Leveraging Opportunity and Responsibility to Advance Racial Equity

By Dennis Murphy, President and CEO, Indiana University Health

It has been a year since IU Health joined with other Indianapolis business and civic organizations to sign the Business Equity for Indy (BEI) Racial Equity Pledge. By signing the pledge, we agreed to use our resources and influence to accelerate progress on racial equity.

Addressing disparities in healthcare access and outcomes is a key strategy for the BEI Committee and especially for its healthcare members such as IU Health. We signed the pledge as part of our ongoing commitment to improving the diversity and inclusiveness of our own organization while also working to address disparities in healthcare access and outcomes in the communities we serve.

To advance equity of access, we need to look at things like expanding health insurance coverage, locating healthcare facilities and services in underserved neighborhoods, and ensuring communities of color can get the care they need when they need it. Rates of testing and critical diagnostic procedures like mammograms, blood pressure, and blood glucose tests, and colonoscopies should be equitable regardless of race.

Advancing equity in outcomes means that there should not be major differences in survival rates and other measurable outcomes of treatments and procedures based on a patient’s race.

Historically, patients from communities of color have not been treated equitably by healthcare systems – either in terms of access or outcomes. For example, death rates from cancer and diabetes-related amputations are significantly higher among Black patients than white patients, even when adjustments are made for the severity of illness, age, and other factors.

We’ve seen this again during the COVID-19 pandemic, when nationally Black, Native American, and Hispanic patients have died at two to three times the rate of white patients when adjusted for age.

In Indiana, however, we’ve had better outcomes among communities of color. Here, Black people represent 8% of all COVID-19 deaths, while they make up approximately 10% of the state’s population. Similarly, Hispanic Hoosiers are 7% of the Indiana population, but makeup only 3% of COVID-19 fatalities. At IU Health, our outcomes are similar. The mortality rate for our Black patients since the start of the pandemic is about 10%, while the death rate for white patients is 14%.

There have also been inequities in access to and rates of vaccination in communities of color both nationally and locally. The good news is that the reluctance to get vaccinated against COVID-19 is changing and rates are picking up. However, there remains a large gap in vaccination percentages. For example, in Indiana, only about 40% of the Black adult population is vaccinated, versus 51% for white people. The vaccination rate among Hispanic people is also lower with roughly 41% being fully vaccinated. Closing this vaccine equity gap remains an imperative for business and community leaders alike. 

The Indianapolis business community has a significant role to play in getting our vaccinations rates up among all population groups. This most recent surge caused by the Delta variant was overwhelmingly a surge of the unvaccinated. Nearly 90% of patients with COVID-19 in our hospitals were unvaccinated.

Our BEI group, focused on addressing impediments to health, has developed recommendations and resources to encourage vaccination inside the Vaccinations Employer Playbook. This playbook provides six key recommendations that can help increase vaccination rates among employees. I encourage everyone to take advantage of this playbook and look for creative ways to support vaccination among all workers, especially employees who are less likely to have convenient access to vaccination options.

I’m proud that IU Health was one of the first organizations to sign the Racial Equity Pledge. But the pledge is just one facet of our overall effort to improve diversity, equity, and inclusion at IU Health and in the communities we serve. As we look ahead, there’s still much work to be done, and IU Health remains committed to BEI and improving equity within the healthcare industry.

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