Equity is at the core of C-TAC’s founding vision that all Americans, especially the sickest and most vulnerable, living with serious illness should receive high quality, person- and family-centered care that honors their dignity and reflects their goals and values.
Now COVID-19, racial injustice and growing poverty in this country have given us further clarity as to those who are the most vulnerable, sick and in need of a fair and just health care system.
To achieve equity for those with serious illness, we must acknowledge the inequity of care that persons have and continue to receive as the result of systemic racism – defined simply as prejudice plus power — existing in attitudes, behavior, polices, and procedures. And to transform the way in which we care for persons living with serious illness, we must also address the systemic institutional barriers that deny their ability to receive the highest level of care.
We announced a plan to address long-standing inequities in our healthcare system in July and have formed a taskforce to guide this effort. This initiative will also be a key area of focus at our 2020 Summit, held virtually from Oct. 27-30. See Summit sessions.
We believe that the first step in advocating for equity is defining the term as it relates to our work. After deliberation and careful coordination with our Equity Taskforce and the C-TAC Board of Directors, we have developed a working definition.
We define Equity for C-TAC’s work as: the transformation of Serious Illness Care for all Americans, with a particular focus on achieving the highest level of anti-racist care for those who are the sickest, most vulnerable and disadvantaged.
Our Taskforce’s guiding principles in developing this definition are:
- Equality in ensuring that all people have access to care is not enough. Our present pandemic has uncovered the harsh reality that has been known for years but ignored — that Equality for the economically disadvantaged and marginalized in the health care system is not adequate to change outcomes. We are working to ensure that individuals receive the high-quality care they need and deserve, while also securing that individuals and their families will not face the systemic institutional barriers in achieving that care in the future.
- While we recognize that many factors and prejudices contribute to inequity, we are focusing on systemic racism as a root cause.
- We must work at the systemic level on policies and practices in the health care system with measurable outcomes.
- We must work with a broad coalition to achieve this, including: health systems, health plans, health providers, and community care networks.
Over the course of the next few months, C-TAC’s Equity Taskforce will develop a plan to re-envision C-TAC’s 2030 Moonshot and clarify our founding vision that “all people with serious illness, especially the sickest and most vulnerable, receive care consistent with their values and honoring their dignity” by:
- Addressing internal and external strategies as we examine culture, policies, practices, attitudes of our board, staff, and members.
- Incorporating anecdotes and data from those patients and families who have been disadvantaged by the U.S. healthcare system.
- Naming and unmasking systemic inequities.
- Identifying and spreading models of care to address inequities and provide support for those who are living with serious illness, reflecting their goals, and honoring their dignity.
We envision that this work will be driven by staff and the Board, with input from our Coalition members and with our support and recommendations as a Taskforce. We gathered critical feedback on our above approach from the Oct. 8 C-TAC Board meeting and will continue to do so at the 2020 National Summit. We anticipate staff putting forward C-TAC’s equity plan for board review in February 2021.
Appendix
Definitions of other key terms:
* Anti-Racism is the work of actively opposing racism by advocating for changes in political, economic, social, and healthcare spheres. (Adopted from: Race Forward) ** Systemic or Structural Racism is the normalization and legitimization of an array of dynamics – historical, cultural, institutional and interpersonal – that routinely advantage Whites while producing cumulative and chronic adverse outcomes for people of color. Structural racism is diffused and infused in all aspects of society including its history, culture, politics, healthcare, economics and entire social fabric. (Adopted from: Race Forward)
