Indiana hospitals plan to start tracking health inequalities

INDIANAPOLIS (AP) — In an ongoing effort to close the health disparity gap, Indiana’s five major hospital systems are collaborating to create a dashboard that will track how patients of different racial backgrounds are being treated. .

Hospital systems’ laser focus on racism as a public health crisis came in the wake of the 2020 Black Lives Matter protests and a high-profile incident in which a black doctor named Susan Moore alleged racist treatment. in a Carmel hospital a few weeks before his death. of COVID-19 in another hospital.

Hospital systems, which have met weekly to develop the dashboard, shared an overview of diabetes care data earlier this week. Eventually, the indent will expand to include information on infant mortality and mental health.

We don’t know when it will be ready.

Nationally, diabetes affects one in six Blacks and one in 10 Whites. About 24% of Blacks and 29% of Hispanics/Latinos with diabetes have uncontrolled diabetes, compared to 11% of white diabetes patients.

In Marion County, where black people make up 20% of the population, 37% of those who receive diabetes care are black patients, said Dr. Brownsyne Tucker Edmonds, vice president and chief equity officer in health at IU Health.

Local data shows doctors are doing a better job ordering key tests to control patient diabetes for their white patients than their black counterparts. For white patients, doctors order such tests an average of 62% of the time. For black patients, that metric dropped to 58%. It was even lower for Latino patients, 56%.

“We have work to do in all areas,” said Tucker Edmonds, also associate dean for health equity research at IU School of Medicine. “We don’t have any superstars here…. There is a need to bring the gaps to light so that we can begin to call for collective action.

In addition to raising awareness of the disparities, Tucker Edmonds said, making the dashboard public could encourage patients to ask their providers about testing and ensure they are receiving appropriate diabetes follow-up.

Tucker Edmonds shared the data during a Greater Indianapolis NAACP Virtual Forum on Racism as a Public Health Crisis, co-sponsored by the Indianapolis Recorder and WFYI. Hospital leaders did not give a specific timeline as to when the dashboard might be released to the public.

For the second year in a row, leaders from central Indiana’s hospital systems came together to discuss what they have done and plan to do to address health inequities. The first forum took place last January months after the city declared racism a public health crisis and weeks after Dr Moore posted a video that went viral in which she alleged she received racist treatment at a hospital. IU Health.

Moore died a few weeks later in December 2020 and following her death, IU Health launched an investigation into the incident. In May, an external committee concluded that the medical care she received at IU Health did not contribute to her death.

All hospital executives present said they had raised their minimum wages to support all employees. IU Health raised its starting minimum wage to $18 an hour, a move that affected more than 11,000 people and cost more than $39 million a year, the system’s president and CEO said. health, Dennis Murphy.

The state’s largest hospital system has spent more than $1.5 million to train its more than 36,000 employees and created an office of health equity, which has eight people, including chief Tucker Edmonds. , Murphy said.

Like IU Health, Eskenazi Health raised its minimum wage to $18 an hour, a change that by the end of June this year will have affected 814 employees, 521 of whom are employees of color, Dr. Lisa Harris said. , CEO of Eskenazi.

In addition to this $2 million investment, the hospital invests an additional $2.2 million annually in programs to recruit and retain employees of color, including a program that partners with colleges and historically black universities. One-third of the hospital’s leadership team is now made up of people of color, which approximates the overall workforce breakdown, where 40% are people of color, Harris said.

Wages at Franciscan Health have also increased to a low of $15 an hour, on track to reach $18 an hour, said Dr. Jim Callaghan, president and CEO of Franciscan Health Indianapolis, Mooresville. and Carmel. Additionally, the South Side Health System is working to increase the number of minority-owned businesses it works with.

Franciscan has launched a $1 million scholarship and loan relief fund that targets minority students in health care professions and will initially benefit 36 ​​people and plans to expand to Indianapolis soon. apprenticeship program he runs for construction people.

The Community Health Network’s minimum wage has increased twice in the past 18 months, said CEO and President Bryan Mills. Over the past year, the hospital system has hired its first chief diversity officer and added three new diverse board members, representing “a lot of change” for an organization of its size, it said. he declares.

These efforts, however, hospital leaders agreed, are just the beginning.

Over the past year, IU Health has expanded its patient advocacy program. Upon admission, all patients are now told they can contact a patient advocate if they wish, Murphy said.

The hospital system is also working to create a Social Vulnerability Index – based on socioeconomic status, disability, housing type and minority status – to help flag patients who could benefit from a proactive visit. of a patient advocate.

Eskenazi Health, which is investing $75 million in a new East Side Health Center, is looking to bolster its mental health efforts, Harris said. The hospital system is providing its staff with stress and trauma management training, which it will now extend to the community, in an effort to reduce the stigma associated with mental health care.

And, all healthcare leaders agreed that there is more, much more, to be done. They have pledged to return in six months to provide the community with another update on the breakthroughs they have made in this area.

Working together, they said, will be crucial for success.

“You think of Community as an employer, we can do pretty much 100% of these changes within our walls,” Mills said. “As a sole-source, we can’t change Central Indiana…We have to stick together and luckily we have a relationship with each other that we trust each other in.”

Nor can health systems do it alone.

Statistics suggest healthcare only influences 20% of our health, Tucker Edmonds said. The remaining 80% are the so-called social determinants of health, including 40% socioeconomic factors, 10% the physical environment and 30% health behaviors.

With record numbers of patients seeking care, hospitals need to figure out both how to effectively manage the surge and focus on preventative care to keep people healthy in the first place, Harris said.

“If people are falling into the river because the bridge collapsed, the long-term answer is not to pull people better from the river,” she said. “We have to repair the bridge. It comes down to investing in the health of people in our community.


Source: The Indianapolis Star