Safety-Net Providers: A Missing Feature of the Health Equity Research Landscape.

Safety-net health care systems disproportionately serve the most marginalized and historically excluded groups in the U.S. Research from these systems not only focuses on those most affected by health inequities but is often strengthened by environments that are rich in direct experience, genuine community engagement, and awareness of social injustices. Despite this, research from safety-net systems is limited. Safety-net institutions face substantial structural barriers, primarily financial, that undermine their capacity to develop necessary infrastructure and compete for grants. We present a case study of a research center based in a safety-net system in Chicago to explore these challenges and potential solutions. Recommendations include the implementation of equity-focused funding approaches, research collaborations that take advantage of the expertise and community connections of safety-net providers, and strengthening the complex funding structure for safety-net hospitals. Health equity research must be driven by those most affected, and safety-net systems are well-positioned to help accomplish this.