Join the conversation on disparities, racism in health care

Addressing disparities and inequities within the health care system and developing strategies to correct them continues to be a priority for CHEST, and the CHEST 2021 educational program includes a variety of sessions that explore how society’s most disadvantaged and vulnerable populations are impacted by these disparities.

“Our goal in developing these sessions for CHEST 2021 was to not only address disparities in various illnesses and in various stages of illnesses, but to also address them from different perspectives,” said Viren Kaul, MD, FCCP, Assistant Professor of Medicine at SUNY Upstate Medical University and Division Chief of Pulmonary Medicine at Crouse Health. Dr. Kaul is a member of the CHEST Scientific Program Committee and led the curriculum group that selected these special CHEST 2021 sessions.

“The issue of disparities is a very complex issue—it’s a disease issue, it’s a societal issue, it’s about who is involved, both patients and providers, and how they are affected—so clearly, there’s a lot to be learned here and a lot we have to understand if we’re going to improve things,” Dr. Kaul said. “And we are now recognizing, as researchers are looking more specifically into individual diseases—lung cancer, COVID, sleep disorders, for example—that we’re seeing a reflection of those disparities and inequities in our patients.”

Two of the planned sessions—Disparities in the Management of Lung Cancer and Disparities in Sleep Medicine—will explore how socioeconomic status and racial inequalities impact patients’ access to care and the level of care they receive.

“Studies have shown that your quality of care, and, indeed, your life expectancy, disproportionately depends on the color of your skin and what zip code you live in,” Dr. Kaul said. “We know, for example, that Black Americans with lung cancer are 16% less likely to be diagnosed early, 19% less likely to receive surgical treatment, and 7% more likely to not receive any treatment at all compared to white Americans. That’s not just a sliver—it’s a lot, and it represents a huge disparity.”

Finding solutions, he said, begins with recognition, and the COVID-19 pandemic has provided an urgent and devastating reminder of how disparities in the system disproportionately affect already underserved populations.

A pair of sessions—Racism in Health Care: The Fuel That Lit the COVID-19 Fire and A Tale of Two Worlds: Providers of Color and Patients of Color at the End of Life During COVID-19—will explore how the pandemic has shone a harsh spotlight on the public health impact of economic and social inequities.

“The pandemic has highlighted what we already knew—that inequalities will hinder your access to care, the care you get once you do start getting it, and our perception of care,” Dr. Kaul said. “It’s all about trust in medicine, and at the end of the day, we can have the best medicine, but if it doesn’t get delivered to the right people at the right time, then the question is, is it really the best medicine?”

CHEST 2021 attendees also can learn about CHEST initiatives to address disparities and inequities in health care through the CHEST Foundation Listening Tour. Launched in October of last year, the Listening Tour traveled to five cities across the country to uncover health disparities from the patient’s perspective. With more than 25 patient participants, more than 50 physician participants, and various attendees from community-based organizations, media, and local government, the Listening Tour brought to light some glaring inequities. Visit foundation.chestnet.org/tour for detailed summaries and important insights gained from the Listening Tour.