The United States has never achieved a single high standard of medical care equity for all of its people and the trend line does not appear favorable. The closest we have reached is basic Medicare (Parts A and B), military medicine, the Veterans Health Administration, and large nonprofit groups like Kaiser Permanente. It seems that the nature of we individualistic Americans is to always try to seek an advantage.
But even achieving equity in medical care would not ensure equity in health. The social determinants of health (income level, education, politics, government, geography, neighborhood, country of origin, language spoken, literacy, gender, and yes — race and ethnicity) have far more influence on health equity than does medical care.
Narratives can both reflect and influence culture. Considering the harmful effects of the current political divisiveness in the United States, the timing is ideal for our three leading medical and health education organizations — the American Medical Association (AMA), the Association of American Medical Colleges (AAMC), and the Centers for Disease Control and Prevention (CDC) — to publish a definitive position paper called “Advancing Health Equity: A Guide to Language, Narrative and Concepts.”