Equity in Health Care

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Beti Thompson is life goals.  When you type her name in the search bar on Google you get page after page of her–her research, her accolades, her accomplishments.  She has her PhD in Sociology, is a Member and Professor at the University of Washington, the Associate Program Head of the Cancer Prevention Program, the Associate Director of Minority Health and Health Disparities for the Fred Hutchinson Cancer Research Center, and she is also my aunt (I told you, she is life goals!).  A large part of what she devotes her time and research towards correlates directly with social justice, so when she was in town for a few days, I knew that I needed to take advantage and interview her.  The following are excerpts from our conversation.

Me: “What do you think about when you think about equity? Especially in terms of health?”

Beti: “There are three kinds of ways of looking at fairness. One is that you take the status quo and the status quo means there are haves and there are have nots and that is how it will always be.  The second approach is to look at equality and to give everybody exactly the same thing.  And what this means is that the rich get a lot more, the middle class get a little more, and the poor get a tiny bit more.  And then, there is equity.  And equity, to me, is all about fairness.  If somebody is really underserved you give them more than someone who is in the middle class, and certainly more than somebody who is in the upper class or has the most riches and resources. So for me, equity is all about fairness and I think that is why I work with the underserved populations–because I am so interested in making sure that people get fair treatment.”

Me: “Can you give me an overview of how your program [specifically the Minority Health and Health Disparities for the Fred Hutchinson Cancer Research Center] relates to social justice?”

Beti: “The program is really dedicated to underserved populations in Washington state primarily.  What we strive to do is make sure that underserved populations have access to equitable care. Especially in the area of health and particularly in terms of activities related to cancer prevention and control.”

Me: “What is the biggest issue confronting these populations in regards to health?”

Beti: “The biggest issue is access to care.  Something that is very interesting is that with the Affordable Care Act in place we saw some great decreases in terms of problems of getting health care. But what also happened was that some of the co-pays were stressing people out and still preventing them from getting good access to care.  On the other hand, in Washington state some cancer prevention services, such as mammograms, pap tests, and even testing for colorectal cancer, had to be covered by the insurance provider.  So it is one step closer to social justice when it comes to access to care.”

Me: “If there is one thing that you would change about the health care system in our country what would it be?”

Beti: “I would make more lay health workers associated with clinics and other medical offices.  The reason for this is that lay health workers are people who are like the people who you are trying to reach.  They are people of the same nationality.  They speak the same language.  They usually have grown up in the same geographic region and so forth, so they really understand the people you are trying to reach.  And by associating them with a clinic what you get is the ability to reach out to people.  Most health workers are happy to go into people’s homes for example, to meet them at health fairs, to meet them at their workplace, to meet them at a variety of settings that you don’t normally experience in a medical office.  And to have more lay health workers out there talking with people, dealing with the barriers and focusing on the facilitators–I think it would do a tremendous job in getting more underserved individuals into health care.”

If you are interested in seeing some of Beti’s research, check out an extensive list of her articles, labs, and projects by clicking here.  If you would like to hear more from my interview with Beti about her innovative work, please read tomorrow’s blog, entitled “Getting Creative: How a  20 Foot Long Colon Named Casper is Helping to Create Social Justice.”

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