Collection of policy papers aims to guide policymakers, stakeholders and the public in achieving reform
Jan. 22, 2021 (ACP) – The COVID-19 pandemic and other national events in 2020 shone a bright light on the disparities facing people of color in the United States. Now, the American College of Physicians is providing a comprehensive roadmap to achieve a more inclusive and healthier future.
ACP lays out the way forward in a new report titled, “A Comprehensive Policy Framework to Understand and Address Disparities and Discrimination in Health and Health Care” and three accompanying policy papers. “As a physician, I want every one of my patients to be in the best possible health that they can be,” said Dr. Jacqueline W. Fincher, president of ACP. “Research shows us that many people experience inequities and disparities in health access and outcomes, simply because of their race, ethnicity, religion and cultural identities, and where they live. This is unacceptable. At ACP, we are committed to good health care for all, poor health care for none.”
ACP is uniquely qualified to provide guidance to policymakers, stakeholders and the general public. The goal of the new reports is to get their attention, mold their thinking and put them on a path toward reform.
“First, we're really trying to get policymakers to commit to understanding all these disparities in health and health care,” Fincher said. “Second, we really want them to comprehensively address this multifaceted and very interconnected set of contributors to health and health care disparities such as racism, discrimination and lack of coverage and access to care, plus factors like poverty and socioeconomic issues that contribute to the problems we have.”
The framework report, published in the Annals of Internal Medicine on Jan. 12, notes that “research has shown that Black, Indigenous, Latinx, Asian American, Native Hawaiian, Pacific Islander, and other persons in the United States experience disparities in health and health care associated with their race, ethnicity, religion, and cultural characteristics and identities.” These disparities contribute to higher rates of illness and death and poorer quality of health care, the report says.
“As we know, you can't address a problem unless you first admit you have one,” Fincher said. “So, we had to call out the problem: There are cultural identities and ethnicities that are directly linked to disparities and inequities in our country.”
ACP understands, however, that it must do more than simply highlight what's wrong. “As I always told my daughter growing up, don't come to me with a problem unless you've got a solution that you think we ought to look at,” Fincher said. “So, you can't just complain. You've got to come up with ideas. That's what we've tried to provide.”
To help the nation change its course, ACP proposes a “comprehensive, interconnected, and evidence-based policy framework to understand, address, and end such disparities,” the authors write in the report.
Specifically, ACP lists 17 recommendations in its framework report. Among them:
- ACP recommends that U.S. policymakers commit to understanding and addressing disparities in health and health care related to a person's race, ethnicity, religion and cultural identity/personal characteristics, as aligned with ACP's mission “to enhance the quality and effectiveness of health care for all.”
- ACP recommends that policymakers consider discrimination and hate against any person on the basis of personal characteristics to be a public health crisis.
- ACP believes that public policy must acknowledge the long history of racism, discrimination, abuse, forced relocation and other injustices experienced by Indigenous persons and commit to focused and culturally appropriate policies to address their present reality of injustice, disparities and inequities.
- ACP believes that more research and data collection related to racial and ethnic health disparities are needed to empower policymakers and stakeholders to better understand and address the problem of disparities. Collected data must be granular and inclusive of all personal identities to more accurately identify socioeconomic trends and patterns.
The three accompanying ACP policy papers tackle how to understand and address these topics: “Disparities and Discrimination in Law Enforcement and Criminal Justice Affecting the Health of At-Risk Persons and Populations,” “Disparities and Discrimination in Education and in the Physician Workforce” and “Disparities and Discrimination Affecting the Health and Health Care of Persons and Populations at Highest Risk.”
What's next? “Let's get going,” Fincher said. “We don't have time to waste.”
“A Comprehensive Policy Framework to Understand and Address Disparities and Discrimination in Health and Health Care” is available on the Annals of Internal Medicine website.
The accompanying three papers, Understanding and Addressing Disparities and Discrimination in Education and in the Physician Workforce, Understanding and Addressing Disparities and Discrimination Affecting the Health and Health Care of Persons and Populations at Highest Risk, and Understanding and Addressing Disparities and Discrimination in Law Enforcement and Criminal Justice Affecting the Health of At-Risk Persons and Populations are all available on the ACP website.