COVID-19 Makes It Clear: Without Equity, There’s No Cure

The COVID-19 pandemic has exposed just how critical public health is to the fabric of our communities – our safety, economic stability, personal connections and social justice. After seeing the disproportionate impact of the virus on minority and economically disadvantaged communities, it’s clear that equity must be a public health imperative.

With the development of vaccines and advanced treatments for the coronavirus, there is hope on the horizon, but questions are being raised about how they will be distributed. How do we ensure vulnerable, too often overlooked communities are prioritized? Will the process be equitable? These are the right questions to ask, and underscore that we recognize equity must be a primary consideration in our systems and institutions, particularly when it comes to public health and the way we deliver healthcare.

I’ve written about this topic before. It’s very important to me, and it’s a key priority for Sutter Health. We’ve been working for several years to advance health equity and eliminate gaps in health outcomes for vulnerable patient groups. Our work in this space has encompassed a number of areas, including managing chronic illnesses like asthma, opioid prescribing, maternal health, and even COVID-19. In fact, we are incredibly proud that as the result of work that started over a decade ago, our C-section and maternal mortality rates now sit well below California’s nationally leading average, and our maternal mortality rate demonstrates no inequity in race or ethnicity. Also, to impact the way care is delivered across our integrated system we are conducting unconscious bias training that will ultimately reach all clinicians. This work began with our boards and clinical leaders years ago.

As a crucial next step in Sutter Health’s commitment to providing more equitable outcomes and overcoming injustices in the nation’s healthcare system, this month we launched our Institute for Advancing Health Equity. Embedded within Sutter Health, the Institute will serve as an innovation incubator that generates knowledge and solutions and shares its expertise and experience to change the way care is delivered. By using the resources and data within our integrated network, the Institute is uniquely positioned to produce high impact research that can be directly applied into clinical settings to improve patient care and outcomes.

The increased awareness generated during the pandemic about the prevalence and impact of health disparities, combined with the kind of data and insights our Institute and others are generating about ways to address them, offers us an important opportunity. All of us within healthcare – providers, insurance companies, policymakers and regulators – must find better ways to improve equitable health outcomes for all, no matter a person’s race, gender, income, sexual orientation or zip code.

A similar opportunity exists to expand equitable access to care. At the onset of the COVID-19 pandemic, state and federal policymakers removed regulatory and financial barriers to make it possible for healthcare providers and systems like ours to expand our use of telehealth so patients could safely access care as we sheltered in place. Thankfully, discussions have already begun within the legislative arena about making telehealth – or virtual care – benefits permanent.

We’ve seen the benefits of virtual care firsthand at Sutter through our own experience and through partnerships with community-based clinics and care providers, who care for many uninsured and lower-income patients. Expanded telehealth access during this pandemic has increased access to healthcare for the most vulnerable by nearly 50%. It’s reduced no-show rates and given community health providers, particularly in more remote areas, an effective way to stay connected to patients and assess their needs. Over time, this drives down costs by keeping people healthier.

We must ensure that telehealth becomes a permanent and pervasive part of the healthcare delivery system, and that long-term solutions intentionally focus on vulnerable populations to support equitable availability and adoption. This is not about simply offering another method of care. Virtual care is a critical component of the health equity equation as it helps ensure equitable access to care, particularly for the most vulnerable among us. A number that’s certain to grow as the economic toll of the pandemic wears on.

In the year ahead, these conversations and actions must continue, and our commitment to creating a more equitable healthcare system must deepen with it. We must get to the point where health inequities are something we proactively consider and collectively work to resolve. Because the longer it takes to remove barriers and inequities, the longer it will take our society to truly heal in the wake of this pandemic.