Speaker: Access to health care is not enough to close the gap, ending racism is key
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SCOTTSDALE, Ariz. — Although improving access to health care can improve transplantation access, addressing racism is key to bringing access to all patients, according to a presenter at the Cutting Edge of Transplantation Summit.
“Social factors influence health directly through things like, socially and economically deprived living conditions; through exposure to environmental and occupational pollutants; [and] through exposure to violence in one's community through behavioral health, if a person engages in drug use that directly relates to her health outcomes,” Kimberly Jacob Arriola, PhD, MPH, from Emory University, said in the presentation. She added, “But if we focus on health care and we think about this issue carefully, what we realize is that we've got to attend to upstream determinants of health.”
Jacob Arriola compared the cause of limited transplant access to an upstream problem. Similar to how a factory can pollute a river and become the upstream cause to downstream problems like illness, racism can be the upstream cause to the downstream problem of health inequity.
According to her presentation, racism is a fundamental cause of poor health, and it impacts transplantation differently by organ due to varying policies and management. As Healio previously reported, the eGFR equation was recently updated to remove a race factor that limited access to Black transplant candidates.
Further, Jacob Arriola said that racial bias can impact a candidate’s evaluation process or ability to gain a transplant. This can be due to limited access to transportation, social support, finances or food. However, she said these problems are long-lasting effects of racism that have created segregated neighborhoods, for example, and food deserts.
“In conclusion, access to health care is necessary but not sufficient for optimal health,” Jacob Arriola said. “Social factors drive inequities and access to transplant, and racism is a fundamental cause of transplant inequities as a specific social factor.”
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Jacob Arriola K. What do you mean by access for all? Presented at: Cutting Edge of Transplantation Summit. Feb. 23-25, 2023; Scottsdale, Ariz.
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