Health Equity

Much of my career has evolved around health equity. I found in family medicine my vehicle for social justice and equity in health.

I wrote about my beliefs and reasons for promoting Health equity on this chapter in The Practical Play book II, available on line.

In “Embracing her Latinx community, fighting for equality amid COVID-19”, Anne Blythe writes about my work to mitigate the disparities suffered by Latinx communities in North Carolina and the US.

I have rural family medicine “roots”. I owe much of my knowledge and the foundation of the doctor I am today to having started my first job after residency working in a rural setting in Eastern Iowa, in a rural/industrial town of 20,000 people with a cachment area of 110,000 rural lives on both sides of the Mississippi river. I practiced full spectrum family medicine, delivered babies, covered the emergency room, admitted patients to the hospital and the ICU, and scrubbed into my patients’ surgeries as the first assistant for surgeries and C-Sections for the one surgeon and one OB in the town. My nurse Leslie taught me many tricks, and in rural family medicine I learned the deep importance of a well functioning interdisciplinary team.

I am running with the vision of WONCA becoming a major contributor of equity and justice in health. Within that health equity agenda, we MUST address disparities in rural health. Led by Bruce Chatter and Bellinda O’Sullivan and John Wynn-Jones several WONCA members wrote about the need to scale up global action on rural workforce development and gave a checklist as a tool for countries to use. I enjoyed the process of developing this work, and believe this Rural Pathways Checklist can provide guidance to WONCA member organizations to support the development of their rural workforce.

Since May 2020 I have played a role as advisor to the North Carolina Department of Health and Human Services, for the health of historically marginalized populations (HMP). In this state of 10 million people, 40 % of whom are considered rural, 10% are of Latinamerican/Hispanic origin, 22% Black or African American, 1.2% Indigenous American, the inequities are quite severe. In addition I co-lead the testing team for the state from September 2020 to August 2021. Some of the results of the work of the HMP team have been equitable distribution of Covid testing and vaccines, the promotion of the Community Health Worker program with the hiring of 700 CHW teams all around the state, and the development of a

In July 2020 I was appointed by the Governor of North Carolina to the Andrea Harris Social, Economic, Environmental, and Health Equity Task Force.   Our policy recommendations include the “expansion of Medicaid (government based health insurance). Increase investments in rural hospitals, community health centers, and federally qualified health care centers to provide quality health care, digital literacy training, vaccinations, and vaccination awareness campaigns to increase the number of undocumented, low-income, and other vulnerable patients served and vaccinated. Support workforce development programs and leverage partnerships with NC historically black colleges and universities, and community colleges to develop executive educational programs, and create a medical school pipeline for students of color.”

To advance health. we must work on equity. Pursuing health equity, teaching it, and having it in our heart as a personal value that allows us to notice when disparities exist and be the advocates to lift up a community, act on needed change, and make a difference. So many family doctors I know are great examples of lives dedicated to making this difference.

The Health equity lens described here can be useful