Case study shares example of closing health care disparities through antiracist organizing

July 13, 2022

“Imagine a world where racial disparities in healthcare could be virtually eliminated. Actually, there is no need to imagine — it has already happened at a health care center in Greensboro, North Carolina, for Black and white patients with breast and lung cancer.”

“Think about that: a critical pathway to closing the racial gap in health outcomes in the United States may already exist. All it took to close the gap and improve treatment completion rates for everyone was the tireless work of the Greensboro Health Disparities Collaborative (GHDC), a group made up of community leaders and advocates, public health researchers and health care professionals. Prior to GHDC’s work, white patients were completing their cancer treatment at a significantly higher rate than Black patients, with a gap of 7 percentage points. To be clear, when it comes to cancer, not completing treatment is fatal. This is the little-known story of how this coalition of volunteers, guided by anti-racist principles, community-driven solutions and authentic partnership — plus an unwavering focus on the structural racism at the root of the inequity — got it done.”

The Greensboro Health Disparities Collaborative (GHDC) is proud to announce the publication of an in-depth case study (PDF), which begins with the words above and tells the story of how and why the GHDC was able to successfully resolve racial disparities in cancer treatment completion.

The Collaborative is a 19-year-old community-academic medical partnership that uses anti-racism, community organizing principles and community-based participatory research to guide successful efforts to implement systemic change. The University of North Carolina at Chapel Hill, Cone Health and the University of Pittsburgh Medical Center have been stalwart partners in conducting rigorous research with the GHDC over the years. The case study is a result of collaboration by The Bridgespan Group, the Groundwater Institute and the Racial Equity Institute.

(L-R): Drs. Geni Eng, Alex Lightfoot, Cleo Ryals, Kristin Black, and Stephanie Baker represent the UNC Gillings School within the Greensboro Health Disparities Collaborative.

Collaborative members associated with the Gillings School of Global Public Health include Geni Eng, DrPH, professor of health behavior; Alexandra Lightfoot, EdD, associate professor of health behavior; Cleo Samuel-Ryals, PhD, adjunct associate professor of health policy and management; Stephanie Baker, PhD, adjunct assistant professor of health behavior; Samuel Cykert, MD, adjunct professor of health policy and management; and alumna Kristin Black, PhD, current chair of the School’s Alumni Association.

The case study tells the story of the GHDC’s founding and how the group went on to conduct the National Cancer Institute-funded Accountability for Cancer Care through Undoing Racism and Equity (ACCURE) study, which eliminated racial inequities in breast and lung cancer treatment outcomes. Results from the ACCURE study were published in the Journal of the National Medical Association. Further information about the ACCURE interventions are described in a chapter of the book “Racism: Science & Tools for the Public Health Professional” and on the GHDC website.

The voices of several GHDC members, including co-chairs Terence “TC” Muhammad and Kari Thatcher and founding members Eng and Jennifer Schaal, are featured in a teaching case study module called “Seeking Health Equity: Examining Racism as a Social Determinant of Health.”

COLLABORATORS

The University of North Carolina at Chapel Hill Gillings School of Global Public Health is the #1 public school of public health in the United States. Its mission is to improve public health, promote individual well-being and eliminate health inequities in North Carolina and around the world. With its special focus on the science of implementation and delivery, UNC Gillings faculty, staff and students are bridging the gap between academic research and practical public health that can make a world of difference – and a different, healthier world.The ACCURE grant project featured in the case study was funded by the National Cancer Institute through the UNC Center for Health Promotion and Disease Prevention, which is part of the Center for Disease Control and Prevention’s network of prevention research centers.

Cone Health in Greensboro, NC, is a not-for-profit health care network serving people in Alamance, Forsyth, Guilford, Randolph, Rockingham and surrounding counties. Their brand promise – We Are Right Here With You – is shared by more than 13,000 employees, 1,800 physician partners and 1,000 volunteers. As one of the region’s largest and most comprehensive health networks, Cone Health has more than 100 locations, including five hospitals, six ambulatory care centers, three outpatient surgery centers, six urgent care centers, two retirement communities and more than 120 physician practices.

UPMC in Pittsburgh, PA, is inventing new models of patient-centered, cost-effective, accountable care. UPMC’s mission is to: (1) serve their communities by providing outstanding patient care; and (2) shape tomorrow’s health system through clinical and technological innovation, research, and education. The largest nongovernmental employer in Pennsylvania, UPMC integrates more than 92,000 employees, 40 hospitals, 800 doctors’ offices and outpatient sites, and a more than 4 million-member Insurance Services Division — the largest medical insurer in western Pennsylvania.

Racial Equity Institute, LLC is an alliance of trainers, organizers and institutional leaders who have devoted themselves to the work of creating racially equitable organizations and systems. They help individuals and organizations across the nation to develop tools to challenge patterns of power and grow equity. They guide communities and organizations through a multi-phase capacity-building process designed to help leaders and organizations proactively understand and address racism in their organizations, and in the communities where they work.

The Groundwater Institute works with leaders of major institutions across the country in the corporate, nonprofit and government sectors. They partner with leaders who intend to bring the full weight of their organizations and influence to bear in the struggle for racial equity. They believe in the power of connecting community, grassroots networks and institutional leaders together in this work. The Groundwater Institute’s work strengthens leaders’ skills to communicate, translate and apply a racial equity analysis for strategic action to impact change.

The Bridgespan Group is a global nonprofit that collaborates with social change organizations, philanthropists and impact investors to make the world more equitable and just. Bridgespan’s services include strategy consulting and advising, sourcing and diligence, and leadership team support. They take what they learn from this work and build on it with original research, identifying best practices and innovative ideas to share with the social sector.

Contact the UNC Gillings School of Global Public Health communications team at sphcomm@unc.edu.