The U.S. faces growing and increasingly unsustainable health inequities, and the number of voices calling for substantive healthcare system reforms is growing.
A new paper by the Duke University School of Nursing, “Community-engaged Mpox vaccination provides lessons for equitable healthcare in the United States,” examines why the recent U.S. response to the Mpox epidemic achieved successes and how these lessons can inform equity-focused improvements in the broader healthcare complex.
The U.S. is often the first to introduce advanced preventive and therapeutic interventions. Yet, the dominant healthcare delivery models must be equipped to deploy them in communities experiencing harmful SDOH and health inequities.
The recent response to the Mpox epidemic provides valuable insights into future directions for addressing equitable healthcare.
After the first round of Mpox vaccinations showed patterns that were similarly inequitable as past rollouts of necessary prevention modalities (e.g., HIV pre-exposure prophylaxis [PrEP]), the CDC quickly changed its approach to meaningfully engage grass-roots community leaders in the design and implement of local vaccination campaigns.
The resulting approach focused on deploying decentralized, community-based, and culturally and contextually aligned service delivery models that better served those most affected by Mpox.
“We must re-think the way healthcare is delivered in this country, especially when, where, and how care is delivered to groups persistently burdened by harmful social determinants of health that perpetuate health inequities,” says Vincente Guilamo-Ramos, Dean of the Duke School of Nursing and lead author. “The financial and human costs of these inequities are already in the danger zone and cannot be sustained for much longer.”
The paper also highlights the need to design healthcare interventions that more comprehensively address harmful social determinants of health, drawing from an innovative framework developed by the Center for Latino and Family Health at Duke University, accessible at www.DUSONtrailblazer.com.
