Over 30 leaders in the Commonwealth’s health care sphere, including elected officials, health insurance plans and providers, and health policy academia, met Thursday for a cross-disciplinary “strategy dialogue” on improving Virginia health equity. Panelists discussed topics such as payment parity, affordable housing, broadband access, and education at the 2021 Virtual Colloquium Addressing Health Equity in Virginia, hosted by Virginia Commonwealth University.
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The colloquium featured four keynote speakers, each with unique health care perspectives to round out discussions from the various health equity panels. Dr. Janice Underwood, PhD., the state’s chief diversity officer (CDO) and first state cabinet-level appointee to report to the Governor, kicked off the colloquium. She cited landmark legislation that declared racism as a public health emergency in the Commonwealth and said Virginia has set national standards for addressing the “dual pandemic” of COVID and structural racism.
“Treating the root cause of structural racism — white supremacy — has proved more difficult than finding a vaccine for coronavirus. I assure you, however, that Virginia is ready to lead a national conversation — and we have been — about making the necessary policy and social changes needed to heal the [health equity] divide.”
Dr. Underwood also highlighted two health equity dashboards Gov. Ralph Northam’s administration announced in May. The Equity-in-Action dashboard uses federal and state data to track Virginia’s COVID response, while the Equity-at-a-Glance dashboard assesses the impact of social determinants of health throughout the state.
Beth O’Connor, director of the Virginia Rural Health Association, provided context on health resource distribution for the nearly 2.5 million Virginians living in rural areas. Notable disparities include higher poverty and incarceration rates, and what O’Connor described as the “rural cancer paradox:” more rural Virginians are dying from cancer than urban residents despite not being diagnosed, because they are less likely to be screened for cancer in the first place.
O’Connor also stressed that health care delivery models in urban areas may not necessarily work for rural communities.
“We see many outreach initiatives that try to take an urban model and squish them down, and make them fit rural. But rural is not “mini” urban. Anybody who has ever driven a tractor knows that smaller is not the same thing.”
Providing one of two keynote academia perspectives, Dr. Jean Giddens, Ph.D, RN, dean of the VCU School of Nursing, provided a look into health equity themes in current nursing curricula. These include diversity, health equity leadership, clinician wellbeing, policy, and education.
Dr. Giddens emphasized that health equity progress must include cross-sector collaborations between academia, practice, and other fields.
“[Collaborations] are going to be needed to optimize nursing’s impact, but we also have to be willing and more effective and engaging in the larger context, meaning across other health professions and with policymakers.”
Dr. Susan Gooden, Ph.D, dean of the VCU L. Douglas Wilder School of Government and Public Affairs, closed out the colloquium by urging health care stakeholders to keep five key points in mind going forward:
- Health inequity is “saturated” over time, and patterns of inequity continue to replicate themselves.
- Health equity should be viewed as a problem to be solved, not a condition to be tolerated.
- The public sector workforce plays a key role in ensuring health equity for all Virginians.
- Different silos — academia, healthcare workers, policy makers, and more — must communicate and address health equity together.
- Stakeholders should take “silver linings” from the pandemic, such as the development of telehealth, and build upon them for future health policy decisions.