Dr Rashon Lane Addresses How Racial, Ethnic Inequities Factor Into Cardiometabolic Health Care

Senior health equity scientist Rashon Lane, PhD, MA, of Sutter Health’s Center for Health Systems Research, joined The American Journal of Managed Care^® for an interview before her presentation at the Institute for Value-Based Medicine^® event in San Francisco, California, hosted by Sutter Health.

In addition to sharing research related to disparities and inequities in the cardiometabolic space, she addressed “how we might need to think differently about how we are intervening on disparities.”

Transcript

Can you share the key takeaways from your presentation: Equitable Treatment in Cardiometabolic Health Across the Lifespan?

I really wanted to talk about how we think about research and science and cardiometabolic disease prevention, and specifically in thinking not only from a very descriptive standpoint of what's going on, but how it’s going on, and why it's going on in certain racial ethnic groups, in particular. I focus on that because oftentimes when we look at where disparities lie, we think about how racial and ethnic minoritized communities have the largest disparities. And that's reflective across the United States, but also in California, and within our health care system, at Sutter Health, and across our footprint.

So for me, it's really important to think through, not only that these things are happening, but they're happening for a reason. And that the way that we intervene on those things, that we need to be mindful around what root causes we’re addressing to fully address the issue. So, not just understanding pharmacological treatment, or understanding access to care, but that there are issues within an individual’s community, within society, within policies, to all impact an individual's cardiovascular and cardiometabolic health.

Can you discuss the causes or challenges that contribute to the inequities in metabolic health care?

I think when we think about the causes, and then some of the root factors, we need to think about what we often talk about in social sciences as “isms.” So, classism, racism, heterosexualism, and genderism that impact individuals lived experiences. When we think about this, we also can think about it from an intersectional perspective. So the ways in which someone's identity is impacted by multiple systems of oppression. And so when we talk about societal and community things, we're talking about policies and legislation, but things that could also include redlining and gentrification, housing insecurity, food insecurity, policies that impact individuals’ health.

What we know about health and health care is that up to 80% of someone's health is outside of the health care system, and so when we think about social determinants of health and structural determinants of health, these things are social. We have to account for things like racism and someone's experience within the health care system but outside of that, as well. Those lived experiences all impact, how you're going to access care, what care you might be provided, what experiences, and what quality of care you experience.

This can even be thought of more widely as how that impacts your health from a metabolic standpoint. So what we know from the research is that individuals who experience more stress—and that's in relation to higher cortisol levels, higher allostatic loads—are more likely to have cardiovascular disease and these can also be attributed to experiences of discrimination, of the isms that I spoke to.