On Nov. 14, a team of equity researchers at Mount Sinai’s Institute for Health Equity Research (IHER) announced via a press release that they will use a $2.5 million grant from the National Institutes of Health (NIH) to evaluate how disproportionate access to healthcare impacts patient health.
The press release states that “The researchers will assemble and analyze a formidable data set to examine the associations between the level of segregation and selected quality measures in order to craft a blueprint for reducing these disparities, which they will disseminate to other hospitals and health systems. They will also study the impact of Mount Sinai’s historic efforts to integrate clinical practices on quality of care and patient outcomes.”
Further, “The study, known as DISRUPT, short for ‘DIsmantling Structural Racism Underlying the organization of ambulatory PracTices: an observational study of clinical desegregation,’ will collect retrospective data for more than 15 million ambulatory patient visits from five academic medical centers across New York City to evaluate the current level of segregation in medical, pediatric, and OB/GYN practices and its impact on quality measures of preventive, procedural, and chronic disease management for Black, Latino, and Medicaid populations. The researchers will obtain the data from the INSIGHT Clinical Research Network.”
“‘We are thrilled that the NIH has provided its support for our investigation into structural racism in the clinic setting,’ says principal investigator Nina Bickell, M.D., M.P.H., Professor of Population Health Science and Policy at the Icahn School of Medicine at Mount Sinai,” the release adds. Bickell will co-lead the study with Carol Horowitz, M.D., M.P.H., Professor of Medicine, and Population Health Science and Policy, and Dean for Gender Equity at Icahn Mount Sinai, and Lynne D. Richardson, M.D., Mount Sinai Professor of Emergency Medicine and Health Equity Science at Icahn Mount Sinai. Horowitz and Richardson also serve as Director and Co-Director of IHER.”
Bickell says in the release that the investigation achieves one of the strategies set forth by Mount Sinai’s Diversity and Equity Task Force in its Road Map for Action. The task force was formed during the pandemic.
IHER, established in 2020, aims to study the effects of health issues on communities that are at risk, including those that are non-white, low-income, immigrant, uninsured, and LGBTQ+. The researchers collaborate with providers, payers, and policymakers with the ultimate goal of translating their findings into sustainable and scalable initiatives.
Bickell comments that “It is remarkable to have access to detailed clinical data for 15 million patient visits. Our study will provide an unprecedented investigation that looks across New York City to gauge the degree to which clinics have achieved integration. With this data in hand, we will look at the relationship between integration, or separateness, and quality of care, relying on standard quality measures. For example, in general medicine clinics, we will assess quality by looking at metrics such as the proportion of patients with uncontrolled diabetes or hypertension, and the number of patients with coronary artery disease who are taking statins.”