31 May 2013 ~ 0 Comments

Collaborate or Perish: Maybe not so far from the truth…

Author: dunawaya

Collaborate! That is the clarion call heard throughout all facets of our current health care environment. From patient-doctor relationships to ACA-related federal grant applications, collaboration is recognized as economically efficient and is more and more frequently a mandated requirement for funding. As the Missouri Foundation for Health and the Missouri Health Equity Collaborative convene leaders from communities throughout Missouri to discuss the latest findings on health disparities (June 4, 2013; register for this event), we can use the opportunity to foster and strengthen health equity interventions across all sectors and delve deeper into what it means to collaborate!

What does it mean to collaborate “across all sectors?” Let’s look at the different directions collaboration takes in health care encounters (and while we are at it, let’s assume that good communication is a part of that collaboration). In an ideal world, you—as a patient—access the health system by collaborating with doctors, clinics, hospitals, and other practitioners as you move toward wellness. If you are fairly adept at making sure you get clear, actionable information that makes sense for you and your circumstances, or if the physician has taken the relatively simple steps to make sure you understand the treatment, your chances are good that you will be moving toward better health. These are the basics of health literacy, which is, after all, good collaborative communication that closes the gap between the demands of the health system and individual abilities.

The Health Literacy Gap

Adapted from Ruth Parker: http://www.iom.edu/~/media/Files/Activity%20Files/PublicHealth/HealthLiteracy/Parker.pdf

What happens when there is no collaborative communication? Inadequate attention to health literacy principles and techniques by providers is one classic example of how and why the gap widens; faulty feedback between the health system and the patient often results in poor outcomes. But isn’t this just another way to say that patient-centeredness—or a focus on the individual—is missing? Taken to the extreme, the lack of attention to the individual circumstances that define a patient is a key driver of health disparities.

Let’s take this concept of collaborative health literacy out a bit farther and apply to the findings of disparities research. As studies continue to be released telling us that, yes, disparities do exist, we are left with the aggregated compilation of a disadvantaged patient, riddled by chronic conditions, and up against a system too addled by its complexity to adequately get an underserved population on the path to equitable wellness. Where is the individual in this construct? The studies, much like the health care system itself, are treating us as averages, not  unique individuals… the patient is not the same thing as the population! It is easier to collaborate with an individual than with the idea of a collective identity (is that even possible?).

As we professionals look forward to meeting again to gain and share insights into the behaviors and structures that drive soul-depleting, wealth-draining health disparities, let us see the individual within the whole: a person with a unique set of beliefs, motivators, and responses. Ask patients to share those beliefs and ask what motivates them. This is an invitation to collaboration. And while we’re at it, let’s work together to do this at our own institutions and all get on the same page about how we approach equitable health care. The statistics that describe the larger patterns of disparity are, after all, made up of data points that are actual people who have the ability to collaborate with us if we ask.

Nick Butler is Project Director for Community Engagement at the Center for Health Policy. He has been collaborating with communities and organizations for several decades to align around improved health outcomes.

The opinions and views expressed in this blog and/or comments are those of the author(s) and do not reflect any position of the Center or the University.

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