What can pharma do about social determinants of health?

The Milwaukee Bucks–my home town sports team–yesterday boycotted Game 5 of their NBA playoff series. This historical event serves to bring attention to the inequalities African-Americans and other minorities face in our society. In health care, disparities also exist. As I mentioned in my Health Affairs blog piece with Meena Venkatachalam, COVID-19 has highlighted these inequalities:

African Americans represented 13 percent of the US population, as of May 30, 22 percent of COVID-19 patients were black. Furthermore, as of March 30, 33 percent of hospitalized COVID-19 patients were African American. These health disparities were well known before the COVID-19 pandemic; life expectancy for African Americans in the US is 3.5 years lower than for the American population as a whole.

A key question is what can pharma doing about ameliorating social determinants of health (SDOH) that lead to inequalities in health outcomes? My colleague Maureen Hennessey summarizes some of these initiatives in a piece in Clinical and Medical Affairs. Just a few of her many sage recommendations are below:

  • Strategic planning. Formulate a strategic plan to address SDOH, integrating SDOH within a precision population health strategy.
  • Diversity hiring: Commit organizational leadership to diversity in hiring, development, and training, including cultural competency training
  • Inclusive trial design: Promote clinical trial designs that better assess and address participation barriers, gaining input from diverse populations
  • Inclusive clinical trial outreach: Support participatory discussions by healthcare providers with patients about clinical trials and other options; discussions should be supplemented by informational materials and strategies relevant to patients’ ethnicity, culture, language, and cognitive functioning
  • Measure, measure, and measure again. Collect, analyze, and develop data obtained on SDOH to drive preventive and predictive biopsychosocial strategies and algorithmic interventions
  • Work to improve health literacy. Develop resources to support healthcare providers, patients, and caregivers in advancing health literacy
  • Join the policy discussion. Engage in policy development that reduces unnecessary government restrictions and proposes structures and safeguards to advance innovation and scientific research to address social determinants and promote population health

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