Reaffirming our commitment to health equity

We launched our inaugural organizational strategic plan to embed racial justice and advance equity in medicine three years ago because we recognized that the health consequences of social inequities were far too great for the AMA to be a passive bystander. While we were not the first to speak out against systemic injustices in health care, we realized that we had a role to play in creating a more just and healthy future for all people.

We have learned a great deal—and have made meaningful progress—through the implementation of our first organization-wide equity strategic plan. And we are reaffirming our commitment to this work with the next two-year installment of our strategic equity plan that retains these five core approaches:

• Embedding equity by infusing racial equity and social justice into the fabric of the AMA's culture, systems, policies and practices.
• Building alliances and sharing power by acknowledging and learning from the voices and experiences of historically marginalized and minoritized physicians and stakeholders.
• Ensuring equity in innovation by integrating racial justice and health equity into health care innovation efforts, while amplifying the voices of historically marginalized individuals in the innovation sector.
• Pushing upstream by addressing all determinants of health and the underlying causes of inequities across the health care ecosystem.
• Fostering pathways by amplifying marginalized narratives, quantifying past harms and embarking on a healing journey to pave the way for transformative change.

While the first AMA strategic plan for equity was released amid the uncertainty of a historic pandemic that disproportionately affected Black, Latinx, rural and Indigenous people, our reaffirmation of this plan is occurring against the backdrop of worsening health outcomes for the same historically marginalized groups.

Maternal mortality, particularly for Black women, continues at alarming levels. Rates of heart disease, diabetes and obesity are rising as well—early warning signs for lifelong health complications and premature death. And while these issues are most directly affecting the health of marginalized groups, they point to deeper problems within our health system and society that keep every one of us from achieving optimal health.

It is incumbent upon physicians and the health organizations they lead to understand these concerning health trends, their root causes, and their implications for our health system and society at large. The opportunity—and responsibility—before us to advance health equity rests on strategic prioritization and coordination, particularly across organized medicine. Doing so requires a willingness to ask difficult questions, explore new concepts and ways of understanding the challenges, and, importantly, further developing the skills to bring others into our collective equity efforts.

Among the lessons learned in our first three years advancing racial justice and equity through this strategic plan is that we can mobilize and take action against a seemingly insurmountable challenge. Many organizations across the health care ecosystem—health plans, health systems, research and regulatory agencies—have committed to advancing equity alongside the AMA, and this creates enormous opportunities for mutual learning and partnership.

We’ve learned that progress toward equity is uneven, and change is often unpredictable. Organizational leadership, especially from C-suite leaders, is crucial in championing equity work and building institutional capacity to support these efforts across an institution. We have seen that we can all learn and grow if we create opportunities for development and growth. And we have learned that the nature of this work is personal and goes beyond the technical.

At its core, equity work is about helping people to witness and affirm the humanity of all. It is about caring in a deep and profound way and being open to the need for change. Advancing health equity is as much about changing perceptions and mindsets as it is about education, data, structure and metrics.

Achieving health equity is a long-term endeavor, but the AMA is encouraged by what we have so far accomplished by being strategic and building alliances to further these efforts.

Since the launch of our first strategic plan, the AMA has expanded education opportunities for physicians, residents and students in numerous ways, including:

• The AMA STEPS Forward® open-access resources, with toolkits dedicated to addressing social determinants of health and advancing racial justice and health equity.
• The Health Equity Education Center in our AMA Ed Hub™, with curated resources from the AMA’s more than 15 external partners.
• The popular “AMA Prioritizing Equity” video series.
• The National Health Equity Grand Rounds series on a variety of urgent equity topics.

The AMA also collaborated closely with leading health equity organizations to help launch several important initiatives, including:

• The Rise to Health Coalition.
• The Peer Network for Advancing Equity through Quality and Safety.
• The multiyear, Chicago-based West Side United partnership.
• The In Full Health Learning & Action Community to Advance Equitable Health Innovation to foster greater inclusion in technology and investment spheres.

These efforts, in addition to many others not highlighted here, were bolstered by a focused federal advocacy campaign that advanced nutrition guidelines aligned with policies of our AMA House of Delegates, eliminated harmful race-based clinical algorithms, and helped extend Medicaid coverage for a full year postpartum with passage of the American Rescue Plan Act in 2021 and Consolidated Appropriations Act in 2023.

They also have been aided by the AMA’s advocacy in the courts, which helped uphold the Indian Child Welfare Act with a U.S. Supreme Court ruling in Haaland v. Brackeen, fought to protect pregnant women from being criminalized for a substance use disorder, and enforce a ban on dangerous and highly addictive menthol cigarettes. The AMA’s advocacy also helped remove the Food and Drug Administration's discriminatory restrictions on blood donations by men who have sex with men.

Across our organization, and at every level, the AMA is committed to deeply embedding equity into our culture, practices and strategies. It is woven into what we do, and who we are.

We are humbled by the recognition we continue to receive in advancing equity because we know many organizations and physician leaders have committed themselves to this work for much longer. But we continue to believe we can contribute—that we can be allies in not only educating physicians on why this work matters, but also by building alliances and partnerships to break down barriers. That we can help build institutional capacities and improve the health of people and communities too often overlooked and ignored in our health care system. That this work can, by extension, be foundational in improving the health of all people living in the U.S.

This is work we are called to do by the ethical guidance of our profession, and by the AMA’s remarkable mission: to promote the art and science of medicine and the betterment of public health.