Investing in Healthier Communities

Doctor talking to mother and son at community outreach program

Academic medical centers serve at the crossroads of community health, health equity, and population health and are actively working to prevent and address persistent public health challenges, such as gun violence, maternal mortality, substance use disorders, and mental health concerns.

Throughout our history, structural racism and inherent biases have created health inequities that impact minority communities and other marginalized groups, who have borne the greatest burden of health insecurity. The COVID-19 pandemic has laid bare these existing health inequities, taking a disproportionate toll on marginalized people and communities throughout the nation. Medical schools, teaching physicians, and teaching hospitals play a unique role in fostering and participating in collaborations with community organizations, federal agencies, and other entities to address these challenges—in both times of crisis and on an ongoing basis—to promote health for people everywhere and reduce the inequities that exist between communities nationwide.

Health Equity

Medical schools and teaching hospitals continuously work across all of their missions by collaborating with communities to ensure all people have the same opportunities to reach their full health potential—a state of health equity. As pioneers in research and clinical best practices, these institutions create the evidence base that makes the case for policies, partnerships, and practices that facilitate health equity. Diversity and implicit bias training for learners, researchers, and providers; social risk adjustment in screening, referral, and payment; and initiatives to increase diversity in clinical trials can all help improve health outcomes for underrepresented communities.

As anchor institutions, academic medical centers advocate for federal, state, local, and community partnerships to address social factors, such as affordable housing, transportation, access to healthy food, job security, economic inequities, and environmental health.

Equitable data collection that both identifies communities disproportionally at-risk and suggests structural interventions is foundational to ensuring just, equitable preparedness and response to any public health crisis. Race and ethnicity represent only small part of the data collection needed to ensure health equity. Indeed, neither race nor ethnicity are modifiable risk factors. Rather, they are poor proxies for the social risks and social determinants to which communities of color and the residents who live within them are exposed. Beyond sociodemographic data, we need standardized, valid, inclusive data collection on the social needs and social determinants most likely to correlate with increased exposure, susceptibility, and severity of illness and infectious diseases.

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Addressing Racism in Medicine

Throughout our history, structural racism and inherent biases have created health inequities that impact minority communities and other marginalized groups, who have borne the greatest burden of health insecurity and mistrust. The COVID-19 pandemic has highlighted these existing health inequities, taking a disproportionate toll on marginalized people and communities throughout the nation. Medical schools, teaching physicians, and teaching hospitals play a unique role in fostering and participating in collaborations with community organizations, federal agencies, and other entities to address these challenges—in both times of crisis and on an ongoing basis—to promote health for people everywhere and reduce the inequities that exist between communities nationwide.

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Public Health

To operate most optimally, the nation’s health care system—including teaching hospitals and their affiliated medical school faculty—requires a strong public health infrastructure. Decades of underfunding at the national, state, and local levels, however, have strained foundational public health capabilities, as looming and ongoing threats—such as the COVID-19 pandemic—far outpace available resources. Academic medical centers advocate for health, health equity, and population health and are actively working to prevent and address persistent public health challenges, such as gun violence, maternal mortality, substance use disorders, and mental health concerns.

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Emergency Preparedness

Teaching hospitals and their faculty physicians and staffs are critical to the U.S. health care system’s ability to respond to natural and human-induced disasters and other emergencies. As they have demonstrated during the COVID-19 pandemic, academic medical centers have decades of experience in mobilizing resources during times of crisis and often lead regional responses in collaboration with their state and local health departments, regional emergency management systems, and community partners.

Maintaining emergency preparedness and mounting a robust response require a strong commitment to programs under the Centers for Disease Control and Prevention (CDC) and the HHS Assistant Secretary for Preparedness and Response. The most effective preparedness strategy also requires ongoing, stable financial support for the nation’s core public health and health care infrastructures, including academic medical centers.