Tag Archive for: Denice Cora-Bramble

Healthcare Equality Index logo

Children’s National receives LGBTQ+ Healthcare Equality Leader designation

Healthcare Equality Index logo

Children’s National Hospital is one of 496 health care providers nationwide earning coveted “LGBTQ+ Healthcare Equality Leader” designation.

Children’s National Hospital has received a perfect score of 100 and the designation of “LGBTQ+ Healthcare Equality Leader” in the Human Rights Campaign Foundation’s 15th anniversary edition of the Healthcare Equality Index (HEI). This is the nation’s foremost benchmarking survey of health care facilities on policies and practices dedicated to the equitable treatment and inclusion of their LGBTQ+ patients, visitors and employees.

“Our hospital has been on its own journey toward greater diversity, equity and inclusion (DEI) since the early 2000s,” says Denice Cora-Bramble, M.D., M.B.A., chief diversity officer at Children’s National. “Over the past two years we have expanded the scope of our DEI work, which included assessing and improving the care to LGBTQ+ patients as well as the work environment for LGBTQ+ staff. Our improvement efforts are being recognized by this designation.”

The HEI evaluates and scores health care facilities on detailed criteria falling under four central pillars:

  • Foundational Policies and Training in LGBTQ+ Patient-Centered Care
  • LGBTQ+ Patient Services and Support
  • Employee Benefits and Policies
  • Patient and Community Engagement

“Every person deserves to have access to quality health care, be respected and heard by their doctor and feel safe in the facility where they are receiving care. But LGBTQ+ people are often subject to discrimination in all spaces, including health care facilities, which leads to members of the community avoiding care and anticipating our voices will not be respected in an incredibly vulnerable environment,” said Tari Hanneman, director of Health & Aging at The Human Rights Campaign. “The HEI, at its core, strives to ensure LGBTQ+ people are protected and affirmed by their health care providers and feel safe seeking services. Our active participants are truly pioneering the health care industry by implementing robust, comprehensive LGBTQ+ inclusive policies that hopefully, because of their work, will become standard practice.”

In addition to active survey participants, the Human Rights Campaign Foundation proactively researched the key policies for LGBTQ+ inclusion at over 1,300 non-participating hospitals. Those hospitals were much less likely to have LGBTQ+ non-discrimination policies in place, which is a stark contrast to the near-perfect adoption by active participants. Among the researched hospitals, in which the Human Rights Campaign Foundation was able to find or obtain enumerated patient non-discrimination policies, only 70% have policies that include both sexual orientation and gender identity compared to 99% of HEI participants.

“We are designing effective, data-driven and responsive programs that will lead to a more diverse, equitable and inclusive workplace,” says George Francois, M.B.A., executive director of the Center for Cancer and Blood Disorders and chair of the Children’s National DEI Program’s LGBTQ+ sub-committee. Francois was a driving force behind the improvement efforts. “More importantly, we are determined to ensure the continued delivery of high-quality health care services to all patients.”

coronavirus

Higher COVID-19 rates seen in minority socioeconomically disadvantaged children

coronavirus

Minority and socioeconomically disadvantaged children have significantly higher rates of COVID-19 infection, a new study led by Children’s National Hospital researchers shows.

Minority and socioeconomically disadvantaged children have significantly higher rates of COVID-19 infection, a new study led by Children’s National Hospital researchers shows. These findings, reported online August 5 in Pediatrics, parallel similar health disparities for the novel coronavirus that have been found in adults, the authors state.

COVID-19, an infection caused by the novel coronavirus SARS-CoV-2 that emerged in late 2019, has infected more than 4.5 million Americans, including tens of thousands of children. Early in the pandemic, studies highlighted significant disparities in the rates of infection in the U.S., with minorities and socioeconomically disadvantaged adults bearing much higher burdens of infection. However, says Monika Goyal, M.D., M.S.C.E, a pediatric emergency medicine specialist and associate division chief in the Division of Emergency Medicine at Children’s National whose research focuses on health disparities, it’s been unclear whether these disproportionate rates of infection also extend to youth.

To investigate this question, she and her colleagues looked to data collected between March 21, 2020, and April 28, 2020, from a drive-through/walk-up COVID-19 testing site affiliated with Children’s National — one of the first exclusively pediatric testing sites for the virus in the U.S. To access this free testing site, funded by philanthropic support, patients between the ages of 0 and 22 years needed to meet specific criteria: mild symptoms and either known exposure, high-risk status, family member with high-risk status or required testing for work. Physicians referred patients through an online portal that collected basic demographic information, reported symptoms and the reason for referral.

When Dr. Goyal and her colleagues analyzed the data from the first 1,000 patients tested at this site, they found that infection rates differed dramatically among different racial and ethnic groups. While about 7% of non-Hispanic white children were positive for COVID-19, about 30% of non-Hispanic Black and 46% of Hispanic children were positive.

“You’re going from about one in 10 non-Hispanic white children to one in three non-Hispanic Black children and one in two Hispanic children. It’s striking,” says Dr. Goyal.

Using data from the American Families Survey, which uses five-year census estimates derived from home address to estimate median family income, the researchers separated the group of 1,000 patients into estimated family income quartiles. They found marked disparities in COVID-19 positivity rates by income levels: while those in the highest quartile had infection rates of about 9%, about 38% of those in the lowest quartile were infected.

There were additional disparities in exposure status, Dr. Goyal adds. Of the 10% of patients who reported known exposure to COVID-19, about 11% of these were non-Hispanic white. However, non-Hispanic Black children were triple this number.

Although these numbers show clear disparities in COVID-19 infection rates, the authors are now trying to understand why these disparities occur and how they can be mitigated.

“Some possible reasons may be socioeconomic factors that increase exposure, differences in access to health care and resources, as well as structural racism,” says Dr. Goyal.

She adds that Children’s National is working to address those factors that might increase risk for COVID-19 infection and poor outcomes by helping to identify unmet needs — such as food and/or housing insecurity — and steer patients toward resources when patients receive their test results.

“As clinicians and researchers at Children’s National, we pride ourselves on not only being a top-tier research institution that provides cutting-edge care to children, but by being a hospital that cares about the community we serve,” says Denice Cora-Bramble, M.D., M.B.A., chief medical officer of Ambulatory and Community Health Services at Children’s National and the research study’s senior author. “There’s still so much work to be done to achieve health equity for children.”

Other Children’s National researchers who contributed to this study include Joelle N. Simpson, M.D.; Meleah D. Boyle, M.P.H, Gia M. Badolato, M.P.H; Meghan Delaney, D.O,. M.P.H.; and Robert McCarter Jr., Sc.D.