The MHA is a member of The Root Cause Coalition, whose mission is to reverse and end the systemic root causes of health inequities for individuals and communities through cross-sector partnerships. The coalition has opened its request for proposals to present at the sixth National Summit on the Social Determinants of Health, which will be held virtually Oct. 4 through 6.
Proposals will be accepted through March 15 to serve at the summit as a featured speaker or to lead a breakout session on health inequities and social determinants. The proposal questions are available for review, and official proposals may be submitted online. Questions may be directed to coalition representatives through email or by calling (202) 266-2635.
"Of all forms of inequality, injustice in healthcare is the most shocking and inhumane." — Dr. Martin Luther King Jr.
At this point one month ago, the wounds of George Floyd’s death were fresh as protests across the country called attention to the racial injustices faced by people of color in our society. Together with then MHA Board Chair John Fox, I made it clear that racial inequities present in Michigan communities are unacceptable and must end. Since then, healthcare leaders and organizations across the country have declared racism a public health emergency, conveying the seriousness and urgency that is being dedicated to the issue. At the MHA, we’ve held to our promise to listen, and we will continue to do so to be a part of the solution to eliminate implicit bias and inequities in care and to address social determinants of health.
A fresh reminder of inequities in care and social determinants of health can be seen in how COVID-19 has disproportionately affected people of color in southeast Michigan. Dr. Joneigh Khaldun, chief medical executive and chief deputy director for health at the Michigan Department of Health and Human Services, recently testified to the U.S. Senate Health, Education, Labor, and Pensions Committee, stating that the COVID-19 pandemic “has also further unveiled the tragic injustice of racial inequality in our society.” Food deserts, lack of readily available transportation and access to healthcare are all key social determinants of health that can lead to higher rates of obesity, heart disease and hypertension, which increases the risk of suffering adverse effects from COVID-19. While we may not be able to prevent the spread of a novel virus to our country, we can influence the health of our communities and our communities’ ability to respond to an outbreak. Within our organizations, we’re currently evaluating improvements our organizations can take to be better prepared for a surge of COVID-19 patients, such as increasing inventory of personal protective equipment, expanding bed capacity, ensuring vulnerable populations have access to testing and appropriate care and improving infectious disease protocols. At the same time, we can and should make an impact by helping the populations of our communities eliminate barriers to achieving a healthy lifestyle.
Another stark reminder of our need to address health disparities in our state is maternal mortality and the fact that women of color are 2.4 times more likely to die from pregnancy-related causes in Michigan. During this year’s State of the State address, Gov. Whitmer brought attention to this issue that the MHA Keystone Center has been actively working to improve. While we work to remove implicit bias within society, one clear target for our attention is the health of our mothers and their babies.
Improving health equity is a giant lift, but the MHA Keystone Center is equipped to support healthcare systems in leading this change. Besides just focusing on improving maternal health outcomes, the MHA Keystone Center will soon be releasing a new guide, Eliminating Disparities to Advance Health Equity and Improve Quality. This tool will be used by our member hospitals to first identify health disparities within their communities and then develop a plan for how best to address them. The guide will direct our members on how to ensure equitable care is provided to all patients through an organizational approach that starts with establishing health equity as a strategic priority. While acknowledging the problem and the issues that cause it is half the battle, the guide outlines concrete actions that can be implemented today to drive improvement moving forward.
There is no question that ensuring health equity needs to be a focus for the MHA and the healthcare field moving forward. Despite the examples of improving health equity, more can still be done. The MHA is a member of the American Hospital Association Institute for Diversity, and just as we work closely with the AHA on a range of federal advocacy issues, we will be collaborating with them on this effort as well. The mission of the MHA is to advance the health of ALL individuals and communities, and that mission has never been more relevant than today.
“I realized when you look at your mother, you are looking at the purest love you will ever know.” ― Mitch Albom
Last week Gov. Gretchen Whitmer presented her State of the State address, establishing her priorities for the upcoming year. A considerable portion included a focus on healthcare, particularly maternal health. In Michigan, 52.5% of maternal deaths caused by cardiomyopathy, infection/sepsis and hemorrhage are determined to be preventable. Whenever we see statistics in healthcare, we can always have a discussion about methodology, but frankly, any preventable death is unacceptable and deserves our full attention.
In pursuit of our association’s mission to advance the health of individuals and communities, we commend Gov. Whitmer for taking a leadership role on this issue and bringing needed attention to a topic that affects us all. Michigan’s birthing hospitals play a key role in welcoming new life to Michigan’s families and must do everything in their power to protect the health of a mother and baby during their most vulnerable time. It is our sincere belief that the governor’s plan will provide much needed support to the efforts that the MHA Keystone Center and our member hospitals have already undertaken to ensure health equity by addressing disparities and social determinants of health.
Specifically, the governor’s plan will extend postpartum Medicaid benefits for a full year for mothers, increase access to treatment for substance abuse and mental health services for mothers and expand access to home visiting programs. The full care continuum reaches outside the four walls of a hospital, and these initiatives can make a large impact in ensuring all mothers and babies remain healthy.
Training our future physicians, nurses and healthcare professionals in implicit bias will also go a long way in establishing acceptable treatment and practices for our hospital community. I’m excited to see Randolph Rasch, dean of the Michigan State University College of Nursing and Dr. Audrey Gregory, CEO of the Detroit Medical Center, have been identified by Gov. Whitmer to lead this important effort.
The MHA Keystone Center has been actively working to address this issue since 2009, when the MHA Keystone: Obstetrics collaborative was established. Several years ago, the work of the collaborative merged into the Michigan Alliance for Innovation in Maternal Health (MI AIM), with recent data showing encouraging results from our efforts. Between 2014 and 2017 in Michigan:
Severe maternal morbidity decreased by 10.5%.
Complications from hemorrhage decreased by 19.6%
Maternal hypertension complications decreased by 19%
The MHA Keystone Center is also involved in the Obstetrics Initiative (OBI), an interdisciplinary quality initiative funded by Blue Cross Blue Shield of Michigan that engages maternity care providers and hospitals in a collaborative effort to safely reduce the use of primary cesarean deliveries for low-risk pregnancies.
In addition, I’m proud to have 48 of Michigan’s birthing hospitals engaged in providing process and outcome data to the MHA Keystone Center. However, more work can be done. We’d love to see full participation and encourage all of our members offering obstetrical services to submit this data. For those birthing hospitals that are participating, the MHA Keystone Center is debuting a new MI AIM dashboard later this month.
I also encourage our members to join the MHA Keystone Center at this year’s Maternal Infant Health Summit, March 30 and 31 in Lansing. Hosted by the Michigan Department of Health and Human Services, MI AIM and the Maternal Infant Health Strategy Group, professionals from across the healthcare community will come together to support our shared goal of ensuring health equity to all Michigan mothers and babies.
Lastly, the pressing need to improve maternal health is not limited to Michigan, and it has drawn the attention of the U.S. House Education and Labor Committee at the federal level. Two observations from members of our own congressional delegation at a recent hearing of that committee:
“The United States has one of the highest maternal mortality rates in the developed countries, and deaths among women of color is fueling that growth.” – U.S. Rep. Brenda Lawrence (D-Southfield), Black Maternal Mortality Caucus co-chairwoman.
“We have an emergency going on in America right now, and I cannot think of a better instance of the sanctity and preciousness of life than this, than the life of the mother.” – U.S. Rep. Haley Stevens (D-Rochester Hills).
Over the past 100 years, the MHA has been involved in many efforts to improve care and quality. As we embark on a new calendar year, I can think of few causes worthier of our attention and efforts. I hope you will join Gov. Whitmer, the MHA Keystone Center, our member hospitals, and all of our maternal health partners in this critical endeavor.