Health Equity Lens Research Articles

The Time is Now: Climate Change and Aging Adults’ Mental Health

Climate change is a major public health emergency, with significant consequences to not only physical health, but also to mental health across the lifespan. Aging adults are more likely to be exposed and vulnerable to heat waves and extreme weather events (e.g., hurricanes, floods), poor air quality, and vector-borne infectious diseases. Risk factors include chronic medical conditions; limited mobility due to medical or neurological disease (e.g., stroke, Parkinson's disease); sensory deficits; cognitive impairment; polypharmacy; psychiatric illness; linguistic isolation; and living alone or having limited support. Psychiatric impacts of climate change include new-onset or exacerbation of existing symptoms of anxiety, depression, posttraumatic stress, sleep disturbances, and cognitive impairment, in addition to eco-distress (anticipatory anxiety about climate change and its consequences).Following a brief overview of the mental health impacts of climate change across the lifespan, we will review age-specific and socio-economic-cultural determinants which increase the risk of adverse outcomes for this vulnerable population. We will discuss the prevalence and phenomenology of psychiatric conditions that can occur in aging adults exposed to heat waves and/or natural disasters. Using a diversity and health equity lens, we will provide tips for clinicians to help facilitate discussions about climate change and its mental health impacts. We will review the extant evidence focused on treatment interventions and propose adaptation and resilience-enhancing strategies. Finally, we will discuss effective communication strategies regarding this crucial topic.

Psychedelic Renaissance: Clinical Health Justice, Patient Safety, and Equity Need to Be Put First

Psychedelic Renaissance: Clinical Health Justice, Patient Safety, and Equity Need to Be Put First

Global Warming in Pakistan and Its Impact on Public Health as Viewed Through a Health Equity Lens.

Pakistan is extremely vulnerable to the negative impacts of climate change. The recent monsoon season caused widespread, deadly flooding, affecting 15% of the total population when extreme heat waves were followed by the worst rains and floods in the country's history. But Pakistan was not the cause of its own misfortune. The atmospheric buildup of carbon dioxide (CO2) is the greatest contributor to climate change. If we look at the increase of carbon dioxide in the atmosphere, we find that Pakistan is, like all developing nations, essentially a non-contributor of the problem, contributing considerably less than 1% of global greenhouse gas emissions. Moreover, although significant factors exacerbating the effects of climate change in Pakistan include an inadequate sewage system, air pollution from industrial waste, and deforestation, the country could not afford to proactively fix these, nor prepare for flooding and heavy rains. It lacks the funding for climate resilience efforts. As a result, Pakistan is suffering from a high prevalence of poor health outcomes. Children, the elderly, women, and the homeless, especially those living with poverty and disease, are at a high risk of morbidity and mortality. Since mitigating the devastating effects of climate change will continue to be an ongoing challenge for Pakistan, it urgently needs financial investment so that it can build climate-resilient infrastructures and institute mechanisms to deal with global warming's worst effects. Industrialized nations are responsible for global warming, and they must take responsibility for fighting global warming by helping developing countries cultivate greater public health emergency preparedness.

How psychologists can help achieve equity in health care-advancing innovative partnerships and models of care delivery: Introduction to the special issue.

For as long as the United States has been a country, the distribution of good health has been unequal. In this special issue, we consider what psychology can do to understand and ameliorate these inequalities. The introduction sets the context for why psychologists are well positioned, well trained, and needed to champion health equity via innovative partnerships and models of care delivery. A guide is provided for engaging and maintaining a health equity lens in advocacy, research, education/training, and practice efforts for psychologists, and readers are invited to apply a health equity lens to reimagine their existing and forthcoming work. More broadly, the special issue brings together a collection of 14 articles across three core themes: (a) integration of care, (b) intersections between social drivers/determinants of health, and (c) intersecting social systems. The articles collectively highlight the need for new conceptual models to guide research, education, and practice, the importance of engaging in transdisciplinary partnerships, and the urgency of collaborating with community members in cross-system alliances to tackle social drivers of health, structural racism, and contextual risks, all of which are fundamental drivers of health inequity. Although psychologists are uniquely positioned to investigate causes of inequality, develop health equity interventions, and advocate for policy changes, our voice and vision have been missing from broader national dialogues around these issues. This issue is poised to provide examples of existing equity work and inspire ALL psychologists to engage for the first time or deepen existing health equity work with renewed vigor and reimagined possibilities. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PRESIDENTIAL SYMPOSIUM: REIMAGINING AGING AND LONG-TERM CARE FOR HEALTH EQUITY DURING AND POST-COVID-19: A HEALTH SCIENCES FOCUS

Abstract In line with the theme of the conference, this symposium highlights exemplars of health sciences scholars who are identifying key issues and opportunities to re-imagine aging and long-term care, through a health equity lens, as highlighted by COVID-19. This lens is inclusive of the wide range of long-term care stakeholders whose well-being and health outcomes have been affected throughout the COVID-19 pandemic, including older adults, family caregivers, and the healthcare workforce. We focus in particular on vulnerable aging populations, such as older adults who are living with neurocognitive disorders, racial/ethnic minority older adults, and older adults receiving palliative care. Finally, we consider these issues at both individual and systems-levels. Our first presenter examines person and family engagement in assisted living for older adults living with ADRD and the impact of COVID-19. The second presenter provides insights into palliative care needs in nursing homes, and the implications for transition to an endemic. The third presenter examines long-term care needs in the community, with a focus on the consequences of unmet needs for racial/ethnic minority older adults. The fourth presenter highlights the role and capacity of the nurse practitioner in nursing homes during COVID. Our final presenters provide a systems-level look at the COVID-19 response, focusing on self-organizing community coalitions to support nursing homes. Presentations reveal how re-imagining aging and long-term care in health sciences, requires consideration of health inequities experienced throughout COVID-19, whether newly emerging inequities, or long-standing challenges and inequities that have been exacerbated by COVID-19.

Investigating implementation of school health policies through a health equity lens: A measures development study protocol.

School-based policies that ensure provision of nutrition, physical activity, and other health-promoting resources and opportunities are essential in mitigating health disparities among underserved populations. Measuring the implementation of such policies is imperative to bridge the gap between policy and practice. Unfortunately, limited practical, psychometrically strong measures of school policy implementation exist. Few available explicitly focus on the issues of equity and social justice as a key component of implementation, which may result in underassessment of the equity implications of policy implementation. The purpose of this study is to develop equity-focused measures in collaboration with practitioners, researchers, and other key implementation partners that will facilitate evaluation of policy implementation determinants (i.e., barriers and facilitators), processes, and outcomes. We will actively seek engagement from practitioners, researchers, and advocacy partners (i.e., stakeholders) who have expertise in school health policy throughout each phase of this project. We propose a multi-phase, 1-year project comprising the following steps: (1) selection of relevant constructs from guiding frameworks related to health equity and implementation science; (2) initial measure development, including expert feedback on draft items; (3) pilot cognitive testing with representatives from key target populations (i.e., school administrators, teachers, food service staff, and students and parents/guardians); and (4) measure refinement based on testing and assessment of pragmatic properties. These steps will allow us to establish initial face and content validity of a set of instruments that can undergo psychometric testing in future studies to assess their reliability and validity. Completion of this project will result in several school policy implementation measurement tools which can be readily used by practitioners and researchers to evaluate policy implementation through a health equity lens. This will provide opportunities for better assessment and accountability of policies that aim to advance health equity among school-aged children and their families. Open Science Framework Registration doi: 10.17605/OSF.IO/736ZU.

Medical-legal partnerships can mitigate climate health impacts on the underserved.

To the Editor: Climate change has been referred to as a “wicked problem par excellence” because it constitutes a “series of linked problems that cannot be solved (or even diagnosed) in isolation.”1 Furthermore, climate impacts those least able to adapt, disproportionately affecting “the most vulnerable, including among children, older populations, ethnic minorities, poorer communities, and those with underlying health problems.”2 Clinicians must be willing to work with allies outside of the medical arena to address climate change with a health equity lens. We, a family physician, and a legal aid lawyer in Florida, believe that Medical-Legal Partnerships (MLPs) represent an underappreciated model for successful cross-disciplinary collaboration that can mitigate climate impacts on underserved populations. We call for more clinicians concerned about climate change to consider working with MLPs, and for more interdisciplinary research3 into MLPs and their ability to deliver meaningful improvements in climate resiliency. Climate effects on health can be exacerbated by inequality, such as increased precipitation contributing to incidence of mould in substandard housing that worsens a child’s asthma.4 Landlords may ignore the requests from low-income tenants to fix leaky pipes that cause the mould, rendering the child sicker and missing school more frequently. Many patients including immigrant populations5 may be unaware of their legal rights to have housing and sanitary codes be enforced and can benefit from a lawyer to advocate on their behalf. Other examples of climate vulnerabilities include unsafe working conditions or substandard educational environments.

Racial and Ethnic Differences in Maternal and Child COVID-19 Vaccination Intent Among Pregnant and Postpartum Women in the USA (April-June 2020): an Application of Health Belief Model.

This study investigated racial/ethnic differences in pregnant and postpartum women's intentions to receive the COVID-19 vaccination (maternal COVID-19 vaccination intent) and intentions to vaccinate their children against COVID-19 (child COVID-19 vaccination intent) during the early months of the COVID-19 pandemic (April-June 2020). This study also assessed Health Belief Model constructs to examine their influence on maternal and child COVID-19 vaccination intent by race/ethnicity. This study includes 489 US pregnant and postpartum women (18-49years) recruited via Prolific Academic to complete a 55-item cross-sectional online survey. Crude and adjusted logistic regression analyses were conducted to determine the associations between race/ethnicity, maternal COVID-19 vaccination intent, and child COVID-19 vaccination intent. Among pregnant women, the odds of maternal COVID-19 vaccination intent (aOR = 2.20, 95% CI: .862, 5.61) and child COVID-19 vaccination intent (aOR = .194, 95% CI: .066, .565) among NH Black women were statistically significantly lower than that of NH White women after adjustment for demographic, health, and health belief model variables. Among postpartum women, although some racial differences in maternal or child COVID-19 vaccination intent were observed, these differences were not statistically significant in unadjusted and adjusted models. The findings have implications for future research and interventions which should adopt a racial health equity lens and identify strategies grounded in institutional trustworthiness and systems perspectives to address racial/ethnic disparities in COVID-19 vaccination intent among pregnant and postpartum women during novel pandemics.

Using Trusted Relationships and Community-Led Approaches to Promote COVID-19 Vaccine Confidence and Uptake across Ontario.

Data underscore how challenging it can be for populations that experience systemic and historical barriers to access necessary health information and services, including COVID-19 vaccinations and testing. In this paper, we describe the initiatives used by member centres of Alliance for Healthier Communities to promote vaccine confidence and uptake, highlight specific examples that applied a health equity lens, describe some of the challenges that centres faced and explore the key enablers for these initiatives. Lessons learned here can be used to engage in other health promoting activities including population health efforts currently under way across the country.

Leveraging Implementation Science for Cardiovascular Health Equity: A Scientific Statement From the American Heart Association.

Reducing cardiovascular disease disparities will require a concerted, focused effort to better adopt evidence-based interventions, in particular, those that address social determinants of health, in historically marginalized populations (ie, communities excluded on the basis of social identifiers like race, ethnicity, and social class and subject to inequitable distribution of social, economic, physical, and psychological resources). Implementation science is centered around stakeholder engagement and, by virtue of its reliance on theoretical frameworks, is custom built for addressing research-to-practice gaps. However, little guidance exists for how best to leverage implementation science to promote cardiovascular health equity. This American Heart Association scientific statement was commissioned to define implementation science with a cardiovascular health equity lens and to evaluate implementation research that targets cardiovascular inequities. We provide a 4-step roadmap and checklist with critical equity considerations for selecting/adapting evidence-based practices, assessing barriers and facilitators to implementation, selecting/using/adapting implementation strategies, and evaluating implementation success. Informed by our roadmap, we examine several organizational, community, policy, and multisetting interventions and implementation strategies developed to reduce cardiovascular disparities. We highlight gaps in implementation science research to date aimed at achieving cardiovascular health equity, including lack of stakeholder engagement, rigorous mixed methods, and equity-informed theoretical frameworks. We provide several key suggestions, including the need for improved conceptualization and inclusion of social and structural determinants of health in implementation science, and the use of adaptive, hybrid effectiveness designs. In addition, we call for more rigorous examination of multilevel interventions and implementation strategies with the greatest potential for reducing both primary and secondary cardiovascular disparities.

Learning to Lead: 3 Models to Support Public Health Leadership Development

The current public health system is underresourced and understaffed, which has been exacerbated by the coronavirus pandemic. In addition, there has been a decline in the public health workforce at both state and local levels during the last decade. While workforce numbers dwindle, public health systems have to address increasingly complex challenges-such as climate change, chronic diseases, and health equity-challenges that require skilled, adaptive leaders. This article describes the importance of leadership development and how 3 public health training centers (PHTCs) are building leadership skills in the public health workforce. To address the need for public health leadership training, the PHTCs in the Health & Human Services (HHS) Regions 4, 7, and 10 all offer public health leadership institutes (PHLIs). The 3 PHLIs discussed in this article vary in longevity (3-18 years), cohort length (8-12 months), and format (virtual, in-person, and hybrid); yet, all 3 emphasize adaptive leadership through a health equity lens and intentional opportunities to apply skills in practice. Each PHLI conducts extensive evaluation based on Kirkpatrick's levels of evaluation and collects common metrics collected by all PHTCs. Data from the PHLIs illustrate high levels of satisfaction with learning, presentation of data, identification of workplace actions, and improvement of subject matter understanding. Each PHLI also has numerous stories of impact. With public health leaders leaving the workforce and the complexities of practice increasing, leadership training is critical to the current workforce and succession planning. These PHTCs provide a significant, enduring resource toward the development of our nation's public health leaders, as well as meeting the unique needs of their regions' workforces.

Health inequities start early in life, even before birth: Why race-specific fetal and neonatal growth references disadvantage Black infants

Clinicians and researchers use published standards to assess and classify the size and growth of the fetus and newborn infant. Fetal growth is slower on average in Black fetuses as compared with White fetuses, and existing standards differ in whether they are race-specific or not. Here, we apply a health equity lens to the topic of fetal and newborn growth assessment by critically appraising two widely available growth standards. We conclude that using race-based standards is not well-justified and could perpetuate or even worsen inequities in perinatal health outcomes. We therefore recommend that neonatal and perinatal providers remove race from the assessment of fetal and newborn size.

Building implementation science capacity among practitioners of cancer control: development of a pilot training curriculum.

Cancer control interventions are difficult to implement with fidelity, while tailoring to fit contexts. Engaged approaches are suggested to advance equity. On-the-ground practitioners are needed to serve as collaborators in the implementation process with research teams, but few trainings are designed with them in mind. The Cancer Control Implementation Science Base Camp (CCISBC) was created to improve capacity among cancer control practitioners when implementing evidence-based cancer screening programs in specific contexts. Development of the curriculum included the following: (1) performing a literature review assessing extant curricula, (2) comparing competencies of these curricula, (3) user-centered design, (4) producing learning materials, (5) recruiting two teams to test a pilot, (6) running the pilot, and (7) evaluating results. Nine competencies overlapped between four of the curricula scanned in this study, all of which served as the basis for learning objectives. Principles that emerged from design sessions included staying clear about terminology, supporting the brokerage of knowledge, reframing theories, models, and frameworks as tools, and including equity in everything. Pilot testing showed that the average learner increased 74.5% in knowledge and 75% in confidence regarding implementing evidence-based cancer screening. Evidence suggests that the training increased the skill of implementing evidence-based interventions (EBIs) with a health equity lens. In order to scale practice-based evidence, practitioners will need to be engaged. This engagement is optimized when practitioners are trained to collaborate on implementation research. The CCISBC is a feasible program to develop capacity among practitioners in comprehensive cancer control in order to optimize EBIs tailored to context.

Electronic health strategies to improve medication adherence in patients with cardiometabolic disease: current status and future directions.

Enabled by widespread technological advancements, electronic health (eHealth) strategies have expanded rapidly over the last decade, presenting opportunities to support self-management including medication adherence for cardiometabolic disease control. eHealth can minimize access barriers to medications, enable timely assessment and shared decision-making, and provide medication reminders and health data feedback. This review summarizes current evidence for effectiveness of eHealth strategies for improving medication adherence in patients with hypertension, type 2 diabetes, and/or hyperlipidemia, and identifies priorities for future research. Current research supports the effectiveness of eHealth strategies to improve medication adherence and clinical outcomes for cardiometabolic disease. Although patient acceptability of eHealth strategies is generally high, engagement may decline over time. In addition, differences in effectiveness across intervention characteristics and sociodemographic groups are understudied, limiting generalizability and tailoring of interventions to local health system resources, culture, and patient needs or preferences. eHealth is a promising tool for addressing low medication adherence. Further work incorporating rigorous evaluation, assessment of patient engagement over time and effectiveness of intervention characteristics and components, and a health equity lens addressing eHealth use in vulnerable groups will increase understanding of the full potential of eHealth for improving medication adherence in diverse patients with cardiometabolic disease.

How is weight teasing cross-sectionally and longitudinally associated with health behaviors and weight status among ethnically/racially and socioeconomically diverse young people?

BackgroundWeight stigma is prevalent among young people and harmful to health. The current study used a health equity lens to examine cross-sectional and longitudinal associations between experiencing weight teasing (a form of weight stigma) with a range of weight-related health behaviors and weight status in an ethnically/racially and socioeconomically diverse sample of young people. We also assessed whether ethnicity/race and adolescent socioeconomic status (SES) operated as effect modifiers in these relationships.MethodsAdolescents (n = 1568) were enrolled in EAT 2010–2018 (Eating and Activity over Time) and followed into young adulthood. Weight teasing; screen time; moderate-to-vigorous physical activity (MVPA); sleep duration; breakfast frequency; fruit, vegetable, sugar-sweetened beverage (SSB), and fast-food intake; and body mass index (BMI) were assessed at baseline (mean age = 14.4 years) and eight-year follow-up (mean age = 22.2 years). Multivariate linear regression estimated marginal means and 95% confidence intervals. All analyses adjusted for BMI and sociodemographic characteristics.ResultsWeight teasing was cross-sectionally associated with longer screen time, shorter sleep duration, and higher BMI during adolescence; and cross-sectionally associated with shorter sleep duration, lower breakfast frequency, higher fast-food intake, higher SSB intake, and higher BMI during young adulthood. In the longitudinal analyses, weight teasing was not associated with health behaviors but did predict higher BMI (teased: 28.2 kg/m2, not teased: 26.4 kg/m2, p < 0.001). White and higher adolescent SES subgroups had higher MVPA, more frequent breakfast intake, lower fast-food intake, and lower BMI than their respective counterparts. The relationships between weight teasing and health behaviors and weight status were largely consistent across ethnic/racial and adolescent SES subgroups.ConclusionsFindings add to growing evidence that weight-based mistreatment poses a threat to weight-related health and that young people across ethnic/racial and SES subgroups are vulnerable to the negative effects of weight teasing. Limitations include attrition at follow-up and the self-reported nature of many measures. Results suggest a need for increased attention to existing recommendations to reduce weight stigma in young people from diverse ethnic/racial and socioeconomic backgrounds including training for healthcare providers to better equip them to address the harms of weight teasing and foster more compassionate care to promote health-supporting behaviors in young people.

Global profile of individuals undergoing total knee replacement through the PROGRESS-PLUS equity lens: Protocol for a systematic review.

BackgroundOsteoarthritis (OA) is a heterogenous degenerative disorder often causing destructive joint changes with severe pain and functional disability. Modifiable and non-modifiable risk factors, social context and psychological factors influence the development and progression of the disease. Total knee replacement (TKR) aims at reducing pain and improving function and is more successful with pre-operative and post-operative rehabilitation. However, most international research on rehabilitation interventions is conducted in high income contexts.ObjectiveThe aim of our systematic review is to gain an overview of the demographic and social profiles of adults undergoing TKR for primary knee OA in lower, middle- and high-income countries through a health equity lens to inform the translation of intervention research in local contexts.MethodsA systematic review will be conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Eligibility criteria include observational studies and grey literature (theses) since the beginning of the databases reporting on demographic data of adults awaiting or undergoing TKR surgery. The PROGRESS-Plus framework will be used to describe equity elements.ResultsA narrative summary and description of the global profile of individuals undergoing total knee replacement for osteoarthritis.ConclusionA snapshot of the global demographic and social profile of individuals receiving TKR for primary knee OA through an equity lens will shed light on the similarities and differences between individuals from different contexts. Global demographic profile information may inform or assist in the development of translational strategies for evidence-based rehabilitation.Clinical implicationsTranslation of existing rehabilitation interventions to local contexts could improve pre-operative and post-operative outcomes for individuals on our surgical waiting lists.

Advancing Health Equity Efforts to Reduce Obesity: Changing the Course.

Population-based solutions are needed to stabilize and then reverse the continued upward trends in obesity prevalence in the US population and worldwide. This review focuses on the related, urgent issue of disparities in obesity prevalence affecting US racial/ethnic minority and other socially marginalized populations. The review provides background on these disparities from a health equity perspective and highlights evidence of progress in equity-focused obesity efforts. Five recommendations for advancing equity efforts are offered as potential approaches to build on progress to date: (a) give equity issues higher priority, (b) adopt a health equity lens, (c) strengthen approaches by using health equity frameworks, (d) broaden the types of policies considered, and (e) emphasize implementation science concepts and tools. Potential challenges and opportunities are identified, including the prospect of longer-term, transformative solutions that integrate global and national initiatives to address obesity, undernutrition, and climate change.

183 Advancing Structural and Systematic Equity in Epidemiological Analyses of Large Datasets

OBJECTIVES/GOALS: Health inequities represent complex structural and systematic processes that lead to disparate outcomes for populations or subgroups within populations. This project aims to improve the available structural and systematic approaches to the study of such inequities at the population level. METHODS/STUDY POPULATION: Using examples from diabetes research, two critical factors that may impact the validity or utility of health equity models will be examined; and proposed methodological approaches to offsetting potentially resulting biases will be offered. The factors include: (1) inequitably missing and misclassified data in large datasets and (2) the presumed positioning of socially constructed variables such as race, ethnicity, and gender within modeled structural and systematic mechanisms. This examination intersects theories and praxis in epidemiological modeling and health equity promotion with the goal of advancing rigorous, equity-focused epidemiological methods. RESULTS/ANTICIPATED RESULTS: Inequitably missing and misclassified data are generally expected to obscure inequities. Treatment of missing or misclassified data as informative measures of inequity is expected to partially offset this bias. The implicitly modeled components of socially constructed variables are expected to be non-uniform across structural and systematic mechanisms of inequity. Models that apply these variables as informatively heterogeneous constructs, using multi-phase analyses to test modeling assumptions and to assess intersectionality, may provide better context about the mechanisms by which inequity has been distributed and, perhaps, by which equity may be achieved. DISCUSSION/SIGNIFICANCE: Equitable epidemiological methods are essential to the advancement of evidence-based health equity on the population level. Potential structural or systematic inequities in large-scale datasets and traditional data analyses should be thoughtfully reviewed through a health equity lens.

Health Equity and Disparities in ROP Care: A Need for Systematic Evaluation.

Retinopathy of prematurity (ROP) is a vasoproliferative retinal disorder that can have devastating visual sequelae if not managed appropriately. From an ophthalmology standpoint, ROP care is complex, since it spans multiple care settings and providers, including those in the neonatal intensive care unit (NICU), step down nurseries, and the outpatient clinic setting. This requires coordination and communication between providers, ancillary staff, and most importantly, effective communication with the patient's family members and caregivers. Often, factors related to the social determinants of health play a significant role in effective communication and care coordination with the family, and it is important for ophthalmologists to recognize these risk factors. The aim of this article is to (1) review the literature related to disparities in preterm birth outcomes and infants at risk for ROP; (2) identify barriers to ROP care and appropriate follow up, and (3) describe patient-oriented solutions and future directions for improving ROP care through a health equity lens.

Implementing High-Quality Primary Care Through a Health Equity Lens.

The COVID-19 pandemic highlighted the importance of centering health equity in future health system and primary care reforms. Strengthening primary care will be needed to correct the longstanding history of mistreatment of First Nations/Indigenous and racialized people, exclusion of health care workers of color, and health care access and outcome inequities further magnified by the COVID-19 pandemic. The National Academies of Sciences, Engineering, and Medicine (NASEM) released a report on Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care, that provided a framework for defining high-quality primary care and proposed 5 recommendations for implementing that definition. Using the report's framework, we identified health equity challenges and opportunities with examples from primary care systems in the United States and Canada. We are poised to reinvigorate primary care because the recent pandemic and the attention to continued racialized police violence sparked renewed conversations and collaborations around equity, diversity, inclusion, and health equity that have been long overdue. The time to transition those conversations to actionable items to improve the health of patients, families, and communities is now.Appeared as Annals "Online First" article.