Ending Health Inequities

Ending Unequal Treatment: Strategies to Achieve Equitable Health Care and Optimal Health for All

Dear Colleagues,

The National Academies of Sciences, Engineering, and Medicine (NASEM) has released Ending Unequal Treatment: Strategies to Achieve Equitable Health Care and Optimal Health for All. This report provides a comprehensive update to the Institute of Medicine’s 2003 landmark report, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, which is widely considered one of the most groundbreaking reports on health care equity. I wish I could boast that the U.S. is well on its way to achieving health equity but in the two decades between these two reports, little progress has been made, so racial and ethnic inequities remain a fundamental flaw of our health care system.

Despite the dangerously high human and financial costs of health inequities — which have grown to unsustainable heights — the nation has historically lacked the political will to fix the problem. Ending Unequal Treatment highlights that the health differences seen in minoritized populations are emblematic of injustices not only in the U.S. health care system but in society at large. To end racial and ethnic inequities in health and health care we must invest in new models that ensure care is delivered equitably, while also investing in social policies and programs that support families and communities like housing, education and food access. Investing in the health of minoritized groups is not a zero-sum game: The investments do not mean a loss for majority groups. In fact, the report finds that investing in those most at risk of health inequity benefits everyone. This should be taken as a call-to-action to muster the political will required for progress.

The report also challenges us to reimagine our health care system’s priorities and processes. Our current system is organized largely to provide sick care, with a financing system that incentivizes expensive treatments and procedures. What we need is a health care system that delivers “whole person” care by providing health promotion and disease prevention as well as clinical care when needed.

We are nurses, so we can move mountains. I challenge each of us—whether we work on the front line, in academia, in policy, as nurse scientists, or in other sectors—to resist the status quo and commit our efforts to creating a new health care system that delivers optimal health for everyone.

Vincent Guilamo-Ramos

Key to this effort will be our nation’s highly skilled nursing workforce, which is instrumental to providing the kind of person-centered care that can help end health care inequities. At more than 6 million strong, nurses are the largest segment of the health care workforce, contributing invaluable expertise and leadership in all areas of health. Voted the most trusted of all professions for more than 22 years, we have public opinion on our side. We have proven time and time again, whether during a natural disaster or global pandemic, that nurses are effective innovators, and we move mountains to achieve our goals.

I encourage you to join us — whether we work on the front line, in academia, in policy, as nurse scientists or in other sectors—to commit to creating a new system that delivers optimal health for everyone.

Sincerely,

Vincent Guilamo-Ramos, PhD, MPH, LCSW, ANP-BC, PMHNP-BC, FAAN
Executive Director, Institute for Policy Solutions and Professor
Johns Hopkins School of Nursing