Disparities in Healthcare: A Persistent Challenge

Healthcare disparities refer to unequal access to medical treatment and services based on race, ethnicity, socio-economic status and geographic location. These disparities are a persistent challenge and have a significant impact on the health and well-being of millions of people across the country.

Minority populations and those living in poverty are particularly vulnerable to healthcare disparities. They often have limited access to quality medical services and are at a higher risk of chronic health conditions. This is due to factors such as lack of insurance coverage, language barriers, cultural beliefs and geographic barriers that prevent access to care.

Additionally, patients with chronic and/or serious health conditions are disproportionately affected. The Consumer Financial Protection Bureau (CFPB) report stated that those who have consistent medical debt over the course of their lives are 76% more likely to suffer from chronic pain. Individuals encumbered with medical debt are also more likely to die younger. This is due to several reasons:

1. Lack of insurance coverage: People with chronic health conditions often require frequent and ongoing medical treatment, which can be expensive. Without insurance coverage, they may have limited access to the care they need, putting their health at further risk.

2. Inadequate medical services: Minority populations and low-income communities often lack access to quality medical services, making it difficult for people with chronic conditions to receive the care they need. This can lead to a lack of proper treatment and management of their conditions, which can lead to further health problems.

3. Cultural and language barriers: People with chronic health conditions who come from minority communities may face language and cultural barriers when seeking medical care. This can make it difficult for them to understand their health condition and treatment options, leading to inadequate care.

4. Limited access to specialty care: People with chronic and serious health conditions may require specialized medical services that are not readily available in their communities. This can result in a lack of proper treatment and management, leading to a decline in their health.

5. Financial toxicity: People with chronic health conditions may have to bear a disproportionate economic burden due to the high cost of medical care and lost income due to illness. Stressing about the financial burden can further exacerbate their health problems and reduce their quality of life.  

These disparities can have serious consequences for people with chronic and serious health conditions, leading to worse health outcomes and a lower quality of life. Patients experiencing financial toxicity may forego or delay care because of the financial burden. CoverMyMeds reports that 66% of patients experienced anxiety and depression symptoms as a consequence of delays in their therapy, and 54% of those, as a result, started taking medication in addition to their prescribed, but delayed therapies.

What can be done to bridge the gaps and reduce disparities?

Investing in and improving health equity requires a multifaceted, multidisciplinary approach. The COVID-19 pandemic has created additional challenges for patients and families due to unemployment, loss of insurance, expenses associated with hospital and intensive care unit admissions and expensive medications. Additionally, CMS has implemented a new health equity measure this year to keep this top of mind for providers. Providers can improve health equity by implementing the following strategies:  

1. Addressing Social Determinants of Health (SDOH): Providers can identify and address social determinants such as poverty, education and housing that have a significant impact on patients' health outcomes. According to the U.S. Department of Health and Human Services (HHS), It is estimated that clinical care impacts only 20% of county-level variation in health outcomes, while SDOH affect as much as 50%, with socioeconomic factors such as poverty, employment and education delivering the largest impact on health outcomes.

2. Implement or improve patient financial assistance strategies: Providers may be offering patient assistance in some capacity, but the most efficient way is to utilize technology that automatically matches patients to programs and foundations that offer philanthropic aid to vulnerable populations. Additionally, improving the enrollment process beyond manual practices is critical for efficiency and to improve the ability to help as many patients as possible.  

3. Improving cultural competence and language access services: Providers can provide training to staff to improve their cultural competence, which involves understanding and respecting patients' cultures, languages and beliefs. Additionally, providers can ensure that patients who are not fluent in English receive interpretation services to improve communication between patients and healthcare providers.

4. Increasing community outreach: Providers can partner with community organizations to educate and engage communities on health issues and provide care and wellness services to underserved populations.

Reducing disparities in care will always be a challenge within healthcare. It may take decades until health equity is achieved. However, there are steps that providers can take now to inch us closer to an equitable state.