Annual Meeting

21st century medicine must tackle health inequity: AMA CEO

Progress in the AMA’s efforts to reimagine medical education, rise to the challenge of chronic disease, and attack dysfunction in health care has expanded the organization’s reputation for leadership and innovation, said AMA Executive Vice President and CEO James L. Madara, MD.

But, Dr. Madara told delegates at the opening session of the 2019 AMA Annual Meeting in Chicago, progress in each of these areas is being slowed and he issued a call for action to address this bottleneck.

 

“What has become clear is that the inequities that persist throughout health care present obstacles to achieving our goals,” he said. “As a nation, and as an association, we need to ensure that when solutions to improve health care are identified, that positive impacts are recognized by all—that one shared characteristic of such solutions is that they also bend toward health equity.”

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Highlights from the 2019 AMA Annual Meeting

To illustrate his point, Dr. Madara noted that life expectancy for someone living in downtown Chicago is 82 years. But in the city’s Fuller Park neighborhood, just 20 minutes to the south, life expectancy is only 65 years. One would have to travel back in time to the Great Depression to get back to an era when that was the national average, he said.

“How—in a country and in a city as dynamic, rich in educational assets, and affluent as ours—can there be such enormous differences in life expectancy from one neighborhood to the next?” Dr. Madara said. “One answer is found in what we now refer to as the social determinants of health.”

Food and housing insecurity, income inequality, and limited access to health care and transportation all “conspire to erode a person’s prospects for a healthy life,” he said.

“Here in Chicago and, indeed, in much of the country—including rural America—these inequities are barriers to optimal health,” Dr. Madara said.

That’s why the AMA is taking a leadership role in working toward health equity in various ways.

This includes launching the AMA Center for Health Equity and hiring Aletha Maybank, MD, MPH to lead the unit as the AMA’s first chief health equity officer. Dr. Maybank was previously the founding director of the New York City health department’s Center for Health Equity,

The work done by the AMA Health Equity Task Force, chaired by AMA Trustee Willarda Edwards, MD, serving as a springboard to the center’s launch. Other work in this area includes the AMA Integrated Health Model Initiative to support the creation of 23 new ICD-10 codes related to social determinants of health such as access to nutritious food and the financial ability to pay for medications.

Dr. Madara assured delegates that the AMA is in this effort for the long haul.

“Improving health equity will take time, it will take patience and, perhaps most of all, it will take perseverance,” he said.

Dr. Madara mentioned other new AMA developments, including:

  • The $15 million Reimagining Residency initiative.
  • First Mile Care, a spinoff of the AMA’s Silicon Valley innovation company Health2047, described as “Uber but for prediabetes.”
  • The continued growth of Akiri, another Health2047 company, which has developed a clinical data liquidity solution.

“This nation can’t afford to travel backward when it comes to health care and life expectancy. We need to work creatively and collaboratively to move forward—to create a health care system that deserves a place in the 21st century,” Dr. Madara said.