Health Equity: Our Bold Path
This fall, Boston Children’s launches the Sandra L. Fenwick Institute for Pediatric Health Equity and Inclusion.
When Andrea Bauer, MD, struggled to recruit children from underrepresented families for a study focused on brachial plexus injuries, a traumatic condition that disproportionately affects newborns from racially and ethnically diverse backgrounds, she knew just where to turn. She reached out to Valerie L. Ward, MD, MPH, a pediatric radiologist and chief equity and inclusion officer.
“It’s crucial that research serves individuals who have the condition. We weren’t mirroring the right population,” says Dr. Bauer, an orthopedic surgeon.
Dr. Ward’s team offered simple strategies to build rapport with families of the children most affected by the condition. Make eye contact, sit down, drop the jargon, get rid of the clipboard, and focus on the family. Feature children of all backgrounds in recruitment materials. By adopting a more attuned approach, Dr. Bauer’s team enrolled families across demographics, including a vital contingent of diverse infants.
This success is a win for child health and a sign of things to come. This fall, Boston Children’s officially launches the Sandra L. Fenwick Institute for Pediatric Health Equity and Inclusion to amplify our commitment to providing world-class health care regardless of race, ethnicity, sexual orientation, gender identity and disabilities. Our bold aim: transform pediatric practice, people and policy to eliminate disparities in how children grow and thrive.
We plan to bring diverse perspectives, backgrounds and experiences to this work. You’ll also see an emphasis on gender equity and on the LGBTQ community and children with disabilities.”
“We’re at the beginning of our journey into this new world,” says Boston Children’s President and CEO Kevin B. Churchwell, MD. “It’s time to put our focus and determination on these issues. We’re putting equity, diversity and inclusion at the core of who we are and all we do.”
While obstacles to equity are complex, the reason for Boston Children’s proactive push is not. Racism and discrimination deprive many children of full health. A disproportionate 65% of U.S. children who died from COVID-19 were Black and Latino. Scientific research often excludes females, individuals from underrepresented backgrounds and children from lower socioeconomic households; the list goes on. There’s much to accomplish—but we can collectively take heart in a truth Dr. Bauer’s team learned well. Sometimes the right intervention makes all the difference.
Improving practice
Dr. Ward will hold the Sandra Labas Fenwick Family Chair in Equity and Inclusion and is shaping the strategic direction of the institute as its director. Each year, the institute will champion one or more landmark studies. It will also provide seed grants to faculty and staff to support research that explores causes and barriers to child health equity and innovate solutions. The inaugural focus is on improving access to care.
Projects include an offshoot of the brachial plexus study that focuses on enhancing family understanding, treatment compliance and long-term outcomes for infants from diverse and limited English proficiency families.
The institute will support a similarly proactive intervention to address missed care opportunities. Dr. Ward and her collaborators have undertaken extensive work to better understand patients who miss an appointment. “If I missed the opportunity to care for your child, then it’s important to understand why,” she says.
Her team is “getting granular about interventions” the Fenwick Institute can test and advance. For instance, Black and Latino children are 50% more likely to have missed an MRI exam compared with white children. Researchers are looking into ways to provide transportation to appointments and evaluate the impact on care. They’re also investigating why and which parents of newborns miss neonatal ultrasounds and why and which children miss pre-surgical virtual visits.
“If a child is missing a telehealth appointment because the family is without broadband access, let’s see what we can do,” says Dr. Ward.
Successful projects will be integrated across the hospital—reducing disparities in our system. But Dr. Ward envisions an impact far beyond Boston. “We aim to become a national model for pediatric health equity and inclusion.”
The staffing and structure of the institute will model the change it seeks, adds Dr. Ward. “We plan to bring diverse perspectives, backgrounds and experiences to this work. You’ll also see an emphasis on gender equity and on the LGBTQ community and children with disabilities.”
Growing people, advancing policy
America’s population is shifting and becoming increasingly diverse, but our health care workforce doesn’t represent the population it serves. The Fenwick Institute will invest in attracting and developing talented people from varied backgrounds. It will champion everything from internships for high school students to the targeted recruitment of physician-scientists from underrepresented groups.
Recently, Dr. Ward partnered with colleagues to launch a program that enabled 28 diverse high school students to explore careers in health. The teens met with 43 physicians, surgeons, nurses, pharmacists, computer specialists and researchers across Boston Children’s.
Ultimately, the institute aims to eradicate systemic barriers to pediatric health equity, diversity and inclusion. Leaders will work closely with our Office of Government Relations, community organizations, health equity researchers and policymakers to develop partnerships and advance policy to make transformational change possible.
Through its comprehensive approach, the Fenwick Institute is carrying forward a tradition set by Boston Children’s more than 150 years ago: changing the world for the better by working passionately, relentlessly, until every child has the chance for a healthier life.
