Original ArticleMovement Advocacy, Personal Relationships, and Ending Health Care Disparities
Section snippets
Health as a human justice issue and the role of movement advocacy
Dr. Martin Luther King, Jr. famously stated, “Of all the forms of inequality, injustice in health is the most shocking and the most inhuman.”4 When the injustice is great, power differential between oppressor and oppressed is large, and willingness of the powerful to reform the system is low, then movement advocacy is necessary. Think the 1960s Civil Rights Movement, or Rodney King, Freddie Gray, Laquan McDonald, and the police departments of Los Angeles, Baltimore, and Chicago. Deeply rooted
Movement advocacy to change systems
Presidential candidate Hillary Clinton described the power of advocacy when she met with representatives of the Black Lives Matter group. She stated, “Look I don't believe you change hearts. I believe you change laws, you change allocation of resources, you change the way systems operate. You're not going to change every heart. You're not. But at the end of the day, we could do a whole lot to change some hearts and change some systems and create more opportunities for people who deserve to have
Interpersonal relationships, trust, and achieving health equity
A key challenge, however, is that the daily work of achieving health equity requires trusting interpersonal relationships, difficult to attain when addressing charged issues such as racism, heterosexism, and class distinctions. Reducing disparities requires self-awareness and commitment, whether by clinicians understanding their subconscious biases in shared decision making with patients,14 administrators recognizing that how their clinic delivers care may systematically lead to worse outcomes
Reconciling movement advocacy and trusting relationships
So, is it possible to reconcile movement advocacy and constructive tension with the creation of trusting relationships and safe spaces required to achieve health equity? I attended a workshop on conflict resolution led by Jennifer Smith, MD, whose perspectives were shaped by countless difficult family situations she encountered as a palliative care physician and general internist at Cook County Hospital.17 Dr. Smith explained that a conflict is a personal narrative with a beginning, middle, and
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Cited by (14)
Lessons for achieving health equity comparing Aotearoa/New Zealand and the United States
2018, Health PolicyCitation Excerpt :The U.S similarly has a difficult time discussing race, class, and social inequities, worsened recently with divisive rhetoric by elected national leaders [24]. Implementing recommendation 1 to have a strong, explicit equity lens in quality of care and payment policies requires honest discussions about the drivers and nature of health inequities [163], and a commitment to dismantling systems of racism and colonialism. New Zealanders might ask themselves if they have the most appropriate free market signals and support from the state to encourage, develop, evaluate, and disseminate successful models for innovation, equity, and efficiency [164].
Racism as a Source of Pain
2023, Journal of General Internal MedicineNew Horizons-Addressing Healthcare Disparities in Endocrine Disease: Bias, Science, and Patient Care
2021, Journal of Clinical Endocrinology and MetabolismTerritorial features of consumer behavior in the medical services market
2021, E3S Web of ConferencesAdvancing health equity in patient safety: A reckoning, challenge and opportunity
2021, BMJ Quality and Safety
Funding: Dr. Chin was supported by a National Institute of Diabetes and Digestive and Kidney Diseases Midcareer Investigator Award in Patient-Oriented Research (grant number K24 DK071933), the Chicago Center for Diabetes Translation Research (grant number P30 DK092949), Robert Wood Johnson Foundation Finding Answers: Solving Disparities Through Payment and Delivery System Reform Program Office, and the Merck Foundation. The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.
Prior presentation: This paper was presented in part in Integrating Health Literacy, Cultural Competency, and Language Access Services: A Workshop, Institute of Medicine Roundtable on Health Literacy, Irvine, California, October 19, 2015, and the Society of General Internal Medicine Annual Meeting, Hollywood, Florida, May 12, 2016.
Conflict of interest: Dr. Chin co-chairs the National Quality Forum (NQF) Disparities Standing Committee. He is the Immediate Past-President of the Society of General Internal Medicine and a member of the America's Essential Hospitals Equity Leadership Forum. He has provided technical assistance to the Center for Medicare and Medicaid Innovation and is a member of the National Advisory Board of the Institute for Medicaid Innovation. The views expressed in this commentary do not necessarily represent the views of the National Quality Forum, Society of General Internal Medicine, America's Essential Hospitals, Centers for Medicare and Medicaid Services, Institute for Medicaid Innovation, National Institutes of Health, Robert Wood Johnson Foundation, and Merck Foundation.