For over 30 years, AcademyHealth's Annual Research Meeting (ARM) has been the premier forum for health services research, where attendees gather to discuss the health policy and health system implications of research findings, sharpen research methods, and network with colleagues from around the world. This year’s meeting in Boston was the largest one yet with more than 2,900 attendees and included 150 sessions with more than 700 speakers and nearly 1,500 posters.
In this post-ARM series, blog posts will summarize key takeaways from sessions on four hot topics:
- Data and methods: Dealing with increased volume, variety and velocity of data
- The Affordable Care Act: Evaluating the latest in health care reform
- Translation and dissemination: Moving evidence into action
- Race, ethnicity and health
This is the fourth and final post:
Race, racism and diversity are at the forefront of conversation in America today. Across the board, industry leaders and communities are working to combat racial bias, reduce disparities and make strides towards inclusion— the health care and health services research fields are no exception. As stated in a recent report, “AcademyHealth believes the moment is right for a different kind of conversation to find new solutions about race, privilege, and equity in HSR.” This sentiment was an important, and prominent, theme at this year’s Annual Research Meeting (ARM) with sessions covering the role of both research and practice in finding and implementing new solutions to improve health equity.
AcademyHealth Board Member Eduardo Sanchez began the first plenary of ARM16 by declaring the environment and atmosphere of the address as a “safe space” for “open conversation and honesty.” Moderated by Sanchez, this plenary set the tone for ongoing conversation throughout the meeting and was referenced in many subsequent sessions. During their presentations, panelists sought to examine the many ways that health services and policy research (HSR) can and should address questions of race and ethnicity to inform policy and practice and ultimately improve health and the performance of the health system.
Early on in the plenary, several attendees took to social media to live tweet and offer positive feedback on the opening address.
Panelist Paula Braveman from the University of California San Francisco, School of Medicine, followed Sanchez with a challenge to attendees saying, “When a race variable predicts an outcome, I challenge you to ask, ‘Is it race or racism?’” Braveman also encouraged attendees to be aware that the race variable represents the totality of the experience that a person has had over his or her life—including experiences with health and the health care system. Eliseo Perez-Stable, Director, National Institute on Minority Health and Health Disparities, emphasized how important it is that researchers take a broad look at health disparities research by including an examination of both race and social class. Perez-Stable reminded attendees of the link between disparities and other social disadvantages due to discrimination, sharing a personal story of a patient’s expressed gratitude for his notes to patients being written in Spanish.
The final panelist, Joan Reede, Dean for Diversity and Community Partnership at Harvard University, noted that diversity has an important role in dealing with complex issues, posing the question: “What are we asking diversity to do?”. As our country becomes more diverse, Reede explained, diversity is important to realize our values, resolve complex issues and contribute to viability. Reede concluded her remarks by confronting and addressing current inadequacies in HSR, noting, “In a time of evidence and data, when it comes to diversity we do not track data/evidence”.
Panelists at this session included, Aswita Tan-McGrory, Rosalind Raine, Amol Navathe with session chair, Alyce Adams.Presenters shared methods for identifying at-risk populations and for testing interventions to reduce disparities with research focused on critical barriers in the ability to conduct health disparities research. As the first panelist to present, Raine from the University College of London revealed that while England’s publicly funded healthcare system, the National Health Service, is free for everyone regardless of their ability to pay, widespread socio-economic disparities exist both in use and outcomes. Her research evaluated different interventions to address disparities in screening uptake and found that a reminder letter reduced the socioeconomic gradient in screening uptake. Tan-McGrory presented findings on best practices for collecting patient race, ethnicity, language, and disability data, which included asking the patient how they choose to identify as well as what language they prefer. Tan-McGrory concluded by sharing a personal story about her biracial children noting that one of her daughters self-identifies as Irish (like her dad) while her other daughter may choose to identify with her mother’s ethnic background.
During this session panelist explored the intersections of race, gender and socioeconomic status, health care delivery and the patient-provider relationship. Presenter Amelia Haviland noted that disparities, including differential treatment, within a plan or provider, may be based on patient characteristics. Haviland’s findings concluded that care may be improved and disparities may be reduced if physicians and advocates encourage patients to voice concerns. Other panelists, Anushree Vichare, Diana Burgess, Ruth Ludwick,presented findings highlighting the importance of healthcare provider communication, focusing on how patient income levels might play a role in the perception of a care giver’s communication skills.
Sponsored by the Centers for Medicare & Medicaid Services, Office of Minority Health (CMS OMH), participants in this session learned about the recent activities of CMS OMH and discussed cutting-edge research findings related to racial and ethnic disparities. Panelists, Judy Ng, Joseph Betancourt, Sai Loganathan and Amelia Haviland, emphasized the value of quality data in enabling organizations to monitor performance. When asked if organizations are both collecting and using data adequately, Betancourt shared that many organizations know they have a long way to go, but that it should certainly be a priority in achieving quality research on disparities. “Data collection is the foundation on which local and national interventions are built,” Betancourt said.
This special session, held on the final day of ARM 2016, was moderated by AcademyHealth Vice President and co-author of the recent diversity report, Margo Edmunds. In her opening remarks, Edmunds explained the goals of AcademyHealth’s diversity efforts were to build community around health equity and inclusion and encourage new partnerships, all while creating a safe space for all. Edmunds also detailed the session’s connection to the opening plenary as a companion session. When asked who was in attendance for the plenary, most session attendees raised their hand. Panelist at this session included, Marshall Chin, University of Chicago, Soma Stout, Institute for Healthcare Improvement, Reginald Tucker-Seeley, Dana-Farber, Cancer Institute and Harvard School of Public Health and Rachel Hardeman, University of Minnesota School of Public Health. Throughout the session panelists emphasized ideas shared during the opening plenary, particularly the value of leadership and the challenge to attendees to “do better.” Presenters agreed that staff training is critical to assist employees in working with diverse populations. During the question and answer period, session attendees reflected on sentiments shared during the opening plenary and asked panelists to share their thoughts and reactions to the many challenges discussed. Panelists noted that a culture change of this magnitude will take time and dedicated effort, but the benefits of creating a “scholarship of belonging” would be many.
While race, ethnicity and health was certainly one of the most talked about themes at ARM this year, the conversation did not end with the conclusion of the meeting. AcademyHealth is committed to continuing the conversation on equity, diversity and inclusion in HSR by implementing a plan for promoting it throughout the field, communicating clearly about goals for increasing diversity and inclusion, publicly reporting on progress, promoting best practices and expanding training opportunities and recruitment strategies with communities of color. For more on AcademyHealth’s diversity efforts, read the report on workforce diversity 2025 roundtable here.