HHS Health Chief: Equity is Everyone’s Issue

With equity an executive priority across all government services, health leaders are opening up about the opportunities that technology plays in advancing the equity conversation, but it requires workforce development as well as a focus on issues outside of direct health care.

According to the Centers for Disease Control and Prevention (CDC), health disparities are “preventable differences in the burden, disease, injury, violence, or in opportunities to achieve optimal health experienced by socially disadvantaged racial, ethnic, and other population groups and communities.”

The cause of those disparities can include factors like affordability, access to care and health insurance coverage. Their impacts can be detrimental. In a recent study published in the Journal of the American Medical Association, experts found that the overwhelming health disparities in the country impact life expectancy, predominately among African Americans.

“This is not just a problem of black and brown people. But it’s a problem for the entire country because we all are losing the investment that we’re making in people,” said Thomas LaVeist, dean of Tulane University’s School of Public Health and Tropical Medicine, at a Washington Post event last week.

Dr. Rachel Levine, assistant secretary for health at the Department of Health and Human Services, named several factors that contribute to health care inequities — all of which are areas the agency is looking at from a policy perspective, too.

“One of the most significant issues is lack of access to care for many in the African American community, and that can be in urban areas. And in rural areas, it has to do with potential lack of health insurance. But also, I think, the social determinants of health,” Levine said at the event.

From Levine’s perspective, health inequities are a systematic issue. “The work done at the Department of Commerce is a health issue. The work done by Secretary Pete [Buttigieg] in the Department of Transportation — that’s a health issue. Housing and [the Department of Housing and Urban Development] — those are all health issues,” Levine said.

As the challenges surrounding health equity increase, agencies are looking at technology to help combat the ongoing problems. Over 20 federal leaders as part of GovCIO Media & Research’s Health Tech Equity Working Group have discussed these challenges and where there are opportunities to make a difference.

Among the insights from the group is how agencies are prioritizing making health services more equitable through data sharing and addressing bias in health IT.

According to Fay Cobb Payton, professor emeritus of information technology and analytics at North Carolina State University, technology like AI can create efficiencies in health care to combat health care disparities.

“Technology is great for the automation. It’s great for analyzing quantitative data; they can give quicker, faster diagnoses, spit out treatment plans,” Cobb Payton told GovCIO Media & Research in an interview. She also emphasized that any use of technology should focus on the workforce because “it requires human intervention, from the very start of the process to the implementation to the policy play.”

Cobb Payton stressed that AI cannot be a sole solution to the health care disparities and inequities.

“You always need a human in the loop with the technology. And you need to ask the question of, ‘Who are the humans?'” she said. “Are the humans themselves aware of a health equity, social determinants of health, any biases that may creep into their interpretation of whether it’s care delivery, whether it is treatment plans, whether it is policy implementation?”

There are efforts on the commercial side showing promise for addressing equity in health care. Abbie Lennox, a member of Bayer’s Consumer Health Executive Committee, said the organization is looking at new technologies to increase communication and education of medicines for patients.

“We’re doing a huge amount of work at the moment on actually trying to use ‘e-labeling’ — so QR codes where people can go to the shelf, they can scan a QR code or they can scan a QR code on the box,” Lennox said at the Washington Post event. “It’s easier to talk in language that everyone understands, through those sorts of things with a digital medium that it brings.”

While these health care leaders are aware that these challenges can’t be fixed overnight, they are determined to get closer in closing that gap.

“I think the most important point here is that I can’t tell you what it will cost to fix the health inequities — and it will cost something. But it also will cost something to not fix the inequities,” said LaVeist. “To make the argument that we shouldn’t do things because it’s expensive — I don’t think there’s an argument that’s sustained logically because there’s a significant cost of inaction.”