BETA - What is health equity?

What is health equity? So in cancer, health equity is when outcomes for cancer, so outcomes for cancer, so survival, a response, screening, survivorship, toxicity, when all those are known for each group and people have equal access to reap the benefits of survival, survivorship, response, screening, toxicity, then that is health equity. I think the most important piece of health equity is realization that if some groups benefit more than others, and especially as myeloma therapies get more expensive and some of the new therapies get centralized into larger centers, then that creates a health inequity because not everyone has access to those centers and to those clinical trials and to some of those benefits of those drugs. And so we're working really hard at creating health equity in cancer so that the screening is uniform. So if you get screened in Alaska, get screened in Detroit, or if you get screened in Indianapolis, that the screening is equal and have equal access, that response rates, that the drugs that we use, that everyone has equitable access to those drugs. But having groups behaving differently, some groups benefiting, other groups not, that's tough because that involves a lot of different players. That involves some of the dynamics of the medications that we use has to do with the costs of the different drugs and has to do with the safety of the different drugs and therapies that we use for myeloma. And that's a tough puzzle to piece together, is how can we make everyone benefiting from these new drugs, especially when they end up being so centralized into certain places? So health equity involves just thinking about having everyone have equal access to the same opportunities so as to have the best possible health outcomes. In order to think about health equity as it relates to multiple myeloma, this means that we need to be thinking about the factors that are driving disparities for this population. As long as we have those disparities present, and not addressing those factors, then that means that we can never achieve health equity. So essentially when I think about health equity in myeloma and its relevance, I think about meeting patients where they are, recognizing what their unique barriers are, and providing personalized care that can help them overcome those barriers in a way that we then see that everybody has a level playing field and that outcomes are equivalent between different groups of individuals. So reasons why health equity is just so challenging is because it's hard to, in any individual patient or even at a population level, to identify all of the factors that are contributing to these gaps in care or these disparities. And so one of the challenges is that there isn't a single fixed meaning, there isn't a single individual level intervention or even an interpersonal intervention that is going to lead us towards health equity. It needs to be a concerted effort by multiple people dedicated to doing this work and addressing problems on multiple levels. So when I say multiple levels, I always frame this in the manner of the socio-ecological model where we're thinking about individual determinants, interpersonal, then we're moving up, we're thinking about health system, and then we're thinking about the community as well as policy level. So unless we are addressing all of those determinants, then we can never truly achieve health equity because there's always going to be another factor in one of those circles that will continue to worsen these gaps that we currently see. Thank you.