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

By Kendra Tinsley | Tuesday, October 9, 2018

October 9 blog post

At age 70, Rose (not her real name) wasn’t particularly interested in our hypertension reduction initiative. This was despite warnings from her doctors that her blood pressure was so chronically high that they were worried she might suffer a stroke.

Despite knowing this initiative had the potential to dramatically improve — even possibly save — her life, Rose had a clear response to an invitation to participate: “I understand my health is important, and that I need to focus on my blood pressure. But I have $5 to get me through the last 20 days of the month, so it's just not my top priority.”

Fortunately, Rose was engaged with a proactive team of nurses at the Community Health Center of South East Kansas (CHCSEK). Because leadership at CHCSEK prioritize addressing social determinants of health, staff are empowered to help address barriers to receiving the health care to which more privileged citizens routinely have access.

By connecting Rose to food and transportation assistance, the CHCSEK staff removed roadblocks to managing her dangerously high blood pressure. Once these fundamental needs were met, Rose was ready and able to participate in our hypertension initiative. Twelve weeks later, her blood pressure was under control. Hypertension no longer posed an imminent threat to her health, and it’s quite likely that Rose avoided costly future procedures as a result.

I share this anecdote from my state to illustrate how social factors can lead to health inequity and how we can address them by taking proactive steps that start in our own backyards. That is the essence of the Achieving Health Equity Call to Action developed by the Institute for Healthcare Improvement’s Leadership Alliance.

The organizations who take part in the Alliance recognize that health professionals are in a unique position to lead efforts to eliminate health disparities and foster health equity by working with communities, patients, providers, payers, legislators, and policymakers. Nationwide, there are many inspiring examples of such leadership, including the Alliance for a Healthier South Carolina, Saskatoon Health Region, and the Michigan Department of Community Health to name a few.

In Kansas, many health care organizations are tackling health disparities they are uniquely positioned to address.

For example, Kansas remains one of just 18 states that have not expanded Medicaid. My organization’s co-founders — the Kansas Hospital Association (KHA) and the Kansas Medical Society (KMS) — are trying to use their relationships with policymakers to get health coverage for the more than 150,000 Kansans left without health coverage.

KMS recently announced the formation of the Health Equity Network for Change (HENC) to improve health care for medically underserved populations through the use of health information exchanges and data analytics. Kansas-based KAMMCO will provide the data source, health exchange, and analytic tools to HENC.

I’m proud to say that the board of directors of my organization, the Kansas Healthcare Collaborative (KHC), endorsed the Health Equity Call to Action, re-energizing our efforts to foster health equity and eliminate health care disparities.

As part of our work to operationalize the strategies and action items outlined in the Call to Action, KHC encourages hospitals and physician practices in Kansas to capture and analyze REAL (race, ethnicity, age, language) data to identify disparities in care and leverage the findings to develop quality improvement priorities. In partnership with Blue Cross Blue Shield of Kansas (BCBSKS) — the largest commercial insurer in Kansas — we are considering ways that the Call to Action can be incorporated into the BCBSKS Quality-Based Reimbursement Program.

But there is also work for us to do even closer to home. With our board’s support, we are taking steps to promote diversity in our organization. We believe that the composition of our leadership should reflect that of our state — and that doing so will better help us identify and work to remove barriers to health equity closest to us. We most certainly have opportunities to do our part to improve health equity, but first we must look at ourselves and take action.

As a member of IHI’s Leadership Alliance, I encourage health care professionals at organizations large and small to likewise take a hard look at yourselves and consider what action you can take today to chip away at social inequities that lead to health disparities.

Kendra Tinsley, MS, MHCDS, CPPS, is Executive Director of the Kansas Healthcare Collaborative and member of the IHI Leadership Alliance. Phil Cauthon, MS, is Communications Manager at the Kansas Healthcare Collaborative.

Editor’s note: The IHI Leadership Alliance plans to continue sharing more in-depth examples of its efforts in pursuit of health equity through the month of October. Look for more on the IHI blog and the This Week @ IHI newsletter.

You may also be interested in:

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

How to Achieve the Triple Aim for All

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

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