Tackling Health Inequities Through Collaboration and Community-Based Care – Managed Healthcare Executive

Fulton County’s Strategic Approach to Health Equity and Sustainable Development Goals

Addressing Health Disparities in Alignment with SDG 3 and SDG 10

Fulton County, Georgia, is confronting significant health inequities that present a direct challenge to achieving Sustainable Development Goal 3 (Good Health and Well-being) and SDG 10 (Reduced Inequalities). A notable disparity exists where life expectancy in the southern part of the county is seven years shorter than in the north. This gap reflects deep structural inequities that have been exacerbated by recent events.

• Primary Challenge: The closure of local hospitals and the COVID-19 pandemic have worsened existing health disparities.
• Systemic Impact: The loss of a hospital resulted in the collapse of the entire local healthcare ecosystem, including primary care clinics and specialty services.
• Consequence: Communities were left without reasonable access to emergency rooms and a comprehensive network of healthcare services, hindering progress toward universal health coverage as outlined in SDG 3.

Fostering Partnerships for the Goals (SDG 17)

In response, Fulton County has adopted a strategy centered on multi-sector collaboration, directly embodying the principles of SDG 17 (Partnerships for the Goals). Recognizing that local government cannot rebuild the healthcare infrastructure alone, leaders have forged critical alliances to restore access to care and promote health equity.

1. Establish Strategic Partnerships: The county has partnered with Morehouse School of Medicine and Grady Health System, leveraging their medical expertise and shared vision for health equity.
2. Create New Access Points: The collaborations are focused on establishing new facilities and programs to serve as access points for essential healthcare.
3. Rebuild the Safety Net: This partnership-driven model is methodically reconstructing the healthcare safety net to ensure community well-being and resilience.

Innovations in Mental Healthcare and Universal Access (SDG 3)

Fulton County’s commitment to SDG 3 is further demonstrated through its focus on mental health and barrier-free access, directly addressing Target 3.4 (promote mental health and well-being) and Target 3.8 (achieve universal health coverage).

• Barrier-Free Access: The county’s Department of Behavioral Health & Developmental Disabilities operates on the principle of providing care to all individuals, regardless of their ability to pay.
• 24/7 Behavioral Health Crisis Center: A key initiative is the establishment of a crisis center that offers immediate support. Patients are greeted by medical professionals and “peers”—individuals with lived recovery experience who provide support and guidance.
• Supporting Recovery: The center allows patients to stay for up to one week, ensuring they have the necessary support to transition successfully back into the community and continue their recovery journey.

A Framework for Sustainable Community Health

By combining local government leadership, academic partnerships, and a foundation of community trust, Fulton County is creating a sustainable framework for equitable healthcare. This comprehensive approach directly addresses long-standing gaps in health access and outcomes, providing a replicable model for advancing the Sustainable Development Goals at a local level, with a significant emphasis on SDG 3, SDG 10, and SDG 17.

Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being

  This goal is central to the article, which focuses entirely on healthcare access, health outcomes, and well-being in Fulton County. The text discusses critical health infrastructure like emergency rooms, primary care, and specialty care. It also directly addresses mental health through the creation of a Behavioral Health Crisis Center and highlights the severe health disparity of a seven-year difference in life expectancy within the county.

• SDG 10: Reduced Inequalities

  The article’s premise is built on the inequality in healthcare access and outcomes within Fulton County. It explicitly states that “access to healthcare… can depend heavily on where a person lives” and points to “deep structural inequities.” The efforts described, such as providing “barrier-free access to care” and aiming for “health equity,” are direct actions to reduce these inequalities.

• SDG 17: Partnerships for the Goals

  The article emphasizes that the county’s strategy for rebuilding its healthcare system relies on collaboration. It details how county leaders are forming “partnerships with Morehouse School of Medicine and Grady Health System to create new access points for care.” This highlights the use of multi-stakeholder partnerships (government and academic/health institutions) to achieve sustainable development objectives.

What specific targets under those SDGs can be identified based on the article’s content?

SDG 3: Good Health and Well-being

1. Target 3.4: By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.

   The article’s focus on establishing a “24/7 Behavioral Health Crisis Center” and supporting patients on their “journey to recovery” directly aligns with the goal of promoting mental health and well-being.

2. 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.

   This target is addressed through the county’s efforts to rebuild the “whole ecosystem” of healthcare, including primary and specialty care. The policy to “offer barrier-free access to care… regardless of your ability to pay” is a clear move towards universal health coverage and financial risk protection.

SDG 10: Reduced Inequalities

1. Target 10.2: By 2030, empower and promote the social, economic and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status.

   The county’s actions aim to overcome health disparities linked to geographic location and economic status. Providing care “regardless of your ability to pay” directly promotes the inclusion of individuals from lower economic statuses, ensuring they are not left behind.

2. Target 10.3: Ensure equal opportunity and reduce inequalities of outcome…

   The core issue identified is the “seven years shorter” life expectancy in the southern part of the county, which is an inequality of outcome. The entire initiative, aimed at achieving “health equity” and closing “long-standing gaps in access and outcomes,” is a direct attempt to meet this target.

SDG 17: Partnerships for the Goals

1. Target 17.17: Encourage and promote effective public, public-private and civil society partnerships…

   The article explicitly describes the county government’s strategy of forming “partnerships with Morehouse School of Medicine and Grady Health System.” This is a textbook example of a public-civil society partnership designed to leverage combined expertise (“all of the medical expertise”) and a shared “vision for health equity” to achieve a common goal.

Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

SDG 3: Good Health and Well-being

1. Implied Indicator: Availability and utilization of mental health services.

   The creation and operation of the “24/7 Behavioral Health Crisis Center” serves as a direct indicator. Progress could be measured by the number of patients served and the success rate of transitioning them “back into the community with all the support that they need.”

2. Implied Indicator: Coverage of essential health services.

   The article mentions the loss of “reasonable drive-time access to an emergency room” and an “extensive network of healthcare services.” Progress can be measured by the number of “new access points for care” created and the reduction in travel time to essential services for residents in underserved areas.

SDG 10: Reduced Inequalities

1. Indicator: Difference in life expectancy between geographic areas.

   The article provides a baseline indicator by stating the life expectancy in the southern part of the county is “seven years shorter than the north.” A reduction in this seven-year gap would be a direct and powerful measure of progress in reducing this inequality of outcome.

SDG 17: Partnerships for the Goals

1. Implied Indicator: Number of multi-stakeholder partnerships established for sustainable development.

   The article explicitly mentions the partnerships formed with “Morehouse School of Medicine and Grady Health System.” The number and scope of such partnerships created by the county government to address healthcare gaps can be used as an indicator of progress.

Table of SDGs, Targets, and Indicators

Source: managedhealthcareexecutive.com