Addressing the Gap in Health Equity
By Pooja Bhalla, DNP, RN, Illumination Foundation CEO
More than 20 years ago, the 2001 Institute of Medicine (IOM) report, Crossing the Quality Chasm, highlighted a significant gap between the quality of healthcare people should receive, and the quality of care they actually receive. Countless studies followed, culminating in another influential IOM report the following year, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care (2002), which found that people of color often receive a lower quality of care than their white counterparts—even when insurance and socioeconomic status, combined health problems, and other factors were taken into account. And here we are in 2023, having the same discussions and still trying to figure it all out.
Fortunately, many things have changed in the past 20 years, particularly in California, which is leading efforts not only to envision quality healthcare as a way to achieve equity but also to include Managed Care Plans (insurance companies) in the process. The mission of the state’s CalAIM initiative is to transform Medi-Cal for more than 14 million Californians, offering more equitable, coordinated, and person-centered care. This program, which began in January 2022, promises to address the complex challenges faced by our most vulnerable residents, including those experiencing homelessness, those needing behavioral health care access, children with complex medical conditions, and our growing aging population.
Last year, Illumination Foundation hosted a consortium focused on integrating effective solutions to lowering the barriers vulnerable populations experience in accessing healthcare, housing, education, and work opportunities. Among the panelists was Kara Carter, senior vice president of strategy and programs at the California Health Care Foundation, who spoke about healthcare inequality.
“Too many Californians face structural barriers to care based on the color of their skin, their ethnic background, or the language they speak, Carter said. “Like the nation as a whole, California has long maintained policies, practices, and norms that give preferential treatment at the expense of Black, Latino/x, Asian, Pacific Islander, and Indigenous people. Health care is just one of many systems—including housing, education, and employment—that perpetuate this structural racism and engender stark inequities in care and outcomes.”
Carter described California’s healthcare system as fragmented, likening it to grocery shopping for dinner and having to get each ingredient from a different store. Chicken here, carrots there, and milk from somewhere else.
“Too many Californians face structural barriers to care based on the color of their skin, their ethnic background, or the language they speak”
— kara carter
“That’s the complexity of the California Healthcare system,” Carter said. “Fortunately, we are seeing this begin to change in California, especially with the increase in telehealth options, but we still have a long way to go.”
In 2023, Illumination Foundation will mark its 15th anniversary. Over this span we have worked tirelessly to increase access to healthcare for our vulnerable clients, creating a comprehensive delivery system that includes the establishment of Illumination Foundation Medical Group, through which we deliver primary healthcare services directly to our clients. We believe that the integration of housing and healthcare is fundamental to long-term housing and health stability.
Learn more about housing and healthcare for those experiencing homelessness at www.ifhomeless.org.
