Over the past few weeks inequities and health disparities in quality of care have been highlighted with reports showing how COVID-19 has been infecting and affecting vulnerable populations and marginalized communities at a disproportionately high rate. Although COVID-19 doesn’t see dimensions of diversity such as race, location, gender, age, or socioeconomic status, it is highlighting our healthcare system’s role to play when it comes to addressing inequities and health disparities of care for more vulnerable populations.
Although the resulting findings are outcomes of multiple variables, systems, and institutions – healthcare providers and life sciences companies should be thinking about their role in creating equity within the industry as we are impacted by COVID-19 but additionally the new normal that we will experience as we recover from the virus.
We have seen the following key areas where the healthcare industry has shown areas for improvements in their attempts for greater diversity and equity:
- Addressing our approach on clinical trials for treatment and vaccines
- Ensuring health and safety of essential workers
- Mitigating bias of medical personnel and healthcare workers
- Understanding disparities in pre-existing conditions
Health Disparities and Inequities: Addressing Our Approach on Clinical Trials for Treatment and Vaccines
As pharmaceutical companies are proactively working to create antivirals and a vaccine for the novel coronavirus, in addition to all pharmaceutical drugs on the market, it is important to incorporate inclusivity on a holistic level when it comes to trial design and execution. A ProPublica analysis found that African Americans and Native Americans are under-represented in clinical trials of new drugs, even when the treatment is aimed at illnesses that disproportionately affects them. Last year the FDA released guidance on increasing diversity and inclusivity in clinical trial design, as studies show that only 5% of participants are African American (12% of the US Population) and 1% are of Hispanic descent (16% of population). This has shown to have potentially drastic effects on patient outcomes. For pharmaceutical companies determining if they should start, stop, or continue their clinical trials during this time, it is imperative to focus on mitigating bias when it comes to trial design and increase outreach, advocacy, and cultural competency in this effort.
No matter what the drug being tested is, there are specific questions you should be asking. Does the location of the clinical trial prevent individuals to be able to participate? Does the timing of the trial make it difficult for individuals of certain occupations to take off work? Are there ways to provide childcare and offset cost? Have we performed enough outreach and education in communities in which we lack representation? Addressing these questions, among others, can help promote inclusivity and embrace genetic diversity.
Ensuring Health and Safety of Essential Workers
There is no better time than the present for the healthcare industry including hospital personnel, pharmaceutical and medical device manufacturers, and insurance providers to consider the future of delivery of care and distribution of resources. Recent studies show that 78% of social workers, 77% of health care workers, and 53% of critical retail workers are women. In addition, it’s these workers: in public transportation, grocery store associates, in-home care providers, among others, that are upwards of 50% more likely to be people of color, of lower economic status, and undocumented immigrants, putting them at higher risk of being infected by respiratory viruses such as COVID-19. It’s also these workers that are less likely to afford or have access to health insurance.
Mitigating Bias of Medical Personnel and Healthcare Workers
Over the last decade there has been consistent research that has been published highlighting the disparities in the quality of care provided to those of vulnerable populations; highlighting empathy gaps that arise based in race and occupation, with less sympathy and empathy to patients of color experiencing pain. As we look toward the future and solutions, it’s important that the healthcare industry focuses on implementing measures to reduce the bias in the field such as educating medical practitioners on the impacts of unconscious bias on the outcomes of their patients through mandatory trainings, proactively increase diversity of employees, and increase outreach and community partnerships.
Understanding Health Disparities in Pre-existing Conditions
As we’ve seen as data has been released, marginalized and minoritized patients have and will continue to suffer disproportionately during the COVID-19 crisis. The inequities and health disparities related to race have been the forefront of media news coverage, as reports demonstrate that individuals of color have higher rates of obesity, diabetes, and asthma making them more susceptible to getting the virus. There are also impacts on those differently abled, language access, families of mixed documentation and their ability to receive quality care that should be considered by those in the health care and life science industries.
The COVID-19 crisis has highlighted areas in which our industries can improve and mitigate health disparities and inequities in the life science and health care industries: from drug development and clinical trial designs, understanding and mitigating the disparities in pre-existing conditions, ensuring the health of those in the front lines of healthcare service – especially during this pandemic, and proactively working to mitigate own biases towards diverse patient populations. There is significant room for improvement in equity from discovery to delivery.
“Whiteness and maleness are implicit. They are unquestioned. They are the default. And this reality is inescapable for anyone whose identity does not go without saying, for anyone whose needs and perspective are routinely forgotten. For anyone who is used to jarring up against a world that has not been designed around them.” – Caroline Criado Perez, Invisible Women: Data Bias in a World Designed for Men