Health Equity: A Game Rigged from the Start

What is health equity? l always think of health equity as that game where everybody pulls on straws. To onlookers the game seems fair, every person has an opportunity to choose their own straw...or everyone has the "same" chance for quality of care and improved health outcomes. But no matter what it seems like on the surface, someone always started with the short end of the stick before the game had even begun.
What do I mean by this?

I relate the shortest straw to the environmental injustices, such as Flint, Michigan and Cancer Alley, Louisiana. How can they have improved health outcomes, when they started out with a burden of diseases before they ever drew their first breath?

I relate the shortest straw to the lack of upward social mobility in this country. Because even those honest people who try to pull themselves up by the bootstraps, they statistically will never become the next Bezos. Most won't even enter the middle class.

 

I relate the shortest straw to the currently ever so vulnerable medicare and medicaid. Whose reimbursements take so long and are so little that many private, amazing physicians don't deem it worth the participation. This creates less availability, longer waitlists, festering diseases and worse outcomes.

So no health equity doesn't exist. Full stop.

But it should.

When you as future physicians wonder why it took so long for that person with a black toe to come in...or when you notice that there is a specific disease that your community acquires over and over again, remember the straws. Be grateful that by chance, you may have started with the mid-sized straw or even the longest straw of the group. If you were the one who started with the shortest straw and somehow made it, remember where you came from. Remember that you were likely the exception, not the rule. Everyone deserves to walk in and be treated with
respect. Everyone deserves the best care with the best treatment modern medicine can offer. Although this isn't feasible in the real world, we can try our best to take every opportunity to even the playing field.