Federation of Medicine shows progress in advancing health equity

Andis Robeznieks , Senior News Writer

U.S. medical societies belonging to the AMA Federation of Medicine are at different stages in advancing health equity, with 74% reporting they have taken at least one action to ground their efforts in local history and context. In contrast, 16% say they have taken action to identify opportunities for improvement.

Those were key findings included in AMA Health Equity in Organized Medicine 2023 Survey Report: Insights, Solutions, and Resources to Take Action (PDF), which is based on the first-ever survey conducted of state medical associations, national medical specialty societies and county medical  organizations about health equity. 

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The survey data collected helped provide insights on actions to advance health equity taken by these organizations, while identifying barriers and resources needed to take further action. The report is intended to effectively assess the collective progress made, build on learning and achievements, and identify where future action and attention are needed.

AMA policy defines health equity as “optimal health for all.”

“We recognize that organizations are in different stages of their equity journey,” the report states. “Factors such as available financial and staff resources and equity expertise may be related to implementing and reporting on some equity initiatives.”

The report is also intended to help develop a shared understanding of other organizations’ work to advance health equity and to learn from other’s progress and insights.

Results are stratified by organization type, distinguishing state and territory associations from specialty societies, so that organizations can benchmark themselves to their peers while avoiding comparisons with dissimilar organizations.

The questionnaire was developed by the AMA with most questions derived from actions found in  the professional societies pillar of the Rise to Health Coalition, a group brought together by the AMA, the Institute for Healthcare Improvement and racial justice organizations to coordinate actions that will have a strong national impact on breaking down barriers to health equity.

Key findings from the survey include:

  • 74% of the organizations took at least one action to ground their equity efforts in the context of local or organizational history. These included actions such as identifying historical harms related to the organization’s policies or practices, publicly acknowledging the organization's past harms, and taking action to address those harms.
  • 72% took action to make equity a strategic priority, such as aligning performance incentives to organizational equity goals, assessing the organization’s budget to ensure it will advance health equity, and ensuring senior leadership and board members reflect the diversity of the community served by the organization.
  • 47% took at least one initiative to advance health equity such as advocating to eliminate harmful, race-based clinical algorithms and decision-making tools that incorrectly use race as a proxy for genetic or biological ancestry, and revising policies guiding hiring, promotion, advancement, compensation, and mediation practices to achieve equitable outcomes.
  • 29% took actions intended to promote a thriving community such as addressing root causes of health inequities by leveraging unique organizational assets and strengths to address social determinants of health or engaging in collective advocacy to address those root causes.
  • 16% have taken action to identify opportunities for improvement, such as gathering qualitative data on individual and community experiences to understand the full scope and context of inequities in key conditions that the organization addresses or collecting key quantitative relevant sociodemographic data on organizational leadership, staff and membership.

The report also highlighted actions taken by individual organizations responding to the survey.

This included an apology by the Minnesota Medical Association for denying so many physicians of color career visibility and advancement, systematically blunting their “leadership trajectory” and confining them “to practice environments intended to marginalize and disenfranchise” them.

Also highlighted was the collective action taken by the American College of Radiology and the Radiological Society of North America to jointly establish the Radiology Health Equity Coalition, which conducted a study on racial disparities in mammography-screening technology and created an outreach guide for pursuing community health partnerships.

“We are working to eliminate racial and ethnic disparities, geographical, and gender disparities,” the radiology societies say in the report. “Once we started the Coalition, it really expanded our horizons of what needs to be done.”

A second Health Equity in Organized Medicine survey will be conducted in early 2024. Learn more about the AMA Center for Health Equity and the AMA’s strategic plan to embed racial justice and advance health equity.