a great companion guide to the HEOA.
Tools and Resources
Roadmap to Reduce Disparities – a link to the Solving Disparities Roadmap to Reduce Disparities, a six-step framework for health care organizations to improve minority health and foster equity.
CMS Health Disparities Guide – a PDF document from the Centers for Medicare and Medicaid Services with a basic framework for addressing disparities, and a resource guide for more information.
Equity of Care: A Toolkit for Eliminating Health Care Disparities – a PDF toolkit published by the Health Research and Education Trust for eliminating health care disparities.
Preventing Readmissions Among Racially and Ethnically Diverse Patients – a PDF document from the Centers for Medicare and Medicaid Services.
Addressing Social Determinants of Health in Hospitals – Deloitte Center for Health Solutions conducted a nationally representative online survey of 300 hospitals and health systems to identify their current health-related social needs activities and investments and their potential future efforts.