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Overcoming 5 Leading Obstacles to Achieving Racial Health Equity

Implicit bias, patient trust, care access barriers, unequal healthcare quality and patient experience, and racism in R&D and clinical practices are barriers to racial health equity.

The medical industry is far from achieving racial health equity, according to a new report from Accenture. But it could be.

The report, which outlines some of the stark racial health disparities still plaguing the US, also looks at the barriers keeping the nation from confronting its problems and a roadmap for mitigating these issues.

Looking at race, specifically, because it is the most prominent predictor of health inequity, the researchers noted that outcomes still aren’t equitable for all. There are 3,400 more infant mortalities among Black babies than White, the report authors said, and an additional 9,200 Black cancer deaths each year, too.

Racial health inequities result in more than 200 life years lost among Black people via a reduction in life expectancy, the researchers added.

“Companies can create and lead in a new performance frontier of health equity,” the report authors said. “A reinvention mindset with a health equity lens across the enterprise will make Life Sciences organizations, Health, and Public Health institutions stand apart.”

5 Barriers to health equity

In an analysis of peer-reviewed research and expert commentary, the researchers outlined the five interconnected barriers blocking health equity from coming to light: implicit bias, lack of trust and fear, access barriers, uneven quality and experience, and racism in research and development or clinical practices.

“We understand that inequities result from historic and systemic barriers that require interpersonal, institutional and policy changes to resolve,” the researchers noted. “Nevertheless, these five interconnected obstacles give healthcare ecosystem participants a unique opportunity to address inequity through tangible actions.”

There are economic costs to letting these barriers stand, the researchers said. Citing 2018 figures from the W.K. Kellogg Foundation, the Accenture authors pointed out that racial health inequities can rack up a bill of $93 billion in excess medical spending each year. That’s not to mention the human cost of health disparities.

The report goes on to say that the healthcare industry needs a unified approach to upending these racial health inequities, working to address the root causes of disparities.

Realigning the healthcare ecosystem

The report looks to three key medical industry sectors—payers and providers, biopharma, and public health—as responsible for bringing action to health equity. Foremost, these actors need to address algorithmic bias in data analytics, design inclusive products and services, and create sustainable structural change, the Accenture authors recommended.

For the healthcare payer and provider space, that will look like casting a second glance at data analytics insights produced by an algorithm, which the industry knows can be subject to bias. It will also include emphasizing cultural competence, packaging services with consideration for health literacy, making long-term philanthropic investments, and aligning executive incentives with health equity.

For biopharma, the researchers emphasized diversity in clinical trials and consideration for patient access during the product development and marketing phases. Moreover, efforts to support treatment affordability, improve the patient experience, and account for algorithmic bias will be essential.

Finally, the researchers said public health entities should prioritize better health data interoperability and exchange, develop SDOH and quality-of-life programs, and create an accountability structure for health equity. Equally important will be identifying valuable community health partnerships and pushing or pulling on the most effective policy levers.

Boosting equity would churn ROI, save lives

Acting on this realignment would not just pay dividends, but it would save human lives, the report authors mentioned. For example, programs to support better health insurance literacy among Black and Latino patients would result in 3.8 million more lives accessing preventive services. In dollars and cents, a health insurance literacy program would return $699 million for health payers.

Investing in clinical decision support tools for Black cancer patients would yield $655 million in provider revenue for recommended surgeries, but more importantly, would save 42,000 lives.

And by equitably recruiting patients for clinical trials, biopharma companies would see $487 million in revenue per successful drug. Equitable trial recruitment would also result in 26,000 more patients getting a drug that could save their life, the researchers said.

“The time has come for the healthcare ecosystem to act, individually and collectively, to address historical inequities,” the report authors concluded. “By adopting a philosophy of continuous reinvention, healthcare ecosystems can keep redefining what is possible. Progressing health equity through continued learning, and change, will unlock more and more human and economic outcomes.”

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