Black History Month: Reflecting on health disparities and our journey to address them  

“Of all the forms of inequality, injustice in health care is the most shocking and inhumane.”

Martin Luther King Jr. spoke these words in 1966 during a speech to the Medical Committee for Human Rights, and they are still apt today. More than 50 years later, Black people — and other people of color — continue to face disparities in health and wellness.

While Black History Month is a celebration of the diverse culture and accomplishments of Black people, it is also an opportunity for reflection and action on health disparities. Where do we stand, and what is MultiCare doing to ensure everyone has the chance to live a healthy life?

The burden of health disparities

Health disparities are preventable differences in the health of certain populations. Unrelated to biology, these disparities are often linked to gender, race, ethnicity or socioeconomic status (a combination of a person’s social standing and access to financial resources).

“When you hold all other variables constant, including socioeconomic status, a person’s race is the most predictive variable of their health status and their ability to access high quality health care,” says Sarah Dryfoos-Guss, program manager for health equity strategy at the MultiCare Center for Health Equity & Wellness.

Below are just a few of the ongoing health disparities affecting Black Americans:

• Black people are 40 percent more likely to have high blood pressure and 60 percent more likely to be diagnosed with diabetes than those who are white.
• During the pandemic, Black Americans have died from COVID-19 at 1.4 times the rate of white people.
• Across many types of cancer, Black people have the highest death rate and shortest survival of any racial or ethnic group.

There’s no one single cause of health disparities. The culprit is a tangled web of issues, many of which are rooted in the past.

“Our history of slavery and Jim Crow-era laws, some of which are still on the books today, directly shape the way that Black people receive or do not receive health care, whether they can buy a home — due to redlining and intentional gatekeeping — or land a high-paying job because of implicit biases and racial nepotism,” says Dryfoos-Guss.

Beyond systemic issues, the stress of living in an environment where one frequently encounters racism and discrimination takes a toll on health.

“There’s a lot of data now that shows how stress affects our health, and it’s incredibly taxing — and dehumanizing — to live in an environment where you are constantly confronted with racism, whether it’s overt or subtle,” says Dryfoos-Guss.

Dryfoos-Guss likens the experience to life in a pandemic.

“When there’s a constant perceived threat, like COVID-19, you feel anxious, you feel stressed, you feel like there’s something lurking,” Dryfoos-Guss says. “That is how many people of color feel every day, except the threat is in the form of other humans.”

Working toward a more equitable future — inside and outside MultiCare

While health disparities continue to have far-reaching effects on the lives of Black Americans and other people of color, it’s not a reality we have to accept.

MultiCare has been on an intentional journey to tackle inequities within our communities and our organization since 2015, when the Center for Health Equity & Wellness was first established. Among other goals, the center focuses on ensuring every patient and family MultiCare serves has the opportunity to be as healthy as possible.

For example, throughout the pandemic, the center has partnered with local organizations to provide COVID-19 vaccines and testing to underserved communities. The center is also developing a health equity dashboard.

“While there’s a lot of national data about health disparities available, it can be hard to find data on a local level,” says Dryfoos-Guss. “If you don’t know exactly what the disparities are within your particular community, then it’s it hard to do anything about them.”

The dashboard will pull patient demographics and health outcomes data from MultiCare’s electronic medical record system, bringing disparities to light and better enabling MultiCare teams to take action.

“For example, it could tell us that 85 percent of white people are receiving colon cancer screenings, as opposed to 39 percent of Black people,” says Dryfoos-Guss. “From there, we could easily implement changes in how we care for patients to bring up that 39 percent.”

MultiCare is also invested in developing and fostering a more equitable, diverse and inclusive environment from within. In 2020, MultiCare launched the Belonging Program.

“The program’s goal is to develop a culture where everyone feels a genuine sense of belonging, where everyone is valued, can show up as their authentic selves and feel like they are part of the team,” says Shareka Fortier, senior consultant for belonging & leadership development at MultiCare. “We are actively looking to increase diversity and integrate the tenets of equity, inclusion and true belonging into our workforce and internal operations.”

The program’s initiatives have included the following:

• Incorporating belonging into the employee onboarding experience
• Providing educational resources to staff and leaders, such as unconscious bias training
• Offering consultations and coaching

Another component of the program is the launch of the Belonging Advisory Council, a group of 40 employees from across all levels of MultiCare who represent the diversity of the organization and the communities it serves. Council members are champions for diversity, equity, inclusion and belonging (DEI-B). They also provide their perspectives and recommendations in furthering DEI-B internal efforts at MultiCare.

“How we lead, what policies and practices we implement, as well as how we treat each other as colleagues has a big impact on the care we provide,” says Fortier. “I am excited and proud to support MultiCare in taking intentional steps in our belonging journey. Through system collaboration, empathy, curiosity, courage and actionable impact, we will continue to make strides in becoming an organizational culture where employees and patients feel welcome, safe and a true sense of belonging.”