Why It Matters
A growing number of health systems are investing in upstream efforts to address the major social, economic, and environmental drivers of health inequities in their communities.
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Go Upstream to Pursue Health Equity

By Richard Foster | Wednesday, October 17, 2018

October 17 blog photo

Over seven years ago, the South Carolina Hospital Association (SCHA) and its member health systems made a commitment to join with other stakeholders across our state in pursuit of the Triple Aim of better health and health care for all South Carolinians. This decision to align our efforts on the population and community health front resulted in the creation of the Alliance for a Healthier South Carolina (AHSC), a multi-sector, collective impact-based coalition that now has over 60 member organizations.

From the early stages of the AHSC, our membership has worked to ensure that our collective decisions and actions are all filtered through a health equity lens. In 2016, AHSC leadership established the SC Call to Action for Health Equity built on four key areas of equity-based strategic focus:

  1. Establish just and equitable organizational cultures;
  2. Focus on diversity and inclusion in the educational and workforce pipeline;
  3. Actively partner with at-risk communities and populations on solutions targeted to eliminate specific inequities; and
  4. Ensure equity stratification of health data collection, analysis and dissemination.

The vast majority of AHSC members and health systems have adopted the guiding principles of this call to action and are addressing specific policy and practice barriers that result in major disparities in health care access and health outcomes.

Earlier this year, the SCHA Board representing a diverse mix of health system senior leaders endorsed the Institute for Healthcare Improvement Leadership Alliance’s Health Equity Call to Action as a framework for the next stage of our collective efforts in pursuit of improving the health and wellbeing of everyone in SC. In particular, a growing number of health systems across our state are working with community partners to invest in upstream programs and solutions focused on the major social, economic and environmental drivers of health inequities.

Several key examples of these financial and human resource investments in South Carolina include:

  • The health system in Anderson is building an equitable organizational culture with a focus on diversity and inclusion across all levels of their workforce and providing opportunities for members of the community to have a more active voice in all aspects of their health and care.
  • The health systems in Spartanburg are partnering with many community organizations to reinvigorate a vulnerable neighborhood. These efforts include investments in safe green space, affordable housing options, a minority-owned healthy food hub, and targeted training and employment opportunities for residents.
  • The largest system in the Columbia area has partnered with a network of churches and faith-based organizations to institute health improvement outreach programs targeted to stroke and diabetes prevention and influenza immunization.
  • The Medical University of South Carolina has ensured that minority-owned businesses in their local community make up a significant portion of the companies contracted for the construction and ongoing maintenance of their new Women’s and Children’s Hospital.
  • The health system serving Orangeburg and many other rural counties is working with a local public charter school, High School for Health Professions, to provide scholarships and employment opportunities for minority students.
  • Both Greenville health systems are partnering with community-based organizations to provide outreach services for a growing Latino population including coverage for community health workers and community paramedics.

We still have a long way to go on our collective journey here in South Carolina in pursuit of health equity and improved health for vulnerable people and communities. However, a growing number of urban and rural health systems across our state are taking unprecedented steps with key community partners to move upstream and provide and pay for programs and services designed to remove social, educational, and economic barriers to good health and wellbeing.

In the next stage of this journey, the AHSC will work closely with our member organizations to establish a statewide Health Equity Action Plan to guide and support our future efforts to eliminate equity-based health disparities and give a more active voice to those with lived experience. Join us as we travel upstream together in search of health equity and social justice for all.

Rick Foster, MD, is Executive Director for the Alliance for a Healthier South Carolina and member of the IHI Leadership Alliance.

Learn more about the IHI Leadership Alliance work on pursuing of health equity:

How to Achieve the Triple Aim for All

Lesson from Kansas: Start Addressing Health Equity in Your Own Backyard

You may also be interested in:

IHI white paper — Achieving Health Equity: A Guide for Health Care Organizations

Equity is a featured track at this year's IHI National Forum.

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