Health Equity, Patient Centricity, Patient Diversity: Building Trust in the Communities We Serve

For the past few years, health equity, patient centricity and patient diversity have been the new buzz words, spurred on by social unrest in the United States and a global pandemic, but what do they actually mean? What do they look like in practice? As an industry, we recognize that these should have been our focus all along, but with that realization comes the question, how do we go from concept to reality?

Change starts from within. I would suggest that no matter where you sit in the healthcare space – pharma, payer, HCP, or other – a mindset shift is the necessary start for the buzz words to go beyond a notion, to being engrained in the fabric of our organizations and industry. This requires buy-in at all levels, from the top down. Education and training are needed to understand the true meaning of health equity, the contributors to health inequity beyond the medical, and equitable access to all healthcare options—including clinical trials. We must change the narrative to one that acknowledges the impact of factors such as race and ethnicity on quality healthcare.

A commitment to advancing health equity cannot be seen as the responsibility of a particular person or role in organizations or the responsibility of a particular healthcare sector. Everyone needs to see themselves as part of the solution and identify ways in their “sphere of influence” to incorporate change. This requires that organizations make an investment in educating their employees, but also in the communities they are seeking to serve.

We must “show up.” There is a famous quote often attributed to Albert Einstein that says, “insanity is doing the same thing over and over and expecting a different result.” Applied to the healthcare industry, this means that we cannot continue to put the burden on patients to proactively seek out healthcare services and solutions and then wonder why the most vulnerable and underrepresented populations are still left out. The responsibility lies with us as an industry to bring services and solutions into these communities – from providing awareness to enabling access. A community-based approach to healthcare in all sectors is key. 

In 2021, the Centers for Disease Control and Prevention called racism a “serious threat” to public health1, but we also know that “medical care accounts for only 10-20% of health outcomes2.” What does this mean? How do we reconcile these two statistics? We must understand that while racism is a threat to public health, it is not just pervasive in the lack of access and awareness about healthcare for vulnerable populations, but also in the social and environmental factors that influence the overall health of these populations, such as food insecurity, access to education, etc. An effective community-based healthcare approach recognizes the additional barriers to equitable healthcare that exist and seeks to meet needs without agenda. According to a 2021 Pew Research survey of Black Americans, 52% said “a major reason why Black people have worse health outcomes than others is because they live in communities with more environmental problems that cause health issues3.” So how can we as the healthcare industry “show up?” 

One Vice President from an pharmaceutical industry survey conducted by Deloitte Insights stated, “We [the health care industry] have a very tall hill to climb and trust has to be at the core, given the past injustices to Black bodies. It will take time and investments, more than just money.” Fortunately, there are some healthcare companies doing just that. 

Companies have established food pantries in communities where they are located and are providing relevant disease and health information to the populations most at risk. This is fundamentally the right thing to do, and more companies must show up this way. The added bonus is that trust is built by continuously “showing up.” Now when it’s time for an individual to see a doctor or participate in a clinical trial, the relationship with the community has been established. The individuals within the community know your name –and most importantly they know you care.

Benjamin Franklin said, “No one cares what you know, until they know that you care”. Applied to the healthcare industry, this would read, “no one cares what you have, until they know that you care”. We can have the best healthcare solution, service or clinical trial, but until the community knows that we care, they don’t care what we have.

Contributor: Angel Akinbinu, Director of Site and Patient Diversity, Syneos Health

References

1Media Statement from CDC Director Rochelle P. Walensky, MD, MPH, on Racism and Health | CDC Online Newsroom | CDC

2Social Determinants of Health 101 for Health Care: Five Plus Five - National Academy of Medicine (nam.edu)

3Black Americans’ views about health disparities, experiences with health care| Pew Research Center

4Trust in the health care system | Deloitte Insights