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Public health
To battle
racism,
experts
say make
health equity “Th ere’s this
implicit bias that
we have had to
a central fi ght consciously
and unconsciously
principle with the way the AMERICAN ACADEMY OF FAMILY PHYSICIANS
system is structured
because of a lack of
opportunities. Despite gains in expanding insurance
coverage, a number of health dispari-
Dr. Gary LeRoy
By Steven Ross Johnson ties have either not improved or gotten
President of the American
Academy of Family Physicians wider over the past three decades. Nota-
THE CIVIL UNREST that has erupted ble is the HIV incidence rate, with black
across the country following the May 25 teens and adults diagnosed at more than
death of George Floyd while in police eight times the rate of whites in 2017, ac-
custody has sparked calls from health- Floyd’s death comes amid the cording to the Kaiser Family Foundation.
care leaders to address structural racism COVID-19 pandemic, which has dis- Gaps in health outcomes could
as a public health crisis. proportionately hit communities of widen as African Americans continue
For Dr. Gary LeRoy, a dramatic shift color. Data compiled by the Atlantic’s to be among the hardest hit by layoff s
is long overdue in how the nation not COVID Tracking Project found that Af- due to stay-at-home orders during the
only discusses but addresses the issue. rican Americans accounted for nearly pandemic. Unemployment for African
LeRoy, president of the American Acad- a quarter of all COVID-19 deaths since Americans hit 16.8% in May, the highest
emy of Family Physicians, said he hasn’t the outbreak began; a death rate that’s rate since March 2010, according to the
seen much change in how healthcare two times higher than expected based on Bureau of Labor Statistics.
providers tackle racial health disparities their share of the population. Th e larger

since he entered medical school in 1984. context, highlighted by many public of- Efforts to improve health inequity

“There’s this implicit bias that we ficials over the past week, is the role that have providers studying how to address

have had to fight consciously and un- institutional racism plays in perpetuating socio-economic factors like poverty,
consciously with the way the system is health inequities. food insecurity and housing instability.
structured because of a lack of opportu- But the connection between race and But experts say many health organiza-
nities,” LeRoy said. health has been well-documented for tions have yet to really address the role
Much of healthcare has yet to fully at least 30 years. HHS in 1990 issued its structural racism and racial bias play as
acknowledge how racial discrimination Healthy People 2000 report that listed health determinants within their own
and bias have shaped the structures and eliminating “health disparities among institutions, as well as throughout their
policies that helped create the sys- different segments of the population” communities.

temic socio-economic dis- by 2010 as one of its three Though minority groups combined

advantages present in many broad goals. Among the made up approximately 37% of the U.S.
predominantly-minority THE TAKEAWAY population segments not- population in 2015, they accounted for
communities, he argued. Experts say healthcare ed were racial and ethnic just 14% of hospital board members that
“In the healthcare pro- providers should minorities. year and 11% of executive leadership
fession, we’re not making begin any effort to Progress toward many posts, according to a 2015 benchmark
widgets; we’re saving lives. address systemic of the goals laid out in the diversity survey from the American Hos-
Prejudice and inequities racism by making Healthy People reports for pital Association’s Institute for Diversity
and racism can kill people— health equity a factor 2000, 2010 and 2020 has in Health Management, the group’s
and it does kill people.” in all operations. been incremental at best. most recent available data.

8 Modern Healthcare | June 8, 2020