May 16, 2023
New Michigan Medicine program seeks to address adolescent and child health-care inequities
Michigan Medicine has launched a first-of-its-kind program designed to identify and address equity issues for young patients and their families receiving care at University of Michigan Health, throughout Michigan and across the nation.
The new Program for Equity in Adolescent and Child Health (PEACH) is supported by U-M Health C.S. Mott Children's Hospital, along with 10 clinical departments across Michigan Medicine, as well the Michigan Institute for Data Science, Office for Health Equity and Inclusion, Poverty Solutions, and Precision Health.
PEACH will help deliver equitable care for all pediatric patients and their families. Its leaders define equity issues as those within the control of the health system, either in care received or a patient or family’s experience. Equity issues could include differences in how patients and their families are treated relative to their gender, race and ethnicity, income, ability status, sexual orientation, weight status and more. These issues have been studied frequently in adults; however, there is limited research on them in pediatric populations, and even fewer interventions to address equity issues for kids and teens.
“I got tired of my research often describing problems for which I was only infrequently able to make a difference,” said PEACH founder and director Gary L. Freed, M.D., M.P.H., a pediatrician at Mott. “I started PEACH because I believe there are likely many instances where we in the healthcare system unintentionally treat people differently through our unconscious biases. If we find those instances and develop improvement strategies and protocols to change how we deliver care and patient experiences – things within our control – we can make a difference in the lives of children and their families.”
PEACH asks for faculty and staff to bring forward instances or situations where they believe an inequity may exist; PEACH will provide support to help explore these ideas, translate feasible ideas into research efforts, and then design and implement quality improvement programs to address any inequities identified.
Anyone from Mott or the supporting departments can bring potential areas of inequity forward to PEACH, regardless of their level of training or experience in research or improvement. The PEACH team will meet and assist them in facilitating and conducting a project. The team includes physicians, researchers, quality improvement specialists, data analysts and communications experts – all in place to support those who bring forward their ideas.
"The launch of the PEACH program fills me with a sense of hope," said PEACH associate director Susan Woolford, M.D., M.P.H., a pediatrician at Mott. “So often one is involved with good work, but it is unlikely to bring about rapid change on a large scale. This feels different. With PEACH, we have the opportunity to impact significant outcomes for children across the health system and beyond. At a time when there are many symbolic initiatives to address inequities and disparities, PEACH is poised to make substantive changes.”
Although the work of PEACH starts at Michigan Medicine, PEACH leaders believe that pediatric equity issues are present in other health systems across the state and the country. Findings from PEACH projects will be disseminated to inform local, state, and national decision makers to provide actionable steps to identify and address inequities. Ultimately, the goal is to improve equity in pediatric care for all. Faculty and staff concerned about a pediatric equity issue that they have observed, experienced or even thought about – or if they just want to learn more – are encouraged to reach out by sending PEACH an email (peach-comms@med.umich.edu) or by calling 734-615-7272.
More information is also available on the PEACH website, where people may submit an intake form to help the team take the best next steps on an equity project idea.
"Not only will PEACH bring about improvements for our patients, but it also democratizes research by providing the infrastructure to help anyone with an important question study the issue and address the inequities identified,” Woolford said. “This is truly a novel model for addressing the thorny issues of diversity and health inequities. It will be attractive for those wanting to work at an institution fully committed to all patients and will increase trust among families who rely upon us to be the leaders and the best in caring for their children."