Recapping the Health Equity Summit 2021
The effects of the social determinants of health are well-documented, but how many of us keep their influences in the front of our minds for our patients each day? We know their importance, yet we may forget their importance—or, worse, contribute to them—through our everyday actions and/or inaction.
Whether your workplace is an acute care clinical setting, primary practice office, community clinic, or other location, it is imperative that we keep the social determinants of health front of mind. As holistic care providers, educators and researchers, our social mandate requires understanding how social position, socially determined circumstances, and racism contribute to the health needs and outcomes of individual patients as well as larger populations. As Dr. Olajide Williams explained during his presentation at PCNA’s November 2021 Health Equity Summit, it literally is a life-or-death factor for our patients.
Health Equity Summit Recap
Dr. Williams framed his discussion with the roots of racism in the U.S. and described not only structural racism, but interpersonal racism and internalized racism—all leading to racial bias, which significantly impacts health. Racial bias may make people sick by damaging the brain, the heart, and influencing blood pressure. Dr. Williams challenged the audience to intentionally address racism, and how we work in clinical practice.
As part of the Health Equity Summit, Dr. Keith Ferdinand shared the historical framework for health disparities in our current economic and health care systems. Particularly for patients at risk for, or with, cardiovascular disease, health inequities in cardiology cause health disparities. For our patients who are African American, there is a higher risk for hypertension, diabetes, myocardial infarction, stroke, chronic kidney and end-stage renal disease, and overall cardiovascular mortality—especially premature cardiac death. And while you might think that things are getting better, the current mortality gap between Black and White individuals has been persistent since 1960,i the year the Civil Rights Act was signed into law. Dr. Ferdinand emphasized the importance of clear and empathetic sharing of information during our visits with vulnerable patients. To assure patient understanding, it was recommended to use teach-back methods.
The Health Equity Summit speakers also described how the coronavirus pandemic and recent social equity movement have highlighted racial health disparities. It is well documented that the U.S.life expectancy dropped in the last 20 months, disproportionately affecting Black and Latinx populations.ii While vaccinations, mask mandates, and other recommendations to reduce the spread of COVID-19 have been implemented in a patchwork across the nation COVID-19 disparities in communities of color became apparent due to crowded housing and living conditions, types of occupations, low socioeconomic resources, pre-existing disparities in the prevalence of chronic conditions (such as hypertension and diabetes) that increase risk, cultural norms related to family traditions, and poor access to care.
Neva White described the importance of helping to empower patients in overcoming barriers to cardiometabolic risk reduction. Many factors are global in nature, from housing and community security, to access to healthy food and living wages. Still, other factors can be addressed by what nurses and other health care providers do each day: collaborating with colleagues in the community to ensure patients and others in our neighborhoods have access to tangible resources including health education, screening, and information.
Another Summit session led by Dr. Yvonne Commodore Mensah highlighted how social determinants of health present in the clinical setting. For example, where an individual lives can significantly impact their life expectancy, health issues, and health outcomes. Five miles apart in the Baltimore area may mean the average life expectancy is 83.9 years—or 66.9 years, and the incidence of CVD mortality may increase by 100%. Dr. Mensah also described how health outcomes can be positively impacted through individual patient care, and through knowing more about the community from where patients come. Utilizing a screening tool for core social and economic elements helped identify, for example, patients facing food or housing insecurity, or other issues, which could be addressed by connecting the patients to clinical and community resources and specialists.
The final speaker of the Summit, Dr. Lisa M. Lewis, outlined how preparing a diverse nursing workforce helps meet the healthcare needs of a diverse population. She shared how the demographics of nurses do not parallel the demographics of the patients for whom nurses provide care, and how health equity not only improves access to healthcare but improves their experiences and satisfaction.iii Dr. Lewis shared the importance of mentoring in nursing, and the critical need to address bias in nursing education.
Key Takeaway: There are Steps We Can All Take to Make a Difference
Each day, the choices we make and the interactions we have with others can exert a significant force in improving the health outcomes of our patients and communities.
So what can we do?
- Be informed. Just as you’d seek the latest information about guidelines-based practice, seek out the latest data on what is happening in your community and across the globe with regards to health equity. If you missed the Health Equity Summit in whole or in part, look out for it in our on-demand library soon.
- Recognize your own biases. Take time to consider your conscious and unconscious biases, and how they impact your interactions in the office and on the street. Many books, articles, blogs, podcasts and other sources on health disparity and social determinants of health are available to help you learn more. Many health care institutions also offer health disparity and anti-racism trainings. PCNA will be hosting the second annual Health Equity Summit in mid-2022; check out pcna.net for forthcoming details.
- In interactions small and large, look at the person first. Communicating in a respectful manner, working to understand outside influences that may impact a person’s health, and helping find and connect to needed resources (as much as prescriptions for treatment), may lead to improved long-term outcomes.
As an organization, PCNA is committed to addressing health disparities and infusing health equity goals throughout the organization and activities, with a concentrated focus on our mission of cardiovascular disease prevention and preventive cardiovascular nursing. View our Health Equity Statement and stay tuned for the release of our equity, diversity, and inclusion goals.
PCNA is grateful to the sponsors of the 2021 Health Equity Summit: Bristol Myers Squibb/Pfizer Alliance, Amgen, Johnson & Johnson.
- Smedley BD, Stith AY, Nelson AR. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. National Academies Press, 2003. doi:10.17226/12875.
- Andrasfay T, Goldman N. Reductions in 2020 US life expectancy due to COVID-10 and the disproportionate impact on Black and Latino populations. Proc Natl Acad Sci USA. 2021;118(5):e2014746118. doi: 10.1073/pnas.2014746118.
- Bathija P, Reynolds D. How equity impacts the patient experience. American Hospital Association. 2019. Accessed November 30, 2021.