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Boston Medical Center launches new plan to address racial disparities in health care

Dr. Thea James, left, and Elena Mendez-Escobar are the codirectors of Boston Medical Center’s new Health Equity Accelerator.Suzanne Kreiter/Globe Staff

Boston Medical Center, the safety-net hospital where the majority of patients identify as people of color, is launching a broad new effort to pinpoint racial inequities in health care and work to eliminate those disparities for Black and brown people.

The initiative announced Tuesday, called the Health Equity Accelerator, will bring together researchers and clinicians and include feedback from patients to address longstanding discrepancies in health care and outcomes.

The different outcomes for white people and people of color in pregnancy, cancer, mental health, and other areas can’t be fully explained by different socioeconomic status, BMC leaders said. They said they will study 100 health conditions and how patient outcomes vary by race and ethnicity. Where they find the biggest differences, they will develop strategies for closing those gaps.

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As at many organizations, BMC executives said they were prompted to act by the disparities laid bare by the COVID pandemic and by the Black Lives Matter movement in response to police killings of Black people.

Typically, Black and Latinx people represent 59 percent of patients hospitalized at BMC, but they made up 76 percent of patients hospitalized for COVID during the first surge in 2020, including essential workers who couldn’t afford to stay home to protect against infection.

“[This] is really to take every step of our activities and look at ourselves and say, ‘Here is a disparity. What is it that we are doing on our campus that allows that to persist?’ ” said Kate Walsh, chief executive of BMC. “A lot of this is systemic, and we can break it down.”

BMC is known for serving a diverse population of patients. Most of them live at or below the federal poverty line, and about a third speak a primary language other than English. Many struggle to afford food, housing, or transportation — all factors that can affect their health.

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The new equity plan will build on work the hospital already does to connect patients to healthy food and stable housing. This initiative, though, is not about providing charity for people in need, Walsh said. It’s about changing the way BMC provides care with a new intentional focus on race and ethnicity.

Hospital leaders plan to focus on the disparities they have found in maternal and child health, infectious diseases, behavioral health, chronic conditions, cancer, and kidney disease.

For pregnant patients at BMC, Black women are twice as likely as white women to have serious complications — “far more than we thought,” said Dr. Thea James, the hospital’s vice president of mission. Most of the complications were associated with preeclampsia, a condition characterized by high blood pressure.

The treatment for pregnant women with this condition is to deliver the baby. So BMC is studying the time it takes to decide to deliver a baby by caesarean section and how to shorten the decision time for Black patients, which could reduce the risk of complications such as postpartum hemorrhage, James said.

Such data are sobering. But the hospital’s recent work to vaccinate people against COVID also shows what is possible. BMC worked with community groups and set up clinics at churches and other neighborhood sites. The hospital shared vaccine information with patients in Spanish, Haitian Creole, and other languages. By mid-September, 46 percent of the more than 100,000 people vaccinated by BMC were people of color, more than twice the statewide rate.

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“The vaccines have been a proof of concept of what we can do,” James said. She is co-executive director of the Health Equity Accelerator along with Elena Mendez-Escobar, BMC’s executive director of strategy.

Orlando Watkins, vice president at The Boston Foundation who oversees health programs, said he’s impressed the hospital is acknowledging that providing equal access to care isn’t enough, and that institutions must do more to achieve equity. “Until you recognize race as a factor, making progress is hard to do,” he said.

“BMC is a real anchor institution. They can be an example, a model. They can convene others. … They’re well-positioned to do it because they are such a critical part of our community.”

Many health care organizations in the state, including Boston Children’s Hospital, Mass General Brigham, and Blue Cross Blue Shield of Massachusetts, are working on health equity programs. Blue Cross is developing a plan to reward doctors for reducing racial disparities in health care.

BMC has not specified how much the initiative will cost, but is asking donors to help fund it. The work is expected to continue for many years.

“We may find things that may be difficult to see,” James said. “We’ll not be afraid to interrogate what we see ... and to course-correct.”


Priyanka Dayal McCluskey can be reached at priyanka.mccluskey@globe.com. Follow her on Twitter @priyanka_dayal.