[6 min read]
- Swedish Chief Health Equity Officer Nwando Anyaoku, M.D., discusses what health inequity looks like, who it affects and the factors that determine our access to health care and the quality of care we receive.
- April is National Minority Health Awareness Month.
- Using data and personal stories, Swedish is working to close the gaps and address longstanding barriers to health care in underserved communities.
The U.S. Centers for Disease Control and Prevention
defines health equity, in part, as “the state in which everyone has a fair and just opportunity to achieve their highest level of health.” But what does it take to get there? Even with the best of intentions and aspirations, working toward authentic health equity is requires persistence, self-examination and an understanding of what inequity looks like in each patient’s lived experience. The work requires the will to address longstanding injustices; the removal of economic barriers to health care; and the robust efforts around preventable conditions and access to primary care.
We know that health disparities are deadly. Reams of statistics bear out grim realities in areas such as Black maternal health, cancer rates in Black and African American communities, diabetes rates in the Latin X community and exclusion of LGBTQIA+ patients.
April is National Minority Health Month. To learn more about what disparities look like, what creating health equity means and how Swedish is working toward real and lasting change, we spoke with Nwando Anyaoku, M.D.
, Swedish’s first-ever chief health equity officer. A pediatrician by training, Dr. Anyaoku works with clinical and community leaders and data analysts to advance health care equity and the delivery of care with cultural humility.
Swedish Chief Health Equity Officer Nwando Anyaoku, M.D.
You are the first chief health equity officer at Providence Swedish. Why did Providence Swedish create this role?
We've known for years that there were certain populations that were not optimally served by the health system. The pandemic made that even more clear. And the data in the wake of COVID, the data became made clear to everyone that there were some populations that were suffering higher incidence and higher mortality from the disease. With the social uprising in the wake of the murder of George Floyd, a lot of the factors that affected both of those are similar and have been in place over generations.
Providence Swedish decided that it was necessary to have a clinical leadership role dedicated to understanding the populations we serve and how our health service is accessed. So, the role of the chief health equity officer is really to shine that spotlight using data and stories to inform us as an organization about who we're serving, how we're serving them, and identify where there are gaps or disparities in the outcomes and experience of these different populations and working across our clinical service lines to improve our care delivery to underrepresented communities.
Swedish Chief Health Equity Officer Nwando Anyaoku, M.D., discussed health disparities on a recent New Day Northwest.
What do health inequities look like? Who do they affect?
Health inequities look like different populations having different health access, experience and outcomes. Those different experiences and outcomes of healthcare are not a function of biology. They are a function of longstanding disparities that are a result of historical structural racism in our society.
Over years you start to see a pretty wide gap in health outcomes among different groups of people. We can see differences in life expectancies between Black and Indigenous patients and their white counterparts. For example, pregnancy and birth outcomes can be up to five to six times worse for Black and Indigenous birthing people compared to their Caucasian counterparts. We know that much of this can be seen in the clinical care setting, but there are multiple layers that result in inequity. Health care doesn't all happen within the walls of our clinics and hospitals. Eighty percent of the health determinants among any given population happen where people live, work and play. What is their access to medical care? Can they find nutritious food? Do they live in an area with high levels of air pollution? All these things play a role in our health and the kinds of health care we are likely to need.
And in that, equity is the goal: not to treat everyone the same. Equity means understanding that everyone is coming to the table with different challenges. We must understand what their challenges are and build that into the way that we deliver care for them. It’s giving everyone what they need to achieve their optimal health, no matter who they are or where they live. Your zip code should not be a determinant of your health or life span.
What is Swedish doing to address systemic conditions that foster ongoing inequities?
We are partnering with community-based organizations who serve the populations that we're trying to reach to close these gaps. We have done COVID outreach. Providence Swedish is home to the JUST Birth network, in which we have a doula network and resources to help Black and Native parents through the pregnancy and after. We also have a robust relationship with the Hummingbird indigenous doula network to provide support to our indigenous birthing people. In addition, most of our birthing and parenting classes are free to people who are Medicaid eligible.
We also know that underrepresented minorities have worse outcomes in cancer, especially for example breast cancer. They often do not get access to early screening, they don't get screened on time, so they get diagnosed later and have worse outcomes. Swedish Cancer Institute works with the mobile mammogram unit to go out and target those specific populations to increase breast cancer screening rates. We also work with community partners like Cierra Sisters, an organization dedicated to education and empowering Black and African American women and families around breast cancer and other types of cancer.
Cultural navigators are an important part of our health equity initiative. They reach out to these communities providing education and helping build trust. We have cultural navigators from the Latin X, transgender, Somali, African American and other communities who make sure community members have what they need in terms of follow up appointments and access to refill their medications. They serve as advocates between the clinical team and the patient to improve their care and their outcome.
What is on the horizon for health equity work at Swedish?
The goal is to have the organization and every one of us think about the care we deliver through a health equity lens, not just how are we doing across the board, but how are we doing for specific populations, what are the needs of those specific populations and how can we improve on it.
We're focusing more on the acute care spaces, the hospitals themselves. Also, things like how we are delivering care in the emergency room? What does our care look like in labor and delivery? Or in long term care facilities? This is not a project or an initiative; we want to just become the way we deliver care. That's our goal.
How can we support the work of dismantling inequity?
Start with honoring the humanity in every single person that you encounter, recognize that each person is their own unique person with their own story.
Be intentional about honoring the humanity of everyone. Do not yield to stereotypes, because we have stereotypes in our head about who people are, but at the end of the day, we are all one race, one human race. That is my ask for everyone, wherever you are.