The Problem (and a Solution) to the One-Size-Fits-All Health Inequity
By Crystal Gwizdala
Health care aims to improve patient health and quality of care. Scientific studies are a major foundation for meeting these aims. Health inequities, however, prevent some populations from experiencing the same benefit from disease-specific guidelines.
Women, older adults, Black, Hispanic, and other racially minoritized individuals, and persons with multiple disabilities are some of the people largely underrepresented in clinical trials relative to their proportion of the affected population. Furthermore, the outcomes studied in these trials may not be what matters most to some members of the underrepresented populations. These limitations create a “one size fits all” health inequity — while the population and outcomes are not proportionately studied, everyone receives the same recommendations.
To break down this inequity, Mary Tinetti, MD, Gladys Phillips Crofoot Professor of Medicine (Geriatrics), Melissa deCardi Hladek, PhD, CRNP, and Deborah Ejem, PhD, propose focusing on health priorities-tailored care in a recent JAMA Internal Medicine Viewpoint. These health priorities represent patients’ own health outcome goals and care preferences.