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A team of health care policy researchers looked at efforts to increase health equity in eight different countries and found some important lessons for leaders in the US health care system trying to do the same.
On a blog published on a website based in New York City Commonwealth Fund and entitled “Advancing Health Equity: Learning from Other Countries.” Nason Maani, Ph.D.And Sandro Galea, MD, MPH, DrPHIn Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, and the United Kingdom, he looked at the experiences of leaders in health care systems working to advance health equity and end systemic racism, as leaders in the US health care system are working. to work. Manny is the 2019-2020 UK Harness Fellow in Healthcare Policy and Practice Research Fellow at the London School of Hygiene and Tropical Medicine, and the Galia Dean and Robert A. Knox is Professor, Boston University School of Public Health.
Placing health equity efforts in the context of the global impact of the COVID-19 pandemic, Manny and Gallia “looked at how eight high-income countries (Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway); , and the United Kingdom) have attempted to change the mindsets of health care leaders and practitioners, measure and eliminate racism in care delivery, and promote equitable access to care. The eight countries fund health care differently than the US and are affected by racism and income inequality in different ways. However, they write that they “provide lessons and practical strategies for supporting historically marginalized groups and reducing health inequity.” To identify how these countries have pursued health equity, we conducted an additional literature review through interviews with five experts (see the Appendix). Global health and health equity. This blog post describes promising, evidence-based approaches to reducing health disparities that are relevant to the United States and can encourage further national education.
Importantly, some of what health care leaders in other countries are doing seems likely to be replicated here in the United States, despite the differences between the American health care system and the eight systems studied by Manny and Gallia. As he noted, “In these eight countries, we have seen medical societies and schools play a critical role in eradicating racism, often by identifying and reducing harmful attitudes. In Canada, a group of medical students documented other students’ perceptions of Canada’s Aboriginal or black people. These include the perception that these patients have little desire to stay healthy, blame themselves for their poor health, and are very different from themselves. Medical societies and schools monitor and respond to racism and discrimination in education and the workplace. In the UK, medical colleges admit that black and minority people in the National Health Service (NHS) do not have equal access and face problems in career progression, pay, sanctions for misconduct and opportunities for bullying and exposure. Harassment,” they reported.
Meanwhile, the researchers wrote: “A second theme that emerged from our literature review and interviews was the importance of measuring health care disparities to identify and ultimately eliminate racism in care delivery.” New Zealand researchers have found that breast cancer screening and treatment rates are lower among Maori than non-Maori women, and that Maori women are less than half as likely to reach the five-year breast cancer survival mark. In France, researchers have found that immigrants from sub-Saharan Africa, North Africa and French overseas territories and their children may face discrimination when seeking care. In the UK, people from black and minority ethnic backgrounds were four times more likely to be detained under mental health laws – which allow people to be detained if they are thought to be at risk of imminent harm to themselves or others – than their white counterparts. . These groups are more likely to access mental health services through the criminal justice system than through primary care. And, “In Australia, an external assessment tool has been developed to help hospitals measure, monitor and report on institutional racism. It assesses preventable hospital admission rates by race, underrepresentation of minority leadership roles and health service funding gaps, and was used to assess all 16 hospital and health service organizations in Queensland, Australia.
Going forward, the authors of the article, “
Health inequities reflect wide disparities in access to education, economic advantages, healthy physical environments, and other resources, and health care providers can play a central role in understanding and addressing the issues. Transnational education provides inspiration and examples for improving common health equity challenges. Our research finds diverse international efforts to advance health equity, providing guidance for US health systems working to reverse racism and policies.
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