In health care today, there’s a good deal of talk about health equity — the fair opportunity for every person to attain their best possible health. Many people think the key to equity is access, and that is part of the complex mix of factors that have created such large racial disparities in health outcomes.
But access is only one part of the answer. It’s just as important to identify what individuals and communities have access to. True equity means everyone can access the same innovative, high-quality medical services, tools and technologies, whether they live in more affluent or challenged areas. Quality care shouldn’t depend on where you live or how much you can pay.
While the majority of health centers nationwide have adopted electronic health records, disparities persist within localities in the availability of enhanced tools, such as cutting-edge, newer technologies, patient portals, access to specialists, telehealth and more.
For example, 3D mammography has become the standard of care for breast imaging and provides more accurate detection and fewer false positives, but it remains limited in many underserved neighborhoods across Chicago.
It’s not equitable for a predominantly Black community — which has disproportionately higher mortality rates from breast cancer — to not have easy access to the same life-saving tools available in other hospitals in more affluent areas of the same city.
Many studies have shown even when minority patients do have access to treatment, they are less likely to receive the best treatment, like robotic surgery, an innovation that can lead to less pain, faster recovery, fewer complications, less blood loss and a greater likelihood of survival.
Disparities like these don’t just perpetuate racial gaps in health outcomes — they actively increase those gaps by leaving certain patients behind while others benefit from ever-greater innovation.
Sinai Chicago is an example of how a safety net hospital system serving a low-income area can deliver high-quality, innovative, high-tech care that helps to level the playing field.
We’re located in economically challenged Black and Latino neighborhoods where health outcomes are historically worse than elsewhere in the region. We’re challenged by the financial barriers that put fulfilling our mission of providing care for all in need at direct odds with the economic realities of a Medicaid reimbursement system that doesn’t pay enough to cover the cost of care. More than two-thirds of our patients are on Medicaid, and nearly 15% have no insurance.
But we remain steadfast in our commitment to ensure our communities get the care they deserve. Over the last few years, we’ve invested heavily in the same technologies that providers in the wealthiest Chicago communities offer, like robotic surgery, 3D mammography, a state-of-the-art electronic health records system and online patient portals.
At Mount Sinai Hospital, we recently performed one of the first pediatric gallbladder surgeries in the U.S. using the Senhance robot. A hysterectomy patient is able to have a virtually scarless surgery, go home sooner and be back on her feet faster. State-of-the-art 3D mammogram and breast imaging services allow us to detect cancer earlier.
It may seem backward to talk about state-of-the-art technology when the health care industry still hasn’t gotten basic access rights. Just this week, a new report showed that between 2010 and 2021, pharmacies in predominantly Black and Latinx neighborhoods had a 40% greater chance of closing compared to pharmacies in white neighborhoods.
There are many other factors at play, such as provider bias, a health insurance system that leaves many behind and the understandable wariness of Black patients to trust the health care system at all, given decades of historical systemic discrimination.
Real equity isn’t just about providing the basics. It’s about everyone having access to the advanced resources and innovations that exist so all people — regardless of ZIP code or race — have their best chance to lead a long, healthy life.
Ngozi O. Ezike, M.D., is president and CEO of Sinai Chicago. She previously served as Illinois public health director.
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