Addressing racial inequities in obstetrics and gynecology

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A recent commentary provided an overview on how inequities should be addressed in obstetrics and gynecology.

Addressing racial inequities in obstetrics and gynecology | Image Credit: © Malik E/peopleimages.com - © Malik E/peopleimages.com - stock.adobe.com.

Addressing racial inequities in obstetrics and gynecology | Image Credit: © Malik E/peopleimages.com - © Malik E/peopleimages.com - stock.adobe.com.

Evidence has indicated an ongoing burden of racism faced by the Black community, and these disparities have been observed in health care. This indicates a need to develop a formal and multifaceted approach for addressing different levels of inequity.

Takeaways

  • Ongoing evidence reveals persistent racial disparities in healthcare, particularly affecting the Black community, emphasizing the need for a multifaceted approach to address these inequities.
  • Obstetrics and gynecology departments should establish divisions for health equity to address disparities in maternal morbidity and mortality and improve healthcare outcomes for minoritized individuals.
  • Creating a formal health equity division within healthcare departments fosters a commitment to equity at the institutional level, often reinforced through a clear mission statement.
  • To combat health disparities, health equity initiatives should begin with community engagement and interventions that bridge the gap between the institution and the community.
  • Diversity and inclusion in the healthcare workforce, including medical education and recruitment, are crucial for addressing health inequities, as they impact both patient care and the ability to reflect the demographics of the population being served.

Obstetrics and gynecology (ob-gyn) departments also need a division for health equity, as disparities in maternal morbidity and mortality and negative impacts of the health care system on minoritized individuals have been reported. Experts created a commentary to describe the best practices for creating a division for health equity in ob-gyn departments.

The investment of departments in a separate health equity festers the inclusion of equity at a department level. This includes a mission statement to help divisional personnel understand the goal of the approach.

Equity should begin with community, with a division of equity acting as a bridge between the institution and community. Health disparities are defined by the CDC as, “preventable differences in the burden of disease, injury, violence, or in opportunities to achieve optimal health.” These issues should be addressed by community informed interventions.

Medical education is also vital when addressing health inequities. A curriculum should be developed with input from department leadership, aiming to enhance the diversity, inclusion, and belonging of faculty and trainees.

Only 3.6% of individuals in academia are Black, and the proportion of Black ob-gyn residents decreased from 2010 to 2018. In comparison, the proportion of Hispanic and Native American residents has not changed.

This indicates the current workforce may not continue to match the US demographic by race and ethnicity based on projected increases of these groups in the general population. Creating a diverse and inclusive health care workforce is necessary to reflect the populations it serves.

Recruitment is the first step in the development of an inclusive health care workforce.However, microaggressions, stereotype threats, and tokenism are all present in the application process. To avoid these behaviors, interviewers should receive implicit bias training. This should be given even after underrepresented faculty are recruited.

A lack of diversity in the health care system has a direct impact on patient health. A stereotype threat may occur between a patient and provider when a stereotype is confirmed or refuted, leading to a negative psychological response. There is also a risk of patients being treated as absent in health care interactions.

Community input should also actively be considered when researching health inequities. Intersectionality should also be considered, and outcomes disaggregated by race and other factors which may influence care.

Systemic changes are necessary to reduce inequity and thhese actions must be employed to promote health equity in divisions ofob-gyn, according to the study.

Reference

Clare CA, Pardo C, Minkoff H. Divisions of health equity in departments of obstetrics and gynecology. American Journal of Obstetrics and Gynecology. 2023;229(5):485-489.doi:10.1016/j.ajog.2023.05.021

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