Meet Eva Durazo, a dedicated principal program manager for the Health Equity team at Blue Shield of California. Eva’s journey embodies a deep-rooted commitment to fostering health equity within communities. With a profound background in public health and research, Eva’s personal experiences have fueled her passion for addressing health disparities. Join us as she shares her insights on the current landscape of health disparities in the U.S., Blue Shield’s initiatives to combat them, and her aspirations for driving meaningful change for marginalized communities.
What is your background and what brought you to Blue Shield?
My passion for this work was inspired through my experiences coming from an immigrant family. My grandfather spoke very little English, mostly Spanish, was working, and had struggled with diabetes from a young age. I remember seeing the challenges he experienced trying to find care in his language that would meet his needs and share the correct information with his family.
I spent many years trying to understand how social and physical environments impact the health of communities and lead to health inequities. Having a PhD in public health, I studied how the makeup of a neighborhood and its resources impact the health of residents. Just before coming to Blue Shield, I was studying adversity and various stressors, including unfair treatment and traumatic events and how they could lead to poor health outcomes and racial and ethnic disparities. Wanting my work to make an impact for those who experience these disparities, I made my way to Blue Shield where I have been for five years. I am on the Health Equity team, where part of my work is to improve healthcare access for communities of color, which is close to my heart.
What are the current statistics surrounding health disparities in the U.S., and what is Blue Shield doing to address them?
A recent report found that Black communities experience the brunt of the impact. They experience the shortest life expectancy, higher rates of cancer (including breast, colorectal, and prostate), higher rates of C sections and poorer maternal and child health outcomes. The report also found that Latinos in California were more likely to be uninsured. These are two communities who have experienced many inequities, and it shows in their general health outcomes. Diabetes and other chronic conditions are also more widespread in Latino, Black, American Indian, and Alaskan Native communities. These communities also experience higher rates of complications, or the inability to manage their illnesses, leading to poorer outcomes in the long run.
What are some reasons these health disparities exist, and how can they be eliminated?
Racism and racial inequities are at the root of the health disparities that we see. Health disparities are a result of historical and current unequal distribution of the social, economic, and political resources in society that seep into the healthcare system. In terms of resolving them, there are two approaches. One involves looking at the social drivers of health and addressing challenges with housing, transportation, access to food, etc. The second is to address the root causes of racism and inequities in society and push upstream to impact policy, and how we look at the healthcare system. This is where Blue Shield can make an impact. It takes a multi-level approach, as it is a complex problem.
What is your team doing to help eliminate health disparities?
The Health Equity team is focused on the inequalities we see for our members. I focus on health equity data. I think data is very important. It helps tell a story to illuminate the actual disparities we face and give us proof that they exist. My focus is on making sure we have enough race and ethnicity data to use in a meaningful way to understand the patterns that impact our members. We have a good amount of data, but we need more. The gold standard of data is self-reported, coming directly from our members. My goal is to increase the amount of data we have and the quality of data we obtain. While race, ethnicity, and language are a focus, other data like sexual orientation, gender identity, disability and veteran status are key to understanding the whole of our members. We are capturing some of these through our member portal.
What has Blue Shield accomplished in bringing health equity to all, and what are Blue Shield’s aspirations and goals toward closing the health equity gap?
Blue Shield has spent several years looking at how we can improve the health of our members. There have been several social determinants of health programs such as getting transportation or food access to our members. When I first came to Blue Shield, we were piloting the Community Health Advocate Program, which was placing community health workers with members to screen for any social needs they might have and connecting them to community resources to address those needs.
More recently, our team has been a part of several maternal health initiatives. For instance, our Doula Program was piloted a couple of years ago to close the gap between Black and White birthing people and now we are looking to expand doulas by going to market with nine different employer groups.
We have also worked to increase the diversity of our provider network over the past year and have brought on two virtual care provider groups that specialize in meeting the needs of different member communities. One is Zocalo Health, which brings culturally concordant care to our commercial members, with the ability to speak Spanish if needed while bringing the cultural ease and trust that the Latino community might need. The other is Marsha Medical Group, who practices on the Folx Health platform, focusing on gender affirming and primary care for the LGBTQ+ community.
We also have a couple of initiatives underway targeting colorectal cancer screening which are included in our goals for the next few years.
Do you have any examples of success stories of those who have benefitted from the work your team is doing to bring members greater health equity?
We have been working with Zocalo Health to hold community events called Cafecitos. We were able to look throughout California at where the highest colorectal cancer screening gaps are for our members and are focusing on a series of Latino community health events this year where the entire community is invited, it is not limited to Blue Shield members. These events are designed to educate and provide information about colorectal cancer screening. Those who are eligible for a screening can take home a ‘fit kit’ which allows them to do the cancer screening at home and receive the results in a couple of weeks.
We have heard success stories from community members who attended these events and were unsure if they wanted to get a colorectal cancer screening, as it can be scary. At the event, there was a physician present who explained the different options of screening and discussed the procedure and its benefits, and people were able to take home the kits to stay on top of their preventive care.
What are your goals for the upcoming year as they relate to health equity?
There are two big goals we are working toward. One is to continue developing our programs to reduce health disparities in maternal health, C-sections, and increase colorectal cancer screenings. This year our goal is to lay the foundational work and partnerships to address the disparity between Black and White birthing people having C-sections and by 2028 reduce that disparity by 50 percent.
What can other employees do to help bridge the gap and bring greater health equity to the communities we serve?
Everyone can make an impact. It may be my team’s focus to look at health equity, but we need everyone’s help to make an impact. We have a health equity foundations course on Shield Learns, our enterprise e-learning platform, that folks can take to get a greater understanding of health equity and some of the topics we discussed today.
We also created tools designed to incorporate a health equity lens in our day-to-day work. We have a tool called the Health Equity Action Lens (HEAL), and another called Health Equity Assessment Tool (HEAT). HEAL walks users though different questions to help them understand the problem, think about the data, and relate it to their own projects and programs, helping ensure there are no communities missing, or differences in care, breaking down barriers and challenges for our members.
Another piece is taking the extra step to think about how your work might impact health equity and begin talking to others about it, brainstorming and problem-solving.
How can we all help spread awareness?
Learning about what we are doing within the organization and being curious about how your own work could make an impact are great places to start. The National Minority Health Association website has some webinars available, and the Center for Disease Control and California Healthcare Foundation websites often share reports or webinars to help folks understand, learn, and gain more information about the problem.
So many of us across the organization are working on programs that touch health equity, especially for different communities. It will take all of us as an organization to make an impact on the health and equity our members experience.
If you would like to join in our fight to end health disparities, we invite you to view our open career opportunities and apply.