January 19, 2017
I was pleased to receive a number of appreciative and thoughtful comments in response to last week’s Study Break on Martin Luther King Jr. I was reminded of one of Dr. King’s compelling and relevant quotes, “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.”
As a medical school in the nation’s fourth-largest and most diverse city, we have a responsibility to ensure accessible, equitable medical care of the highest quality and standards. But offering outstanding healthcare is not enough. We must also increase our awareness and focus our attention on the social determinants of health—the underlying social, economic, and environmental factors that lead to poor health and health inequalities.
The National Academies of Sciences, Engineering and Medicine recently released a 440-page report, Communities in Action Pathways to Health Equity. The report reviews data on disparities in health status and health outcomes in the United States, despite our country’s high levels of spending on health care. Rates of obesity, heart disease, diabetes, stroke, cancer, kidney disease, and other chronic diseases are highest in the poorest areas of the United States. Infant mortality rates continue to be highest among African American infants, as well as among poor white infants in underserved and poor parts of our nation, such as Appalachia. Although health care and access to care are important to address, real change will require addressing the underlying social, economic, and environmental factors that lead to poor health and health inequities—the social determinants of health. To understand the big picture, I encourage you to read this report. The authors make a compelling argument that health inequities are problems for all of us—burdens that adversely affect our nation’s children, their pathway to adulthood, our economic strength, our position in the world, our competitiveness—and most importantly, our fundamental commitment to fairness and social justice. With funding from the Robert Wood Johnson Foundation, the National Academy of Medicine has launched a multiyear Culture of Health Program to identify strategies to support equitable health for all Americans. They have invited members of the public and medical community to join their mailing list. If interested, contact KBogard@nas.edu.
It is incumbent upon us to prepare our students and other trainees for a future of lifelong education as well as continued attention to health equity, social justice, and social determinants of health. Our clinical environments provide a rich and diverse experience for our trainees, and our patients, no matter where their care is provided, deserve nothing less than our best. Our broader curriculum offers education in unconscious bias training, and the Office of Diversity and Inclusion works to promote diversity and better understanding of the social determinants of health that affect us all.
Fundamental to equitable health care is a robust public health system grounded in prevention and education. The current director of the Centers for Disease Control and Prevention, Dr. Tom Frieden, recently reflected upon his institution and the state of the public health infrastructure in an interview National Geographic Magazine.
One of Dr. Frieden’s health priorities over his tenure at CDC has been to address the global threat of antimicrobial resistance. You may have seen in the news that a woman in Nevada died just last week from an infection that was resistant to 26 different antibiotics. McGovern Medical School researchers are at the forefront of this important global health problem. Dr. Cesar Arias’ Center for Antimicrobial Resistance and Microbial Genomics is hosting its first Antibiotic Resistance Symposium this week, with the opening keynote lecture to be given by Dr. Barbara Murray today. This center is a collaborative effort of many whose work is poised to make breakthroughs in antimicrobial resistance.
Whether in the clinic, classroom, or lab, together we can all do our part to make a difference in the health and well-being of the community and patients we serve.