U of U striving to get rid of health disparities

The University of Utah has made great strides recently in our quest to diversify our care teams, especially our physician group. This work is centered on one idea—the elimination of racial and ethnic health disparities. We know that these disparities persist despite significant interventions to reduce them. Our system is reducing health disparities in many fronts, through rigorous evaluation of our quality data, and by changing our physicians' race/ethnic backgrounds to be more diverse. This is not a diversity for diversity’s sake intervention. We know that when patients share identities with providers, there are meaningful results that affect disparities. For example, identity concordance is associated with better communication between patients and providers in one systematic review that involved Black patients, higher patient satisfaction scores between racially/ethnically concordant patients and their physicians, greater patient acceptance of invasive procedures during preventative visits and improved show rates for longitudinal care visits.¹ These outcomes, especially those referring to preventative visits, have a direct impact on health disparities.

In addition, we have learned that diversity in educational settings benefits all learners, not just those who identify as underrepresented in medicine. Diversity in educational settings helps to improve care across racial and ethnic differences. Even though I identify as Latino, I have said many times that I learned more about how to care for Black and Latino patients from my colleagues who identified in that space than from any formal teacher. The ability to see someone who is not from your racial/ethnic identity as your colleague and support changes how you see patients, and changes what you do for them. This was identified as a reducer of health disparities in 2003 when the seminal work from the institute of medicine (now the National Academy of Medicine) on health equity was thrust into the national spotlight with Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care.²

The family medicine residency program at the University of Utah has taken this information to heart. In a multiple-year process, the residency program, led by Dr. Kirsten Stoesser, embarked on a transformation journey to increase the diversity of their residency program. Before the efforts were undertaken, there was little racial or ethnic diversity in the program, and there were some years without any diversity. Because the University of Utah does not consider race in hiring or admissions, this effort was undertaken without knowing the race/ethnicities of the individual applicants. In the February 29, 2024, issue of The New England Journal of Medicine, the outstanding work of diversity transformation is highlighted in the section called Efforts towards Equity. We congratulate the family medicine residency program leaders and residents for making this a reality. The tool presented can be used nationally and does increase diversity, showing once again that our institution can lead nationally in transformation. The article, "Transforming Diversity of a Family Medicine Residency Program," can be viewed on The New England Journal of Medicine site.

1. Guillaume G, Robles J, Rodríguez JE. Racial Concordance, Rather Than Cultural Competency Training, Can Change Outcomes. Fam Med. Oct 2022;54(9):745-746. doi:10.22454/FamMed.2022.633693

2. Smedley BD, Stith AY, Nelson AR, Institute of Medicine (U.S.). Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care. Unequal treatment : confronting racial and ethnic disparities in health care. National Academy Press; 2003:xvi, 764 pages.