As the COVID-19 pandemic spreads throughout the U.S., racial and ethnic minorities
and socioeconomically disadvantaged groups are bearing a disproportionate burden of
illness and death. Here in California, for example, African Americans comprise about
6% of the state’s population, but make up 10.3% of the COVID-19 deaths where
race/ethnicity is documented.
To better understand how this issue impacts patients in Sutter Health’s network, and to help develop solutions, Sutter’s Advancing Health Equity team analyzed data of the system’s COVID-19 patients. The resulting study, “Disparities In Outcomes Among COVID-19 Patients In A Large Health Care System In California,” published in the journal Health Affairs, revealed that African American COVID-19 patients are 2.7 times more likely to be hospitalized than their non-Hispanic white counterparts, and they tend to arrive at Sutter healthcare facilities sicker, and with more severe symptoms. In addition, despite having health coverage, African American COVID-19 patients often do not seek testing and care until it is an emergency requiring hospitalization. The study’s findings highlight that race and ethnicity still play a pivotal role in determining how and when care is accessed.
“The COVID-19 pandemic has ripped a Band-Aid off the structural inequities that exist within our society — we must address these disparities right away, because the cost of not addressing them is measured in human life,” says Stephen Lockhart, M.D., Ph.D., chief medical officer at Sutter Health. “Disparities have always been there, and this research spotlights our moral obligation to advance health equity for future generations, to work toward equivalent healthcare outcomes and culturally competent care for all patients, regardless of their background.”
Advocating for Patients
Dr. Lockhart has spent 35 years at Sutter Health as a physician and administrator, but he wears many more hats. As a board-certified anesthesiologist, university professor, nationally recognized environmental steward, and Rhodes Scholar with a master’s in economics from Oxford University — as well as medical and doctoral degrees from Cornell University—Dr. Lockhart’s Ph.D. in biostatistics and epidemiology was uniquely applicable to help Sutter prepare and execute against the challenges brought by COVID-19.
“The pandemic forced us to make many changes in how we practice, how we interact with our patients and how our patients engage with us,” explains Dr. Lockhart. “Yet the pace and magnitude of the change will be the new normal for healthcare. We have an opportunity to be better and to use our integrated network and the diversity of our patient base to inform and improve our work in all the communities we serve.”
Despite his rise to administrative leadership roles at Sutter, Dr. Lockhart is a caregiver at heart. The overwhelming stories of healing and examples of caring during the pandemic have reminded him, he says, of the great privilege he has as a physician to help people through difficult and frightening times.
“Whether the patient experience is one of the 32,000 babies delivered each year, or battling COVID-19, we help people through the best and worst days of their lives,” Dr. Lockhart says. “The outpouring of gratitude we have seen from the community—gifts of food and cards and more — is a reflection of the care we deliver and I am humbled by the generosity.”
Leaning in to Push Toward Health Equity
Dr. Lockhart is excited about the opportunity to enhance Sutter’s vision of achieving better health equity through research and partnership solutions.
“Our health equity research has taught us that we can augment our effectiveness through coordination with community-based organizations, reinforcing trusted community partners to help expand and enhance their work to achieve better outcomes,” Dr. Lockhart says. “We want to implement change models that not only change care inside Sutter, but also help to influence equitable care well beyond our network.”
Sutter Health operates in California, which boasts nearly universal healthcare coverage, thus mitigating one of the known causes of healthcare disparities—unequal rates of medical coverage. But coverage is not the same as access, and the higher hospital admission and mortality rates for African American COVID-19 patients in California, as revealed by the Health Affairs study, illustrate that expanded healthcare coverage is not enough to resolve health disparities.