Promoting Antiracism and a Multisectoral System in Healthcare

Efforts to close the health gap have shown positive potential but limited movement toward actualized health equity. The top 10 primary care presenting problems have a biological cause only 25 percent of the time, with the resulting 75 percent being due to psychological or social causes (Blount, 2003). Social determinants of health (SDOH), though well defined, elude the public health, primary medical, and behavioral healthcare systems efforts to remedy individual, local, or community concerns permanently. As a society, we acknowledge individual and communal needs, and implement policies to address them, but remain in a cycle of bandaging instead of repairing or rebuilding. Current policies, such as the Patient Protection and Affordable Care Act (ACA), and proposed legislation, such as the Anti-Racism in Public Health Act of 2023 and the Delivering Unified Access to Lifesaving Services Act of 2024 (DUALS Act), offer a step toward increased coverage and service access and attempts to directly address antiracism improvement of health outcomes and the insurance of a fully trained, funded, and accessible integration of primary, behavioral, and public care. Enactment of policies centered on uprooting and repairing systematic and structural inequities while rebuilding a multisectoral system focused on whole-person collaborative care where patient and community needs take center stage are crucial to the eradication of health inequities. Social workers, ethically bound to service individuals and communities affected by SDOH and subsequent health inequities, have seen a drastic decrease in their available workforce, whereas primary care providers, who have taken the Hippocratic Oath to prioritize the health and well-being of patients and—indirectly—for social justice, have seen a slight increase in their available workforce.