Cone Health hosts health equity summit

Cone Health Equity Summit Keynote Speaker Dr. Ron Wyatt (left) and Dr. Olu Jegede, chairperson of the Cone Health Equity Summit and vice president of Clinical Care-Health Equity at Cone Health. Photo Ivan Saul Cutler/Carolina Peacemaker.

According to data from Cone Health, people who reside in Greensboro zip codes 27405, 27406 and 27407 could die more than a decade earlier than people who live in zip codes in other parts of the city.

The Center for Health Equity at Cone Health, created to address such disparities, held a health summit for healthcare professionals and advocates on April 30 at Union Square Campus on Gate City Blvd. to discuss health inequities and ways to address them.

Health inequities are systemic differences in the health status of different population groups. These inequities often have considerable social and economic costs to individuals and societies. Due to high morbidity and mortality from health disparities nationwide, The Center for Health Equity at Cone Health works to address the need to train all healthcare professionals to understand health equity better and become ambassadors for change.

Amidst ongoing efforts to address systemic inequities in healthcare, the troubling trends of Black maternal and infant mortality cast a somber shadow over the state of maternal and child health in America.

“Black women are three to four times more likely to die during childbirth than White women, and five times more likely to die in childbirth than Hispanic women,” said Carolyn Harraway-Smith, MD, FACOG, DABFM. Dr. Harraway-Smith is the Cone Health Systemwide Chief Quality Officer, a faculty member at the Center for Women’s Healthcare and the former Chief Medical Officer for Women’s Health.

Smith noted that part of addressing racism and implicit bias surrounding maternal and infant mortality is understanding the different populations you serve and that medical issues do not present the same in every woman. She also referred to the numerous public anecdotes from Black women who say they are not being heard by their medical providers, thus leading to more serious medical complications.

“For example, what we learned was that for Black women, the blood pressure threshold wasn’t 140/90. For Black women, the change in outcome occurred at 130/80,” Harraway- Smith explained, adding that because the research had yielded new data, treatment options across the board needed to be adjusted.

Harraway-Smith asserted that addressing systemic racism in healthcare starts with training healthcare employees, policy changes, and offering individualized care through medication and programs that allow easier access to healthcare for women of color.

“Just because you are a person of color doesn’t mean that you truly understand all of the equity issues,” said Harraway-Smith. “What we’re looking for is equity, not equality. It’s ok to say, I’m going to treat this patient population with this medication because they have different needs.”

Through precision health tailored treatment, which introduces specialized treatment for different patient populations through genetic testing, better prescription management can be administered, noted Rachel Mills, MS, LCGC, UNCG AP Assistant Professor, Research and Capstone Coordinator in Genetic Counseling.

Mills noted that approximately a third of patients don’t respond to medications as expected.

“With precision medicine, pharmacogenetics, and pharmacogenomics in particular, we are using a patient’s genetic information to guide their treatment. Instead of prescribing everyone the same dosage or the same medication, we use genetics information to determine if that medication is going to work for them,” she said.

Social determinants like environment and lifestyle factors play a larger part in healthcare outcomes than what’s in your DNA.

“Your zip code is more important than your genetic code,” said Mills.

Ronald M. Wyatt, MD, a renowned global health care quality and safety expert, backed up those claims in his keynote address saying that an understanding of adverse childhood experiences, historical inequities and trauma is key when working on healthcare equity for people of color.

Founder and CEO of Achieving Health Equity, LLC., a distinguished Senior Fellow with the Institute for Healthcare Improvement, and Chief Science Officer and Chief Medical Officer at the Society to Improve Diagnosis in Medicine asserted that, “Structures and institutions that sustain and maintain racism as it relates to equity must be addressed.”

Dr. Wyatt began from a historical aspect, where he mentioned Jim Crow laws and segregation, noting that the unequal healthcare we see today can be traced back to when Africans were first brought to America through slavery.

“Inequity means that you must liberate. And I say to anybody, if you’re committed to work in inequity, it requires liberation of how you think and how you act.

This means we must do more than we’ve done,” said Wyatt, reiterating that while collecting research has been necessary, it’s now more important to take real action behind the data.

“In the United States, the color of a person’s skin is an independent risk factor for death. That’s what the data says. We don’t need more data to prove that,” he said.

He shared multiple examples of how the frequent misdiagnosis of African American patients are due to healthcare professionals’ cognitive biases, alongside decades of clinical studies that examined only White, male bodies, and a lack of understanding about the social determinants of biological illnesses. He listed the root causes of healthcare inequity stems from bias, lack of trust, racism, structural competency, and leadership.

According to an Agency for Healthcare Research and Quality (AHRQ) 2018 National Healthcare Quality and Disparities report, African American patients received worse care on 40 percent of quality measures and Hispanics on 35 percent of quality measures when compared with White patients.

Wyatt said that actionable steps are engaging in meaningful partnerships with community organizations to hear what the community wants and needs to improve health outcomes; changing policies and procedures that uphold systemic racism and biases; and implementing National Patient Safety Goal guidelines.

National Patient Safety Goals (NPSGs) are a set of guidelines and recommendations developed by The Joint Commission, an independent, not-for-profit organization that accredits and certifies more than 22,000 healthcare organizations and programs in the United States. The NPSGs aim to improve the quality and safety of healthcare by setting specific, measurable goals for healthcare organizations to achieve. Wyatt played a leading role in constructing the new National Patient Safety Goals that went into effect in January 2023.

“Inaction is a violent act,” said Wyatt, “Equity work is not about making somebody worse so we can make somebody else better. Equity is saying that we can all be better. Do not be complacent. Be an impatient optimist. Never lose your will to stir. Have the courage to say uncomfortable things. Do nothing to this community, without the community. Be impatient for equity.”