By Veronica Perry
On Tuesday, May 12, LaVonna Lewis, Teaching Professor of Public Policy and Associate Dean of Diversity, Equity and Inclusion at USC Price, discussed the prevalence of health disparities in our medical system and how they are intensified during a crisis or disaster.
In the beginning of her discussion, Lewis defined the concept of health disparities for the audience. “Disparities denote differences, whether they are unjust or not, inequity denotes differences in health outcomes that are systematic or avoidable and unjust,” she said. She continued, highlighting the seminal research reported in “Unequal Treatment,” by the Institute of Medicine (now the National Academy of Medicine) and identifying disparities that weren’t irregular occurrences, but actually persistent and repeated experiences across the healthcare system.
She stated that even with so-called “protectors” against disparities such as income, education or insurance, these inequities still endure. Lewis touched on bias, stereotypes and prejudice within the healthcare systems, noting that healthcare providers, insurance providers, patients and health-care decision-makers can also contribute to the prevalence of disparities.
People of color may be reluctant to accept medical treatments, Lewis shared, due to longstanding mistrust of the medical system and also experience contrasting outcomes than their white counterparts. “Black women with advanced degrees have worse outcomes than white women that drop out of high school in terms of low birth weight babies, and maternal health,” she said.
Lewis summarized that medical institutions often treat people of color differently, such as using evidence-based care less often, failing to provide informed consent, longer wait times for procedures and overall poor communication practices. During a pandemic, such as COVID-19, these inequalities are often exacerbated, exposed and spotlighted. Lewis noted that communities of color often experience disproportionately negative effects of pandemics and disasters. “There’s evidence that being a low income wage earner puts you at greater risk for some exposure to the negative effects of these disparities and COVID-19 in particular,” she explained.
Lewis shared recommendations that can make a noticeable difference. She advocated for greater public awareness of these disparities, recognition of differences between public and private health care, and pragmatic actions to address current shortcomings within the medical system. “We have to acknowledge that there are multiple forces at work that need to be interrogated if we’re really going to address health disparities in a significant way. [Meaning,] we must be willing to challenge our assumptions and ask more than superficial questions.” Lewis explained. “We need to understand that policy can change the rules of the game overnight. We need to understand that the media influences how we think about people and on and on, and someone needs to be exploring each of these in greater detail.”
To conclude, Lewis answered audience member questions which included topics such as disparities within the allocation of COVID-19 treatments, health disparities related to African-American women with degrees, recommendations for more inclusive and mindful communication to diverse populations such as Los Angeles, major gaps in current research, legal actions taken against hospitals and healthcare institutions in relation to addressing disparities, how health disparities affect education and what healthcare professionals can do to address disparities and inequities.
Lewis’ complete conversation and its highlights are accessible on YouTube.
Price Talks: Policy in a Pandemic is a virtual series examining policy challenges around the COVID-19 pandemic. USC Price faculty share their expert perspective on the critical issues that are important to us all in lunchtime Zoom presentations open to the public and Price community. Topics include examining the impact of the crisis on the economy, the homeless crisis, voter turn-out in this year’s election, local government services and our public health infrastructure. Learn about our upcoming talks here: https://priceschool.usc.edu/covid-19/price-talks-policy-in-a-pandemic/
Teaching Professor of Public Policy
Associate Dean of Diversity, Equity, and Inclusion