Promoting health equity in CME

What does health equity actually mean in the era of modern healthcare? Put simply, health equity is the absence of disparities in healthcare. Health disparities are systemic and avoidable health differences between groups, due to factors such as race, ethnicity, gender, sexual orientation, disability, age, socioeconomic status, religion, and other characteristics associated with discrimination and marginalization. These disparities have existed for centuries, however the COVID-19 pandemic has played a vital role in highlighting and amplifying them. The importance of addressing health inequities and social determinants of health has become clear across many therapy areas, especially as medicine shifts away from a “one-size-fits-all approach” towards patient-centric and personalized care.

During my first few weeks at Springer Healthcare IME, I’ve been introduced to a variety of different healthcare issues. Although these issues are diverse, they all have one thing in common – they do not impact all people equally. For example, I have learned about the racial and ethnic disparities in the prevalence and management of patients with type 2 diabetes. I am now aware that whilst women are 3–4 times more likely to suffer from migraines than men,¹ few researchers are focused on exploring the determinants of migraine risk in women. I also now recognize that despite an increasing number of pediatric patients seeking transgender care, there are few leading experts with knowledge in this area, with societal stigma and socioeconomic factors making it even more difficult for individuals to access high-quality care.

Health inequity puts social groups who are already disadvantaged at a further disadvantage with regards to their health. ‘Promoting diversity, equity and inclusion into all aspects accredited education’ is one of the five objectives set out by the Accreditation Council for Continuing Medical Education (ACCME) in their 2022–2026 strategic plan,² but how can CME providers put this into practice?

Faculty members are at the forefront of every medical education program. As key opinion leaders, they communicate perspectives that influence the views and behavior of other healthcare professionals (HCPs). Therefore when the diversity of faculty is limited, the diversity of perspectives is limited too. We have recently seen a shift away from the ‘manel’, which describes the familiar sight of a scientific panel devoid of women, people from racial and ethnic minority groups, and other underrepresented populations. These actions go some way towards changing the status quo, ensuring that groups who have been historically marginalized are represented in CME and incorporating diverse perspectives into educational programs.

Experts provide clinical knowledge that is invaluable in bridging the gap between clinical practice and the unmet needs of patients. However, this only works if they are aware of their unmet needs in the first place. Clinicians may not be aware of the demographic and social factors that can impact access to high-quality care, and bias (conscious or unconscious) can affect the judgement of even the most experienced HCPs. Nobody understands the patient experience more than the patient themselves, though patients are rarely consulted on their personal experiences during the development of educational programs. As CME providers, could we do more to incorporate patient expertise into our educational programs? By doing so, we can ensure that a diverse range of voices are heard, in order to inform educational programs that address the needs of groups that have been systemically and socially disadvantaged. There is also opportunity for providers to elevate our needs assessments and learning outcomes, to identify where our programs can address disparities in health and ensure that measurable change is being made in these areas.

According to the Centers for Disease Control and Prevention (CDC), health equity is achieved when every person has the opportunity to “attain their full health potential and no one is disadvantaged from achieving this potential because of social position or other socially determined circumstance”.³ As CME providers, we can play a key role in helping patients attain this, by developing meaningful education programs that provide HCPs with the knowledge, skills and resources to treat all patients equitably and non-judgmentally.

—–

References

1. Al-Hassany L, et al. Front Neuro 2020;11:549038
2. Diversity, Equity, and Inclusion Resources. Available from: https://www.accme.org/diversity-equity-inclusion-resources (accessed October 2022).
3. Health Equity. Available from: https://www.cdc.gov/chronicdisease/healthequity/index.htm (accessed October 2022)