How Medical Providers and Partners Can Work Toward Children’s Health Equity | Health News

The COVID-19 pandemic has exposed for many the reality that vast inequities exist in the nation’s health care system. That can be particularly true for children and families, many of whom face barriers to access and unequal care outcomes as a result of many factors and social determinants of health.

Finding a solution to make children’s health care more equitable for all requires a complex approach and strategic partnerships, said a group of pediatric health leaders and advocates in a recent webinar hosted by U.S. News & World Report.

Providers and partners should consider a three-pronged approach to addressing social determinants of health by working with individuals and families, communities and broader systems and policies, said Dr. Snehal Shah, a primary care pediatrician at the Boston Children’s Hospital Primary Care Center and research scholar in the Sandra L. Fenwick Institute for Pediatric Health Equity and Inclusion. “Health care entities could actually work in each one of those spaces,” she added.

For example, “child poverty has been associated with lots of adverse outcomes in children, and poverty is intergenerational,” Shah said. “Reducing poverty is actually a method of prevention,” she said, noting that federal and state policies that seek to increase resources and benefits have contributed to a decline in child poverty.

“This is an example of where individual providers and health care institutions can advocate for these policies and funding to increase some of the social supports not just to individual families, but to the population as a whole,” Shah said.

Pediatric care providers are also seeking to expand access and meet transportation barriers by tapping virtual care and expanding their footprint into rural communities.

“We’ve been able to successfully overcome this a little bit through the use of telemedicine, which kind of blossomed during the COVID pandemic,” said Dr. Douglas Graham, chief of the Aflac Cancer and Blood Disorders Center of Children’s Healthcare of Atlanta. His center also established an outreach clinic in Columbus, Georgia, several hours from the hospital’s location in Atlanta, “where we go and provide care locally to sickle cell patients that are in the Columbus community instead of expecting all of them to be able to drive to Atlanta.”

That said, not all care can be delivered virtually or outside the main hospital setting, Graham noted, and additional questions remain: “How do we continue that? How do we make sure that insurance is going to support that? How can our providers continue to have that level of care? How do we address some of the challenges that we saw with telemedicine?” he posed.

Community engagement efforts are critical to move the needle around equity, panelists noted, but there is no one-size-fits-all approach. “Whether you’re trying to reach families for sickle cell, for cancer research, for social determinants of health disclosures, for primary care, or for mental health,” taking the time to understand different communities and cultures – and to build trust – is a critical step, said Dr. Anu Partap, medical director of health equity at Cook Children’s Health Care System in Texas.

“When we talk to communities and let our families tell us, ‘What message do we need to provide for you to know that we’re here to help?’ I think that’s when we start to really help families meet their children’s social and emotional needs, help families trust us,” Partap said.

Another challenge exists in “the disparity in research that goes to certain diseases,” Graham said, so effort must be made to invest more and to diversify clinical trials, for instance.

Beyond research, disparities in treatment options for individuals based on their race or ethnicity can further exacerbate health inequities, speakers noted.

For children with sickle cell disease or blood cancers like leukemia, blood stem cell or marrow transplants are a vital treatment option. But disparities exist there, too, for patients seeking matching donors, said Erica Jensen, senior vice president at Be The Match, operated by the National Marrow Donor Program.

“Patients do not all have an equal chance of finding a match. Patients are most likely to match with a donor that shares their same ethnic background, but our current registry lacks diversity,” she said. “We are doing everything possible to increase awareness about this disparity and work within local communities to get people of more diverse backgrounds on the Be The Match registry so that we can save more patient lives.”

Groups like Be The Match are working with pediatric providers and other partners to support and fund efforts to diversify the transplant registry and build awareness about it.

“When we started to look at the statistics and how difficult it is for people of color, and specifically Black children, to get matched, we knew we had to do something about it,” said Audrey Boone Tillman, executive vice president and general counsel of Aflac, which has partnered with Be The Match and worked to support families affected by pediatric cancer and sickle cell disease. (Aflac was a sponsor of the webinar.)

Marcus Smart, a guard for the NBA’s Boston Celtics, has also joined the collaboration between Aflac and Be The Match to help spread the word and expand the pool of potential lifesaving donors. Smart lost his mother and brother after battles with cancer, so taking action around improving health outcomes is personal for him.

“Giving back means more than anything for me because I would want somebody to do that for me if I was in that situation and needed that,” Smart told U.S. News in an interview that was broadcast as part of the webinar.

“It’s more than crucial for us to diversify, to be able to bring awareness, to shed light, to get donors in, especially in the African American community,” Smart said.