Finding Equity in Women’s Health Care
“Health equity” means giving everyone the opportunity to achieve their best health, regardless of race, age, economic status or geography. At UMMS, we are committed to removing barriers to care for all those we serve, improving length and quality of life, as well as disease, disability and death rates, and improving access to care. Here to help us put health equity into greater perspective is certified nurse midwife and professional educator Lauren Arrington, CNM, whose work in health equity is giving patients throughout Maryland and globally the means to reach their full health potential.
Featured Speaker:
Lauren Arrington, DNP, CNM
Lauren Anita Arrington, DNP, CNM, is an experienced midwife, educator, global health advisor, and health equity advocate. She has supported maternal and child health projects and research studies in communities in Nigeria, Kenya, Lesotho, Tanzania, Malawi, Zambia and Bangladesh through positions held at USAID, Jhpiego and the American College of Nurse Midwives. Her work leading a hospital-based quality improvement initiative to reduce peripartum racial and ethnic disparities was recognized with an award from the Alliance on Innovation and Maternal Health and published in the Journal of Midwifery and Women's Health. Lauren is a member of the Board of Commissioners for the Accreditation Commission for Midwifery Education. She is currently leading the development of a perinatal health equity toolkit for the Maryland Maternal Health Innovation Program. At Duke University where she completed her doctoral studies, she was a Margolis Scholar in Health Policy and Management. Transcription:
Finding Equity in Women’s Health Care
Caitlin Whyte: Welcome to the Live Greater podcast series, information for a healthier you from the University of Maryland Medical System. Health equity means giving everyone the opportunity to achieve their best health, regardless of race, age, economic status, or geography. At UMMS, we are committed to removing barriers to care for all those we serve, improving length and quality of life, as well as disease, disability, and death rates and improving access to care.
Here to help us put health equity into greater perspective is certified nurse midwife and professional educator, Lauren Arrington, CNM, whose work in health equity is giving patients throughout Maryland and globally the means to reach their full health potential.
Well, Lauren, to start our episode off today, can you tell us in day to day terms what is health equity and why is it important to everyone?
Lauren Arrington: That's a great question. So health equity means that everyone should have a fair and just opportunity to be as healthy as possible. And so we want everyone to have the resources and access to healthcare that will help them achieve the health and wellness that they desire for themselves. And this often requires removing obstacles to health, such as poverty, discrimination and other consequences of oppression and racism and so forth in our society. And when we think of health equity, we also have to think of it as a basic human right, that everyone should have a right to achieve their optimal health. And when I think of health equity, I also like to think beyond just this idea of survival and closing gaps and inequities, and really think about joy and wellness and happiness and what we all want for ourselves and the role that health plays in that and the need that we all have to feel loved and cared for, to have trusted healthcare providers.
And lastly, when I think of health equity, I also think about justice and the importance of having a health system that really supports health equity and that we don't place blame on people because they experience health inequities. But instead, we reflect on how can we can create a more just society that really gives everyone a chance to live their best life.
Caitlin Whyte: I love that mission and those values. So Lauren, how can women, particularly women of color, advocate for their best health?
Lauren Arrington: So I think advocating for our best health has to start with trusting in ourselves and our bodies and knowing that we are the experts in what we're feeling and what's going on with our bodies and that we also have a lot of agency when it comes to promoting the health and wellness that we want in our lives.
I would definitely recommend that women seek out healthcare providers that they trust and that treat them like a full human being that listen to them, that respect them, that honor their bodily autonomy and that they know that they can switch providers if they're being cared for by someone that they don't feel is addressing their needs or respecting them, that by all means they can find and should find another provider.
I also think we need to encourage women to advocate for themselves by letting healthcare providers and healthcare systems know their concerns. We have patient advocates within most healthcare organizations. There're also our opportunities to complete surveys and provide feedback and let healthcare providers and systems know what really working well, because that will help us to increase that and put more resources towards that and let the healthcare system know what's not working well and what needs to be changed.
Caitlin Whyte: Gotcha. So what can providers do to be more tuned in or more sensitive to their patient's needs?
Lauren Arrington: I really love this question, because I think there is so much that we can do. And I really see the responsibility falling on us as healthcare providers and as architects of healthcare systems to do a better job of being sensitive to the needs of our patients. And first, I think we need to always see our patients as full human beings and not make assumptions. It's really easy to use assumptions and stereotypes as shortcuts that help us sort of navigate our plans and make clinical decisions when we don't have a lot of time. But what patients really need is for us to get to know them and connect with them and understand their needs.
One way to start that process is to make sure that we stop practicing race-based medicine. And the concept of race, as we know it in the United States today, developed in order to justify oppressive systems like slavery. And within medicine and healthcare, there was actually a movement to distinguish people genetically based upon the color of their skin when we know that, in reality, that is completely a false construct, that race is a social political construct, there's nothing genetic there. But unfortunately, we have embedded into our healthcare system practices where we actually give people different care based upon their race and we interpret lab values differently or interpret someone's opportunity to have a vaginal birth after a C-section differently strictly based upon their race, which is just a very horrible way to conduct medicine. And so we have to get rid of that because there is no gene for race and no one is bound to be sicker or healthier just because of the color of their skin. And what makes groups sicker is how they are treated because of the color of their skin. So racism, discrimination, oppression, those are the things that create the inequities, not something innate within one group or another.
And one thing I'm really happy about is that the University of Maryland's Medical System has committed to getting rid of race-based medicine by removing race adjustments for things like lab values and the vaginal birth after C-section calculator and pulmonary function tests. And this is a fantastic step in the right direction.
We also need to make sure that when we're making care plans and partnering with our patients, that we really understand their preferences and their resources. And we really engage in a shared decision-making process. I can't develop a care plan without knowing things like what type of grocery stores my patient has access to or if they live in a safe community or if they can even afford their medication or what their emotional status is right now, or if they're burdened by tremendous stress. And so I have to develop care plans in partnership with my patients and really connect them to resources in the community that support their health. And I have to advocate for those resources when they don't exist.
So I think at the end of the day, we really have to be partners with our patients, not see them as a problem, not pathologize them and remember that we have the expertise, the brilliance, the resources to improve care and to really support the health of the people we care for.
Caitlin Whyte: So I've heard about providers having health equity statements. Can you tell us more about those and how patients can access this information?
Lauren Arrington: Sure. So there is a movement now in a lot of healthcare organizations to focus more on health equity, and that is fantastic. At our practice at Women's Health Associates, which is part of University of Maryland St. Joseph's Medical Center, we developed a health equity statement for our patients that is displayed on the wall in all of our exam rooms. And we also present it on our Facebook pages, on social media and other places. And what it does is affirm our commitment to health equity. And it goes through some of the practices that we're committed to in order to support health equity for our patients. And it's, we hope, a way to assure them that this is on our mind, that we are there to care for them as whole people and not to make assumptions and stereotypes or practice race-based medicine. And it's also a reminder for us that that's our responsibility.
Caitlin Whyte: Well, as we come to the close of our episode, what would you say is the most important thing a woman can do for her health?
Lauren Arrington: That is a really hard question, because there are so, so many things. At the end of the day, I think reducing stress is really important. And I think that's something that really connects to our wellness and our ability to even tend to our health and to pay attention to what's going on with our bodies and to make it to appointments and to take preventative measures. So I think recognizing because we live in a world where there's a lot of stress and where there are a lot of things vying for our attention, and so I think taking time to be present in your body, to get to know your body, to love your body, to honor this vessel that is carrying you through this life and then take care of it in that spirit and then access resources and advocate for resources that will help you do that.
Caitlin Whyte: I love that. Well, Lauren, is there anything else we didn't touch on that you'd like to add?
Lauren Arrington: I think the only thing I would add is that I'm really excited about the potential for us to reimagine and transform healthcare. We know that in this country, despite the fact that we spend more money than pretty much any other country on healthcare, we don't end up with the healthiest people. And so, we have designed a very elaborate healthcare system that is by and large really good at acute care and pretty good at sick care, but we're not as good at preventative care. We're not as good at addressing chronic conditions in a really meaningful way. And so, I think we have a wonderful opportunity to really think about how can we transform our healthcare system, how can we use our expertise and brilliance to create a healthcare system that has a more robust public health component and that is really committed to the health and the wellness of our community and not to the dollars and to the hierarchical and oppressive structures that much of our country is rooted in.
So I'm excited about that opportunity. And I would just encourage everyone to kind of reimagine how you approach your health and reimagine how you approach care, because we have so many wonderful possibilities and opportunities to create a more just and effective healthcare system.
Caitlin Whyte: Well, thank you so much, Lauren, for this information and for joining us today. You can find more shows just like this one at umms.org/podcast. And thank you for listening to Live Greater, a health and wellness podcast brought to you by the University of Maryland Medical System. We look forward to you joining us again.
Finding Equity in Women’s Health Care
Caitlin Whyte: Welcome to the Live Greater podcast series, information for a healthier you from the University of Maryland Medical System. Health equity means giving everyone the opportunity to achieve their best health, regardless of race, age, economic status, or geography. At UMMS, we are committed to removing barriers to care for all those we serve, improving length and quality of life, as well as disease, disability, and death rates and improving access to care.
Here to help us put health equity into greater perspective is certified nurse midwife and professional educator, Lauren Arrington, CNM, whose work in health equity is giving patients throughout Maryland and globally the means to reach their full health potential.
Well, Lauren, to start our episode off today, can you tell us in day to day terms what is health equity and why is it important to everyone?
Lauren Arrington: That's a great question. So health equity means that everyone should have a fair and just opportunity to be as healthy as possible. And so we want everyone to have the resources and access to healthcare that will help them achieve the health and wellness that they desire for themselves. And this often requires removing obstacles to health, such as poverty, discrimination and other consequences of oppression and racism and so forth in our society. And when we think of health equity, we also have to think of it as a basic human right, that everyone should have a right to achieve their optimal health. And when I think of health equity, I also like to think beyond just this idea of survival and closing gaps and inequities, and really think about joy and wellness and happiness and what we all want for ourselves and the role that health plays in that and the need that we all have to feel loved and cared for, to have trusted healthcare providers.
And lastly, when I think of health equity, I also think about justice and the importance of having a health system that really supports health equity and that we don't place blame on people because they experience health inequities. But instead, we reflect on how can we can create a more just society that really gives everyone a chance to live their best life.
Caitlin Whyte: I love that mission and those values. So Lauren, how can women, particularly women of color, advocate for their best health?
Lauren Arrington: So I think advocating for our best health has to start with trusting in ourselves and our bodies and knowing that we are the experts in what we're feeling and what's going on with our bodies and that we also have a lot of agency when it comes to promoting the health and wellness that we want in our lives.
I would definitely recommend that women seek out healthcare providers that they trust and that treat them like a full human being that listen to them, that respect them, that honor their bodily autonomy and that they know that they can switch providers if they're being cared for by someone that they don't feel is addressing their needs or respecting them, that by all means they can find and should find another provider.
I also think we need to encourage women to advocate for themselves by letting healthcare providers and healthcare systems know their concerns. We have patient advocates within most healthcare organizations. There're also our opportunities to complete surveys and provide feedback and let healthcare providers and systems know what really working well, because that will help us to increase that and put more resources towards that and let the healthcare system know what's not working well and what needs to be changed.
Caitlin Whyte: Gotcha. So what can providers do to be more tuned in or more sensitive to their patient's needs?
Lauren Arrington: I really love this question, because I think there is so much that we can do. And I really see the responsibility falling on us as healthcare providers and as architects of healthcare systems to do a better job of being sensitive to the needs of our patients. And first, I think we need to always see our patients as full human beings and not make assumptions. It's really easy to use assumptions and stereotypes as shortcuts that help us sort of navigate our plans and make clinical decisions when we don't have a lot of time. But what patients really need is for us to get to know them and connect with them and understand their needs.
One way to start that process is to make sure that we stop practicing race-based medicine. And the concept of race, as we know it in the United States today, developed in order to justify oppressive systems like slavery. And within medicine and healthcare, there was actually a movement to distinguish people genetically based upon the color of their skin when we know that, in reality, that is completely a false construct, that race is a social political construct, there's nothing genetic there. But unfortunately, we have embedded into our healthcare system practices where we actually give people different care based upon their race and we interpret lab values differently or interpret someone's opportunity to have a vaginal birth after a C-section differently strictly based upon their race, which is just a very horrible way to conduct medicine. And so we have to get rid of that because there is no gene for race and no one is bound to be sicker or healthier just because of the color of their skin. And what makes groups sicker is how they are treated because of the color of their skin. So racism, discrimination, oppression, those are the things that create the inequities, not something innate within one group or another.
And one thing I'm really happy about is that the University of Maryland's Medical System has committed to getting rid of race-based medicine by removing race adjustments for things like lab values and the vaginal birth after C-section calculator and pulmonary function tests. And this is a fantastic step in the right direction.
We also need to make sure that when we're making care plans and partnering with our patients, that we really understand their preferences and their resources. And we really engage in a shared decision-making process. I can't develop a care plan without knowing things like what type of grocery stores my patient has access to or if they live in a safe community or if they can even afford their medication or what their emotional status is right now, or if they're burdened by tremendous stress. And so I have to develop care plans in partnership with my patients and really connect them to resources in the community that support their health. And I have to advocate for those resources when they don't exist.
So I think at the end of the day, we really have to be partners with our patients, not see them as a problem, not pathologize them and remember that we have the expertise, the brilliance, the resources to improve care and to really support the health of the people we care for.
Caitlin Whyte: So I've heard about providers having health equity statements. Can you tell us more about those and how patients can access this information?
Lauren Arrington: Sure. So there is a movement now in a lot of healthcare organizations to focus more on health equity, and that is fantastic. At our practice at Women's Health Associates, which is part of University of Maryland St. Joseph's Medical Center, we developed a health equity statement for our patients that is displayed on the wall in all of our exam rooms. And we also present it on our Facebook pages, on social media and other places. And what it does is affirm our commitment to health equity. And it goes through some of the practices that we're committed to in order to support health equity for our patients. And it's, we hope, a way to assure them that this is on our mind, that we are there to care for them as whole people and not to make assumptions and stereotypes or practice race-based medicine. And it's also a reminder for us that that's our responsibility.
Caitlin Whyte: Well, as we come to the close of our episode, what would you say is the most important thing a woman can do for her health?
Lauren Arrington: That is a really hard question, because there are so, so many things. At the end of the day, I think reducing stress is really important. And I think that's something that really connects to our wellness and our ability to even tend to our health and to pay attention to what's going on with our bodies and to make it to appointments and to take preventative measures. So I think recognizing because we live in a world where there's a lot of stress and where there are a lot of things vying for our attention, and so I think taking time to be present in your body, to get to know your body, to love your body, to honor this vessel that is carrying you through this life and then take care of it in that spirit and then access resources and advocate for resources that will help you do that.
Caitlin Whyte: I love that. Well, Lauren, is there anything else we didn't touch on that you'd like to add?
Lauren Arrington: I think the only thing I would add is that I'm really excited about the potential for us to reimagine and transform healthcare. We know that in this country, despite the fact that we spend more money than pretty much any other country on healthcare, we don't end up with the healthiest people. And so, we have designed a very elaborate healthcare system that is by and large really good at acute care and pretty good at sick care, but we're not as good at preventative care. We're not as good at addressing chronic conditions in a really meaningful way. And so, I think we have a wonderful opportunity to really think about how can we transform our healthcare system, how can we use our expertise and brilliance to create a healthcare system that has a more robust public health component and that is really committed to the health and the wellness of our community and not to the dollars and to the hierarchical and oppressive structures that much of our country is rooted in.
So I'm excited about that opportunity. And I would just encourage everyone to kind of reimagine how you approach your health and reimagine how you approach care, because we have so many wonderful possibilities and opportunities to create a more just and effective healthcare system.
Caitlin Whyte: Well, thank you so much, Lauren, for this information and for joining us today. You can find more shows just like this one at umms.org/podcast. And thank you for listening to Live Greater, a health and wellness podcast brought to you by the University of Maryland Medical System. We look forward to you joining us again.