Joel S. Weissman (
Rachel R. Adler, Brigham and Women's Hospital and Harvard University.
Health Aff (Millwood). 2023 Oct;42(10):1402-1410. doi: 10.1377/hlthaff.2023.00474.
Hospital equity officers have become critical leaders in the effort to address the determinants of health care disparities, including structural racism. In this mixed-methods study, we surveyed a national sample of equity officers and interviewed a subset of respondents to provide additional perspective. About one-half of survey respondents reported at least some obstacles to achieving their health equity objectives, including racist beliefs among people working in their hospitals and health care systems, policies that perpetuate racism, and a lack of staff diversity. To address these challenges, some hospitals are collecting information about instances of racism, reviewing clinical algorithms for evidence of bias, or forming community partnerships. However, in interviews, equity officers pointed out that racism is a public health issue that cannot be adequately addressed solely within the health care system. Given the relative newness of most hospital equity officer positions, our research may be viewed as an early glimpse into the challenges and opportunities of this evolving work.
医院公平事务官员已成为解决医疗保健差异决定因素(包括结构性种族主义)的关键领导者。在这项混合方法研究中,我们调查了全国公平事务官员的样本,并对其中一部分受访者进行了访谈,以提供更多的视角。约有一半的调查受访者报告说,在实现其公平目标方面至少存在一些障碍,包括其所在医院和医疗保健系统中工作人员的种族主义观念、使种族主义永久存在的政策以及缺乏员工多样性。为了解决这些挑战,一些医院正在收集有关种族主义事件的信息,审查临床算法中是否存在偏见,或建立社区伙伴关系。然而,在访谈中,公平事务官员指出,种族主义是一个公共卫生问题,不能仅在医疗保健系统内充分解决。鉴于大多数医院公平事务官员职位相对较新,我们的研究可以被视为对这项不断发展的工作的挑战和机遇的早期观察。