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The turbulent journey of Covid-19 has taught us many lessons about the strengths and weaknesses of our health care system.

In particular, the pandemic has shone a bright light on long-existing disparities in health care access, experience and outcomes that affect so many populations and communities in the United States.

As many of us have long known, these disparities are not random. They are the systemic and predictable consequences of generations of structural racism, sexism, homophobia and other enduring discriminatory practices that for too long have been tolerated and allowed to flourish.
As this once-in-a-generation pandemic bore down on us, it revealed the inescapable and often fatal realities of health care inequity. We saw health injustice writ large as people from marginalized communities were more likely to get Covid-19, get sicker and die from the virus.

Consequently, the quest for health equity has become central in efforts to curb the pandemic because it demonstrated clearly and undeniably the interconnectedness of health and wellness throughout society — in ways previously unseen or misunderstood, and some we have been in denial around. The National Institutes of Health defines health equity as “the absence of systemic disparities in health and its determinants, between groups of people at different levels of social advantage.”

So, what does this mean? Broadly speaking, it means that everyone has the same opportunity to be as healthy as possible, regardless of socioeconomic status, race, ethnicity, gender identification, sexual orientation or physical ability. But the truth is far more complicated.

Accepted identifying categories are often a proxy for the differences in socioeconomic factors and access that have long, stubborn and historical roots. Achieving health equity means closing the gaps between these different populations and digging out the deep roots of injustice to ensure that all have what they need to achieve optimal health.

Health care organizations have risen to this task by making strategic commitments and dedicating personnel and resources to this quest. A key part of this has been an understanding that effective strategies to address disparities require collaboration, communication and partnership with the affected communities.

It is well known that a person’s zip code is a more significant determinant of their life expectancy than their genetic code. Marginalized communities have rightful mistrust of the health care establishment due to their historical experiences.

Health care delivery systems therefore must effectively use data to identify inequities and the affected populations. Then they need to establish their trustworthiness with the affected communities if they hope to have an effective impact. At Providence Swedish Health Services, we are focused on working toward the delivery of high-quality equitable health care through the establishment of our Office of Health Equity Diversity and Inclusion (OHEDI).

This focus on health outcomes and cultural humility in care delivery aligns with forming effective community-based collaborations to address health equity in access, experience and outcomes. We are also focused on increasing diversity in the health care workforce and helping build an inclusive culture.

Education and training are also priorities; recent trainings on implicit unconscious bias are helping our caregivers understand the experience of patients from marginalized communities.

Beyond the pandemic, our OHEDI program and its team of cultural navigators serve as a resource for patients and providers in connecting around language, culture and other social determinants of health. They help patients access the primary care they need for management of chronic conditions like hypertension, diabetes mellitus and cancer screenings.

They also serve as a vehicle of outreach and collaboration to the community and help with enrollment in health insurance and other issues of access. Currently, we have cultural navigators for Latinx, Somali and African American populations. We are also committed to addressing the Black maternal health crisis through the work of our Justice Unity Support Trust Birth Network because as we know, Black women are three to four times more likely to die from complications surrounding pregnancy and childbirth than their white counterparts.

The quest for health equity requires intention and a willingness to understand and address the challenges around basic access and outcomes that have for generations been faced by marginalized populations. Our work around closing these gaps will save lives today and for future generations, and deliver on the promise of high quality, equitable care for all of society.

Dr. Nwando Anyaoku is the chief health equity officer at Swedish Health Services in Seattle, which is affiliated with Providence Health & Services.