Disparities exist in different sectors of the world, and the race to make certain aspects of life equally accessible is a constant challenge.
Reducing health disparities has been on the agenda in the medical world for several years. Unfortunately, even though equity is one of the several objectives of social development, health inequities keep increasing in “small but substantial proportions of countries.” This may primarily be due to reduced health status and service coverage in poor populations.
This means there are avoidable, unjust differences in how certain people or societal groups are given access to healthcare in several countries, especially among the poorer population.
Health disparities in pharmacy practice can affect patients’ access to prescription medications, medication counseling, prescription refills, and other pharmaceutical care.
According to several evaluations, connections have been made between the prevalence of health disparities and social determinants of health (SDOH) and how SDOH can contribute to these disparities.
In this blog post, we’ll explore how pharmacists can help reduce health disparities and maintain equitable access during practice.
What Are Health Disparities?
According to the Centers for Disease Control and Prevention (CDC), health disparities are preventable differences that affect an individual’s health outcome (e.g., mortality, health status, life expectancy, etc.) or the person’s ability to achieve optimal health.
Health disparities are usually influenced by a person’s social or economic status, environment, and geographic location.
It might be necessary to distinguish between health equity, health disparities, and health inequities to understand health disparities.
Health disparities are caused by health inequities, defined as differences in health outcomes and distribution of health resources that stem from unfair and unjust systemic policies and practices that create barriers to health opportunities.
Health equity, on the other hand, refers to the state in which everyone has a just and fair opportunity to achieve their highest state of health regardless of social or economic differences or other factors that affect a person’s access to care or health outcomes.
Causes of Health Disparities
There are different causes of health disparities, including:
Education Inequality.
According to the CDC, there is an education-health disparity link where the likelihood of individuals experiencing health risks like obesity and intentional and unintentional injury increases with low levels of education.
Compared to people with a low level of education, individuals with a higher level of education can access and understand basic health information that can help them make appropriate health decisions.
Poverty.
One of the social determinants of health is poverty, which increases an individual’s health risks.
For example, someone experiencing poverty may have limited access to food, clean water, and a sanitary environment, all of which can exponentially increase the spread of diseases and compromise the person’s immune system.
Access to healthcare is also limited in rural communities, as seen in a study where Americans living in rural areas are more likely to die from certain health risks compared to those in urban communities.
Lack of Healthcare Access.
Lack of healthcare access or even poor quality of healthcare can result from several factors, including social determinants of health like culture, education, finance, etc., implicit bias on the part of the healthcare provider, and stigmatization, among others.
This lack of quality access to healthcare can result in differences in the health outcomes of affected individuals (health disparity).
Individual Factors.
Individual factors, including lifestyle and healthy behaviors, can result in health disparities because a person’s behavior toward their health shapes their general health and well-being.
Unfortunately, some behaviors are riskier than others.
For example, the health outcome of a smoking addict might be different from that of someone who doesn’t smoke but has the same health condition.
Environmental Conditions.
Environmental conditions like poor air quality can significantly affect an individual’s health status and outcome, increasing health disparity.
Strategies for Reducing Health Disparities in Pharmacy Practice
Pharmacists can help reduce health disparities in respective communities in different ways. Technological advancements and pharmacists’ expanding roles have made this much easier.
Here are some proven strategies pharmacists can use to reduce health disparities:
Addressing Cultural Incompetence.
Cultural competence is needed, especially for pharmacists who often have direct access to patients. It involves understanding how a person’s or society’s cultural beliefs can influence their health decisions.
Cultural incompetency must be addressed and eliminated in pharmacy practice to reduce health disparities.
This can be achieved by understanding the cultural beliefs of the community you serve and the cultural diversity of individual patients and by providing informed counseling for each person.
Using Memes to Bridge Health Literacy Gaps.
Memes might sound silly, but the use of memes to convey complex medical information can be surprisingly effective.
It is a creative idea that utilizes humor to engage with the patients and make them pay attention to the information they need.
According to a study, factual memes can help increase health literacy, especially among socially active vulnerable groups, because memes are easily shared across social media platforms.
However, when using memes, it is important to note culturally acceptable lingo, the use of large, clear fonts, and inclusive images.
Using Language Interpretation Services.
Language barriers are one significant cause of health disparities. They directly affect the communication between the pharmacist and the patient, leading to inaccurate and unsatisfactory service.
However, language interpretation services can help eliminate this barrier and significantly reduce health disparity due to the language barrier.
Language interpretation services include human interpreters and sign language for people with hearing impairments.
Organizing Community Outreaches.
Community outreaches can help bridge the literacy gap that might contribute to increased health disparities.
Education is a crucial aspect of health as it helps patients understand what is happening in their bodies. This automatically gives them the ability to make informed health decisions. It also increases the feeling of inclusivity and can significantly improve medication adherence.
Pharmacists can help reduce health disparities caused by illiteracy by collaborating with community leaders to organize community-based outreaches, where the local community can be educated on relevant health issues using culturally relevant resources and people.
Providing Personalized Medication Counseling.
An important point about the definition of health disparities is that it focuses on avoidable differences in an individual’s health outcomes.
Differences in health outcomes can also result from a lack of understanding of your patient’s needs.
Every patient, even in the same social group, has different medical needs. A pharmacist’s ability to offer personalized medication counseling to each patient can help increase their health outcomes, which are heavily influenced by their treatment regimen, including medications.
Offering Point-of-Care Testing to Underserved Communities.
Offering point-of-care testing (POCT) to underserved communities can increase access to healthcare services and reduce health disparities.
For example, people living in rural communities have been known to have limited access to medical services, including pharmaceutical services. Pharmacists can organize outreach programs to these places and offer POCT services.
This gives the underserved population significant access to healthcare, where they can get tested and get their results, and high-risk individuals can be identified and given the right treatment just in time.
Activating Patient Assistance Programs (PAPs).
Patient assistance programs are usually pioneered by pharmaceutical companies, but some state programs and NGOs also participate in them.
PAPs aim to provide underinsured or non-insured patients access to medications.
This means that Americans who do not have the luxury of being under a health insurance program or whose insurance does not cover their medications can register with a patient assistance program where they will be given access to needed medications with little to no cost.
However, the assistance offered varies from program to program, as do the eligibility requirements.
Pharmacists can help their affected patients by encouraging them to sign up for some of these patient assistance programs.
Actively Advocating for Health Equity.
Through effective communication with patients, pharmacists can identify different causes of health disparities in their community and advocate for change.
Pharmacists can help reduce health disparities by speaking out against them and working with other health professionals to advocate for policy changes that promote equitable access to resources for everyone.
Encouraging the Use of Telepharmacy Services.
Telepharmacy services use telecommunication technology to provide pharmaceutical services to people living in rural and underserved communities.
They are also helpful for patients with limited access to pharmaceutical care due to the gravity of their health or reduced mobility (as seen in older adults).
The role of pharmacists in reducing health disparities among this group would be to encourage them to use available telepharmacy services. This can also include training older adults on how to use the services or platforms effectively.
How I Used Population Health Management to Reduce Health Disparities
My journey in population health pharmacy began with a simple but profound question:
As a Black pharmacist, how could I make a meaningful difference in ethnic populations and underserved communities?
This question drove me to study the specific healthcare needs of those around me, especially people from backgrounds that, like mine, often faced barriers to quality care.
For example, my sister, who is disabled, has frequently received inequitable care. As a
population health pharmacist, I made it my mission to incorporate disability-focused
services into the programs I created.
Growing up with a Mexican stepfather introduced me to Latinx culture and the unique
healthcare challenges that Latinx individuals often face. My intermediate Spanish skills became a bridge in my work with Latinx communities, where I refined my cultural
competency and provided care beyond medication.
Sometimes, this meant spending extra time on the phone with a patient to listen to non-medication-related concerns, letting them know that I cared about them as a person. These conversations fostered trust in my clinical advice and allowed me to offer more meaningful,
personalized care.
I also integrated social determinants of health (SDOH) into my pharmacy programs. For example, despite functioning as an HEDIS Medi-Cal Program Manager, I collaborated with teams across states. I worked two years in advance to establish and connect members with local food Rx programs, which linked patients to community-based organizations (CBO's).
This was important because to support patients in achieving lower hemoglobin A1c's, they needed access to food and medications that empowered them to do so.
I also proposed and fostered partnerships between population health nurses and physicians and myself to expedite patient case resolutions. With my work, I chose to advocate for maternal health equity initiatives to reduce Black maternal deaths and created training on trauma-informed care to increase awareness of issues, e.g., historical trauma and medical mistrust, affecting Black and Native American, aka American Indian and Alaskan Native (AIAN) patients—this is something I continue to do at aPHP.
My journey in population health pharmacy has been about more than filling prescriptions or managing clinical cases. It has been a commitment to bridging the gaps that often divide patients from the care they deserve and referencing my lived experience to do so.
Through lived experience, cultural understanding, and a drive to advocate for equitable healthcare, I have developed a practice rooted in compassion, collaboration, and an unwavering belief in the power of pharmacists to make a difference.
Conclusion
The impact of health disparities on the patients should be taken seriously. From increased non-adherence to medication to mortality, it can have significant effects on families, communities, and society at large.
Pharmacists are crucial players in reducing health disparities because of their unique position in the healthcare system, and every opportunity should be utilized to increase health equity among patients.
Pharmacists should also understand that reducing health disparities is not a one-person job and be open to collaborations with other healthcare professionals, community leaders, and fellow pharmacists.
Together, we can create a system for a just and fair distribution of access to resources that affect the health outcomes of the general population.
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