Three experts came together at the 2021 Oregon State of Reform Health Policy Conference to talk through diversity, equity, and inclusion investments and their impacts on the social determinants of health. The panel reviewed efforts underway to collect better data around the social determinants of health, create a more inclusive health care workforce, and connect with underserved communities.
The panel conversation included Jeremiah Rigsby, chief of staff at CareOregon, Tyler TerMeer, CEO of the Cascade AIDS Project, and Courtney Kenney, health equity & policy manager at the Oregon Primary Care Association.
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Kenney says the COVID-19 pandemic has created new momentum to more broadly address the social determinants of health across the system.
“We know that the pandemic has made social needs more severe and there’s been that broad recognition that SDOH has really driven the inequity of the pandemic. And we also know that social needs, of course, have a direct impact on other health outcomes and on costs.”
However, she says the pandemic has also made innovations related to social needs more difficult. Data sharing and referrals to community resources became more complicated, and Kenney says the pandemic delayed “higher level decision-making” as the health care workforce operated at maximum capacity and roles shifted.
Kenney says during the pandemic it has become increasingly important — particularly for federally-qualified health centers — that they are able to demonstrate the impact of social determinants on health through more meaningful data collection. That data can then be used to push for more flexibility in payment models.
TerMeer says his organization is continuously working to become a more inclusive and affirming environment. He says the Cascade AIDS Project has been known as an organization that predominately has served white gay men, but they have worked in recent years to improve their outreach to communities of color, the transgender community, and women living with HIV.
He says the most important step the Cascade AIDS Project took was in 2019 when they hired an outside consultant to evaluate how the organization was perceived by the community. The consultant evaluated barriers for their staff and barriers for the people they served.
“Probably the most profound thing that happened for us in 2019 was realizing that we needed to own the mistakes of our past — not just once but in an ongoing way.”
That year they released an open letter to the Black community validating their experiences with the organization, acknowledging the organization’s missteps, and committing to doing better.
TerMeer says the Cascade AIDS Project has been building stronger relationships with Black-serving organizations to continue to better serve these communities.
Rigsby says “diversity, equity, and inclusion” can have a lot of meanings including developing a culturally-responsive workforce, bringing marginalized groups into the health care system, and investing in community-based organizations.
“In the last few years we’ve also recognized that none of that is possible unless the staff internally are living and breathing this mission and have an idea of what equity, diversity, [and] inclusion means in our day-to-day work …”
He says it’s important to “pull each lever available to us” to try to move the needle on DEI work. These levers include supporting proclamations declaring racism a public health crisis, supporting better data collection and better utilization of that data, and investing in upstream services.
“Within the CCO space it’s important for us to be adaptable to what’s available in the community, what the resources are, and make sure we get our members the right access at the right time. But it’s also [important to] start pushing these other boats forward as we’re trying to move the needle on what it means to be inclusive and what it means to have a diverse workforce.”