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Utah hospitals declare systematic racial disparity a public health crisis

By Lauren Bennett, KSL.com | Posted - Jan. 12, 2021 at 7:10 p.m.



SALT LAKE CITY — After seeing a number of Black Americans killed in 2020— including George Floyd, Ahmaud Arbery and Breonna Taylor, to name a few — Utah doctors knew the country's treatment of people of color needed to change in many aspects, and especially in health care.

The COVID-19 pandemic has accelerated and highlighted health disparities among minority populations with a disproportionate number of individuals in marginalized communities at a higher risk to become infected.

"We have seen that Utah is not exempt from experiencing inequities, as one can see with the striking disproportion of cases of COVID-19 in our communities of color," said Dr. Paloma Cariello, associate dean for health equity, diversity and inclusion in the University of Utah School of Medicine.

Now, the state's four major health care systems are declaring racism a public health crisis and have vowed to do better; the Utah Hospital Association along with Intermountain Healthcare, MountainStar Healthcare, Steward Healthcare and University of Utah Health, released a joint statement on Tuesday denouncing systemic racism.

"Racism and discrimination, in any form, are shameful and must be eliminated from our society," the statement says.

"This is not a political statement," Greg Bell, president of Utah Hospital Association, said at a news conference. "This is not about identity politics; this is about hospitals who serve millions of people in Utah every year, young and old of every persuasion, of every nationality and ethnicity."

The hospitals' declaration comes as Salt Lake County also announced its efforts to fight against systemic bias and institution racism by hiring hired Efren Garcia as the new Diversity Affairs Officer for the county and appointed Pastor Corey Hodges from The Point Church as the new chair of the Mayor Jenny Wilson's Council on Diversity Affairs.

In addition to making a commitment to address equity in the level of care each patient receives, several of the hospitals have hired permanent positions to ensure equity in care is achieved.

"We've listened to our patients, we've listened to our members, we've listened to our caregivers, and what we've heard saddened us at times and caused us great concern — especially when we realize that racism is affecting the health and well-being of the people we're meant to serve and the people we work with," said Intermountain Healthcare President and CEO Dr. Marc Harrison.

In an effort to take concrete action, Intermountain Healthcare has hired a chief equity officer with plans to hire a physician and nurse whose jobs will be to focus on equity in patient care. At times, both patients and health care workers have raised concerns about racism and possibly felt overlooked.

A newly hired advocate will now serve as a third-party ombudsperson whose responsibility it is to handle these issues and make sure things are done in a fair and equitable fashion, Harrison said. Lastly, Intermountain will fund more scholarships to help encourage diverse candidates to apply for and join its team.

MountainStar Healthcare has employed an assistant vice president of inclusion since 2006, and that position was expanded in 2019 to include diversity, according to MountainStar Healthcare President Gregory R. Angle. The organization also created a corporate council on diversity inclusion to address patient care equity, hiring diversity, and cultivating community partnerships among other things.

"This coalition and the ... statement ... provides, I think, a special stepping stone for Utah on its path toward unfettered equality for all people," said Steward Healthcare Chief Medical Officer Dr. Arlen Jarrett. "I believe coming together in this way, we are taking a substantial step up and onto a higher path of discovery and cooperation that I think will lead to a continued change in our culture for the better."

The University of Utah School of Medicine formed an anti-racist commission to coordinate efforts that will "advance our goals and to improve proved our culture," expanded Dr. Michael Good, CEO and dean of the School of Medicine.

"Looking at the COVID-19 pandemic, it has shown us how connected we really are," Cariello said. "It has opened our eyes to health inequities that existed long before COVID-19, and the importance of addressing them immediately became obvious even to those who did not recognize that. It has underscored the significance of addressing chronic conditions through the health inequity lens and illuminated the role that anti-black racism plays in health disparities and how elimination of racism we will be better for all of our patients."

The death of George Floyd, and others in 2020, sent shockwaves throughout the country and ignited Black Lives Matter protests all over, with participants demanding an end to institutional racism and police brutality.

With racial injustice pushed into the national spotlight, those in Utah's health care community felt prompted to "be introspective about what we can do and recognizing that these health disparities exist for each of our health systems," explained Mikelle Moore, senior vice president and chief community health officer for Intermountain Healthcare.

While police reform is a large focus of the Black Lives Matter movement, Bell said Tuesday's statement is not anti-police; it is simply acknowledging that Black lives do matter and the health care community in Utah is committed to doing a better job of putting those words into action.

"This is also not relative to police. People sometimes inject an element of, 'Are you in favor of Black Lives Matter, and are you against the police?' We all recognize the critical and crucial role law enforcement plays in our community, and we support our men and women in blue, and we're grateful for them," Bell explained. "But, they reflect what society reflects, and we need to do a better job of supporting them. So, our 60,000-plus health care workers are going to be changing, and being educated, and being more helpful, and being more cognizant of our role to play; and that will spill over into their family and their friendships and their neighborhoods — and, likewise, will be followed more and more by law enforcement, by education and other elements of our society."

Cariello said there is an abundance of data showing that people of color often receive lower-quality care than white patients. For example, she cited a recent study that found Black infants die at a higher rate than white infants when treated by white and Black doctors. The mortality rate was cut nearly in half when a Black infant was treated by a Black doctor, but the disparity still existed regardless of the race of their doctor.

"That needs immediate action," she said. "We're investing in our communities. We are re-examining our policies, and we are committed to change. And this is on us; we cannot have people of color have to show their change in institutions. So, the first step is to acknowledge racism is a problem and it threatens the health of the public."

After examining Intermountain's outcomes relating to race and childbirth, a doctor found its methods need refining.

"One of our leaders looked carefully at some of our outcomes around race and childbirth and infant mortality, and have discovered like the rest of the country, we have opportunities for improvement," Harrison said.

In the end, Utah's health care community hopes treating racism as a public health crisis can help put an end to troubling statistics.

"We're simply saying that we can do better. We will do better, and we must be better," Bell said. "This is a message to all Utahns that when you come to all health care — whether that be in the clinic or whether it be in the hospital, an emergency room — ... regardless of your background, your appearance, you're going to get kind, compassionate, competent care. And that doesn't matter whether that's in a small hospital in Beaver, Utah, or a major medical center in Salt Lake City, Utah."

Lauren Bennett

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