By SHARI RUDAVSKY, The Indianapolis Star
INDIANAPOLIS (AP) — In an ongoing effort to narrow the health disparities gap, Indiana’s five major hospital systems are collaborating to create a dashboard that will track how patients of different racial backgrounds are treated.
The hospital systems’ laser focus on racism as a public health crisis came in the wake of the 2020 Black Lives Matter protests and a highly publicized incident in which a Black doctor named Susan Moore alleged racist treatment at a Carmel hospital a few weeks before she died of COVID-19 at a different hospital.
The hospital systems, which have been meeting weekly to develop the dashboard, shared a glimpse of the data around diabetes care earlier this week. Eventually the dash will expand to include information about infant mortality and mental health.
It’s unclear when it will be ready.
On a national scale, diabetes impacts one in six Black people and one in 10 white people. About 24% of Black people and 29% of Hispanic/Latino people who have diabetes have uncontrolled diabetes, compared with 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 health equity officer at IU Health.
Local data shows that doctors do a better job at ordering key tests for controlling patients’ diabetes for their white patients than their Black counterparts. For white patients, doctors order such tests on average 62% of the time. For Black patients that measure fell to 58%. It was even lower for Latino patients, 56%.
“We have work to do across the board,” said Tucker Edmonds, also associate dean for health equity research at the IU School of Medicine. “We don’t have any superstars here…. It is needed to shine a light on where the gaps are so that we can begin to call for collective action.”
In addition to increasing awareness of the disparities, Tucker Edmonds said, making the dash public could encourage patients to ask their providers about the tests and ensure that they’re receiving appropriate diabetes follow-up.
Tucker Edmonds shared the data at a virtual Greater Indianapolis NAACP forum on racism as a public health crisis, co-sponsored by the Indianapolis Recorder and WFYI. Hospital leaders did not give a clear timeline for when the dashboard may go 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 was held 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 had received racist treatment at an IU Health hospital.
Moore died a few weeks later in December 2020 and after 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 of the hospital leaders present said that they had increased their minimum wages to ensure all employees have a living. IU Health raised its minimum starting wage to $18 an hour, a move that impacted more than 11,000 people and cost more than $39 million annually, said the health system’s president and CEO Dennis Murphy.
The state’s largest hospital system spent more than $1.5 million in training its more than 36,000 employees and created an office of health equity, which has eight people in it, including the head, Tucker Edmonds, Murphy said.
Like IU Health, Eskenazi Health has increased its minimum wage to $18 an hour, a change that by the end of June of this year will have affected 814 employees, 521 of whom are employees of color, said Dr. Lisa Harris, Eskenazi’s CEO.
In addition to this $2 million investment, the hospital is investing another $2.2 million annually in programs geared toward recruiting and retaining employees of color, including a program that partners with historically Black colleges and universities. A third of the hospital’s senior leadership team are now people of color, coming close to reflecting the overall distribution of the workforce, where 40% are people of color, Harris said.
Wages at Franciscan Health have also increased to a minimum of $15 an hour, on track to go up to $18 an hour, said Dr. Jim Callaghan, president and CEO of Franciscan Health Indianapolis, Mooresville and Carmel. In addition, the south side health system is striving to increase the number of minority-owned businesses with whom it works.
Franciscan has started a $1 million fund for scholarship and loan forgiveness that targets minority students across health care professions and will initially benefit 36 people and plans to expand an apprenticeship program it runs for people in the building trade to Indianapolis shortly.
Community Health Network minimum wages have 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, which is “a lot of change” for an organization of its size, he said.
These efforts, however, the hospital leaders agreed, are just the beginning.
Over the past year IU Health has expanded its patient advocate program. Upon admission, all patients are now told they can reach out to a patient advocate should they desire one, Murphy said.
The hospital system is also working to create a social vulnerability index — based on socioeconomics, disability, housing type, and minority status — to help flag patients who might benefit from a proactive visit from a patient advocate.
Eskenazi Health, which is investing $75 million in a new health center on the east side, is looking to boost its mental health efforts, Harris said. The hospital system has been offering stress and trauma management training to its staff, which it will now expand to the community, with an eye toward reducing the stigma of receiving mental health care.
And, all the health leaders agreed there is more, much more, to be done. They pledged to return in six months to provide the community with another update on inroads that they have made in this area.
Working together, they said, will be crucial to success.
“You look at Community as an employer, we can make virtually 100% of those changes within our walls,” Mills said. “We as a sole provider cannot change central Indiana… We’ve got to lock arms and fortunately we’ve got relationships amongst ourselves that we trust each other.”
Nor can the health systems do this alone.
Statistics suggest that health care influences only 20% of our health, Tucker Edmonds said. The other 80% are the so-called social determinants of health, including 40% socioeconomic factors, 10% the physical environment and 30% health behaviors.
With a record number of patients seeking care, hospitals need to determine both how to handle the increase efficiently as well as focusing on preventive care to keep people healthy in the first place, Harris said.
“If people are falling in the river because the bridge has collapsed, the long-term answer is not to get better at pulling people out of the river,” she said. “We need to fix the bridge. That gets back to the investment in the health of people in our community.”
Source: The Indianapolis Star
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