Health equity guide aims to improve care for Black patients with serious illnesses
Key takeaways:
- The guide offers tools to improve communication, pain management and caregiver burden for Black patients with illnesses like cancer and heart failure.
- Interventions can be implemented in palliative care settings.
Black individuals in the U.S. with serious illnesses receive disproportionately poor pain management and health care communication, compared with white individuals, a focus group led by the Center to Advance Palliative Care showed.
Black individuals with these illnesses — such as cancer, heart failure or dementia — also experience higher family caregiver burden, findings showed.
To address these inequities, the Center to Advance Palliative Care (CAPC) issued a comprehensive guide titled, “Advancing Equity for Black Patients with Serious Illness.”
The guide provides a roadmap for generating sustainable health equity interventions in the areas of needs assessment, patient/caregiver engagement, design and partnership development, business and operational planning, seeking funding and support, and data collection and assessment.
The guide also provides advice about overcoming challenges and finding community in the context of health equity work.
“Everyone has a stake in this, and everyone can do something,” Brittany Chambers, MPH, MCHES, director of health equity and special initiatives for CAPC, told Healio. “Sometimes health equity seems like such a big issue, and people might not realize that they can make a difference. Our guide’s real intention is to show that doing anything still moves the needle and gets us toward optimal care for all patients.”
Healio spoke with Chambers about the motivation for the guide, the key recommendations, and how this effort may impact clinical practice.
Healio: How did this guide come about and why is it needed?
Chambers: In 2021, CAPC began looking at how to better integrate health equity as part of our strategic goals. We decided to look at the literature and tried to understand the existing gaps. It became very apparent that Black patients have a lot of disparities in terms of how their pain is managed. They are less likely to receive pain management medications, and they are also less likely to be believed about their pain.
We then tried to determine how we could empower our audience of providers caring for these patients to make a difference. This guide ended up having several different pillars. It discusses how to bring patient voices into the designing of interventions to address inequities. It also gives providers practical tips about how to get started in implementing an equity initiative.
Healio: How did you develop the guide?
Chambers: We put together a steering committee of health equity experts in the serious illness care field who came from different organizations. The committee also included various clinicians and researchers. Patient voices also are represented — we conducted the focus group to ensure that our recommendations resonated with them.
Healio: What are your key recommendations?
Chambers: We start by providing some key terms and their definitions, because we know not everyone is familiar with the language of health equity. We have a chapter on the community and the patient voice — how do you make sure that what you’re designing will resonate with the community you’re trying to reach?
We share some interventions we are aware of and how they would be implemented in different settings, such as hospice care or the hospital. We try to give readers a sense of how to implement these in any environment.
We also provide a spectrum of the types of action providers can take. They can do a staff training initiative, or something big and splashy with a funder involved. We describe a range of ways to make a difference.
Healio: Who do you hope will use this guide, and how might it impact patient care?
Chambers: Any clinician or administrator in health care could use this guide. As long as an institution recognizes that there might be a gap and wants to do something about it, this guide is applicable to them. We try to give very specific information about how to get started, where to find data to support your case and how to do business planning. We try to make it like a recipe book — they can skip around to find materials they need. We tried to make it a very practical, A-to-Z guide that empowers people.
We also have a section on evaluating the interventions someone has implemented. For example, anyone who implemented a staff training initiative can loop back in a few months and link it to see if patient outcomes have improved. You can make correlations — you can’t necessarily tell it is because of the training, but you can at least see whether there have been improvements. Then if it’s working, scale it.
Healio: Is there anything else you’d like to mention?
Chambers: One other area we talked about was communication not being as high-quality between Black patients and their providers. Our guide provides some examples that address that in terms of building rapport. Clinicians may have some ambivalence on how to break through that, have those difficult conversations and build that trust. They may shy away from it based on their perceptions or what they have read about different communities. Sometimes, it might just take more time or more intention. Sometimes it simply takes more than one conversation, but we want clinicians to know that they can get there.
References:
- Center to Advance Palliative Care. Advancing Equity for Black Patients with Serious Illness. Available at: https://www.capc.org/health-equity-guide. Accessed Jan. 12, 2025.
- Center to Advance Palliative Care. New health equity guide provides a roadmap to transform care for Black patients with serious illness (press release). Available at: https://www.capc.org/about/press-media/press-releases/2024-11-13/new-health-equity-guide-provides-a-roadmap-to-transform-care-for-black-patients-with-serious-illness/. Published Nov. 13, 2024. Accessed Jan. 12, 2025.
For more information:
Brittany Chambers, MPH, MCHES, can be reached at brittany.chambers@mssm.edu.
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