Simplifying Healthcare: What You Need to Know This National Minority Health Month

In my last newsletter , I shared a special Women’s History Month edition of Simplifying Healthcare focusing on women’s underrepresentation across clinical trials, investment, and healthcare leadership. For this edition, I thought I would take a similar approach with National Minority Health Month (NMHM) and discuss disparities in data, coverage and funding, as many of these same issues translate to racial and ethnic minority groups across healthcare.??

The U.S. Department of Health and Human Services (HHS) Office of Minority Health has announced this year’s NMHM theme as “Be the Source for Better Health” –?a call-to-action to improve health outcomes through providing equitable, culturally informed care.

People’s health outcomes differ across their individual and community’s lived experiences. When we think about engagement strategies and involving patients in their own care, it’s incredibly important for systems, researchers, and providers to all be patient-first and culturally mindful in their work.??

One of the organizations that is currently doing this well is MyLúA Health , who I’ve previously spoken about in my newsletter . Their focus on meeting patients and providers where they’re at through the use of accessible digital tools in a culturally focused and sensitive manner can be used as a model for patient engagement across populations.

In addition to culturally competent care and the patient-provider relationship, it’s vitally important to think about how we engage diverse populations across all health care ecosystem touchpoints, including research, investment, policy and community outreach efforts. As vast issues of disparity are complex and not entirely “simplify-able”, I’ll instead focus on sharing my thoughts and key disparities to keep top of mind during this year’s recognition of National Minority Health Month.??

Social Determinants of Health?

Social determinants of health are defined as non-medical elements (often political, social and economic) that influence health outcomes of individual patients and populations. These can include factors like geographic location, access to food or (lack thereof in food deserts), education and job opportunities, and income.??

As an example of the social determinants of health in practice, my former colleagues in South Dakota and I reviewed prostate cancer mortality rates across local male populations and how other non-health factors could be affecting those disparities across different races. We found the Native American male population had higher mortality rates when compared to white males, which was found to be caused by the lack of access to treatment.? While the original hypothesis was that this was driven by lack of access to insurance coverage, upon further review, we found this was not the case. Because the typical treatment protocol required daily visits to the hospital, and the Native people did not always have access to the transportation needed to travel to the care facility for the multi-round course of treatment, the ability to meet the standard protocol was difficult. Uncovering the root cause provided the insight needed to adjust how the radiation therapy was offered to allow for other transportation solutions.??

When focusing on healthcare-related factors, access to coverage also continues to be a driver of disparity across populations. While the national uninsured rate declined over the last decade by around 5% due to the Affordable Care Act, Hispanic and American Indian/Alaska Native populations still report higher uninsured rates in comparison to other groups.??

Not seeking care due to lack of coverage and increased cost further widens treatment gaps, fragments care needs, and worsens health outcomes for these populations. However, insurance stakeholders can eliminate some financial barriers through actionable efforts like contracting essential community provers (ECPs) to expand provider networks and extending cost-sharing to all services needed to jumpstart preventative care as part of the Affordable Care Act.?

Representation in Clinical Trials and Data?

Understanding the unique needs of distinct populations is a critical piece of the larger movement toward health equity. We need to ensure full representation of the end-patient population in clinical trials and the data sets we’re building models on to improve health outcomes across diverse populations.?

As we found to be true with women’s clinical trial representation in last month’s newsletter issue, representation of racial and ethnic groups in these studies is significantly lower when compared to their share of the population . By not engaging a more diverse group of trial participants, a vicious cycle occurs in which treatment gaps across populations are widened, and patients are further exposed to bias and assumption, which erodes their confidence in the healthcare system and begins the cycle anew.??

However, there is work underway to be more inclusive. One area of improvement is through the use of AI and clinical algorithms to help mitigate bias and ensure diverse representation in healthcare R&D. These often include tactics like demographic/healthcare data analysis to identify underrepresented populations, language adaptation of outreach and trial materials, and virtual trial facilitation, which ultimately ensure end-to-end culturally informed engagement throughout the entire clinical trial process.?

Organizational Investment?

With collaboration across key players in the healthcare ecosystem, the industry is finally beginning to gain traction in thinking through equitable care for all –?but investment will need to continue and continue over time.?

According to 德勤 's 2024 Health Equity Outlook , just over half of healthcare leaders surveyed anticipated increased organizational investment in health equity, and 80% responded that health equity comprised their top business goals this year.???

Addressing disparities and achieving equitable health outcomes certainly seems to be a priority for many organizations, starting with efforts like data quality improvement and culturally informed community engagement. It’s easy to move away from business goals that don’t produce a short-term ROI, but health equity is a long-term effort that requires buy-in from all stakeholders to move the needle.??

Looking Ahead + Final Thoughts??

As I say with many things in our industry, these challenges do not have easy or immediate solutions. Underrepresented groups in healthcare will require continued dialogue, advocacy, and measurement to see any meaningful change.?

Please look forward to next month’s issue of Simplifying Healthcare, where I’ll break down what readers need to know about the Biden-Harris Administration’s recently announced Strategy to Strengthen Global Health Security .??

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Until next month.???

- Ruth ????

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Have an idea for a future topic or questions in the world of healthcare? I’d love to hear from you!?