Health Equity Is Pursuing Social Justice in Health.

Abstract

If you don’t like something change it. If you can’t change it, change your attitude.—Maya AngelouOf all the forms of inequality, injustice in health care is the most shocking and inhumane.—Martin Luther King, Jr Throughout 2020 and 2021, we have continued to see health care systems across the world fall to the strains of the coronavirus disease 2019 (COVID-19) pandemic, with no clear end in sight. At the time of this editorial, there have been 218,205,951 confirmed cases of COVID-19 and 4,526,583 deaths reported worldwide, and we are in the throes of the third wave, driven by the delta variant [1World Health OrganizationWHO coronavirus (COVID-19) dashboard.https://covid19.who.int/Date accessed: September 2, 2021Google Scholar]. The impact of this pandemic on our vulnerable populations has been devastating, with a particular impact on our Black, Hispanic, and Indigenous populations, who have experienced worse COVID-19–related outcomes due to a complex combination of societal and health care factors. If there is a silver lining in the pandemic, it is that it has shone a bright spotlight on the long-discussed health disparities our vulnerable populations face, the direct impact of social determinants of health on clinical outcomes, and the gaps that we must work to close as a health care community. Achieving health equity and a data-driven, community-based healthier future for all is a national priority that has the support of governmental agencies, national organizations, and health care systems across the United States [2US Department of Health and Human ServicesOffice of Disease Prevention and Health Promotion. Healthy People 2030.https://health.gov/healthypeopleDate accessed: November 15, 2021Google Scholar]. Radiology is playing an important role in achieving health equity with the newly formed health equity coalition, which aims to build the community effort needed to make a meaningful impact in addressing health disparities. This special issue of JACR on health equity brings together a diversity of topics and authors and will serve as a foundational pillar that showcases the equity work being done across the specialty. To effectively close the current health gaps and prepare for emerging health disparities, we must build a sustainable framework that will allow us to remain nimble while systematically developing multilevel interventions that empower patients and bridge health disparities by addressing factors within and outside the health care system. To accomplish this goal, we must gain a better understanding of the root cause of health disparities. We can start by defining what we are really talking about when we discuss vulnerable populations and what we truly mean when we ask how we can advance health equity. Systemic discrimination and health disparities have many forms that are not limited to the typical racial/ethnic constructs, language barriers, or financial barriers. Learning how to best approach these topics requires a nuanced understanding of what vulnerability and systemic barriers mean in the context of health care. This ultimately requires a deliberate willingness to fully appreciate the situation, context, and environment that have placed patients in a position in which they have diminished opportunities to achieve better outcomes and a healthier future. Radiology is at the forefront of health equity, and as leaders in health care, it is our responsibility to tailor our care to fit the needs of all patient populations, particularly those most in need. As radiologists, how we approach closing the gap in health disparities is not always intuitive. In this special issue, we have gathered a series of papers by our colleagues across radiology that discuss the spectrum of health disparities, shed light on issues specific to our specialty, and open the discussion of closing the gaps in our health system. Our hope is that by engaging in this issue, readers will feel empowered to enter a conversation with us, continue to identify gaps, and work to create solutions that can be built upon throughout our clinical domain and improve the livelihood of many as a society. As Braveman et al wrote, “advancing health equity is advancing social justice in health” [3Braveman PA, Kumanyika S, Fielding J, et al. Health disparities and health equity: the issue is justice. Am J Public Health 101(suppl 1):S149-S155.Google Scholar]. As radiologists, today we have an opportunity to take decisive steps to achieve a healthier future for all because the future of health equity is now. We invite you to enter this special issue with an eye toward an equitable future and a mind toward impactful change that will allow us to navigate together the intersection of social justice and health equity.