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N.C. hospitals join others in declaring racism a public health crisis

N.C. hospitals join others in declaring racism a public health crisis

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RALEIGH — North Carolina hospitals have joined the growing number of organizations and governments in declaring racism a public health crisis.

The N.C. Healthcare Association, which represents all 130 hospitals in the state, released a statement this week pledging to work harder to provide equitable care to everyone. Among the challenges to that goal, the association said, are the barriers to employment, education and economic opportunity that people face because of their race.

"Persistent racism, one of several social injustices driving widening disparities of care disproportionately harming people of color, is an urgent threat to our public health in North Carolina," the association wrote. "It's time to elevate this issue to mission critical status."

Local and state governments across the country have approved similar resolutions in recent months. In North Carolina, they include county commissioners in Wake, Durham and Mecklenburg and the board of health in Chatham County.

The declarations were inspired by the renewed focus on racial inequality following the killing of George Floyd by Minneapolis police in late May.

The resolution from the North Carolina hospitals association doesn't mention Floyd or the protests that followed his death. It refers instead to how the coronavirus pandemic has highlighted long-term health disparities that "impact people of color and other marginalized groups."

Steve Lawler, the health care association's CEO, said in an interview that the social movement that arose after Floyd's death was also a factor in drawing attention to health inequality. Lawler said hospitals have long worked to overcome the disparities in health care and the resolution signals a determination to build on those efforts.

"We've been active in this space for a good long time, but we've been working independently within our own organizations," Lawler said. "And what we're looking at now is banding together."

The resolution calls for hospitals to work in three areas:

• Education: Hospitals will provide anti-bias training and professional development to their boards, executives and staff.

• Innovation: Hospitals and the association will identify and implement effective ways to reduce health care disparities and share what works with other hospitals in the state.

• Data: Hospitals and the association will gather and analyze data to identify gaps in health care delivery and outcomes and to "track and hold ourselves accountable to measurable change."

This kind of work already goes on. Lawler said Vidant Health based in Greenville, for example, looked at people who were readmitted to the hospital after treatment and found that poor, often African-American patients in rural counties were missing follow-up visits because of a lack of transportation.

Vidant began providing those patients with computer tablets they could use to check in with a care manager each day and get some coaching.

"That had a significant impact on reducing readmissions," he said.

And Lawler said researchers at Duke have studied for years how race and other factors outside the hospital affect the likelihood that people with heart failure are readmitted to the hospital.

Duke Health is among the hospital systems that have already spoken out about racial inequality this year. This summer, the hospital system announced its own pledge, which it calls Moments to Movement, "to stand against racism in all its forms, to be self-aware, and to make equitable choices daily."

In August, the UNC Health System appointed its first executive director for health equity to lead an effort to change policies and practices to make the health system more accessible to the communities it aims to serve.

Resolutions declaring racism a public health crisis have not been universally embraced. Bladen County commissioners voted 6-3 against such a declaration earlier this month.

But Lawler said the hospital association received no pushback or hesitation from any of its members, which range from small community hospitals to large research institutions and include Veterans Administration and military hospitals. The challenge now, he said, is to follow through on the association's pledge and sustain it.

"This isn't something that we hope to be a flash in the pan — that we're making a statement, do some work and then declare victory," he said. "This is going to be work that is ongoing and become part of everything we do. Because it is going to take time and take commitment."

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