Inequity is a Public Health Crisis

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Inequity is a Public Health Crisis

On May 25, 2020, George Floyd died in police custody. The video of his death and the death of Manuel Ellis, Breonna Taylor, Ahmaud Arbery, and countless others spurred protests across the nation dramatically increased our awareness about the devastating effects of police violence and structural and systemic racism. At the unveiling of a new initiative to address racism by the Centers for Disease Control Director, Dr. Rochelle P. Walensky called racism “an epidemic that affects the health of our whole nation.” State and local leaders here and across the country recognize how racism contributes to this crisis, including Washington State Board of Health, Jefferson County Board of Health, King County and Public Health-Seattle, Tacoma-Pierce County Board of Health, Thurston County Board of Health, and Whatcom County Board of Health.

The desire to confront racism and its effects contributed to the Alliance’s Board of Directors and staff developing our own organizational intention regarding racism, diversity, equity, and inclusion, that is now posted on the Alliance website.

The Alliance is committed to becoming an inclusive and anti-racist organization. We pledge to create an environment where all employees and members, regardless of skin color, culture, ethnic origin, gender, sexual orientation, ability, or age, feel valued and have opportunities for growth. We commit to identify, discuss, expose and challenge inequities, including structural racism in healthcare systems across Washington.

This is more than a proclamation. It is also a focus of our work in the coming years. We aim to bring an equity and inclusion lens to all we do and to all we influence.

There are few examples of inequity as stark as COVID-19 and its disproportionate effects on BIPOC communities. Washington State Department of Health data show that 3% of the Black population and 7% of the Hispanic population in Washington have been fully vaccinated, compared to 67% of whites. CDC data report people who are Hispanic make up 13% of Washington’s population, but they are 30% of the reported cases and of those hospitalized, 22% are Hispanic. Other research indicates COVID-19 may reduce life expectancy rates for Black and Hispanic populations at a level 3 to 4 times that of whites.

The confluence of the factors identified above, and many others, prompted the Alliance to look closely at how we can uniquely contribute. As a start, recently, the Alliance’s Quality Improvement Committee and Health Economics Committee approved the use of the Area Deprivation Index (ADI), first created by the Health Resources and Services Administration using American Community Survey data and published by Amy Kind, MD, PhD, and her research team at the University of Wisconsin-Madison, to address inequities in health care in our state.

The ADI enables a ranking based upon 17 indicators from the American Community Survey data including income, education, employment, and housing quality. It is our intention to use the ADI to identify and help us work together to address health inequities in Washington, with a focus on quality and wasteful low-value services. We are grateful to the help and support not only of our committee members, but also our Board of Directors and those who submit data to our voluntary database for helping us make this type of reporting possible in the future. We could not accomplish this without deep commitment by so many.

As Reverend Dr. Martin Luther King, Jr. said, “Of all the forms of inequality, injustice in health is the most shocking and the most inhuman because it often results in physical death.” I look forward to reporting back on the progress of this work to support the change that is long overdue.

All the best,


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