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Disparity affects people of all kinds, but it is particularly relevant to racial and ethnic minorities. Statistics show that minority groups — including African Americans, Asian Americans, Hispanic or Latino Americans, Native Americans, and Pacific Islander Americans — have difficulty accessing and receiving health care. More specifically, they experience disparities in health coverage, quality of treatment, and prevalence of chronic health conditions.
When it comes to health coverage, statistics show that only 5.9% of white patients were uninsured in 2017. This is compared to the 10.6% of African Americans, 7.3% of Asian Americans, 16.1% of Hispanic or Latino Americans, 14.9% of Native Americans, and 8.3% of Pacific Islanders who were uninsured. Dayna Bowen Matthew, JD, Ph.D., reports that the problem isn’t minorities’ unwillingness to get insurance; it’s the socioeconomic inequality they face that renders them too poor to afford it.
Because they have to pay out-of-pocket, minorities are also less likely to seek out medical treatment. As a result, they are disproportionately affected by health problems. For example, in 2017, 8.3% of white patients reported having fair or poor health to the US Department of Health and Human Services (HHS). In contrast, 13.8% of African Americans, 10% of Hispanic or Latino Americans, and 17.4% of Native Americans reported having fair or poor health. Minorities are also more predisposed to certain diseases, like Hepatitis C, tuberculosis, and HIV/AIDS, than white populations. Clearly, there is a direct correlation between lack of healthcare access and ongoing health problems in minority communities.
When minorities do choose to seek out care, however, they still experience lower quality treatment. The National Center for Biotechnology Information (NCBI) finds a strong relationship between a patient’s race and their course of treatment. For example, it reports that African American patients are less likely to receive any of the 16 most commonly performed hospital procedures, creating a significant gap in care. Further, Hispanic and Latino Americans and Pacific Islanders are less likely to receive quality inpatient and outpatient treatment than any other group.
Healthcare disparities don’t just exist in primary care — they also happen in pharmacy care. This can be seen in the rising number of pharmacy deserts that disproportionately affect minority communities, particularly African American and Hispanic or Latino American communities. Pharmacy deserts are defined as neighborhoods in urban areas that are more than 1 mile away from a pharmacy; or, in lower-income neighborhoods with less transportation, that are less than 0.5 miles away from a pharmacy. A report from Health Affairs found that in the 30 most populous cities in the U.S., minority communities were a hotspot for pharmacy deserts. The most pronounced disparities were in Chicago, where roughly 1% of white neighborhoods were pharmacy deserts, compared to 33% of Africah American neighborhoods in the city.
Pharmacy deserts are just one example of disparity. As pharmacies become more and more clinical, they may also fail to perform necessary tests or run routine procedures on minority patients, just as primary care providers do. Rising costs of insurance and higher out-of-pocket prescription costs may also make it more difficult for minorities to get the services they need. Healthcare disparities are therefore not just relevant to hospitals and doctor’s offices, but also to pharmacies.
As with any issue, the problem of healthcare disparity is complex. A number of factors play into who receives care, as well as the quality to which they receive it. However, the CDC reports several leading causes of healthcare disparity. They include discrimination, poor housing and infrastructure, lower-paying and higher-risk occupations; education, income, and wealth gaps; and lack of insurance, transportation, and childcare.
Healthcare disparities have serious consequences. For minorities, they lead to greater health risks and more cases of illness and disease. As a result, they contribute to higher mortality rates and lower quality of life. In addition, they reinforce healthcare inequality, which will continue to grow if action is not taken. Finally, they perpetuate inequality in other areas of society and lead to a less inclusive world altogether.
In the fight against healthcare disparities, pharmacies and pharmacists are on the frontline. The American Society of Health-System Pharmacists (ASHP) reports that, as medication-use experts, patient care providers, and health system administrators, pharmacists can use their role to make a difference. They are strongly positioned to identify social determinants of health and mitigate any obstacles that prevent care.
Independent pharmacies in particular play an essential part in identifying and eliminating disparities. Because they live and work within minority communities, pharmacy staff understand the problems rooted in their communities. They also maintain relationships with minority patients, which gives insight into the unique challenges they face. And, because they have a genuine desire to provide care to all people, especially those in their own communities, they are more apt to meet these challenges with enthusiasm. Here’s what your pharmacy can do to help:
First and foremost, you should educate yourself and your staff on the realities of race-related disparities. You can accomplish this in a number of ways: attending classes and seminars, staying up-to-date on new data and statistics that come out regarding disparities, and, most importantly, talking with people who are directly affected by them. In any case, being aware is the first step to creating change, so make sure that you and your staff understand the full experiences of the people you serve.
Once you and your staff are educated, you are better equipped to spread the word about disparities in your community. Whether it be in day-to-day conversations with patients or in pharmacy-sponsored awareness events, it is up to you to ensure that your community identifies and understands disparities — not just in healthcare, but in all aspects of life. By bringing attention to the issue, you can get other patients involved and increase the number of people working to make a difference.
Not only is it important to monitor state-wide and national data on healthcare disparities, but it is important to collect your own data in your pharmacy to better understand your patients, particularly your minority patients. By tracking who comes into your pharmacy, what unique struggles they face, and what particular goals they have, you can better understand the disparities specific to your area. You can also gauge how your pharmacy is doing in addressing obstacles that may arise due to social determinants of health.
Because different patients come from different cultures, they may have different perceptions on matters like health, illness, and disease. As a pharmacist, it is important to educate yourself on cultural differences — both through traditional education programs and through talking with your patients directly — so that the people who walk through your door feel comfortable. In addition, you should encourage culturally sensitive practices among your technicians and the staff that work with you. In this case, inclusive care is a team effort that you and your staff should take seriously.
Just as you encourage diversity in your patient base, you should encourage diversity in your team. This may mean hiring a technician from a minority community, or it may simply mean recognizing and appreciating the differences in the staff you already have. Promoting diversity, even at a small scale, not only increases positive interactions within your team, but it transcends into your interactions with patients.
In many areas, minorities face difficulty accessing pharmacies. To address this problem, try getting out into your community and taking your services to where your patients are. Offer on-site vaccinations, set up clinics at a convenient location, or advertise your services to patients door-to-door. Doing so not only increases the number of patients you can see, but it demonstrates to them that you care.
Above all else, the most important thing you can do as a pharmacist is to treat your patients with the kindness and compassion that they deserve — regardless of race, ethnicity, or any other outside factor. When working with patients, be attentive, be empathetic, and be willing to make them feel at home in your pharmacy.
If you want to expand your reach and help create change for minorities outside of your community, you can advocate for them at the state and national levels. You can attend meetings and conferences, sign petitions, call representatives, and spread the word about the importance of healthcare equity. As you make the step up, you can make your voice heard and help generate traction.
PioneerRx is committed to ensuring that all patients get the care they need. Our pharmacy management system and its features allow pharmacists and healthcare providers to better understand their patients, their needs, and their goals on a personal level. This is particularly important in caring for minority communities.
Our eCare Plans, for example, allow you to document your patients’ information and determine the barriers they may face to healthcare. Our Patient Risk Scores feature expands on eCare Plans by allowing you to monitor patients’ health concerns and intervene early. And, finally, our SMS and RxLocal Messaging Systems help you to communicate with patients directly and increase personal health engagement.
With the help of PioneerRx, you can better understand your patients and work to promote diversity and inclusivity in your pharmacy. Although disparities persist, you can do your part in helping to identify and eliminate the ones you see in your community. In the process, you can help to create a more equitable pharmacy system, healthcare system, and world as a whole.