Creshelle Nash, M.D.
Medical Director Health Equity and Public Programs
Everyone everywhere can lead happier, healthier lives when we take good care of our communities. Systemic disadvantages by race, gender or socioeconomic factors create inequities that deprive individuals, families, and communities of their health, education, economic stability and quality of life. These impacts can span generations, leaving a lasting impact on the health of our communities. The healthcare system has historically contributed to systemic inequities. Still, with the right leadership, the healthcare system, including insurers, can be part of the solution. It’s up to each of us to be better health equity allies.
Why Health Equity Matters
The CDC defines health equity as every person having the opportunity to attain their full health potential, with no one disadvantaged from achieving this potential because of social position or other socially determined circumstances. This is not only a problem at specific points in time, for example, discrimination within a healthcare visit, but a pervasive need that has stark long-term effects on our nation’s health and prohibits us from achieving health equity. Consider life expectancy. As of 2018, life expectancy among Black people was four years lower than White people, with the lowest expectancy among Black men. And while the leading cause of death for all adults in America is cardiovascular disease, 47% of Black adults have been diagnosed with cardiovascular disease, verses 36% of White adults.
Looking even further at Arkansas, our state (431 per 100,000 deaths) is far above the national rate (317.4 per 100,000 deaths) for heart disease deaths. For Black adults, that number jumps to 475 per 100,000 deaths.
These facts matter, as they show where we can improve our communities’ physical and mental health through a dedicated approach to equitable, affordable access to care for everyone. We all play a role in advancing health equity.
How You Can Be a Health Equity Ally
We cannot achieve health equity overnight. It requires a thoughtful commitment to making a long-term change in our society. At Arkansas Blue Cross and Blue Shield, we take a three-pronged approach to advancing health equity within our work, including:
As the Medical Director for Health Equity and Public Programs, it is my job to push beyond the “comfort zone” and ask the right questions of our staff. What do they see in our health programs? Are we reaching those most in need or at highest risk? Are we addressing health equity? How can we improve and build a more inclusive environment for all? We’re using the knowledge generated by the responses to these questions to break down internal and external silos and infuse our health equity framework into everything we do.
As a leader in the Arkansas community, Arkansas Blue Cross advances health equity where our members live and work by engaging non-traditional, cross-sector partners. Partnerships in one community may look different than in another, as it’s all about localizing care to work for those needing it. For example, we’ve partnered to support the development of Community Health Worker certification in the state with the Arkansas Community Health Worker Association (ARCHWA). We’re partnering to conduct faith-based outreach and engagement across the state. We host listening sessions with minority mayors to learn about the specific needs in their communities.
Internal and external education about health equity, its role in healthcare, and how to advance it among your organization and community is critically important for gaining support for your health equity program. And to back up this education, organizations must collect race, ethnicity and language data to build a diverse database we can stratify across all quality measures. One example of how diverse data collection improves health outcomes is the National Institutes of Health All of Us research program. Having a diverse group of participants can lead to important breakthroughs.