Last year, Nationwide Children’s launched a new movement for the entire hospital to “Stand Against Racism, Stand for Health Equity.” Most people know what we mean when we say we “Stand Against Racism,” even if it’s not always understood just how much of a crisis racism is for children’s health (I wrote about that crisis a few months ago in this space).
But what does it mean to “Stand for Health Equity?” What is health equity?
Let’s start with the first part of a definition that many people use. It’s from the Robert Wood Johnson Foundation, an organization that has been an important partner for Nationwide Children’s as we address these issues:
“Health equity means that everyone has a fair and just opportunity to be as healthy as possible.”
That may sound simple, but because many factors contribute to a person’s health, it’s not. An affordable, high-quality place to live matters. So do a safe neighborhood, educational opportunities, enough food to eat, a job that pays a “living wage,” a life free of discrimination and access to high-quality, comprehensive health care.
Once you start exploring any of those factors, health equity begins to seem even more challenging. Take health care access. You need a doctor or other provider close enough for easy travel, which is not assured in rural areas. You need some form of transportation. You need health insurance or another way to pay. Adults need time off work. Patients who speak English as a second language may need interpreters to assist at medical visits. Medical documents need to be translated into multiple languages.
Some people don’t have any of those barriers. Some have all of them and more, so they do not have the “fair and just” opportunities for health care access that others have. They may not have the same opportunities across the other factors (housing, employment, education) that contribute to health either.
That’s why there is a second part to the Robert Wood Johnson Foundation’s definition of health equity. It demands action. It demands the kind of “stand” we are taking at Nationwide Children’s:
“(Health equity) requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care.”
It’s not enough to be a hospital that can provide world-class care. We must actively help people receive that care. It’s not enough to have jobs available; we must train people for those jobs, especially people who are disadvantaged or who don’t typically have an opportunity to work in health care.
Nationwide Children’s has done this work for decades, through programs such as our community revitalization initiative Healthy Neighborhoods Healthy Families, or our school-based health care initiative called Care Connection. We develop affordable housing, we train people for jobs, we mentor students, we take health care into the schools (because we know that’s where the kids are), and we place primary care centers in neighborhoods with limited access to health services.
We also study health equity, so we can do a better job of improving it. Earlier this year, we formed the Center for Child Health Equity and Outcomes Research, led by our nationally recognized health equity expert Deena Chisolm, PhD. Studies from this center will help us, and our colleagues around the world, better understand the effects of health disparities in health care access, health policy and community initiatives, and will inform solutions.
Our efforts have helped many, but if the events of the last year have taught us anything, it’s that so much more needs to be done to ensure health equity. Nationwide Children’s is committed to that goal, and we look forward to working in our community and in our world to achieve it.
Olivia W. Thomas, MD, currently holds the position of Chief Diversity and Health Equity Officer at Nationwide Children's Hospital. Dr. Thomas is also a member of the Section of Primary Care Pediatrics and a clinical professor of Pediatrics and chief of the Division of Ambulatory Pediatrics in the Department of Pediatrics at The Ohio State University College of Medicine.
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