UConn Health Initiative to Advance Sustainable Development Goals through Health Equity

Introduction: Aligning with SDG 3 and SDG 10

A multidisciplinary team at UConn Health has initiated a targeted program to identify and mitigate healthcare disparities, directly contributing to the United Nations Sustainable Development Goals, particularly SDG 3 (Good Health and Well-being) and SDG 10 (Reduced Inequalities). In response to new requirements from The Joint Commission, an external accreditation body, UConn Health formed the Joint Commission Health Disparities Working Group. This initiative, led by Dr. Jeffrey Hines, Vice President for Diversity and Inclusion, aims to build a more effective and inclusive institution (SDG 16) by addressing the health-related social needs of patients at John Dempsey Hospital.

The working group’s approach recognizes that achieving health equity requires addressing social determinants of health, a core principle for ensuring universal health coverage (Target 3.8). Dr. Christopher Steele, a member of the group, noted the importance of screening for challenges such as:

• Utility and housing instability
• Food insecurity
• Transportation needs

Methodology: Data-Driven Approach to Identify Disparities

To pinpoint specific areas of inequality, the working group utilized a health equity “dashboard.” This tool aggregates and de-identifies patient data, allowing for a granular analysis that is crucial for evidence-based policymaking and achieving SDG targets. The dashboard tracks metrics across several categories:

• Age
• Race and Ethnicity
• Preferred Language
• Payor Status
• Zip Code

This data-driven review uncovered a significant disparity in maternal health outcomes, a key focus of SDG 3. The rate of postpartum infections among UConn Health’s Latine obstetric patient cohort was 18.5%, more than three times the rate of the white obstetric cohort at 6%. This finding prompted the development of a targeted action plan to reduce this inequality, in line with SDG 5 (Gender Equality) and SDG 10.

Strategic Action Plan: A Multi-faceted Intervention

The action plan developed by UConn Health represents a comprehensive strategy to improve maternal health outcomes and ensure equitable care. The plan established a multi-pronged approach involving clinical reviews, systemic assessments, and community engagement, reflecting the principles of SDG 17 (Partnerships for the Goals).

1. Clinical Intervention: The team worked with OB-GYNs to catalog postpartum infection types and review the timing and type of antibiotics and skin preparation used during surgical deliveries.
2. Systemic Review: An evaluation of the use of translation services was conducted to ensure effective communication and patient understanding, a critical component of inclusive healthcare.
3. Resource Accessibility: The plan assessed whether necessary antibiotics and appropriate resources were available and effectively distributed to patients at discharge.
4. Community Partnership: A new collaboration was formed with the Hispanic Health Council to support education initiatives, community outreach, and resource provision for patients and their families.

Results and Impact on Sustainable Development

One year into the implementation of the action plan, data from 2023 through 2024 shows a significant decrease in the rate of postpartum infections among the Latine patient population. This outcome, detailed in the working group’s second annual report, demonstrates measurable progress toward achieving Target 3.1 of reducing the global maternal mortality ratio.

Dr. Christopher Morosky, Associate Professor of Obstetrics and Gynecology, stated, “The data made clear that our Latina patients were experiencing postpartum infections at a higher rate, and that is unacceptable… This initiative also shows the power of bringing together data, clinical expertise, and community partnerships.”

This success serves as a model for how healthcare institutions can leverage data and collaboration to address systemic inequalities, thereby advancing the broader 2030 Agenda for Sustainable Development. As noted by Khadija Poitras-Rhea, Associate Vice President of Population Health, it is imperative to identify and address such disparities to ensure all patients receive high-quality care and achieve the best possible health outcomes.

Analysis of the Article in Relation to Sustainable Development Goals

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

1. SDG 3: Good Health and Well-being
   • The article’s primary focus is on improving health outcomes and ensuring quality healthcare. The initiative by UConn Health directly aims to enhance the well-being of patients by identifying and rectifying health disparities, specifically the high rate of postpartum infections in a particular patient group.
2. SDG 10: Reduced Inequalities
   • The core theme of the article is the identification and reduction of health care disparities among different ethnic groups. The working group uses disaggregated data (race, ethnicity, language) to find inequalities in health outcomes—such as the higher infection rate among Latine patients compared to white patients—and implements an action plan to eliminate this gap.
3. SDG 5: Gender Equality
   • The specific health disparity identified and addressed in the article relates to maternal health (postpartum infections in obstetric patients). This directly connects to ensuring the health and well-being of women and addressing inequalities that disproportionately affect them.
4. SDG 17: Partnerships for the Goals
   • The article highlights the importance of collaboration. The solution involves a “collaborative group of engaged internal and external partners,” including the multidisciplinary “Joint Commission Health Disparities Working Group” and “new collaborations with community partners like the Hispanic Health Council.”

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

1. Under SDG 3: Good Health and Well-being
   • Target 3.1: “By 2030, reduce the global maternal mortality ratio…” While the article focuses on postpartum infections (morbidity) rather than mortality, reducing such infections is a critical component of improving maternal health and preventing maternal deaths.
   • Target 3.8: “Achieve universal health coverage, including… access to quality essential health-care services…” The initiative’s goal to ensure “every patient receives the highest standard of care” and that “all patients should receive high quality care” directly aligns with achieving quality universal health coverage.
2. Under SDG 10: Reduced Inequalities
   • Target 10.2: “By 2030, empower and promote the social, economic and political inclusion of all, irrespective of… race, ethnicity…” The program actively works to eliminate a health disparity affecting Latine patients, thereby promoting their inclusion in positive health outcomes.
   • Target 10.3: “Ensure equal opportunity and reduce inequalities of outcome…” The action plan is a direct measure to reduce a specific inequality of outcome (higher infection rates) and ensure equal opportunity for a healthy postpartum recovery.
3. Under SDG 17: Partnerships for the Goals
   • Target 17.17: “Encourage and promote effective public, public-private and civil society partnerships…” The article explicitly mentions the collaboration between UConn Health’s clinical teams (public/institutional) and civil society organizations like the “Hispanic Health Council” to support education and community outreach.

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

1. Explicit Indicators:
   • Rate of postpartum infections disaggregated by ethnicity: The article provides precise data used to identify the disparity: “the rate of postpartum infections among UConn Health’s Latine obstetric patient cohort was 18.5%, compared to the white obstetric cohort at 6%.” This serves as a baseline indicator.
   • Change in the rate of postpartum infections over time: Progress is measured by the “significant decrease in the observed rate of postpartum infections per 1,000 in this population of patients” after one year of the action plan.
2. Implied Indicators:
   • Use of disaggregated patient data: The use of a “health equity ‘dashboard’ — which houses self-reported compositional diversity of the patients, along with de-identified and disaggregated metrics of age, race, ethnicity, preferred language, payor status, and zip code” is an indicator of the capacity to monitor health inequalities.
   • Assessment of social needs: The process of “looking for utility challenges, housing and stability, food insecurity, transportation needs” implies that the number of patients screened for social determinants of health could be an indicator.
   • Number and effectiveness of community partnerships: The collaboration with the “Hispanic Health Council” implies that the formation and success of such partnerships can be used as an indicator for progress under SDG 17.
   • Availability and use of translation services: The action plan’s evaluation of “the use of translation services” suggests this is a key process indicator for ensuring equitable care.

4. Summary Table of SDGs, Targets, and Indicators

Source: today.uconn.edu