Over the past weeks, Indiana Area Agencies on Aging (AAAs) have been reflecting on how best to contribute to the local, statewide and national conversations on racial justice. Our AAAs have individually made their own statements to the communities they serve regarding racial injustice and inequality.

As a statewide association whose members support the health, independence and quality of life of older adults, people with disabilities and complex-care patients by managing social determinants of health, we think the best contribution we can make is to highlight healthcare disparities experienced by persons of racial or ethnic minority status.

Well-documented disparities directly involving clinical health care include access to health care, quality of care, and outcomes of care. Persons of racial or ethnic minority status experience more barriers in accessing and affording care. Quality of care suffers due to both explicit and implicit bias and lack of cultural competency. And outcomes of care are impacted by higher rates of co-morbidities.

But only 20 percent of health care happens in clinical settings. The other 80 percent involves socio-economic influences, health behaviors and the physical environment, all of which lie outside the traditional purview of clinical settings. When people are food insecure, lack transportation, struggle with literacy, experience discrimination and racism, live in substandard housing or unsafe neighborhoods or lack income to provide for basic needs, they experience disparate health outcomes: higher rates of mortality and morbidity, decreased life expectancy, larger health care expenditures, poorer overall health status and more functional limitations.

Indiana AAAs urgently support prioritizing actions that promote racial justice and equality across all these domains to decrease health disparities and improve health outcomes. As individual human service organizations, we prioritize underserved communities as integral to our missions. We commit to purposeful and ongoing attention to data collection, outreach, cultural competency and person-centeredness. And we will lead intentional and meaningful inclusiveness at all levels of our organizations: governance boards, community advisors, agency staff and volunteers.