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Nature Reviews Endocrinology, a peer-reviewed medical journal, recently highlighted our very own Osagie Ebekozien, MD, MPH, Executive Vice President and Chief Medical Officer at T1D Exchange in Healthy Equity in Endocrinology. Dr. Ebekozien, an instrumental voice in equitable care, articulated the importance of health equity in the care of all people living with type 1 diabetes (T1D) and related endocrine conditions.
“Inequities are unjust and unfair; they must be addressed as an individual right. For people living with diabetes mellitus, these health inequities are prevalent in terms of access to care and diabetes mellitus devices (for example, continuous glucose monitoring, insulin pumps and connected pens), glycemic outcomes, the prevalence of complications and mortality,” Dr. Ebekozien shared with Nature.
Dr. Ebekozien, who leads the T1D Exchange Quality Improvement Collaborative (T1DX-QI), a network of 61 diabetes centers across the U.S., is focused on advancing health equity through quality improvement and implementation science. “T1DX-QI has comprehensively used real-world data to quantify real-world equity insights and to benchmark inequitable diabetes mellitus outcomes among centers. Through training and design systems, the T1DX-QI is measuring and testing strategies to reduce the role of implicit bias in diabetes mellitus care,” explained Dr. Ebekozien in Nature.
What is health equity?
According to the Centers for Disease Control and Prevention, “Health equity is the state in which everyone has a fair and just opportunity to attain their highest level of health. Achieving this requires focused and ongoing societal efforts to address historical and contemporary injustices; overcome economic, social, and other obstacles to health and healthcare; and eliminate preventable health disparities.”
The burdens associated with diabetes care are challenging, but they are compounded in communities that disproportionately face health disparities. “Discriminatory practices have expanded the effects of systemic racism through the social determinants of health, including inadequate housing, food insecurity lack of access to healthcare and policy systems, such as the COVID-19 pandemic, have aggravated existing health inequities,” Dr. Ebekozien explained in Nature.
As a result, conducting research is not enough, reminds Ebekozien. Although health equity research aims to examine how healthcare is systematically distributed, we need to develop evidence-based, working solutions to promote the overall health of everyone in the diabetes community, regardless of race and ethnicity.
T1DX-QI health equity research
T1DX-QI research is led by Dr. Ebekozien, the recent author of Type 1 Diabetes, An Issue of Endocrinology and Metabolism Clinics of North America, and the Principal Investigator on multiple quality improvement-driven and real-world data projects.
Dr. Ebekozien’s T1DX-QI health equity work and unfolding standards of care have created forward momentum in addressing racial inequities in diabetes care. As an implementation scientist, he continues to pilot ways to improve the uneven distribution of care that is pervasive in the T1D community.
As humans, we may harbor unconscious biases that can impact healthcare delivery. “Personal contributors can result when diabetes mellitus care providers might have an implicit or explicit belief that non-Hispanic white people with T1DM are better at handling technology or have better support systems than Hispanic or non-Hispanic Black people with T1DM. These beliefs can become large enough to potentially affect decisions about care recommendations or management,” Dr. Ebekozien explained in Nature.
T1D Exchange Health Equity Advancement Lab (HEAL) Program
So, where do we go from here? In terms of taking steps forward, Dr. Ebekozien suggested in Nature Reviews Endocrinology that research should be focused on solutions that can be explored by asking the following questions:
“First, what are the critical components to achieving health equity? Second, what is the role of addressing major institutional policies in health equity? Third, what are practical strategies to empower patients for shared decision-making? Fourth, how can the health system improve community trust, engagement and participation to reduce the effects of systemic contributors?”
At T1D Exchange, we are committed to making a difference in population health, quality improvement, and health equity. Our T1D Exchange HEAL Program is comprised of a network of clinical and research leaders in the diabetes space with a common goal — to contribute best practices for equitable T1D care.
Learn more about T1DX-QI research in our 2024 publications:
Emerging Technologies and Therapeutics for Type 1 Diabetes
Psychosocial Care for Youth with Type 1 Diabetes: Summary of Reviews to Inform Clinical Practice
Young Adults with Type 1 Diabetes
Social Determinants of Health Screening in Type 1 Diabetes Management
Type 1 and COVID-19: Diagnosis, Clinical Care, and Health Outcomes during the Pandemic
