In this second part of a three-part video series, Briana Contreras, associate editor of MHE, spoke with Dr. Maria Hernandez, founder and CEO of Impact4Health. Maria shared not only how healthcare inequities remain to be an issue and what needs to be addressed, but also the progress that has been made over time through awareness, conversations and laws, especially due to the heightened awareness of inequities caused from the COVID-19 pandemic and the tragic deaths of George Floyd, Breonna Taylor and many more - which have now occurred over a year ago.
Below is a brief Q&A of the interview with Hernandez that has been edited for clarity.
Q: What new laws were passed to improve health equity and have they been successful?
A: I think it's important to know there is a huge initiative on its way. It's called the Health Equity and Accountability Act of 2020. If you look it up, it really has simply been introduced. That means that there's a lot more that it needs to go through in order to be passed as a law. If you look at the sort of list of activities that are going to be required, as a part of this action, this particular act, it's going to focus on the kind of data that hospitals need to look at. In order to track inequities, it's going to look at standards of care to meet the underserved communities in a neighborhood. There's many different elements to this. It's not passed, it's basically just getting started. I'd say that's the right thing to look for. That's the right thing to be doing. It might take almost five to six years before that gets done.
So what's happening in between is that you're seeing different states look at what they can do as well. So here in California, for example, just last year, legislation was passed that all OBGYN physicians need to take an unconscious bias course. Again, that's because unfortunately, maternal health in this country is such that women are at the risk of dying, black women are at the risk of dying at two and a half times the rate of others, that approaches third world countries. So it's completely unacceptable because most of those deaths are preventable. So to begin to address that, I think that this was the right thing to do that.
California, one of the larger more populous states is saying, "What if we start to really require this kind of training?" So I think we're gonna see more of that.
Probably the other legislation that isn't quite legislation, but it seems to be seen as a standard that healthcare is trying to address, is the culturally and linguistically appropriate services standards (CLASS). Those were announced by the Department of Health and Human Services way back in 2000. There were a multitude of reactions to that. One of them is that translation services are more common, they're still not required by federal law. Some states do. But that was one of the big heavy lifts inside those standards.
Another was looking at culturally competent care as type of training that people needed to engage in, that the list is really great in and I'm super excited that that's been around for so long. Unfortunately, not everyone is practicing all of those standards. Again, that's one of the things that we try to come in and do and ask, "Are you aware that these are some of the things that you could be doing to reach those communities that you are most concerned about?" So I think we're starting to see more energy around mandating these practices.
I would love to see that hospitals, federally qualified health clinics and faith based nonprofits that serve communities, I'd hope they would feel that they themselves need to help further this work and that they themselves can hold on to those standards for their own benefit and for the benefit of the community and not have to wait for a law to pass. It certainly does help that we have something on the books that potentially could really organize this work. We need to see how far this goes.
I think that the Biden administration is definitely speaking a lot about health equity and they too are looking at, again, how to enhance some of the standards that would would really be a step in the right direction.