Racial and socioeconomic inequity persists in health care quality. The 2001 report from the Institute of Medicine (IOM), Crossing the Quality Chasm, stressed the importance of equity in care as one of the six pillars of quality health care. Even as healthcare organizations begin to take equity more seriously, due in part to the impact on quality of care, outcomes and eventually reimbursement, sustainable and scalable implementation strategies to improve equity are not yet pervasive throughout the delivery system.
There has been progress. Healthcare organizations are utilizing new sources and methods of data collection, engaging in unique community partnerships and moving towards more comprehensive population health management by rethinking workforce, care settings and determinants of health. Similarly, as equity becomes more of a factor in determining quality and outcomes, clinical improvement activities have started to incorporate equity as part of specific interventions and overall strategy.
The federal government has also prioritized equity with respect to overall delivery system innovation efforts. In 2015, CMS OMH published a framework to advance health equity grounded in three domains: 1) better understanding and awareness of disparities, 2) identifying and creating solutions based on that understanding, and 3) accelerating the implementation of measurable actions to achieve health equity. This framework focuses on creating new solutions to achieve health equity through implementation of measurable actions.
Other non-governmental organizations such as the National Quality Forum have also developed similar roadmaps to approaching equity. The NQF roadmap laid out four actions, referred to as the “Four I’s for Health Equity,” that healthcare stakeholders can employ to reduce disparities: 1) identify and prioritize reducing health disparities 2) implement evidence-based interventions to reduce disparities 3) invest in the development and use of health equity performance measures, and 4) incentivize the reduction of health disparities and achievement of health equity
An emerging trend for hospitals and health systems has been to approach equity and quality improvement efforts as co-dependent. Bright spot examples include, a combination of “hot-spotting” and medical-legal partnerships around community housing to reduce childhood asthma rates in Cincinnati or a care transitions intervention between health systems, a social services information hub and food pantry in San Diego.
Evidence-based research can help bridge the gap between such examples of success and sustainable and scalable system transformation. Thus, this forthcoming Theme Issue of HSR will feature studies, evaluations, and policy analyses that use rigorous research methods to promote health equity and reduce health disparities.
Because this transformative work takes place across multiple settings, we encourage work from a variety of disciplines including health services research, medicine, nursing, pharmacy, public health, sociology, social work, economics, political science, anthropology, and others.
Of particular interest, is cutting-edge research that explores intersectionality, reflecting the theoretical framework related to the intersection of two or more social risk factors (e.g. race, socioeconomic status) as they jointly influence equity in health and healthcare.
The deadline for initial submission of abstracts is November 1, 2017. All manuscripts must follow the “Instructions for Authors” listed here. For more information, please visit the Abstract Submission page on HSR’s website. The print publication date for the Theme Issue will be November or December 2018.