Spectrum Health plans to accelerate and expand its ongoing efforts to address racial and ethnic health inequities.
The West Michigan health system already directs significant funding to health improvement programs and plans to increase that commitment in West Michigan as well as in southwest Michigan through its Spectrum Health Lakeland division. As a system, Spectrum Health will dedicate an additional 40% to improve health equity, a total commitment of at least $100 million over the next 10 years.
“For decades, Spectrum Health — including Priority Health — has been committed to meeting the needs of those in our community that experience the poorest health outcomes,” said Tina Freese Decker, president and CEO of Spectrum Health. “Our mission is to improve health, inspire hope and save lives for every person, and we understand the urgent need to do more for communities that for too long have experienced health and social inequities.”
The expanded commitment will make it possible for Spectrum to build on both its Healthier Communities programs in Grand Rapids and Spectrum Health Lakeland’s efforts to achieve racial and health equity.
Spectrum dedicates $6 million every year to Healthier Communities, an organization supporting work that reduces infant mortality, advances family economic security by improving health outcomes and improves community wellness by reducing chronic disease.
Funding is provided by Spectrum but monitored by an independent community board.
The programs include efforts to better manage chronic diseases, such as heart disease and diabetes. Plans also will include supporting populations impacted by health inequities to more easily access health care close to home and help them stay on track with medications, nutrition and healthy lifestyle habits, as well as addressing social determinants of health.
Ken Fawcett, Healthier Communities vice president, said health inequity goes beyond access to medical care. Issues have existed for years, generations and even centuries that impact the likelihood of people achieving equitable health.
“They are complex and intertwined, almost like a rope, and they are going to take some time for us to try to sort out,” Fawcett said.
The COVID-19 crisis particularly has allowed Spectrum to see things clearly with regard to racial disparity. Fawcett said having access to high quality health care contributes to about 15% of an individual’s overall health, genetics contributes to another 20%, and the rest of a person’s health outcomes are a result of behaviors and social factors.
“Some of these things are really foundational. For example, access to a secure source of nutritious food, having access to transportation, to housing, to education, economic security,” Fawcett said. “There’s a tremendous linkage between wealth and health.”
Fawcett echoed similar statistics that populations of color and people living in poverty have a far greater likelihood of having adverse outcomes related to COVID-19. Blacks make up 14% of the Michigan population but also account for 40% of COVID-related deaths.
Additionally, the Latinx population is overrepresented in number of deaths by a factor of three, Fawcett said. While differential access to care helps create these discrepancies, other contributing factors are the aforementioned access to housing, food, education, etc. and also the stress of racial biases.
Ultimately, the goal of Healthier Communities is to address all factors that help to create a predisposition toward bad health outcomes, but it recognizes it can’t change those factors over a period of 90 days. The short-term efforts around COVID must focus on preventing infection in the first place, Fawcett said.
Part of Healthier Communities’ work is addressing racial discrepancy in infant mortality, discrepancies that Fawcett argued are not genetic, but occur because of socialization.
“If you take a look at infant mortality, those individuals moving from continental Africa and the Caribbean have infant mortality rates roughly equivalent to Caucasian (Americans),” Fawcett said. “However, after one generation, the offspring of those immigrants will have infant mortality rates that are two, three, four and sometimes even greater than Caucasians.”
Fawcett said participants in Healthier Communities programs who are women of color have lower infant mortality rates that are more comparable to white Americans. However, only around 40% of eligible women are choosing to participate.
With increased funding, Healthier Communities is looking toward creating interventions that aren’t tied to meeting people in their homes. The millennial population is more mobile than previous generations, so Healthier Communities is exploring digital and mobile options for participation.
Healthier Communities also is engaged in building economic security. Part of the effort is putting nursing resources in public schools with the goal of not only improving the health of students in the short run, but also to keep kids in school and ensure greater educational outcomes and better employability in the long run.
Fawcett said individuals who earn less than $35,000 a year report fair or poor health at twice the rate of those who make $35,000 to $45,000 a year. Healthier Communities hopes to report data that shows better graduation, college entry and workplace readiness rates in the future.
Healthier Communities also has a program where it meets people in their homes and teaches them self-management for chronic diseases like heart and respiratory illness, as well as lifestyle changes to prevent the risk of chronic illnesses.