Health Equity Remains Elusive, But These Strategies Will Help

The opportunity to be healthy and achieve wellbeing eludes many people.

Those who remain unaffected by – and blissfully unaware of – the structural racism that pervades health care are blind to this fact.

We are observing Black History Month this year by raising awareness about our nation’s deeply flawed health care system. More importantly, we have unveiled new initiatives to promote wellbeing and improve health care outcomes for all.

The pandemic helped us see clearly that our health care system remains rife with inequity. Black Americans have not received vaccinations at the same rate as White Americans. Over the course of the vaccination rollout, Black and Hispanic people have been less likely than White people to receive a vaccine, according to the Kaiser Family Foundation.

The same trend applies to mental health or substance use treatment.

“The COVID-19 pandemic has spotlighted racial and ethnic disparities in access to behavioral health care. While their rates of behavioral health disorders may not significantly differ from the general population, Blacks and Latinos have substantially lower access to mental health and substance-use treatment services,” according to the Substance Abuse and Mental Health Services Administration (SAMHSA).

A new study in JAMA Open Network found that opioid overdose deaths among older adults in the U.S. have grown fastest among Black men.

Keep in mind that the pandemic has resulted in more people seeking treatment for mental health and substance use challenges. So, longstanding inequities coupled with increased demand for help means there is even more urgency to remove the barriers that marginalized populations face.

The National Council has initiated new programs to help mental health and substance use treatment organizations recognize the scope and scale of health inequity and take steps to eliminate the structural racism.

We have just completed a new paper in conjunction with the African American Behavioral Health Center of Excellence, established by SAMHSA, at the Morehouse School of Medicine. The paper, Addressing Disparities in Access and Utilization of Mental Health and Substance Use Services Among Blacks and African Americans: Solutions from Community Stakeholders, was a massive effort. Not only does it shed light on the difficulties Black people face when they search for mental health and substance use treatment, it offers solutions to improve the delivery of care.

Our Social Justice Leadership Academy represents a new approach to address workforce development and raise awareness about health disparities. The Academy’s new resources provide individuals in mental health and substance use treatment settings an opportunity to look critically at their organizations to determine how to root out health inequities in the delivery of care. Through this initiative, we believe we can encourage and accelerate changes in policies at the organizational level to promote more equitable delivery of mental health and substance use treatment.

The Academy’s new effort also is intended to provide individuals an opportunity to look critically at themselves to understand how their beliefs influence the delivery of care. Why is that important? Because organizations are more than policies and programs. They are made up of people who influence those policies and programs.

While our Social Justice Leadership Academy is intended to promote health equity one person at a time, the National Council’s Center of Excellence seeks to promote equity one organization at a time. In that respect, the two initiatives complement one another.

The Center of Excellence for Integrated Health Solutions, which delivers clinical and organizational support for National Council members providing integrated primary care, mental health and substance use treatment, has completed a new resource with practical guidance for mental health and substance use treatment organizations to identify and address inequity within integrated care settings. Access for Everyone will help organizations educate staff and embed health equity practices in their culture and the delivery of patient care.

Access for Everyone represents an important component of the curriculum in our Health Equity ECHO, which begins this week.

We also will host a very timely webinar this week focusing on health equity, Understanding Black & African American Experiences in Mental Health and Substance Use Services.

Mental Health First Aid has included many valuable resources in a new post, Black Mental Health Matters: A Resource Guide.

We accelerated our own DEI initiatives this month, not simply to recognize Black History Month, but because we recognize how far we have to go to achieve health equity for all. The incredible reception we have received in response to this wave of new resources demonstrates that mental health and substance use treatment organizations also recognize the scope and scale of health care inequity and that they are prepared to do address structural racism.

The Robert Wood Johnson Foundation observed that “health equity means that everyone has a fair and just opportunity to be healthy.” That doesn’t exist today, and we have so much work to do to help marginalized populations.

This is a good time to begin, and we encourage people throughout the health care continuum to leverage our new health equity-focused resources this month and throughout the year.

All people deserve the opportunity to achieve mental wellbeing.


Charles Ingoglia, MSW
(he/him/his) President and CEO
National Council for Mental Wellbeing
See bio