From the podium of Bornstein Amphitheater, Michelle Morse, MD, MPH, a hospitalist and assistant program director of the Internal Medicine Residency, was filled with hope as she looked at the large audience that had packed the room for the Brigham’s health equity summit on May 29.
The half-day event, “Brigham’s Commitment to Health Equity: Aligning Our Mission, Defining Our Future,” invited faculty, staff and trainees to join national and global leaders to discuss the Brigham community’s shared commitment to pursuing equity. The World Health Organization defines health equity as the fair opportunity everyone should have to attain their full health potential and articulates that no one should be disadvantaged from achieving this potential.
“I’ve never seen Bornstein this full in my 11 years at the Brigham, and it’s an inspiration to see all your faces,” Morse said. “We hope to find ways to channel this support and surge in energy. We feel that change is already afoot because of information coming from the culture surveys, and we hope to see that together we can grow the work in health equity here at the Brigham with input from all of you.”
In addition to the sessions in Bornstein — which included a keynote address by Mary T. Bassett, MD, MPH, director of the FXB Center for Health and Human Rights at Harvard University, and a dynamic panel discussion — the day featured interactive lunch roundtables filled with attendees as well. Several of the events were simultaneously translated into Spanish and Haitian Creole.
Throughout the day, speakers and attendees discussed the importance of recognizing and naming the ways structural racism (also known as systemic racism) harms individuals and communities, and how it connects to care quality, patient safety and patient outcomes.
Brigham Health President Betsy Nabel, MD, challenged attendees to identify a structural barrier they see in the workplace or their local community and commit to making a change that helps address it.
Nabel also reaffirmed the Brigham’s commitment to understanding structural barriers and gaps that prevent patients and their families from receiving equitable care — pointing to the Peter Bent Brigham Hospital’s mission to care for the immigrant, poor community of Boston since its founding in 1913.
“Health equity is part of our DNA. It’s been one of our values for over a hundred years,” Nabel said. “And that spirit of Peter Bent Brigham continues through today. We have a responsibility to continue serving our richly diverse community.”
During the afternoon’s panel discussion — moderated by Nawal Nour, MD, MPH, chief diversity and inclusion officer for faculty, trainees and students at Brigham Health — speakers explored how the Brigham has sought to identify and reduce health inequities through patient care, research, education and community outreach.
Joseph Loscalzo, MD, PhD, Brigham physician-in-chief and chair of the Department of Medicine, discussed both hospital-wide and resident-led efforts to formalize this work through committees focused on health equity and social justice. Zara Cooper, MD, MSc, Kessler director of the Center for Surgery and Public Health, highlighted several instances of Brigham-led research that exposed the consequences of health inequities and the center’s continued work in this area, including a recent partnership with the National Institutes of Health to improve cultural dexterity among surgical trainees.
Achieving health equity is not limited to opportunities directly related to patient care, panelists noted, pointing to how other social determinants contribute to health and well-being.
In one example, they noted how the history of redlining — the now-illegal practice of lenders and real estate agencies preventing people of color from buying homes in traditionally white communities — continues to affect communities of color via wealth gaps and low rates of homeownership. At the same time, panelists added, research has shown people who experience housing challenges are more likely to have poor health outcomes.
Wanda McClain, MPA, vice president of Community Health and Health Equity, explained the importance of addressing some of these gaps by developing a “place-based strategy,” which entails being mindful of how anything from a capital project to hiring practices presents an opportunity to support health equity in the local community. She noted these practices are exemplified by anchor institutions — nonprofits that consciously work to bring measurable benefits to the communities in which they are located.
“This means asking questions like, ‘How are we making purchasing decisions? Are we investing in local, minority-owned procurement?’” McClain said. “‘In terms of human resources, are we doing everything we can to hire people from our local communities? With construction and real estate, are we being environmentally sensitive as we build?’ These are the critical issues we are working to address as part of our anchor institution strategy in the weeks, months and years ahead. These are among the opportunities that will inspire lasting change.”
We Want to Hear from You
It is critically important to hear the voices of the Brigham community to inform our institutional efforts to deliver just and equitable care. All faculty, staff and trainees are invited to share how they are addressing health equity in their own work and suggestions for advancing health equity at the Brigham. Send your contribution to email@example.com. Submissions will be shared in the online edition of Brigham Bulletin on June 14, and a selection will appear in the print edition.