Our Health Equity Work
Our health equity research seeks to understand and inform the differences in the quality of both health and healthcare across different populations. Our projects provide the evidence base that makes the case for health policies, innovations, interventions, partnerships, and practices that will allow each American to attain his or her full health potential.
1. Assessment of U.S. Physician Engagement on Health Policy Issues Survey
There have been major changes to the US healthcare system recently, but there is a lack of information regarding how physicians feel about these new policies, and how engaged they are with. The policy process that led to these changes. In the Fall of 2018, our lab completed a pilot physician knowledge and attitude assessment survey to assess physicians’ attitudes and knowledge of health policy. This semester students will conduct the full study to obtain crucial knowledge that can help us better understand where physicians currently stand in major issues in health policy today.
HELPR Lab Project Leader(s) - ridhi patel, Shaina Haque, Maitri Patel
2. Comparative Utility of Social Determinants of Health Screening Tool
It has been well-established that social determinants of health (SDH), such as education, housing, and food insecurity, strongly affect health outcomes in the United States. Numerous screening tools have been developed for healthcare settings to identify and intervene in various social challenges encountered by patient. However, there is a lack of consensus on. Which screening tools are most accurate and effective. Students in this project would work with our team at University Medical Associates (UMA) to screen patients for social needs in order to assess which SDH tools are the most appropriate, accurate, and effective in an ambulatory primary care setting.
HELPR Lab Project Leader(s) - lawrence jones, Joseph Hall, Courtney Duckworth, Tiana Walker, Jean Nunez, Erica Stephens, Julia Gilliam
3. Equity Coalition: Disparities in the UVA Health System
The UVA Health System has not historically reviewed patient-level data to identify widespread disparities in outcomes across the services we provide. The UVA Equity Coalition aims to change that. Working with the Health System’s Chief Quality Officer, we are building a dashboard to measure disparities, and meeting with departments to help address disparities. The first step is analyzing the last few years of patient data to identify disparities across the service lines of care. Students in this project would work with our team to help select data points for disparities identification and complete the analysis to determine where disparities exist in the UVA Health System.
Collaborator(s) - UVa’s Equity Coalition
HELPR Lab Project Leader(s) - Patricia Gallegos
4. Mapping Current Health Impacts of Structural Racism
In 2018, Dr. Dayna Matthew with the UVA Equity Initiative (Redressing Inequity), proposed developing a community-level measure of racism applicable to counties across the United States. Persistent and pervasive racial and ethnic disparities continue to plague health outcomes in America but remain unexplained even after considering socioeconomic factors. This study hypothesizes that structural racism is a significant, fundamental, but underappreciated cause of African-American health disparities. It defines structural racism as more than individual prejudice, bigotry, bias, or discrimination. It is a system of assigning hierarchical value to people groups, and then structuring their access to power, resources, and opportunity based on the superior or inferior status assigned to their group’s socially constructed race. Because, there is no consensus in the literature on how to measure structural racism, the impact of racial inequality on population health is unknown. Existing metrics that attempt to measure structural racism fall short because they fail to define racism as more than inequitable outcomes among blacks and whites. These disparate outcomes may be due to structural racism, but they could also as easily be evidence of other inequities. Existing measures are ahistorical in their construction and therefore are not proximately grounded in the legal structures that confirm their relationship to racism. Moreover, existing measures do not account for the role of law in operationalizing structural racism and therefore are not cognizant of the mechanisms that institutionalize structural racism at all levels of society. These omissions fail to acknowledge the power of legalized institutions to shape attitudes and therefore all other social, political, and economic institutions. This study seeks to improve existing measures of structural racism by demonstrating first, the central importance of grounding measures of structural racism in historical evidence of legalized racism, and second by providing evidence of the cognitive mechanism by which structural racism influences outcomes. We select one existing metric as an exemplar however propose that all future measures of structural racism will be improved by incorporating a factor to represent that legally enabled institutions are the operational core of structural racism in America.