By Robert MacArthur, MD
Healthcare disparities are preventable differences in healthcare status, access and quality experienced by many consumers due to a variety of factors, including race, ethnicity, income, gender, neighborhood, language and education. For example, according to the U.S. Department of Health and Human Services, the Hispanic community experiences higher rates of diabetes, while heart disease impacts far too many African American residents. Arab Americans also face barriers to healthcare due to cultural beliefs and practices such as modesty, gender preference in healthcare providers and misconceptions about illnesses and conditions. While Michigan’s performance on all measures of healthcare quality and disparity has been rated as “average”, a great deal of work must still be done to continue addressing the disparities that still plague communities across the state.
To develop a more equitable healthcare system, both health plans and providers must focus on delivering patient-centered care. That means helping each and every individual get the care they need with a keen focus on removing their social barriers while also respecting their values, beliefs and preferences. For example, in some cultures, healthcare decisions are made by families and many physical and behavioral health conditions carry social stigmas that can adversely impact the family unit. Understanding this dynamic is critical to developing a unique care plan for every individual that focuses on delivering the highest level of care possible. Deploying the right resources, training staff on culturally sensitive care and providing the appropriate level of education to patients and their extended families are also critical steps.
Minimizing healthcare disparities also requires a focus on social barriers, such as food and housing insecurity or intermittent access to utilities. If someone is struggling to pay their electric bill, their health conditions won’t be a priority. Moreover, intermittent access to electricity can also impact someone’s ability to self-manage their conditions. After all, many at-home medical devices, such as oxygen concentrators, sleep apnea machines, nebulizers, chair lifts and ventilators require electricity. Food insecurity is especially pervasive and often a hidden barrier to high quality care. If an individual with heart disease or diabetes has limited access to nutritious food, no amount of communication or education will help; a food insecurity intervention will be required. While many community and state-level resources already exist that cater to these social needs, lack of awareness can impact the effectiveness of these programs. As healthcare organizations, it’s our duty to help each and every individual in our care to connect to the resources they need.
Throughout my medical career, I’ve seen first-hand how patient-centered care can help minimize disparities in healthcare access and quality. Many of our health plan’s members across the country, including in Michigan, have significant medical, behavioral and social support needs and require a more personalized approach to care to overcome these barriers. Over our 20-year history, CCA’s uncommon approach to complex care coordination has made a significant impact on our communities. We believe that by working together with our provider partners, community organizations, local governments, as well as our members and their caregivers, we can move the dial on Michigan’s healthcare outcomes.
– Robert MacArthur, MD, is chief medical officer of Commonwealth Care Alliance (CCA) and CCA Health Michigan