Few Hospitals Excel in Racial Inclusivity, Health Equity Work

Only 3 percent of hospitals rank among the best in racial inclusivity, which can be a hallmark of concerted health equity work.

Very few hospitals are doing well in racial inclusivity, but there aren’t many that are vastly underperforming either, with a new analysis from the Lown Institute looking at how some organizations advance health equity by tailoring care for underserved communities.

The report, emailed to journalists and published as part of the Lown Institute Hospitals Index for Social Responsibility, flagged the top hospitals for racial inclusivity, defined as “serving more patients from communities of color as expected.”

Using 2021 Medicare data, the Lown Institute looked at how the proportion of communities of color served in a hospital stacked up against the community in which that hospital operated. Hospitals were considered more racially inclusive when they treated a greater proportion of patients of color than there are within the hospital’s surrounding community.

The Lown Institute suggested that serving more people of color can indicate an organization’s health equity work and efforts to close the treatment access and outcomes gaps that plague the nation.

“It’s refreshing to see that some hospitals make caring for those most in need their top priority,” Vikas Saini, MD, president of the Lown Institute, said in an emailed statement. “Inclusive hospitals show that it’s possible to serve everyone, even when it may be against their financial interest.”

It wasn’t common for hospitals to rank high (get a five-star rating) for racial inclusivity using the Lown Institute’s scale; only 3 percent of organizations got the coveted five-star rating. This suggests there’s still work to be done to ensure equitable access to care within a given community.

Still, the data indicated that the US isn’t exactly failing at racial inclusivity either; only 6 percent of hospitals got a one-star rating on the Lown Institute’s scale.

Overall, The Lown Institute identified the ten most racially inclusive hospitals as

  • Boston Medical Center (Boston, MA)
  • John H. Stroger Jr. Hospital (Chicago, IL)
  • UChicago Medicine (Chicago, IL)
  • Penn Presbyterian Medical Center (Philadelphia, PA)
  • Metro Nashville General Hospital (Nashville, TN)
  • South Coast Global Medical Center (Santa Ana, CA)
  • St. Charles Madras (Madras, OR)
  • Grady Memorial Hospital (Atlanta, GA)
  • Methodist Hospitals (Gary, IN)
  • Emory University Hospital Midtown (Atlanta, GA)

This year’s report is notable because it also looks at the racial inclusivity scores of different hospitals serving the same metro area. In many cases, a single metro area could be home to two hospitals with starkly different racial inclusivity scores, which the Lown Institute said reflects hospital segregation.

“Hospitals will say their doors are open to everyone and they don’t turn anyone away, but that can be misleading,” said Saini. “If hospitals really want to undo structural racism’s hold on their communities, they can’t be bystanders. They need to act more systematically and with more intention.”

The Lown Institute identified a total of 11 metro areas with significant hospital market segregation:

  • New Orleans, LA
  • St. Louis, MO
  • Detroit, MI
  • Milwaukee, WI
  • Philadelphia, PA
  • Kansas City, MO
  • Chicago, IL
  • Denver, CO
  • Phoenix, AZ
  • Dallas/Fort Worth, TX
  • Atlanta, GA

The Lown Institute calculated this by looking at the proportion of hospitals within a single market ranking among the most and the least racially inclusive. Every metro area included in the list of most segregated markets had more than 20 percent of its hospitals at the two extremes of inclusivity.

In New Orleans, the city with the greatest hospital market segregation, half of its hospitals ranked among either the most or least racially inclusive.

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