Most of the 340 equity officers surveyed reported systemic and institutional racism and a lack of staff diversity as the leading barriers to their work.
In a commitment to address longstanding health disparities, many hospitals have developed a health equity officer role within their senior staff. A recent national survey–published as an open access article by Health Affairs and conducted by researchers from Mass General Brigham, the American Hospital Association, and other organizations–sought to better understand the obstacles to equity officers’ efforts.
“For most hospitals these are new positions, and the people filling these roles are expected to address a broad range of responsibilities as convener, champion, thought leader, and organizational resource for all matters related to health equity,” wrote the researchers. “Many hospitals have begun specifically to address issues of racism, especially since the death of George Floyd in May 2020 and the subsequent attention on systemic racism. Yet little is known about the experiences of those who take on these responsibilities.”
For the study, the research team surveyed a sample of approximately 1,179 equity officers as well as interviewed a group of the respondents. Of the total sample surveyed, 340 responses were received, representing 825 hospitals. Of those participants, 49 were invited to participate in the interviews, with 18 agreeing to participate.
Key survey findings include:
- Most of the equity officers surveyed (84 percent) said their hospital or health system CEO was very supportive of advancing health equity goals.
- When it came to perceived supportiveness from hospital leadership, though support from clinical and operational leaders was the lowest, more than 50 percent of participants still said they felt they were very supportive.
- Of the total respondents, 45 percent said all the executive and clinical leaders and board members in their hospital were very supportive.
- Nearly half (49.9 percent) of the equity officers surveyed said that at least one of the potential issues they were asked about (lack of staff diversity, racist beliefs of staff, institutional and systemic racism, and a lack of standardized social determinants of health data collection) was a major obstacle to achieving their health equity goals related to racism, and 90.5 percent said that one was at least a minor obstacle.
- Nearly two-thirds of respondents said a lack of a diverse staff was an obstacle, more than half cited racist beliefs by people in the hospital or health system as an obstacle, and more than half said institutional or structural policies that intentionally or unintentionally perpetuated racism were obstacles.
- Standardized social determinants of health data collection was also a common obstacle, with 68 percent of equity officers reporting it as an obstacle.
“The need for hospitals and health systems to develop and pursue antiracist policies, with the goal of undoing the legacy of racism, is increasingly recognized,” wrote researchers. “The position of equity officer is intended to implement this directive.”
The research team concluded by urging hospitals to perform comprehensive and critical self-examinations of their policies and procedures, such as encouraging diverse forms of hospital leadership, assigning accountability, and providing the necessary resources to accomplish objectives.