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Health equity is often discussed as an aspiration in healthcare, but for Octavia Peck Palmer, PhD, FADLM, it has been a guiding principle throughout her career. A past president of the Association for Diagnostics & Laboratory Medicine (ADLM), founder of the association’s Health Equity and Access Division, and recipient of the Humans of ADLM – Diversity, Equity, and Inclusion (DEI) Leadership Award, Peck Palmer has shaped conversations within laboratory medicine about how to ensure everyone has access to high-quality care.
Her work spans advocacy, education, and systems-level change. From leading efforts to embed DEI and health equity into ADLM’s strategic priorities to helping remove race-based adjustments from estimated glomerular filtration rate (eGFR) reporting, she has consistently identified and addressed barriers that prevent patients from receiving the care they need.
We recently spoke with Peck Palmer, who is division director of clinical chemistry at the University of Pittsburgh School of Medicine, about her commitment to health equity, the impact of her Ask a Laboratorian initiative, and the reasons why she believes that health literacy is essential to advancing better outcomes.
Q: What led you to become an advocate for health equity and DEI?
The fact that so many people are medically underserved. I have been fortunate to access and experience quality healthcare. However, knowing that I participate in a healthcare ecosystem that not everyone can access equally is disappointing. I believe that making sure all people can connect with care is part of my job.
Q: Among the many things you’ve achieved in this area, what are you most proud of?
Going into the community and talking to individuals about clinical tests and how to articulate their healthcare needs to their provider, whether that’s a physician, nurse, or nurse practitioner. Sometimes these discussions also help patients communicate more effectively with family members who are trying to help them navigate their health.
The University of Pittsburgh operates philanthropically supported community engagement centers across the region, including one in Homewood, which is historically one of Pittsburgh's largest predominantly Black neighborhoods. After talking with the center's director, Vernard Alexander, about our Ask a Laboratorian initiative, he invited the University of Pittsburgh School of Medicine’s department of pathology to visit the center and engage with the community. My colleague Nathan Clemons, PhD, D(ABMM), MLS(ASCP)CM, a clinical microbiologist, and I spent time with the community introducing ourselves and our profession. We used this opportunity to help individuals learn about clinical tests and their significance and how to navigate their patient portals.
Q: Tell us about Ask a Laboratorian.
Lab medicine and pathology professionals constantly have conversations about how to demonstrate our value as a field. How do we become more transformational, responsive, and proactive? Ask a Laboratorian was designed to help accomplish those goals. It’s a community-centered initiative designed to improve health literacy and empower individuals to take active roles in their care. I am very proud of it!
A similar initiative called Ask a Pharmacist sends pharmacists into communities to teach people how to dispose of expired drugs correctly, understand drug contraindications, and make sense of their symptoms.
Because laboratorians aren’t in front of patients all the time, I was inspired by that model as a means of communicating who we are and what we do. I decided to reach out to see if community engagement centers would be receptive, since their mission is to ensure individuals are equipped to live healthy lives.
Ultimately, building understanding of clinical testing across communities helps people recognize laboratory medicine as integral to their care.
And we regularly look for ways to improve our approach, too. For example, Ask a Laboratorian’s next visit to a community engagement center will be in October, and we plan to survey participants ahead of time to make sure we have the resources they need prior to us getting there.
Q: Can you share examples of the work you’ve done to advance DEI at ADLM?
Prior to becoming president, I founded ADLM’s Health Equity and Access Division and chaired the DEI steering committee, which aimed to understand how the association values DEI and health equity as outcomes of the work we do.
Around that time, while serving on the Board of Directors, I was appointed to the ethics task force. It was a natural progression, since there’s no way to untangle ethics from health equity and DEI: Delivering ethical care demands working to reduce bias.
All of that led to me having the honor to serve as ADLM’s 2023-2024 president. I knew, based on the equity work I had already done, that we needed to go a little bit deeper as an organization. Specifically, we needed to infuse DEI in everything we do, and that could only be done by updating our strategic plan.
I’ve always believed that, when it comes to equity, it’s more important to speak through your actions than your words. I believe ADLM operates in a manner that communicates it values health equity. It’s right there in our mission: better health for all.
Q: How have people benefited from your work in health equity and/or DEI?
Championing DEI and health equity benefited patients across the University of Pittsburgh Medical Center health system when our clinical laboratories adopted a new estimated glomerular filtration rate (eGFR) equation that does not include race as a variable. Before this change, laboratories routinely reported two different eGFR values from the same specimen — one calculated with a race coefficient and one without — leaving clinicians to decide which value applied based on how the patient’s race had been documented or self-identified.
If a patient self-identified as Black or the healthcare professional selected Black as the patient’s race, the patient’s eGFR was calculated and adjusted using Black race as a variable. However, studies have shown that using this approach has likely harmed patients by leading to delays in care, referral services, donor candidacy, and transplants. As a result, in 2021, a task force comprised of the National Kidney Foundation and the American Society of Nephrology recommended clinical laboratories adopt the CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) 2021 creatinine equation, which estimates kidney function without a race variable. I led the adoption of the new eGFR algorithm for use across the healthcare system, an initiative that my department fully supported.
Q: You were nominated for the Humans of ADLM – DEI Leadership Award, but ADLM also wants people to apply for this award on their own behalf. What would you say to encourage self-nominations?
The key reason is it normalizes DEI and health equity, which should be integral components of our profession and how we practice. We can all partner with our medical colleagues and communities to improve healthcare access and delivery. You can be the impetus for change. And nominating yourself demonstrates how well you prioritize not only your career, but also the outcomes of your work — that is, what your career can do for others.
Many of us lose sight of the fact that one day we may be a patient in the healthcare system, if we haven’t been one already. Think about building a system where you’d want to receive care for yourself and your loved ones. If we do that consistently, that’s where the DEI and health equity show up. We all want to have the best possible opportunity to get diagnosed and treated in a timely manner, leading to optimal outcomes.
After all, what is healthcare about if it’s not about equity? Of course, patients won’t all have the same health status, but we intuitively know that intentionally delivering highly variable and biased care would be atrocious. If we’re going to provide healthcare, it must be with the intention of delivering the highest quality care to each person.
Q: What advice would you give to lab professionals who want to advance DEI and health equity but don’t know where to start?
Understand the principles of DEI and what health equity means. Think about your day-to-day life and practice. Is there a gap in access that aligns with one of those principles? Does your work allow for health equity to be realized? How do you relate to these issues?
Once you do that, you’ve got your blueprint. Then you can find your champions, which could include your chair, CEO, supervisor, or lab manager, and start working with them.
I’d love it if people reached out to me. I’m happy to help them map out blueprints for their own areas.
Moriah Sellers is a writer based in the Missoula, Montana, area.