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Advancing equity in US health and healthcare: Health systems’ actions in seven major domains
A focus on equity has risen to the fore in many US healthcare systems, in reaction to the May 2020 murder of George Floyd and its repercussions, and to the many racial and ethnic disparities highlighted anew by the COVID-19 pandemic. Both senior management and boards of directors of healthcare systems across the country have undertaken new efforts, or redoubled existing ones, to address equity, first, in the context of provision of care and the fundamental operations of health systems and, second, in addressing the broad upstream drivers of social and economic inequity that are largely extrinsic to healthcare. This paper describes some of the actions taken by health systems in seven main categories: speaking out publicly against inequity; taking larger steps internally to address diversity, equity and inclusion (DEI); examining themselves through the lenses of structural racism and critical race theory (CRT); widening their traditional equity lens to encompass widespread discrimination against multiple population groups; ramping up efforts to address the quality of care and reducing undesirable variation as a means of reducing inequity and disparities; harnessing data and information technology to assist in these quality-improvement efforts; and using their resources to address upstream health drivers, including those in priority areas of the social and economic determinants of health. All told, a growing number of US health systems now recognise and accept that they must play a dominant role in a process of social and economic transformation to eliminate structural and institutional racism and other forms of discrimination and place the nation on the road to better health.
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Susan Dentzer is President and Chief Executive Officer of America’s Physician Groups. The organisation represents more than 335 physician groups focused on providing coordinated and integrated care and is accountable for both cost and quality for nearly 90 million patients nationwide. She is also a highly regarded health policy thought leader and frequent speaker and commentator on television and radio, besides being author of commentaries in Modern Healthcare, the New England Journal of Medicine Catalyst and other prominent publications. She is the editor and lead author of Health Care Without Walls: A Roadmap for Reinventing U.S. Health Care. Dentzer was previously a Senior Policy Fellow at the Robert J. Margolis Center for Health Policy, the Washington, D.C.-based arm of Duke University that focuses on important health policy issues. She also served as the editor-in-chief of the journal Health Affairs and as the on-air Health Correspondent of the PBS NewsHour. She is an elected member of the National Academy of Medicine and the Council on Foreign Relations and is a fellow of the National Academy of Social Insurance and the Hastings Center. She chairs the board of directors of Research!America, the non-profit, nonpartisan organisation that advocates for health-related research, and is a member of the board of directors of the International Rescue Committee, a leading global humanitarian organisation. She also serves on the RAND Health Board of Advisors and is a fellow of the Hastings Institute and the National Academy of Social Insurance. Dentzer graduated from Dartmouth and holds a Bachelor of Arts and Master of Health Care Delivery Science degrees from the institution.