ACR Bulletin

Covering topics relevant to the practice of radiology

Meeting the Challenges of Providing Equitable Healthcare

The ACR is taking the lead in advancing health equity by providing a roadmap of strategies and resources for radiologists, their partners and the patients they serve.

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Building a health equity program or network as a radiologist requires a commitment to promoting equity, inclusivity and culturally competent care.

—Carla Brathwaite, MS
August 01, 2023

This is a companion piece to Exploring Radiology’s Role in Advancing Health Equity, the first article in a five-part series showcasing physicians' work in tandem with health equity partners to close gaps in awareness, access and outcomes. 

Committed to advancing health equity for marginalized populations and the uninsured or underinsured, the ACR firmly believes that all individuals deserve access to high-quality healthcare services and equitable outcomes regardless of their cultural or socioeconomic background.

The College recognized the importance of addressing healthcare disparities well before the pandemic, having numerous initiatives in place to promote health equity. In the wake of COVID-19, the ACR has ramped up its efforts to ensure equitable access and healthcare services for all. The Bulletin recently spoke with Carla Brathwaite, MS, who serves as the ACR’s diversity, equity and inclusion program manager, to learn more about the College’s work around health equity in moving forward.

What key areas has the ACR focused on to address health equity since the pandemic?

One big push has been for more education and advocacy. The ACR has been actively advocating for federally approved policies that aim to reduce health disparities and improve access to care for at-risk populations. This includes supporting initiatives that address social determinants of health and expansion of health insurance coverage for critical services. Radiologists have opportunities to advocate for equitable resource allocation within their institutions — including promoting the availability of advanced imaging technologies and services in underserved areas.

Make sure you understand your patient population. It is important to gain insight into the demographics and specific health challenges faced by patients in your community.

—Carla Brathwaite, MS

We have also been stressing the importance of establishing partnerships and collaborations. As the convener of the Radiology Health Equity Coalition (RHEC), ACR has been fostering partnerships with like-minded organizations, healthcare institutions and policymakers to address health equity issues collectively. It is vital to engage with other radiologists and healthcare professionals who share an interest in health equity — to team up with local organizations and community partners to help you connect patients to resources beyond medical care.

Why is building partnerships and collaborating with other organizations so important when advancing health equity?

Collaborating with other organizations that share similar goals and values can amplify the impact of efforts to promote health equity. By pooling resources, knowledge and expertise, the collective power of a partnership can drive meaningful and sustainable change. Every organization brings its own unique expertise and perspective to the table. Partnering with organizations working toward the same goals enables more informed and effective strategies to address health equity challenges. Partnerships provide access to new networks and communities that are difficult to reach individually.

This broader reach can facilitate engagement with diverse stakeholders and vulnerable populations to bolster the strength of health equity initiatives. Collaboration also cuts back on duplicating efforts and wasting resources. By working together, organizations can coordinate their activities, identify gaps in services and ensure that their interventions complement each other. In short, presenting a united front makes addressing the root causes of health disparities easier and can influence decision-makers at all levels.

What are some ways radiology groups can establish and perpetuate strong health equity principles?

Building a health equity program or network as a radiologist requires a commitment to promoting equity, inclusivity and culturally competent care. To get started, you must educate yourself on health disparities, social determinants of health and the impact of bias in healthcare. Radiologists should read and contribute research articles, attend workshops and participate in webinars focused on health equity and cultural competence. Where possible, form a working group within your institution to discuss strategies and optimize resources. It is a good idea to develop or compile patient education materials that address the importance of seeking timely and appropriate medical care — keeping in mind that what you disseminate to patients should be culturally sensitive and accessible to diverse populations.

Make sure you understand your patient population. It is important to gain insight into the demographics and specific health challenges faced by patients in your community. This can help you tailor your approach to promoting health equity and addressing any unique needs within the communities you serve. Cultural competence training is beneficial in terms of understanding cultural norms, beliefs and communication styles to improve patient-provider interactions and to ensure patient-centered care.

Why should radiologists be champions for health equity within their own institutions and practices?

Radiologists play a pivotal role in almost every facet of healthcare — charged with interpreting medical images and providing crucial diagnostic information across all areas of medicine. Stepping up to champion health equity within their practice settings is essential for a host of compelling reasons. On the patient-centered care front, many radiologists have direct interactions with patients through image-guided procedures and consultations. By advancing health equity efforts, they can help ensure that all patients receive access to high-quality care, regardless of their socioeconomic status, race, ethnicity or other demographic factors. This approach will lead to better health outcomes and patient satisfaction.

Early detection and intervention fall squarely within the wheelhouse of radiologists. Health disparities can lead to delayed diagnoses and interventions for certain patient populations. Radiologists can play a critical role in identifying signs of diseases or conditions at an early stage, which is particularly significant for communities that may face obstacles to accessing services.

We must also continue the fight to reduce unconscious biases that can impact medical decision-making and contribute to health disparities. Health equity is increasingly becoming a focal point in healthcare policy and reform, and radiologists who take up the fight for a level playing field will align their groups and practices with current trends while positioning radiology leaders to support patient-focused care. Their commitment to equitable care can inspire colleagues and encourage broader adoption of inclusive practices throughout the entire healthcare system.

By promoting inclusivity in research and education, radiologists can shape medical knowledge and practices. This means pushing for more inclusive research methodologies, diverse study populations and culturally competent educational curricula to better inform medical decision-making. Promoting health equity can also help attract and retain a diverse and talented workforce. Radiology departments that prioritize equity and inclusion create a supportive environment where all team members can thrive — fostering a more cohesive and innovative team. Finally, improving upon population health strategies can positively impact health disparities. Radiologists contribute to a healthier society when they recognize that preventable diseases and/or patient conditions disproportionately put underserved communities at a disadvantage.

What are a few examples of what the ACR has done under the umbrella of health equity?

The ACR has a Diversity and Inclusion Committee to foster diversity within the radiology profession and to promote an inclusive culture within the College. This committee has been working to develop resources and educational programs to support underrepresented radiologists and patients. The College is pursuing data collection and research on disparities to help inform evidence-based strategies to improve health equity. For example, in collaboration with the RHEC, the Harvey L. Neiman Health Policy Institute completed a study on racial disparities in mammography screening technology. The findings were published in the October 2022 issue of the Radiological Society of North America’s journal, Radiology.

Through a new ACR-led webinar series, “Life in Black and White: Race in Radiology, Healthcare and Health Outcomes,” participants can learn more about the makeup of systemic racism and its impact on health disparities. The series is designed to enable students across the country — particularly those in small programs with few resources — to engage in discussions around diversity, inclusion and equitable healthcare, and how to become a part of the solution. The webinar series kicked off July 18 and has been split into four sessions, taking place every third Tuesday of the month.

The ACR also worked with multiple organizations to launch a successful National Lung Cancer Screening Day in 2022, with close to 400 medical imaging facilities opening their doors to thousands of medically underserved patients. This year’s Lung Cancer Screening Day is Nov. 11, 2023.

How will the ACR continue to move the needle on achieving health equity?

The ACR will continue to expand its diversity and inclusion efforts to build a more representative radiology community. This could include implementing mentorship programs, scholarships and pipeline initiatives to encourage underrepresented individuals to pursue careers in the specialty. The College will also further invest in data collection and research to identify health disparities and measure the impact of health equity initiatives. This data-driven approach can guide leadership strategies and measure progress toward achieving health equity goals.

Recognizing the significant impact of social determinants of health on disparities, the ACR will collaborate with other healthcare organizations and community partners to identify and address fundamental causes. Through several ACR Commissions — including the Commission for Women and Diversity and the Patient- and Family-Centered Care Commission — there will be a concerted effort to break down barriers and improve imaging access for marginalized populations.

Radiologists have a unique opportunity and responsibility to advocate for health equity within their institutions and practices. By promoting equitable access to healthcare, reducing disparities and embracing patient-centered care, radiologists can make a significant difference around patient outcomes and contribute to a more equitable healthcare system.

Learn More About Health Equity in Radiology

Here are some resources to guide you in integrating health equity principles and practices into your workplace:

  • The ACR’s Health Equity web page, which includes articles, videos and other materials.
  • The Radiology Health Equity Community of Practice web page, which houses virtual educational opportunities.
  • A new ACR-led webinar series, “Life in Black and White: Race in Radiology, Healthcare and Health Outcomes.”
  • An ACR Voice of Radiology Blog post on “The Intersection of Health Equity and Radiology” by Marta Flory, MD, clinical assistant professor in body and cardiovascular imaging at Stanford University.

For more news, see a full list of the latest ACR Bulletin articles.

Author Chad E. Hudnall  senior writer, ACR Press