‘We cannot just sit around and admire the problem’ of health inequity: Nuñez-Smith

The Biden-Harris administration has focused heavily on health equity since it took office in January, as evidenced by executive orders and the creation of the Health Equity Task Force.

Yale Associate Dean of Health Equity Research and Internist Dr. Marcella Nuñez-Smith was appointed chair of the task force in December 2020 and immediately began work on the gender equality issues related to the pandemic.

“We can no longer just sit around and admire the problem,” Nuñez-Smith told Yahoo Finance on Wednesday as part of his week-long series Economics of Health.

For this reason, the objectives of the task force go beyond identifying the causes of the problems, as the first four meetings have shown. In addition to vaccinating equity, the task force has also focused on mental health and systemic racism.

At its final meeting on June 1st, the Task Force discussed “how discrimination and xenophobia endanger minorities, marginalized and medically underserved communities, even during the pandemic. Task force members considered how government and state, local, tribal and territorial (SLTT) officials could best respond to and mitigate xenophobia and discrimination in the United States, “an official memo said.

Each meeting ends with action points, including disseminating awareness-raising information and identifying areas of research to guide policy. It is also an important goal to identify the roles of government and the private sector.

“We need to think about where the incentives are,” said Nuñez-Smith.

Over the years, she said, research and data have accumulated. Pilot programs have come and gone. Non-profit organizations have emerged. But the needle has yet to move – in part due to the lack of a central point – public or private – to drive change.

Some of the questions that need to be asked include, “What exactly is a health dollar in our country? How do we feel about financial ownership? ”Said Nuñez-Smith.

Other countries have pursued approaches that focus on social services and safety nets, resulting in better health outcomes than the US. In comparison, however, the US has inadequate health spending. More than 17% of GDP is spent on health care.

And it will take a multi-pronged approach and more time to build sustainable solutions, said Nuñez-Smith.

In this image from the video, Jeff Zients, White House Coronavirus Response Coordinator, speaks as Dr. Anthony Fauci, Director of the National Allergy and Infectious Disease Institute and Senior Medical Advisor to the President, Dr. Marcella Nunez-Smith, Chair of the COVID-19 Health Justice Task Force, Dr. Rochelle Walensky, Director of the Centers for Disease Control and Prevention, and Andy Slavitt, Senior Advisor to the White House COVID-19 Response Team, appear during a White House briefing on the Biden Administration’s response to the COVID-19 pandemic on Wednesday , January 27, 2021, in Washington. (White House via AP)

Learning from vaccines

Getting vaccines to those most in need was the first step for the government.

“We are learning a lot about the vaccination campaign and what it takes” to understand the role of each actor in the public and private sectors, “said Nuñez-Smith.

These teachings can be translated to achieve health equity in general and to remove existing barriers or determinants of health.

“Why should it matter which door you go through, why should it matter which zip code you live in and which healthcare system is closest to you?” said Nuñez-Smith.

As tech-savvy people could easily find vaccines in the early days, the White House COVID-19 team looked for links to community centers and low-tech options like phone banks to reach the most vulnerable populations.

The actions taken are only the first step in understanding why technology is not the holy grail of health equity, much like it was when telemedicine was introduced years ago. Not everyone had video back then, said Nuñez-Smith.

Likewise, data and its potential impact on the health system are unknown, and built-in biases in the data are a blind spot.

“I’ve learned so much about data architecture over the past few months and understood what some of these limitations are,” said Nuñez-Smith.

After that, applying what we learn to change behavior and achieve better justice will be the next milestone.

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