key: cord-0958586-py10xq5t
authors: Fortuna, Karen L.; Hudson, Matthew F.; Myers, Amanda; Kadakia, Arya; Rivera, Jennifer; Nutz, Tony
title: How can we achieve health equity? Revisit the premise informing the scientific method
date: 2022-02-16
journal: Health Expect
DOI: 10.1111/hex.13369
sha: e6a3698936f60584a772bdf037162e765d3947f1
doc_id: 958586
cord_uid: py10xq5t

nan

How can we achieve health equity? Revisiting the premise informing the scientific method times more likely to die than White, non-Hispanic persons. Similarly, Hispanic or Latino persons and African Americans are, respectively, 2.3 and 1.9 times more likely to die from COVID-19. Apart from racial and ethnic disparities, individuals with a serious mental illness are likely to die of COVID-19. For instance, individuals diagnosed with schizophrenia are nearly three times more likely to suffer COVID-19attributed mortality than those without the disorder. A first step to address such health inequities requires explicitly examining the existing power structure of the healthcare system. This reflection requires carefully critiquing the premise informing its scientific method.

Historically, medicine ascribes to reductionism, which posits that individuals can address complexity by separating challenges into fundamental elements. Reductionism motivates the current ethos of quality improvement and application in science and even permeates the continuum of medical research and practice-including the diagnosis, treatment and prevention of diseases. It nurtures the idea of an expert self with a highly specialized focus on risk aversion who learns to implement short-term solutions that rapidly return the body to homeostasis. Reductionism profoundly influences science and has informed many medical advancements, including the COVID-19

vaccines. However, reductionism in healthcare lacks the necessary characteristics to engage disadvantaged groups-humility, sustained commitment and a willingness to relinquish expert status by acknowledging the lived experience of marginalized stakeholders.

In comparison, a humanistic philosophical approach to science These three practices are necessary first steps to address health inequities. It is essential for all stakeholders, including clinicians, policy-makers, academia and researchers, to confront their scientific biases and implement a framework that promotes community partnerships in every stage of their work. These steps require a balance of both reductionist and humanistic approaches to encourage a more informed approach towards problem identification and problem solving in its scientific method. Such applied curiosity may encourage scientists and patients alike to collectively develop novel insights informing intervention innovation in service of health equity.

Karen L. Fortuna was funded by an NIMH K01 award (K01MH117496).

Data source: NCHS provisional death counts. Numbers are ratios of age-adjusted rates standardized to the 2019 US intercensal population estimate

Project VIVA: a multilevel community-based intervention to increase influenza vaccination rates among hard-to-reach populations in New York City

mHealth Pilot Study: text messaging intervention to promote HPV vaccination