ABH Guest Post: Dismantling Structural Inequities in Health Care Access

The following blog post is written by Naheed Murad, MD, MPH. She serves as Vice President of the ABH Board of Directors. Naheed is the Co-Founder & Director of Zakat, Aid & Charity Assisting Humanity (ZACAH) and Co-Founder & Director of Clinical Operations of Rahma Heart Care.

I came to the US in 1993 from Karachi Pakistan, a city a fraction of the size of Minnesota with a population of 20 million. I witnessed the inequitable distribution of limited resources and the tremendous disparities in wealth, income, and education. My medical school experience at the Aga Khan University Hospital was my first exposure to health professionals coming together and attempting to dismantle the structural inequities in health care access. Our class was assigned to an impoverished urban community of forty thousand people. Our goal was to conduct a Community Health Needs Assessment and establish a community clinic to address the most pressing needs. Working directly with community leaders, amplifying their voices and resources, and seeing their passion was the most rewarding experience of my medical school education. 

A deep connection to my community and witnessing the plight of immigrant and refugee families led me to be a cofounder of two Minnesota based non-profits—ZACAH (Zakat Aid and Charity Assisting Humanity), founded in 2014 with a mission to support low-income and working-class people with direct financial aid, especially those facing the threat of eviction and displacement, and unsheltered homelessness; and Rahma Heart Care, a community clinic providing free cardiovascular services for uninsured, underinsured, and undocumented migrant communities. Housing is the most widely researched structural determinant of health and yet the housing affordability crisis in our state has led to homelessness and housing insecurity being declared a public health crisis. After a 25-year career in pathology and hematopathology, I transitioned into public health so I could continue this work. 

All of the identities I hold- a Muslim, a woman, a physician, an immigrant, a caregiver to my elderly parents, and a community member color the lens with which I view the tremendous health inequities in our society. Health equity ensures our communities have access to high-quality, affordable, and culturally-competent health care, and the leading role and voice in decisions. This necessitates critically evaluating our medical process, from clinical trials where selection biases result in disparities in clinical outcomes to structural barriers such as low wages, lack of supportive and public housing, and racism. Conversations around health disparities cannot ignore how marginalized communities have historically struggled to access health— a critical and honest framing of the narrative is essential. 

While health care providers have a responsibility to promote equity in research, diagnosis, and treatment of health disorders, I believe we have a bigger responsibility to focus on the structural determinants of health that shape our behaviors and drive health outcomes. We need to constantly seek opportunities to leverage our clinical experience and advocacy and ABH provides a solid platform for physicians and healthcare providers to use their expertise and privilege to eliminate disparities and advance health and racial equity in Minnesota.