Many Americans learned about the holiday known as Juneteenth for the first time this year and the significance it has for Black Americans, the commemoration of emancipation and the end of slavery.
On this year's holiday on June 19, several Chicago hospitals -- 36 of them in total -- penned an open letter declaring that systemic racism is a "public health crisis."
"Systemic racism is a real threat to the health of our patients, families and communities," the letter reads. "We stand with all of those who have raised their voices to capture the attention of Chicago and the nation with a clear call for action."
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The document's signatories, which include large systems such as Advocate Aurora Health, Mercy Hospital and Medical Center and University of Chicago Medicine, as well as smaller organizations, said systemic racism results in generational trauma and poverty, and causes higher rates of illness in black and brown communities.
WHAT'S THE IMPACT
Health disparities caused by historical injustices lead to social determinants of health that include poverty, inadequate housing, police brutality, mass incarceration, underperforming schools, joblessness and poor access to healthcare, the hospitals contend.
Declaring that "it's time for action," the health systems signaled their intent to work more closely with community-based partners to implement widespread change.
Since the COVID-19 coronavirus is still very much affecting the lives of Americans, particularly black Americans, the hospitals said that in addition to providing testing and contact tracing, they are also partnering with the City of Chicago to provide services and personal protective equipment to marginalized communities. They're also throwing their weight behind educational programs and advocacy for personal practices that flatten the curve.
The health systems also highlighted the hiring programs they've implemented that help to clear a path for careers in healthcare for people of color, as well as a commitment to keeping dollars in the community to create jobs and rebuild strained economies.
They also vowed to listen to the voices of the underprivileged.
"Many in our organizations will never know the struggle systemic racism has created for our colleagues at work and for members of our community," the signatories wrote. "We vow to listen to our patients and colleagues of color and to learn from their experiences. We commit to be allies, advocates and partners in being the change we want to see in the world."
While these efforts are ongoing, the hospitals acknowledged that more needs to be done, and pledged to take additional steps such as re-examining institutional policies and improving access to primary and specialty care.
An important component of this renewed push for equity is the commitment to provide anti-racism and implicit bias training for physicians, nurses and staff. Along with that comes a commitment to advocacy for increased funding for social needs, social services and programs that promote social justice.
"Our society only truly thrives when everyone has an opportunity to succeed and live a healthy life," the letter reads. "We are committed to moving forward together. By harnessing the collective strengths of our organizations, we will help serve our communities as agents of change."
THE LARGER TREND
On Monday night, CMS Administrator Seema Verma released Medicare claims data showing that Blacks are hospitalized with COVID-19 at a rate nearly four times higher than that of the white population.
Blacks had the highest hospitalization rate, with 465 per 100,000. Hispanics had 258 hospitalizations per 100,000. Asians had 187 per 100,000, and whites had 123 per 100,000.
The disparities go beyond race and ethnicity and suggest the impact of social determinants of health, particularly socioeconomic status, according to Verma. The administration is promoting value-based solutions rather than relying on a fee-for-service system that Verma said is insufficient to address the social determinants and the needs of vulnerable Americans because it limits payment to what goes on inside a doctor's office.
During AHIP's Institute and Expo event last week, Dr. Garth Graham, vice president of community health at CVS Health, said collaboration between health leaders and their local communities is necessary in addressing health disparities among minority groups. African Americans make up 13% of the U.S. population, but account for about 24% of COVID-19 deaths, he said.
Since the COVID-19 pandemic, these disparities have only become more prevalent, with some of the driving factors including disparities related to social determinants of health, the over-predominance of African American and Latino frontline workers, and higher rates of chronic illness such as diabetes and hypertension in minority groups.
One of the reasons SDOH haven't yet been woven into healthcare in a consistently meaningful way is that coding for them remains a very murky process. Providers and payers don't yet have processes in place to handle them well. The way forward is through advanced analytics that can track behavioral change.