For some of us, the past year has brought into sharp focus the complex relationship between systemic racism and health outcomes in the United States. For many more, it has long been apparent and its effects deeply tangible in the lived experience of tens of millions of BIPOC (Black, Indigenous and People of Color) Americans.
COVID-19’s disproportionate impact on communities of color was not a unique event but the continuation of a pattern. According to the Centers for Disease Control and Prevention (CDC), Black Americans are almost three times as likely to be hospitalized with COVID-19 compared with White Americans and twice as likely to die. But they are also two to three times as likely to die from heart disease or diabetes. Similar disparities can be found in Latinx and Indigenous populations and in other communities of color.
Beyond mortality risk, health disparities also mean more serious illnesses to treat — which place cost and resource burdens on the health system in ways that magnify their effects on all of us.
While solving these disparities is a challenge bigger than one person, one company or even one industry — we believe that companies like CVS Health can play a significant role in improving health equity in the United States. Our pharmacy benefit manager, CVS Caremark recently released its 2020 Drug Trend Report, looking at the many ways in which the past year placed a spotlight on issues of social justice and health inequities — and how we can do our part to create equitable health access for every American.
CVS Caremark’s approach with members is to find the most efficient, clinically rigorous path to care. This means not only identifying the most effective treatments for the lowest cost, but also looking at how we can best ensure adherence to those treatments, and communicate health information and provide care that meets the member where they are.
Powered by data, we can compare individual health histories from sources like electronic health records against broad demographic trends from publicly available data sets like the Centers for Disease Control and Prevention and the U.S. Census Bureau.
This approach can be a critical tool in closing the gap on health disparities. By looking at a broad range of objective demographic data sets, we can identify systemic failings that affect communities of color and then correct for them when working with individual members.
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We can make choices about how we communicate, the language we use and the support we offer. For instance, choosing to use text messages instead of email or phone with groups that tend to be more responsive to that approach or tailoring the messages we send to raise awareness of health risks.
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We can provide support and treatment options that are more likely to meet members where they are, informed by both their individual health history and patterns seen in others of their age, gender, education level, geography, income and race. For instance, we can bring clinical support at locations — such as a local CVS Pharmacy or MinuteClinic location — closer to their home. We can connect them to a certified specialist that they trust, or help them utilize telemedicine and other digital tools — whatever is most likely to work for the member’s lifestyle and preferences.
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We can make sure that when we work within communities that face health disparities, we do so with a model that addresses the drivers of those disparities: affordability, accessibility, awareness and trust. For instance, our community-based approach for administering COVID-19 vaccines in vulnerable communities does not simply make the vaccine available — it engages with community leaders, non-profit organizations, faith-based organizations and others to reach vulnerable patients, it provides free or discounted transportation to vaccination appointments and it empowers trusted voices from within these communities to encourage vaccination and address hesitancy.
And while much of this work takes place at an individual level, being informed by data that considers demographic trends and the drivers of health disparities means that — when scaled across millions of members — we can begin to address larger, systemic health disparities and offer more equitable access to care. This means healthier people and fewer unnecessary costs.
We know that this is not the solution to ending health disparities, but it can help close the health gaps and ensure more people get the care they need. Not only is this good for our members, but it’s also a fresh opportunity to use the technology we already have to reimagine how we deliver care and repair a health system in which historic and systemic injustice has already cost too many lives.
