In an eye-opening opinion piece in the January 2022 issue of the Journal of the American College of Radiology (JACR), authors from Vanderbilt University Medical Center offer a frank account of the roots of healthcare inequity, including in radiological care. The opinion article provides a road map for promoting health care equity in diagnostic imaging which, the authors contend, fundamentally lies in understanding that equality of care alone does not promote the equity of that care.

The editors of JACR have focused the January 2022 edition on health equity. The special issue is designed to bring together a diversity of topics and authors on this subject. The editors hope the issue will serve as a foundational pillar to showcase the equity work being done across the specialty of radiology.

The Vanderbilt team reminds readers that the conditions in which individuals live, work, play, and age comprise their social and economic determinants of health. These conditions, such as the quality of available schools and education, public safety, and access to healthy foods, good jobs with fair pay, high-quality medical care, and reliable transportation – as well as social norms like discrimination and racism – are often the root causes of illness. 

The authors explain that in order to address inequity and to advance health equity, different types of support and resources are necessary for different populations. The concept of equity requires an understanding that it may be necessary to offer variable resources to achieve desirable outcomes for all. This approach differs from that of equality, which offers the same resources for all and achieves variable outcomes.

The Vanderbilt team observes that systemic change is needed at the national, institutional, and individual levels to provide equitable care. They urge national radiology societies to embrace the opportunity to promote the importance of health equity and drive the specialty's commitment to health equity. 

Locally, they recommend that radiology departments embed the principles of health equity into all aspects of their organizations' missions. And individual radiology team members, they assert, can provide high-quality, equitable care by improving their understanding of existing disparities in order to be prepared to address the individual needs of a complex, diverse patient population.

Kudos to the JACR for using the platform of its January issue to create visibility and intelligent discussion on the importance of embracing equity in the delivery of radiology services.