Dr. Joneigh Khaldun has been on the front lines of battling healthcare disparities as an emergency medicine specialist in hospitals and public health departments. She recently joined CVS Health as vice president and chief health equity officer from the state of Michigan, where she was the chief medical executive. She spoke with What the Future about why individual wellness depends on way more than the individual.
Kate MacArthur: How is your role empowering you to remove barriers from the equity of care for the future?
Dr. Joneigh Khaldun: What’s exciting about this role is when you think about all the reasons why people are unable to achieve optimal health, things like historical and structural barriers, racism, classism, ableism, discrimination, unequal access to quality jobs, housing and education.
When I think about how we as a CVS Health enterprise can think about our policies, our programs, our partnerships across the country, there’s a really exciting and great opportunity to improve the health of millions of people across this country.
MacArthur: Does the system work for everyone?
Dr. Khaldun: There’s no question that the system overall marginalizes many people in society, and that is why we have such health disparities across this country.
MacArthur: Where do people go if they’re not getting the care they need from the system?
Dr. Khaldun: It goes back to this definition of what the system is. What happens is people aren’t getting the care they need. They're not getting it in the right place, at the right time, or getting it at all.
MacArthur: Many people turn to providers like midwives and herbalists, or remedies like essential oils when they don’t get what they need from the current system.
Dr. Khaldun: We need to be careful when we talk about what's accepted as far as care and not perpetuating inequities by denigrating other cultures. That part of advancing health equity is making sure people have access to the care and services and support that they need, and that they receive it in a way that is culturally responsive to what they need.
Of course, we want people to have access to the highest-quality medical care, which oftentimes does include an M.D. or a specialist. Sometimes it’s really about broader support systems and services, and we can use non-M.D. specialists and professionals to help advance that.
MacArthur: What would you like to see individuals do to help their own cause for better health?
Dr. Khaldun: People do have a role to play in being as healthy as possible. But a lot of these issues with health are not about individual choices, particularly when you’re talking about health equity. They are about systems. If you don't have a job, you don't have insurance. How can we reasonably expect someone to appropriately manage their diabetes and be healthy?
MacArthur: How can organizations play a bigger role in helping people this way?
Dr. Khaldun: First and foremost, [organizations] can take the initiative to hold your own company accountable for health equity, whether it's in performance measurement or how you pay people. Are you even collecting data on different populations? Are you collecting it as robustly as you potentially could? Are you identifying disparities and then looking at your own internal policies, external policies and programs to actually be able to impact those disparities? If you interact with external providers, how are you working with those external partners to be able to collectively address disparities as well? There’s a lot that organizations and companies can do, but that work needs to be both internally and externally centered.
MacArthur: If there was one thing that could make the most impact in creating real positive change what would that be?
Dr. Khaldun: You cannot address what you don’t know and what you don't measure. There's an opportunity and there's an imperative for us as a healthcare ecosystem to better measure granularly how different populations are experiencing healthcare, what their healthcare outcomes are, and then thinking about our data infrastructure and technology systems and interoperability. If we could really focus on health outcomes and understanding our customers, our patients and those nonclinical social determinants of health, that would make a lot of progress.