How can healthcare providers move from discussing equity to measuring it in meaningful and actionable ways? In this segment, Dr. Demetria Smith-Graziani and Dr. Folasade May break down how disparities and the structural, social, and system-level factors that drive them can be quantified using established public health tools and frameworks. They explore practical approaches for tracking differences in outcomes, social determinants of health, insurance status, neighborhood deprivation, and other upstream contributors to inequity.
Together, these insights offer a roadmap for providers and health systems seeking to embed accountability and measurable equity into everyday oncology practice.
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Transcript
Dr. Nicole Rochester:
Dr. Smith-Graziani, your work has helped to clarify how social determinants, structural barriers, and provider factors contribute to inequities in breast cancer outcomes. We’ve talked a lot about some solutions, what about, how do we measure these things? What metrics or accountability mechanisms can ensure that we’re not just discussing these ideas conceptually, but that they’re truly embedded in the care that’s delivered?
Dr. Demetria Smith-Graziani:
Yeah, I think it’s really important because I think often people who don’t maybe understand fully the work of health equity and disparities think that we can’t really measure these things, and that, and because of that, they feel like it is a less scientific process. But actually, there are defined ways. We have to really, collaborate with our partners in the public health space, because they have been measuring these things for many years, and we can use those same tools.
You know, Robert Wood Johnson Foundation has a great introduction to what is health equity, how do we achieve health equity, and they talk about the ways that we can measure it, right? When you think about the achieving health equity being the elimination of a disparity, what you really need to measure is differences in the outcome, right, between a marginalized group and a non-marginalized group. but also the difference in those social determinants that then inform those outcomes. So, if we’re talking in the space of breast cancer, we want to reduce racial and ethnic disparities in breast cancer mortality, right, at stage of diagnosis, but we also, if we’re looking back at what are those determinants, we want to make sure that we are reducing the disparity in insurance status, right?
We are reducing that disparity in the neighborhood deprivation that then leads people to have less access to the care. So all of these different factors can be measured, and there are many experts in the public health space that have been measuring them for a very long time.
Dr. Nicole Rochester:
Thank you for mentioning that, because once again, this is a collaborative effort, you know? It takes all of us. Well, this has been amazing. I really want to thank both of you for joining us today. I’ve learned a lot. I’m sure our audience has learned a lot. As we close, I’d love for you to each share a closing thought, one thing that you want to leave the audience with. So, I’ll start with you, Dr. May. What’s one takeaway?
Dr. Folasade May:
Sure, first of all, thank you for having us. I think my biggest takeaway is I hope that our colleagues recognize that we are trying to help them, and we’re trying to help our patients. I think when people hear about bias, they automatically think that they’re not biased.
I’m a person of color, I have biases, and there are unconscious biases that many of us don’t even recognize about ourselves. So, this is just a call to action to recognize that there is evidence of bias, and it’s data-driven, the work that we do. But it’s also a call of action to maybe think about how we address our patients, and whether we intentionally or unintentionally treat them a little bit differently. It’s also a time to think about how you can help your health system or your practice, improve how we improve care for all of our patients.
Dr. Nicole Rochester:
Thank you, Dr. May. All right, Dr. Smith-Graziani, what’s your takeaway message?
Dr. Demetria Smith-Graziani:
Yes, and thank you for having us. This was a great discussion, some amazing points that were brought up today. I would say that, sort of piggybacking on what Dr. May said, you know, our North Star is our patients.
And we want to center them in all of these decisions that we’re making. I think so much of the change that we can do on a provider level comes when we really lean into that relationship with our patients. And the idea of really listening, actively listening to our patients, and listening to understand, and not to have a response. Right? I think that is really key in where it all starts to really understand where your individual patient is coming from, then allows you to think about all of these different social determinants that have gotten your patient to where they are today, sitting in front of you and using all of that information that you learn about a patient by actively listening, beyond just the pure medical facts of their particular disease and their case, allows us to really, treat the patient as a whole person, and really get better results for them.
Dr. Nicole Rochester:
Thank you so much. Again, thank you, Dr. May. Thank you, Dr. Smith-Graziani. This has been incredible. Lots of great information to reflect on. And thanks to those of you who are tuning in, we are proud to present this Healthcare Provider Roundtable as part of the Patient Empowerment Network’s EPEP initiative. Empowering providers to empower patients. Helping providers support their patients every step of the way. I’m Dr. Nicole Rochester, and until next time, take care, and be well.