In 2021, the Lown Institute, an independent think tank, released a ranking system for U.S. hospitals’ on the degree to which they are adequately caring for the lower income and patients of color. Sadly, only two Atlanta metro area hospitals ranked in the top 100 for racial inclusivity, Grady Memorial Hospital and Wellstar Atlanta Medical Center and Emory University Hospital Midtown. This is likely a function of their location in downtown Atlanta rather than an actual strategy to address racial inclusivity and health equity.
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“Hospitals reside in communities and are part of communities. Our view is they shouldn’t just serve a community, they should genuinely be part of a community,” said Vikas Saini, a physician and president of the Lown Institute. “A lot of the contemporary rankings that look at reputation or mortality, surgical complications, don’t capture that dimension. We set out to create a lens through which to view the hospital system that’s different.”
“It’s not that Black people aren’t getting hospital care — they are — but for every hospital that’s tilted one way, there’s another that’s tilted the other,” Saini said.
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The Lown Institute's report is yet another effort in a series of recent attempts to quantify and rank health care organizations' progress on achieving health equity. The authors delivered a bold and necessary message: Hospitals across the U.S. are racially segregated—that is to say, their Medicare patients' racial demographics don't match the demographics in their surrounding communities. These results might come as a shock to some—especially for those working at hospitals near the bottom of the list. But this data shouldn't be surprising.
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What's causing segregation in our health system, and what can we do about it? Watch the recording of the Lown Hospitals Index racial inclusivity launch to find out.
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Two north Georgia hospitals fall among the 50 most segregated in U.S. metropolitan areas, and metro Atlanta tied for the largest number of such hospitals overall, according to a new study by the Lown Institute.
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Overall, in the top 50 most inclusive hospitals, people of color made up 61% of patients on average, compared to 17% in the bottom 50 hospitals. “This seems to be how the system works — [there is] a pattern of de facto segregation,” Saini, of the Lown Institute, said.
In large urban areas, safety-net hospitals, which provide care regardless of a patient’s insurance status or ability to pay, almost exclusively cater to low-income people of color while other hospitals in the area take care of a whiter, richer population, Saini said.
While there are several factors, including residential segregation and insurance status, driving this trend, it is a pretty clear example of structural racism. “The example I’ve been using is can anyone imagine having a Black airport and a white airport a mile apart? Does that even make any sense? And yet in some ways, that’s what we have with hospitals,” he said.
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A new ranking from the Lown Institute, a nonpartisan healthcare think tank, examines racial inclusivity of more than 3,200 U.S. hospitals to assess which are best at serving the people of color in their communities.
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“The difference between the most and least inclusive hospitals is stark, especially when they are blocks away from each other,” Vikas Saini, M.D., president of the Lown Institute. “As the nation reckons with racial injustice, we cannot overlook our health system. Hospital leaders have a responsibility to better serve people of color and create a more equitable future.”
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"It is a form of segregation, to be blunt," said Dr. Vikas Saini, president of the Lown Institute, describing many markets as the tale of two hospitals. "In big cities where there was a lot more diversity, there was a real tendency for some hospitals to cater to primarily wealthier, whiter and more educated patients. That left other hospitals to take care of the poor, less educated and minority patients."
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“If you want to see structural racism, just look at big city hospitals during COVID. Hospitals with a history of serving communities of color needed refrigerator trucks to hold bodies of deceased patients, while wealthier hospitals nearby had empty beds,” said Vikas Saini, president of the Lown Institute.
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