As the Delta variant causes a surge in COVID-19 cases, restarting to wear masks and forcing hospitals to regain surge capacity, a familiar pattern is emerging. Like its predecessors who are not easily spread, this dangerous SARS-CoV-2 variant particularly affects vulnerable populations in the United States. minority with countryside Communities with lagging vaccination, because of a perfect storm, reduced access to medical services, vaccination hesitation, and targeted misinformation Distrust ingrained in movement and history.
In the past year, governments at all levels have noticed the disproportionate impact of COVID on these groups. At the federal level, President Joe Biden appointed a COVID-19 Health Equity Working Group by executive order.Many states, including Illinois, Louisiana State with Tennessee, Established similar working groups, working groups and councils to promote health equity in the context of COVID-19.The National Governors Association recently emphasized VirginiaThe task force serves as a role model for other countries. These conveners helped drive billions of dollars in federal and state investment to improve testing and vaccination opportunities in underserved areas. Recently, they have worked with community leaders to disseminate effective information about wearing masks, social distancing, and vaccines in constantly changing and sometimes confusing federal guidance.
Although these efforts may help eliminate differences in COVID results, we must recognize that the root causes of these differences have existed for generations before the pandemic, and if health equity is not prioritized, it will be in subsequent generations. continue living. COVID has had a disproportionate impact on vulnerable groups because it has exacerbated pre-existing inequalities in our society. Long-standing health disparities (including inequality in the incidence of comorbidities that increase the risk of adverse outcomes from COVID) and health-related social factors (such as unsafe housing and environmental exposure) have led to huge differences in the number of cases and deaths. These systemic disadvantages require more than mobile clinics, temporary committees and short-term investments.
Rather, they reflect the need for a broader and sustained commitment Health fair-Indeed, for Health justice From all levels of government. President Biden has expressed interest in this commitment through a series of executive orders on racial equality, and the Department of Health and Human Services continues to support key tasks through its Office of Minority Health and Health Equality. However, at the state level, although the structural factors that contribute to health and disease inequality are highly local, similar opportunities to promote health equity after a pandemic have received little attention.
Therefore, we recommend the establishment of a permanent director responsible for health equity in each state. The office will be responsible for coordinating all-round efforts to promote health equity at the state level. Achieving fairness not only requires attention to downstream factors such as inequality of opportunities in healthcare, but also upstream factors outside the field of healthcare. These upstream factors are often referred to as social determinants of health, including education, housing, and transportation, and their combined impact on health and well-being is greater than that of medical care. Similarly, the political determinants of health, including the unequal distribution of social power and the increasing deprivation of rights of certain groups of people, are increasingly recognized as essential to health equity.
Given that such a wide range of issues—many of which have nothing to do with health care itself—are the basis of health inequality, health equity directors must not only work in the health sector, as is the case in these roles today, but also work with the leaders of various departments. cooperate. Government departments, including the Ministry of Education, the Ministry of Housing, and the Ministry of Justice. In this way, they can help break silos and coordinate pan-government health equity approaches that integrate upstream and downstream efforts. For example, after noticing that there are huge differences in the incidence of diabetes among different ethnic groups in the western region of a state, the supervisor can coordinate through the targeted information transmission of the public health commissioner and the governor, and the specific guidance provided by the health minister and the medical assistance agency to the local area. Comprehensive efforts. Hospitals and doctors, as well as education and business departments provide guidance to schools and retailers to promote healthy eating and limit the sale of high-sugar foods.
These health equity executives will use data and analysis to better define state and local health disparities and provide information for the design of efforts to reduce these disparities. They will provide strategic and planning leadership for equity-focused initiatives, and advise government agencies on how their plans affect differences and how to reform them to better promote equity. They may also contact diverse, fair and inclusive staff in each department or agency to assess the specific differences between the agency and its stakeholders, and their relationship to the distribution of health and disease.
Many healthcare organizations, including the private sector, recognize the need for such positions. For example, Humana and Anthem, two Fortune 50 companies, recently appointed a Chief Health Equity Officer (CHEO).exist Centaur, CHEO sets direction and develops strategies to promote health equity in all business areas, including health insurance and nursing services. Responsibilities include leading the work of defining corporate-wide fairness metrics, setting improvement goals and coordinating efforts to achieve these goals, and integrating cultural sensitivity into the design and development of Humana’s clinical programs, products, and services.
If the journey to health and equity requires thoughtful planning and evidence-based intervention across departments, then appointing leaders and giving them the resources to implement the vision we propose here will be an essential part of the journey. As the pandemic rages, we hope that our leaders will continue to consider advancing a comprehensive strategy of health and equity at this unique historical moment.
This is an opinion and analysis article; opinions expressed Author or author Not necessarily those Scientific american.