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Health Equity and the Tripartite Mission: Moving From Academic Health Centers to Academic–Community Health Systems

Park, Brian MD, MPH; Frank, Brian MD; Likumahuwa-Ackman, Sonja MID, MPH; Brodt, Erik MD; Gibbs, Brian K. PhD, MPA; Hofkamp, Holly MD; DeVoe, Jennifer MD, DPhil

doi: 10.1097/ACM.0000000000002833
Perspectives
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Academic health centers (AHCs) play a significant role in educating the health care workforce, conducting innovative biomedical and clinical research, and delivering high-quality patient care. Much work remains, however, to adequately address the social determinants of health and equity that affect communities where patients live, work, and play. Doing so will help achieve the Quadruple Aim while addressing the unjust social structures that disproportionately impact communities of color and vulnerable populations. AHCs have a timely opportunity to focus their leading roles in education, research, and clinical care on social determinants, moving outside their walls to create academic–community health systems: a collection of academic–community partnerships advancing health equity through collaboration, power sharing, and cocreation.

This Perspective proposes four strategies to start developing academic–community health systems. First, embark on all efforts through cocreation with communities. Second, address how future health care professionals are recruited. Third, build the right skills and opportunities for health care professionals to address health inequities. Finally, develop research agendas to evaluate programs addressing inequities. A fully realized vision of an academic–community health system will demonstrate interdependence between AHCs and the community. While considerable AHC resources are invested in building community capacity to improve health and health equity, health systems will also benefit in a multitude of ways, including increasing the diversity of ideas and experiences integrated into health systems. These strategies will support AHCs to embed across each arm of the tripartite mission a focus on partnering with communities to advance health equity together.

B. Park is assistant professor and director of diversity, equity, and inclusion, Department of Family Medicine, Oregon Health & Science University, Portland, Oregon.

B. Frank is assistant professor, Department of Family Medicine, Oregon Health & Science University, Portland, Oregon.

S. Likumahuwa-Ackman is research program manager, Department of Family Medicine, Oregon Health & Science University, Portland, Oregon.

E. Brodt is assistant professor, Department of Family Medicine, Oregon Health & Science University, Portland, Oregon, and director, Northwest Native American Center of Excellence, Portland, Oregon.

B.K. Gibbs is vice president for equity and inclusion and associate professor, Oregon Health & Science University and Portland State University School of Public Health, Portland, Oregon.

H. Hofkamp is assistant professor and assistant residency director of education, Department of Family Medicine, Oregon Health & Science University, Portland, Oregon.

J. DeVoe is professor and chair, Department of Family Medicine, Oregon Health & Science University, Portland, Oregon, and senior research advisor, OCHIN, Inc., Portland, Oregon.

Editor’s Note: An Invited Commentary on this article by M. Karpf appears on pages 1273-1275.

Funding/Support: None reported.

Other disclosures: None reported.

Ethical approval: Reported as not applicable.

Correspondence should be addressed to Brian Park, Department of Family Medicine, Oregon Health & Science University, 3181 S.W. Sam Jackson Park Rd., Mail Code: FM, Portland, OR 97239; telephone: (503) 494-8211; email: parbr@ohsu.edu.

Copyright © 2019 by the Association of American Medical Colleges