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  • Writer's pictureVictoria Behm

Health Equity

First, a story. The photo to the far right shows little me with my grandmother, Victoria Tovar. She was born in 1916 in Colombia, about the same time the photo on the left was taken. That's my great-grandmother, Rosa. You can see they lived in very rudimentary conditions. There were few opportunities...and no doctors. As a teenager, my grandmother Victoria moved in with my grandfather, a Syrian merchant 40 years her senior. They had 10 children. Without a physician in the town, Victoria took on the role of the town healer. People came to her when they were wounded, in labor, and in need of a cure. When my dad was young, he fell out of a mango tree and fractured his forearm. My grandmother set the bone, applied an herbal salve, and prayed for healing.

I grew up hearing many stories about my grandmother’s medicinal prowess and experienced her remedies myself. As her namesake, I have always felt a deep connection with my grandmother, and from a young age, I have known my purpose: to heal. Healing is not just about the clinical encounter. For me, it’s about every encounter–from the food we eat to the relationships we have to the systems that help or harm us.

This is why health equity matters.

The current healthcare system further disenfranchises the poor and the vulnerable: immigrants, children, the elderly, black and brown citizens, women, LGBTQIA+ folx, and disabled individuals in rural, urban, and tribal communities are suffering. Wealth, power, and influence continue to drive a healthcare system that systematically discriminates against and excludes hundreds of millions of people in the United States.

The COVID-19 pandemic has exacerbated these inequities and has brought them to the forefront of the public’s attention. As Kathleen Page and Alejandra Flores-Miller write in a perspective on COVID-19 and the Latinx community, the pandemic "...highlighted deeply rooted disparities that society had chosen to ignore...fundamental changes are needed.”

Pre-pandemic, about 11 million US children lived in a food-insecure household. Some of these kids relied on school meals for some or all of their nutrition. Childhood food insufficiency rates have more than doubled during the pandemic. Despite the efforts of schools, governments, and communities, and generous individuals to meet their needs, data suggest that 1.5 billion meals were missed.

Healing is about every encounter–from the food we eat to the relationships we have to the systems that help or harm us.

For example, COVID-19 cases are 2-3x higher among Latinx people in the US. Undocumented individuals are especially at risk and often avoid testing and treatment for fear of financial strain and deportation. Health care systems have struggled to provide meaningful, culturally relevant care.

A major barrier to providing meaningful health care is the lack of representation in health sciences. It’s getting better, but over half of all biomedical research studies are done in homogenous (i.e., white) study populations. Our biomarkers and health standards are based on these study results, which are likely to be inappropriate for other groups of people. Efforts are underway to enroll diverse participants in studies that will advanced individualized health care and reshape how we prevent and treat disease and optimize health.

Diversity in science is not only good for science...but for all of us. Science should reflect the society it serves, and with more diversity in science, breakthroughs will be applicable and accessible to every person — not just the majority. -Dr. Gowthami Arepally

The same goes for clinical practice in all health care fields. I want better, accessible, and equitable healthcare for all. People around the world are courageously dismantling systems of injustice, oppression, and violence against disadvantaged groups and individuals. Let's all be those people. Let's keep building on the sacrifices and work of those who have come before us. A better, brighter future is ahead IF we reimagine power as a common good that necessitates the courage, wisdom, and tenacity of every voice and experience.

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