Being welcome, included and valued is a basic human need and essential to health and well-being. It’s why eliminating inequities is key to building healthy communities.
HealthPartners has a long history of addressing health equity – from a focus on reducing health care disparities and increasing diversity and inclusion in our workplaces, to engaging with communities to address social factors that affect health such as education, housing and access to food. Despite these efforts, staggering health inequities in our community persist.
“To achieve health equity we must recognize its connection to systemic racism and racial bias. We have the responsibility and opportunity to build a stronger organization where racism – and the inequity that results – have no place.”
Equity in COVID-19 vaccine distribution is essential to countering the pandemic’s disproportionate impact on underserved health populations.
The Centers for Disease Control and Prevention (CDC) also emphasizes the importance of equity, noting, “To reduce the substantial toll COVID-19 has had on individuals and communities, we need to work together to address inequities in the social determinants of health that increase risk of severe illness from COVID-19 for racial and ethnic minority groups.”
We’re using multiple approaches to increase access among these groups:
- We’ve intentionally set up our vaccine locations in areas that serve a high number of diverse patients, and are accessible by bus and light rail.
- Our doctors are reaching out through social and news media, as well as directly to patients, to answer questions and address concerns. We know some patients may be hesitant about vaccines, and that many people in communities of color have challenges trusting health care because of bias and racism experienced in life.
- We’re also identifying patients who need additional help scheduling appointments. We’re reaching out directly to these patients to schedule vaccination appointments as well as arrange for transportation, interpreter services or other support, as needed. We hold appointments for these patients to ensure access, releasing openings later if they go unfilled through this outreach.
As an organization dedicated to the health and well-being of every person, we’re committed to building an anti-racist culture at HealthPartners.
Created in 2020, the HealthPartners Equity, Inclusion and Anti-Racism Cabinet is accelerating our efforts to advance this critical work. The cabinet is made up of a diverse group of leaders from across HealthPartners. Andrea Walsh, HealthPartners President and CEO; Steven Jackson, MD; and Yeng Yang, MD, chair the cabinet.
Dr. Steven Jackson is a physical medicine & rehabilitation physician and the medical director of patient experience at Regions Hospital. Dr. Jackson is committed to ensuring every patient receives the care they need and deserve. He believes cultural humility and a shared curiosity about our differences are key to building a stronger organization and community.
Dr. Yeng Yang is a primary care physician and the clinic practice medical director at our St. Paul Clinic. Dr. Yang has a special interest in patient-family centered care and quality improvement. She believes trusted patient-clinician relationships and experiences built around mutual respect, understanding and curiosity are the foundation to achieving good clinical outcomes.
In our focus on advancing health equity and eliminating racism, we’ve set ambitious goals. The cabinet will provide leadership, direction and oversight to help us reach them. They’ll guide efforts to align our work and build partnerships across the organization.
- Increase the racial diversity of our leadership team by 100% – from 10% today to 20% by 2025 – to match our patient and member population.
- Build an anti-racist culture and deepen our collective understanding of cultural humility – starting with a requirement that all team members complete bias training in 2021.
- Eliminate disparities in maternal and infant care – prenatal, perinatal and early childhood care have a critical impact on the future of both mother and child.
- Eliminate disparities in childhood immunizations – redoubling our efforts to reach families and children to protect against preventable illness and disease.
- Accelerate and expand our efforts to eliminate disparities in chronic conditions and preventive screenings, including type 2 diabetes and vascular disease; preventive care including breast and colorectal cancer screening, and others; as well as a focus in specialty and hospital care.
To accelerate progress on our goal to improve health equity and do our part to stand against systemic racism, we are organizing our work around these four cornerstones:
- Increasing diversity and inclusion in our workplace
- Advancing health equity in our care and coverage
- Partnering with the community and advocating for change
- Strengthening our commitment to St. Paul, as the largest private employer in the city
As we consider equity, inclusion and anti-racism, it’s important to look at the diversity in our region, patients and our physician population.
21.1% of people in the 13-county Twin Cities metro area identify as persons of color.
78.9% are persons who are white.
23.6% of the patients in our care group in 2019 identify as patients of color.
76.5% of patients in our care group are white.
20% of our 1,837 physicians are physicians of color.
80% of our physicians are white.
When we understand and embrace our differences, we are better colleagues. We work together more collaboratively to best serve our patients and members. Plus, we’re more creative and more connected. Overall, we do our jobs better. Having a diverse staff – and leadership team – that mirrors the diversity in our community is important for ensuring health equity.
Examining our biases is an important step to build an anti-racist culture and to foster cultural humility. All of our HealthPartners team members will complete bias training in 2021.
HealthPartners hosts employee forums across our organization that explore topics such as race, gender identity, disability and poverty.
We developed videos and training sessions to help colleagues respond to patients or members who show bias toward them.
Our colleagues volunteer to be Health Equity Champions – partnering to educate peers on cultural humility, anti-racism and reducing bias.
To advance health equity more quickly, we’re connecting existing efforts. And we’re launching new ones. We’ve set high goals on maternal and infant care, childhood immunization rates, and preventive screenings. For example, HealthPartners has adopted two measures to help improve maternal health equity, by eliminating disparities in prenatal and postpartum care.
76.3% of patients of color received prenatal care (a visit in the first trimester) compared to 89.9% of patients who are white. With postpartum care, 71.7% of patients of color had postpartum care (or a visit between 7 and 84 days after delivery), compared to 75.6% of patients who are white.
HealthPartners is focused on eliminating gaps in preventive screenings to help prevent more serious illnesses and health conditions. That’s why we try to make them as convenient and accessible as possible. For example, because we offer access to same-day mammograms, women can get their annual breast exam while already in our hospitals and clinics for another appointment.
When patients don’t understand aspects of their care, it affects health outcomes. To ensure our patients who speak English as a second language or speak no English have the best care possible, we offer language interpreters for several languages including Spanish, Somali, Hmong, Vietnamese, Oromo and Karen. Interpreters accompany patients to appointments, help explain diagnoses and treatments, and assist with medication instructions.
The relationship and communication between a person and their mental health provider is a key aspect of treatment. People want to feel like their identity is understood by their provider. That’s why HealthPartners uses an online tool that can identify mental health providers by language, race, ethnicity, gender and/or sexual orientation. Caregivers who speak 19 languages are available.
“Safety can be formed in a unique way where patients can address grief and trauma that they had experienced because the foundation of trust was established in the room, sitting across from someone who had some shared life experiences. And that is a beautiful thing, knowing that therapeutic work is that much more effective because of some shared identity.”
More than 275 HealthPartners colleagues are raising awareness among staff and clinicians about health equity. It’s a way for colleagues to get involved. A recent topic included talking about end-of-life planning with families and patients who speak limited English or no English.
Colleagues share information on topics related to cross cultural care and health equity through Culture Roots. Examples include cultural humility and advance care planning, health literacy, and unconscious bias.
Patients sometimes need help beyond what we do. A community health worker (CHW) is the link between patients and health and social services. They’re trusted members of the community, who help reduce barriers to care and make it easier for patients and members to access services. For example, we have innovative programs with CHWs for our Medicaid members to support them in treating their health conditions, such as diabetes.
We’re stronger when we can pull organizations together to achieve common goals. We build momentum on specific health topics. Equity is an important part of each of our community partnerships. With like-minded organizations, we push for change.
We’re committed to ending the stigma around mental illnesses through Make It Ok. To address disparities in mental and behavioral health treatment, we partner with organizations like the Minnesota State Baptist Convention, which includes 28 African American churches.
It’s important to talk, play, read and sing early and often with children. We sparked a statewide movement called Little Moments Count. We’ve engaged diverse community partners to guide the initiative.
Eating better and moving more are important habits for kids and families. We’re making it fun and easy for them to do with PowerUp, a community-wide initiative.
We’re an anchor employer in St. Paul. That means we have a responsibility to support the city and community. Our leaders are involved in business roundtables. They’re serving on boards. They’re giving back in big and small ways. Together with other business leaders, we’re helping to keep St. Paul strong.
Ten organizations along the Green Line in Minneapolis and St. Paul are partnering to spend more procurement dollars with local businesses, invest in educational opportunities to hire more area residents, increase transit use and boost prosperity. To date, CCAP has increased the percentage of residents hired by the city’s largest employers and institutions from 13% to nearly 20% in the past five years.
We’ve been focused on matching the diversity of our workforce with the diversity of our patients at Regions Hospital. It’s important for people to see themselves in those who are caring for them. We increased – by 40% – the diversity of our team members at Regions Hospital in 2019.
Our current energy and focus on advancing health equity mirrors historic efforts we’ve taken when our community needed us. We’re open to creative partnerships and innovation. And we invite our members, patients and community members to contact us with their ideas and insights.
- HealthPartners established the Center for International Health in 1980 to care for refugees from Southeast Asia after the end of the Vietnam War. It now serves patients from more than 30 countries.
- In 2001, HealthPartners was among the first organizations in the nation to form a cross cultural care task force to reduce disparities in health care. We began by asking patients to voluntarily report their race, ethnicity and preferred language. We use this information to identify and implement strategies to reduce health disparities.