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Another Voice: Better health equity demands focus on social factors

Another Voice: Better health equity demands focus on social factors

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Legislators April Baskin and Howard Johnson began work on the Erie County Health Equity Act of 2021 before the Covid-19 pandemic laid bare inequities largely overlooked in the past.

The act is intended to diminish disparities in care through the Office of Health Equity, which will operate within the Erie County Health Department.

We are two physicians who have seen health care through the lenses of emergency medicine, primary care, urgent care and public health. We have witnessed disparities in care and access at each of these levels. That’s why we believe any plan forward must address not only shortcomings in our health care system, but also other areas of our lives that influence health outcomes.

The Centers for Disease Control and Prevention identify five social determinants of health: health care access and quality, education access and quality, social and community context, economic stability, and neighborhood and built environment. Social determinants explain how something like income impacts health outcomes.

The Greater Buffalo Racial Equity Roundtable published a report (“The Racial Equity Dividend: Buffalo’s Great Opportunity”) outlining how social determinants have influenced Buffalo. The report details the effects racial and economic inequities have had on people of color. One example illustrates ways in which the absence of commercial spaces negatively impacts job opportunities and access to health care and nutritious food, contributing to negative health outcomes.

The Roundtable’s report notes that addressing racial disparities in education and job readiness would bring “over $1 billion in increased regional GDP annually.” Addressing income and wealth disparities could mean “an additional $12 billion in wealth for area families.” In other words, addressing disparities in care would result in an economic boost to our region-at-large.

White residents regularly realize prosperity from which residents of color are often excluded. Disparity breeds inequity, making statistical evidence vital to addressing and improving such situations.

An effective data aggregation tool will prove useful in collecting information across health care settings (clinics, hospitals, laboratories, etc.). Analysis of solid, real-time data will allow the Office of Health Equity (OHE) to identify areas of focus. The ability to drill data down by demographics like location, age or race means initiatives can be tailored to specific locales.

Having a good idea which neighborhoods are more likely to complete preventive care screenings – think mammograms or colonoscopies – means the OHE will know where to focus efforts to increase compliance. Identifying areas with lower rates of job readiness would allow the OHE to funnel the appropriate resources into that neighborhood to increase job readiness.

We commend Erie County Executive Mark Poloncarz and the County Legislature for their work on the Health Equity Act. It is clear that next steps must include continued collaboration across disciplines and addressing the underlying causes of poor health in our community.

Dr. Olivia Smith Blackwell, former president and CEO of Sheehan Memorial Hospital, practices medicine in North Tonawanda. Dr. Gregory F. Daniel is founder of The Exigence Group, Buffalo.

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"After having served most of his legislative career as a Republican before joining the Democrats in 2018, Hardwick is, indeed, a maverick – one who understands the critical needs for the office’s independence and for repairing the professional culture that Stefan Mychajliw broke," writes The News' Editorial Board.

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