“Health Equity in Action” panelists were (clockwise from upper left): Aletha Maybank, MD, MPH; Lynn Todman, PhD; Reneé Canady, PhD, MPH; and Nicki Britten, MPH

‘Health Equity in Action’ Panelists Urge Health Systems to Reach into Their Communities

ST. JOSEPH, Mich.—When COVID-19 struck a year ago, revealing yet one more health-outcome disparity between African Americans and whites, some health care professionals who had been addressing health inequities in their communities had a head start.

On the West and South sides of Chicago, “racial-equity rapid response teams” sprang into action. They were led by “community voices” and supported by what amounted to prior “emergency preparedness” work.

Around Lake Michigan to the east, in the small but segregated city of Benton Harbor in Berrien County, Michigan, a similar dynamic was unfolding. The Spectrum Health Lakeland hospital system, the Berrien County Health Department and others teamed up, enlisting “community influencers” to inform residents about precautions during the pandemic and opening a clinic in the heart of the medically underserved city.

The first example was cited by Aletha Maybank, the first-ever chief health equity officer of the Chicago-based American Medical Association. The second example came from Nicki Britten, who heads the Berrien County Health Department.

Maybank and Britten joined Reneé Canady, the chief executive officer of the nonprofit Michigan Public Health Institute in an online panel March 24 sponsored by Lakeland and the ongoing Community Grand Rounds program that is focusing on health disparities and health outcomes in Berrien County. The “Health Equity in Action” webinar panel was moderated by Lynn Todman, Lakeland’s vice president for health equity.

Maybank made a distinction between equality and equity. She said everyone is born equal, but in a world of “haves and have-nots,” resources are unequal. They must be redistributed based on need so everyone can achieve optimal health. “I think sometimes what’s really not clear is that equity is definitely an outcome,” she said.

“I think sometimes what’s really not clear is that equity is definitely an outcome.” – Aletha Maybank

The panelists criticized hospital systems as being generally too removed from their communities. Hospitals are understandably concerned about things like reimbursement rates and bedside care, but suffer from insularity, with too little understanding of their communities outside hospital walls.

Canady said hospital board members would be moved emotionally if they invited patients in to talk about “the atrocities that people have to manage, just to live.”

And she urged them to consider the effects on the broader community of their decisions. For example, in their master plans hospitals need to strategize about how locating ambulatory sites and other physical structures will affect residents’ well-being. If they view themselves “as a resource, as an employer, as an advocate, as a partner for so many entities, and as a vital, vital member of a community,” hospitals will also be advancing health equity.

The panelists heartily endorsed the idea of hospital systems lobbying at the federal and state levels for laws promoting health equity in their communities, using the political system while avoiding partisanship.

And they all believe there is too little collaboration between hospital systems and health departments, a situation Canady called “almost absurd.”

But Britten said in Berrien County the health department and the hospital system’s Population Health Department are “really starting to view ourselves as one team that is serving the community”—a partnership a decade in the making.