Reducing health disparities has long been on medicine’s radar, but COVID-19 has put a brighter light on how structural inequities directly impact access and outcomes for a wide swath of patients. Proposals for this focus issue are due Oct. 30, 2020, and will explore how provider-led initiatives can create a just health system that serves all patients.
The Bulletin spoke with the focus issue’s co-editors, Melissa A. Davis, MD, MBA, assistant professor at Emory University School of Medicine, and Efrén J. Flores, MD, officer of radiology community health improvement and equity at Massachusetts General Hospital, to discuss their work in the health equity movement and the types of research submissions they’re looking for.
What does health equity and social justice look like in radiology?
EF: Health equity ensures that all patients have fair access to the care we provide in radiology, regardless of background. Equity related to medicine intersects with other social justice causes, such as fair access to opportunities in life — such as education, housing, work and living conditions — so that everybody has a chance to achieve the best possible outcomes in life.
MD: We’re still trying to define what health equity and social justice looks like in radiology. There’s been a lot of great research around the demographic makeup of radiology and inequities around lung cancer screening for people of color. But we haven’t really had the discussion about marrying social justice and health equity in our specialty, and how we can elevate our impact on marginalized groups from a patient-centered perspective.
The call for papers states that articles that focus on social and structural inequities in healthcare — including “techquity” — will be considered. What is techquity?
MD: Radiology has always been at the forefront of technology when it comes to medicine, and we need to leverage that technology to decrease health inequities, and be specific about this intent. With machine learning and AI, there is the promise that we’ll be pushing radiology forward. The way we ensure that we don’t propagate current inequities that already exist, introduce compounding biases in the tools we’re creating, and close gaps is what I see as “techquity.”
How can radiologists get involved in the health equity and social justice movement?
MD: Take a human-centered approach, and ask questions to ensure that, as radiologists, we’re providing the care that patients expect to be provided. Talk to patients and establish a rapport so you can have these conversations. Ask patients how they were treated before, during, and after their appointments. Talk about their follow-up care and understand any barriers they are running into.
EF: Anywhere there’s a gap or a need in your healthcare institution, that’s an opportunity to collaborate with your colleagues and community stakeholders outside your institution. Try not to feel overwhelmed by all of the barriers that need to be addressed. Start small — many small wins build to a bigger win.
Try not to feel overwhelmed by all of the barriers that need to be addressed. Start small — many small wins build to a bigger win.
What can people expect from the JACR® health equity focus issue?
EF: We plan to cover many topics related to overcoming barriers to care and promoting health equity and social justice. For example, some of the topics of interest are exploring health equity through the lens of a quality and safety priority and expanding the business case to invest resources in health equity. When a radiology practice or hospital system is evaluating how to advance health equity efforts in their community, they must evaluate this as an opportunity to advance the quality of care provided. This requires the commitment of financial resources to achieve this goal. This commitment to enhance health equity efforts can be financially feasible and offer radiology practices new opportunities to offer better care delivery for patients — and promote trust among our patient populations.
MD: We’ll be examining the current state of radiology and how we can build a workforce that’s more diverse and inclusive. I’m hoping this will be an issue where we put forth all the health inequities that we see within medicine and radiology and explore ways to improve and impact those things systematically. We want to make sure we have a diversity of perspectives too. Typically within research, one of the inequities we see is that it’s harder for marginalized groups to get published. I’d love people from throughout medicine and at all levels to submit and share their ideas and research.