Guest Blog Post from Sepsis Alliance
February is Black History Month, which presents an annual opportunity to honor the impactful contributions of Black individuals in all areas of U.S. life. Black History Month also presents an opportunity to recommit to addressing racial inequities. For the health sector, including those of us working in the chronic/infectious disease, infection prevention, and sepsis space, this means recommitting to address inequitable health barriers and improving outcomes for Black patients and communities.
Health Inequities: A Persisting Problem
Inequitable gaps in disease incidence and patient outcomes are complex and deep-seated in U.S. society. Unfortunately, they persist to this day.
Inequities stem from many factors, including unconscious bias among medical professionals, structural racism in health sector institutions, and medical mistrust in medically underserved communities. Social determinants of health – factors and conditions outside of healthcare that impact a person’s level of health – also directly contribute to disparities. These include socioeconomic status and financial stability, quality of and access to education, geography, lived environment, and social and community context, among others.
Communities of color, and particularly Black communities, experience disproportionate suffering due to sepsis and drug-resistant infections. These stark areas of inequity warrant specific attention. According to Sepsis Alliance, awareness of the terms “sepsis” and “antimicrobial resistance” (AMR) among Black Americans is significantly lower than among white Americans, while Black patients are twice as likely to contract drug-resistant infections and bear nearly twice the burden of sepsis deaths.
More broadly, Black Americans are less likely to have access to high-quality care and are less likely to be insured. Studies show that Black patients who are admitted to the emergency room are assigned to significantly lower priority status and experience significantly longer wait times (10.9 minutes longer on average) as compared to case-matched white patients. All these experiential factors – along with many other social determinants – contribute to starkly disparate outcomes, and disproportionate loss and suffering.
In addition to these devastating human costs, PFCD research shows that there are significant economic costs to health inequities as well. There are $236 billion in added medical costs from disparities in disease control experienced by Black patients – meaning that we could be saving $236 billion if Black communities experienced the same level of disease control as white communities.
What’s more, hitting recognized health equity targets in Black communities over the next ten years would save $424 billion in overall medical costs and $115 billion in less absenteeism. Hitting recognized health equity targets in all communities over the next ten years would lead to total savings of $3.8 trillion.
Just as the causes of health inequities are complex and multifaceted, our solutions to the problem must be, too. We must improve workforce diversity and address shortages in health systems and institutions providing direct care. Healthcare professionals need more robust training in implicit bias, structural racism, and care disparities. Those developing new pharmaceuticals and medical technologies must achieve diversity in clinical trials, longitudinal studies, and other medical research – so that we can understand and better address the health needs of all populations. Improving public health education efforts within underserved communities will help to close gaps in awareness, while policy solutions to problems such as inequitable access to insurance and high out-of-pocket costs are also key pieces of this complex puzzle.
Ultimately, health sector institutions must use their organizational voices to lend support to these efforts broadly – no unidirectional approach will be enough. Sepsis Alliance’s Pledge for Equity, Diversity, and Inclusion (EDI) in the Fight Against AMR, Sepsis, and its Underlying Causes brings together health sector organizations committed to taking action, remaining accountable, and contributing tangible solutions in this multidisciplinary space.
Black History Month presents an opportunity to reflect on the continued necessity for this work – and recommit to carrying it forward, all year long. Learn more about the work being done, and about how to get your own organization involved with the EDI Pledge, here.