The Allegheny County Infant Mortality Collaborative (IMC) hosted one of their quarterly meetings last week but took a slightly different approach. Dr. Lyn Robertson, DrPh, MSN, BSN, was invited to speak about ACCURE, a cancer research study she has been heading for the past few years. The ACCURE study focused on the positive effects of anti-racism and equity on cancer treatment care. Although her presentation was not directly related to infant mortality, it did draw upon racial disparities that exist in cancer-related outcomes in the county. As we all know, the racial disparity was a key influence for the development of the IMC.
The presentation began with Dr. Robertson discussing their findings from a post chart review conducted before the trial was initiated. She pointed out that blacks were less likely to receive options for cancer treatment, less likely to have their symptoms addressed, and were less likely to complete their designated treatment plan compared to white women utilizing the same facilities and services. These results raised questions about equality versus equity, as well as direct, indirect and systemic racism. These factors were taken into account when the interventions for the study were being developed, and Dr. Robertson noted that the ACCURE study interventions were able to close that racial disparity gap.
Furthermore, while the study was being conducted, they actually saw some improved rates amongst clients who were not participating in the study. Although these results are likely multifactorial, it could also suggest that the standards of care being provided to the participants in the study shifted into the framework of the participating facilities.
Throughout the presentation, The IMC attendees were fully engaged and began a conversation about structural and systemic racism which has been a recurring theme in health care lately. The conversation was robust and full of thought-provoking comments, some drawing from professional and others from personal experience. Community-based participatory research, racism, implicit bias, microaggressions, and equity were among some of the key discussion points in the meeting.
The final thoughts of the discussion rested on the need for structural and systemic change. The meeting concluded with Jada Shirrel, Chief Executive Officer of Healthy Start, discussing a comprehensive community collaborative project that they have just started working on. The goal of the project is to help illicit, much needed, structural and systemic change in our healthcare system and shift towards equity.