Reflections on Health Equity

In 1900 James Weldon Johnson penned the words to Lift Every Voice and Sing a song whose lyrics pay homage to the struggles and the endurance of African-Americans and, in many ways, articulates the plight of oppressed people everywhere. Amid segregation and Jim Crow he crafted lyrics that spoke to the spirit and perseverance of African-Americans. The last stanza of the first verse ends with these powerful words “facing the rising sun of our new day begun let us march on ‘til victory is won.”

We have come . . . Nearly 121 years after he penned this anthem, I reflect on the power of Johnson’s lyrics and the current plight of Black and Brown Americans as we address ongoing social issues—including health equity. While time has moved on and Jim Crow and segregation are, at least in law, things of the past we must reckon with the residual effects of those systems of oppression and the lasting impacts they have created for people of color that are made manifest in so many ways— including how we access and receive health care.

Stony the road . . . The United States of America is among the wealthiest and most powerful nations on the planet, yet we have a health system that too often perpetuates attitudes and behaviors reminiscent of segregation and Jim Crow— revealed as health disparities. These disparities result in lower rates of care among Black patients with certain health conditions when compared to their White counterparts. They lead to lower life expectancy for people of color, higher rates of maternal mortality for Black mothers (even when allowing for economic similarities with White mothers), and to Black patients literally not being heard by their health care providers. Disparities also lead to our absence from clinical research due to hesitance and reticence linked to unethical behavior— Syphilis and Tuskegee and HeLa and Henrietta Lacks. Overcoming this legacy of mistrust requires building confidence and meeting patients where we are—in the facilities where many of us seek care from people who have earned our trust.

Let us march on . . . Health equity is all the rage. The term has become commonplace in the aftermath of the COVID-19 pandemic and the data showing the disproportionate mortality rates among Black, Latino, and Indigenous people. 

Unlike the pace at which the term has gained public recognition, realization of health equity will require longstanding commitment towards unmasking and facing the truth of the inequities which birthed it and the root of their persistence. I am hopeful that efforts like the one I am involved with through AdvaMed will have real impact on how the medtech industry responds to racial disparities in health.

I truly believe that we have an opportunity – with commitment, persistence, and through the power of collaboration – to address and correct many of the wrongs that have brought us to this place. Years of inaction and incorrect action have gotten us to this point, but our industry has the capacity to do our part to reverse the course of health inequity through efforts to: increase patient awareness of our technologies; eliminate bias in care and related to insurance; and improve research diversity. These changes will require time and patience.

As we and others continue in our work to promote health equity let us be mindful that we are all in this together and, should we find ourselves growing weary in this quest, let us reflect on Johnson’s words “‘til victory is won.” Here’s to our new day.

DeChane Dorsey