Health Equity

Opinion: A Tale of 4 Babies: Health Equity at the Center of the Quadruple Aim

J. Nwando Olayiwola

Early in my career, I delivered babies. Hundreds of babies. During each birth, I spoke with expectant mothers, partners, and family members about their hopes for the new lives entering the world. Regardless of the education of the family, their income, or race, the conversations were the same. They prayed first for the health of the child—10 fingers and 10 toes—and then for joys and opportunities that far surpassed their own.

In these moments, it was clear to me that we human beings are so much more alike than different.

When children enter this world, however, their realities are different. I know this from my own experience as a Black woman, married to a Black man, raising 2 Black children, and as the daughter of immigrants. I also know this as a physician who has spent my career navigating inequities that manifest daily in my practice. For illustration, if we follow 4 babies from 4 different backgrounds, we can see how health inequities appear and potentially lead to 4 very different outcomes.