Addressing racial and ethnic health disparities
April is National Minority Health Month
The U.S. Department of Health & Human Services (HHS) Office of Minority Health designates April as National Minority Health Month, and this year marks the 30th anniversary of the HHS Office of Minority Health. The accessible pharmacist plays an important role in addressing racial and ethnic health disparities.
In underserved communities that serve racial and ethnic minorities, barriers may include accessing insurance and being able to afford care, according to SinfoniaRx Vice President for Innovation Sandra Leal, PharmD, MPH, FAPhA, CDE. “Pharmacists are the most accessible providers in these communities” and can communicate on patients’ behalf to connect them to more care, Leal said. “Pharmacy is a great entry point, especially for those patients who experience significant barriers.”
Health care often defaults to English. “It’s important for pharmacists not to make assumptions,” Leal added. “Don’t take for granted that all people speak English.” For example, prescription labels can be printed in the appropriate language.
According to the U.S. Census Bureau as reported by the Henry J. Kaiser Family Foundation, one in three U.S. residents self-identifies as African American, American Indian/Alaska Native, Asian, Native Hawaiian/Pacific Islander, Hispanic/Latino, or multiracial—and this number is trending toward one in two by 2050.
“In relation to outcomes, specifically overall survival for minorities, it’s a known fact that with some chronic diseases, minorities don’t have the highest incidence of these diseases but tend to die at higher rates than their Caucasian counterparts,” said Maggie Smith, DNP, MSN/Ed, RN, OCN, oncology principal medical science liaison in medical affairs–hematology for Janssen Scientific Affairs, LLC.
Smith rapidly listed reasons for racial and ethnic health disparities, including the following:
- Access to care. “Minorities may not be provided the same opportunities as another race or ethnicity,” Smith said.
- Clinical trials. “Sometimes minorities are not included in clinical trials” because the health care provider may fear they won’t be compliant and will skew the data; meanwhile, “some minorities still have the fear of being used as an experiment and/or Guinea pig,” she added. “Therefore, we don’t get the benefit of knowing how some of these agents work in other ethnic groups.”
- Trust. “Minorities don’t always feel comfortable sharing their concerns, or don’t know how, because they don’t always see individuals who look like them.”
- Economic status. Minorities may not have the resources to get the necessary treatment.
- Education. “Sometimes as a minority, the education factor isn’t always there. We may not necessarily understand what is being explained or expressed to us, and therefore we can’t make an informed decision on the best route we should take to make the best decision for our care.”
According to Leal, patients in Mexico and of Hispanic descent are familiar with pharmacists being the primary care provider, which guided her thinking in using the accessible pharmacist to manage diabetes better for these patients in the APhA Foundation’s Project IMPACT: Diabetes. Leal’s previous role was at El Rio Community Health Center, one of 25 communities disproportionately affected by diabetes that participated in the project. Racial and ethnic minorities comprise 62% of patients who use community health centers, according to the National Association of Community Health Centers.
Launched in 2010, Project IMPACT: Diabetes was conducted by the Foundation in partnership with the Bristol-Myers Squibb Foundation Together on Diabetes initiative that is specifically designed to improve the health of underserved populations. In the project, pharmacists helped patients navigate complex medication regimens, leading to a reduction in glycosylated hemoglobin (A1C) in the patients they managed. Project IMPACT: Diabetes validated that there is value in using pharmacists in underserved communities.