The AMA overviews the fight for equity and the dangers of exclusion
The American Medical Association (AMA) emphasized the importance of equity in achieving optimal health for all individuals and populations, at a presentation at HIMSS23 in Chicago. Presenters Bobby Mukkamala, MD, past board chair of AMA, and Aletha Maybank, MD, MPH, chief health equity officer of AMA, said the reality is that there are significant gaps in opportunities, conditions, power, and resources experienced by communities across the world. The AMA launched a unit in 2019 to address equity, and Maybank’s role is to facilitate the process across the entirety of the AMA, leading to embedding equity in the institution's work.
While there are many great technology innovations being highlighted, the speakers emphasized the importance of making sure all groups can take advantage of them and that developers recognize bias and obstacles to ensure equal access.
The AMA recognizes that access to broadband internet is a social determinant of health and encourages initiatives to measure and strengthen digital literacy. The AMA also wants to see the design, functionality, and content in user interfaces to be created that keep marginalized communities in mind.
The AMA has put into place policies specifically against racism, including racism being considered as a public health threat, and the elimination of race as a proxy for ancestry, genetics, and biology in research and clinical practice.
The U.S. spends more money on health care, yet the U.S. continues to have the worst health of all high-income countries with the lowest life expectancy, highest chronic disease burden, highest suicide rate, and highest rate of avoidable death in general. Black, Latinx, indigenous, and other communities of color, women in the LGBTQ community, people with disabilities, people with low income, and other historically marginalized populations experience even worse outcomes. The AMA launched a new initiative to advance equitable health innovation, which provides a framework for shared understanding and a community of stakeholders committed to putting equity at the center of decision-making as it relates to health innovation investment.
The speakers said a lack of access to capital funding is a significant barrier for Black and Brown entrepreneurs. The absence of generational wealth, due to historical policies, structures, and systemic racism, make it difficult for these groups to grow their businesses from the start. The current assets and debt of these communities also impact their ability to access capital. The speakers suggest that community-driven solutions are needed to support marginalized groups and capitalize on their potential. They propose that equity design needs to be centered as a best practice and clear standards need to be established.
The AMA released a strategic plan in 2021, which includes concepts and terms related to equity and provides a good foundation for understanding the work that needs to be done. Diversity and inclusion are important, but not sufficient for achieving equity. Equity is about the even distribution of power, decision-making, and resources.
The AMA wants to leverage ongoing engagement for improving patient outcomes and professional satisfaction and identify opportunities to integrate the perspective of practicing physicians into the development of their work.