Pharmacy

Overcoming systemic health inequalities can start with recognizing that they exist

Healthcare providers believe that institutions should recognize advantaged and disadvantaged groups of patients as motivation to overcome systemic barriers.

Orville Newton Ray Bignall, MD, FASN, pediatric nephrologist, Nationwide Children’s Hospital, Columbus, Ohio, discusses social determinants of health with Pharmacy Times. As a first-generation American, he has empathy for all types of families who come for treatment. At ASN Kidney Week in Orlando, Florida, Bignall highlights groups of patients seen as disadvantaged in healthcare and why awareness is so important.

Q: What are some ways in which social determinants of health and social misconceptions affect patient and physician care and patient outcomes?

Orville Newton Ray Bignall, MD, FASN: I think they are a very important way that social determinants of health influence patient kidney outcomes through health inequalities. I think examples of healthcare systems in which we operate as healthcare providers favor or disadvantage groups of patients differently. House. Sometimes the characteristics on which we differentially manage our patients also include their location, convenience, or ability for them to access those particular types of care.

You know, I mostly care for kids in Central Ohio, at Nationwide Children’s in Columbus, but I see families driving 3, 4, 5 hours, and even from neighboring states to get care at our hospital. And it amazes me that families will do this in. I will often try to work with the family to arrange care closer to home, but many of these families would rather travel far away than receive local care. They believe that the care they will receive at Nationwide Children’s will provide care with dignity and give them the best opportunities they need for success. I consider that a huge honor for our institution and for the work we are trying to do. It’s just really important to me that all patients are treated with dignity and respect, and we can’t do that if we’re not aware of the ways we treat patients differently.

In our country today, I think we’re a little more willing to acknowledge those differences, in many cases we’ve become more aware of those differences. We talk, like I said, a lot in the context of race and ethnicity, but you know, I’m a first-generation American myself. My parents are immigrants and I think about that immigrant experience a lot when I deal with patients of mine who have emigrated themselves or their parents from another country. I think a lot about the experience they have. I’ll mention rural families I care for in Ohio and some of the incredible efforts they put into making sure their children receive quality care.

I am thinking of children with disabilities, the forgotten area of ​​inequality in our society. I have a very close family friend who is a physician and researcher at the University of Michigan. He is a person who uses a wheelchair for mobility. He has helped me open my eyes to the ways in which our society is so inaccessible to people who move in wheelchairs. And that’s just one aspect of accessibility for people with disabilities. Once we become more aware of these differences and how these differences negatively impact the patients we care for, we should feel energized and motivated to make some positive changes on their behalf.

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