At ZSFG, we want everyone to have a fair and just opportunity to be as healthy as possible. We have reacted to ongoing reports about poorer health outcomes for San Francisco’s populations of color. Equity is different from equality. People with the greatest needs and least resources require more, not equal, effort and resources to equalize opportunities.
We are working on shifting from asking our patients, “What is wrong with you?” to “What has happened to you?” We have been working on processes that continue to look at health outcomes and racial equity. We are giving our staff the right tools and encourage speaking up to identify and eliminate racial disparities.
CURRENT EXAMPLES OF HEALTH DIFFERENCES
CURRENT EXAMPLES OF HEALTH DIFFERENCES
Black/African American Health Initiative
The San Francisco Community Health Assessment showed that racism plays a big part in health disparities in San Francisco. In 2016:
- 36% of B/AA pregnant women do not receive prenatal care
- 26% of Latina/x pregnant women had food insecurity
- 66% of Pacific Islander 5th graders are considered obese
The disparities are worse for the Black/African community. According to the Black African American Health Initiative report from 2018, Black African Americans are more likely to die from 9 out of 10 top causes of death in San Francisco.
CURRENT EXAMPLES OF HEALTH DIFFERENCES
COVID-19 and its impact on the Latinx community
COVID-19 is a global pandemic. It has affected millions of people around the world. in San Francisco, there is a higher rate of COVID-19 infection, hospitalization, and death within the Latino/a/x and Black/African American communities.
- 15% of the population of San Francisco is Latino/a/x
- 50% of all Covid-19 cases in San Francisco are from the Latino/a/x population
- 70% of cases treated at ZSFG are Latino/a/x
Advancing Equity
In 2018, a staff survey showed a big difference in how Black/African American and Latino/a/x frontline staff viewed the working at the hospital compared to White staff, Asian staff, and leadership. The results shaped our current plan that focuses on three priorities:
Understanding Our Patients
We continuously collect and analyze race, gender, and language (REAL) and sexual orientation and gender identity (SOGI) data to give our staff the tools to better understand the people we serve and identify priorities.
Over 90% of our patients have completed REAL data.
More than 3500 staff have completed Sexual Orientation and Gender Identity (SOGI) training.
Eliminating Disparities
We ask that every department develops an equity performance improvement measurement. It includes looking at race, ethnicity, and language to develop a plan for improvement. These measurements are reported to the Health Commission monthly and with the community every 3 months through the equity newsletter.
Currently, over 70% of departments on campus have at least one way to measure equity
Developing Our People
We provide staff with tools to see and lower racial disparities. We are building a more inclusive work culture. We offer training in racial humility, relationship-centered communication, and help make conversations about race, gender, immigration, and sexuality more comfortable.
In quarterly newsletters, [link to newsletters] we report on equity improvement projects and highlight staff who are equity champions.
Taking Action at ZSFG
Equity is one of our core values at ZSFG. We are looking fundamentally at how we do things so we can apply the right resources, provide the right education, adjust hiring policies, and facilitate open and honest dialogue. We also need to be accountable for progress toward health equity. These are just some of the measures we are taking:
- Pop-up equity lounges for night staff to facilitate conversation
- Collecting Race, Ethnicity and Identity (REAL) data to track performance improvements and health outcomes
- ZSFG Equity Guide and Quarterly newsletter
- Create programs to engage and support the professional development of Black African American and Latinx staff
- Better match staff representation with patient population through hiring practices
The ZSFG Equity Council
To make sure we respond to both patient and staff needs, ZSFG created an Equity Council with 17 members from different levels of the hospital – executives, managers, and frontline staff. The Council oversees the hospital’s overall equity efforts to eliminate disparities and promote inclusion.
- Consulting on equity related initiatives and issues
- Ensuring measurable progress in achieving ZSFG’s goals
- Communicating with executive leadership, department and unit leaders, clinicians, frontline staff, patients, and our community about equity efforts
