Re: Local Economic Inequality and the Primary Care Physician Workforce in North Carolina
Re: Local Economic Inequality and the Primary Care Physician ... Journal of the American Board of Family Medicine
sdgtalks
To the Editor:
To the Editor: We were pleased to read the article entitled “Local Economic Inequality and the Primary Care Physician Workforce in North Carolina” by Nenow et al, which describes the association between county-level economic inequality and the primary care physician (PCP) workforce in North Carolina.1 We appreciate the relationship between socioeconomic factors and access to primary care. We found it particularly useful to learn that where there was more economic inequality, there were fewer PCPs, specifically family physicians. We suggest a more drastic measure, which is to prepare more underrepresented in medicine (URiM) family physicians to work in areas of greater income inequality.
The Impact of Income Inequality on Primary Care Workforce
The article recognizes that the high-income inequality in black, indigenous and people of color (BIPOC) households is a result of the historic racism in North Carolina. This effect is not limited to North Carolina, and it is notable to mention that there are states and territories that have high income inequality, with the top being Puerto Rico, District of Columbia, and New York.
Improving Outcomes through URiM Providers
According to the American Medical Association, BIPOC patients who receive care from URiM providers have better outcomes.2 Although there has been an increase in the number of URiM applicants who are being accepted into medical school, the same increase is not being noted in URiM who practice primary care.3 Although there are efforts being made to increase primary care physicians with repayment of student loans, the programs would have a greater impact if there were tracks specifically for URiM physicians. The programming should include incentives that attract high quality URiM physicians including guaranteed initial salary, secured employment position for the partner of the URiM physician, reimbursement for primary and secondary education for dependent children, as well as recognition of the difficulties that URiM physicians can have in communities that have a history of historic racism.
SDGs, Targets, and Indicators
| SDGs | Targets | Indicators |
|---|---|---|
| SDG 1: No Poverty | 1.4: By 2030, ensure that all men and women, in particular the poor and the vulnerable, have equal rights to economic resources, as well as access to basic services, ownership, and control over land and other forms of property, inheritance, natural resources, appropriate new technology, and financial services, including microfinance. | No specific indicators mentioned in the article. |
| SDG 3: Good Health and Well-being | 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services, and access to safe, effective, quality, and affordable essential medicines and vaccines for all. | No specific indicators mentioned in the article. |
| SDG 5: Gender Equality | 5.1: End all forms of discrimination against all women and girls everywhere. | No specific indicators mentioned in the article. |
| SDG 10: Reduced Inequalities | 10.4: Adopt policies, especially fiscal, wage, and social protection policies, and progressively achieve greater equality. | No specific indicators mentioned in the article. |
| SDG 16: Peace, Justice, and Strong Institutions | 16.6: Develop effective, accountable, and transparent institutions at all levels. | No specific indicators mentioned in the article. |
1. Which SDGs are addressed or connected to the issues highlighted in the article?
- SDG 1: No Poverty
- SDG 3: Good Health and Well-being
- SDG 5: Gender Equality
- SDG 10: Reduced Inequalities
- SDG 16: Peace, Justice, and Strong Institutions
The article discusses issues related to economic inequality, access to primary care, historic racism, and the need for underrepresented in medicine (URiM) family physicians. These issues are connected to the SDGs mentioned above.
2. What specific targets under those SDGs can be identified based on the article’s content?
- Target 1.4: By 2030, ensure that all men and women, in particular the poor and the vulnerable, have equal rights to economic resources, as well as access to basic services, ownership, and control over land and other forms of property, inheritance, natural resources, appropriate new technology, and financial services, including microfinance.
- Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services, and access to safe, effective, quality, and affordable essential medicines and vaccines for all.
- Target 5.1: End all forms of discrimination against all women and girls everywhere.
- Target 10.4: Adopt policies, especially fiscal, wage, and social protection policies, and progressively achieve greater equality.
- Target 16.6: Develop effective, accountable, and transparent institutions at all levels.
The article highlights the need for equal access to economic resources and basic services (Target 1.4), universal health coverage and quality healthcare services (Target 3.8), ending discrimination against underrepresented groups (Target 5.1), adopting policies to achieve greater equality (Target 10.4), and developing effective institutions (Target 16.6).
3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?
No specific indicators are mentioned or implied in the article that can be used to measure progress towards the identified targets.
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Source: jabfm.org
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