The COVID-19 pandemic highlighted the reality that our country’s healthcare inequities are genuine and structural and play a substantial influence in determining health outcomes. These avoidable – but persistent – disparities in care and health outcomes are linked to where people are born, grow up, live, work, and age, as well as significant social determinants of health like education, access to food and care, socioeconomic status, employment, and a community’s existing health infrastructure.
According to US News, while the widespread discrepancies in our healthcare system are more significant than any single corporation, organization, or entity, all stakeholders have the potential and obligation to help close these vital gaps. The CVS Health Equity Action initiative, which was recently announced, will focus on providing ongoing support to underserved communities through local relationships, providing equal opportunity for all within our workforce, and using our voice, knowledge, and resources to advocate for better public policy.
However, to successfully address health inequities, we must first determine what the disparities are and where the people who are affected live. We also need a strategy for dealing with the problem.
Combining data from various sources to generate a cohort and person-centric perspective of a population is one approach to do this. As a significant pharmacy benefit manager, CVS Caremark has prescription claim data for one in every three Americans. We built a data layer based on several indices of social determinants of health that can tell us not only what disparities may exist but also where those impacted are located by combining this information with publicly available data from sources such as the Centers for Disease Control and Prevention, the United States Census Bureau, the United States Department of Agriculture, and the Environmental Protection Agency.
For example, the data revealed that persons in poor communities are less likely to start treatment for cardiovascular disease. They’re also less likely to be on a dosage that will help them accomplish their blood pressure objectives, even if they are on therapy. These kinds of discoveries can be put into practice. We can devise strategies to assist individuals at risk in their communities, implementing interventions that address the unique disparities they confront.
For example, our Project Health initiative, which began in 2006, provides biometric assessments in various regions around the country to detect early risks of chronic illnesses related to blood pressure, cholesterol, glucose levels, and body mass index. Another recently launched entrepreneurship program as part of our Health Zones effort provides free transportation to medical treatment, work, or educational programs to persons who need it the most.
While large companies and organizations like CVS Health can use their data and resources to develop such programs, as well as their presence in communities across the country, it is worth noting that engaging those who live and work in the communities we are trying to reach is critical to the success of any initiative to address disparities. Community groups and providers are not just leaders and influencers, but they are also frequently the most trusted sources within a community. By collaborating with them, we can ensure that our efforts are directed to where they will have the most impact. People’s access to health resources such as testing and screenings, preventive treatments, and primary care can be improved by collaborating with such organizations.
Increased trait testing for sickle cell disease, which disproportionately affects people of African origin, is one area of focus for our health equity effort. Our goal is to identify those who are at risk and double the number of patients who are taking hydroxyurea. This low-cost medicine helps manage symptoms that can be excruciating. This is significant since one in every twelve African Americans is born with the characteristic that might cause their children to acquire sickle cell disease. Yet, only 16 percent of women of reproductive age are aware of their status. Furthermore, many people with sickle cell disease do not receive treatment.
Similarly, minorities are disproportionately affected by HIV, with Black and Latino people accounting for 70% of new infections. Despite this, just 1 in 4 people at risk of the disease who could benefit from protective medication known as pre-exposure prophylaxis, or PrEP, are given the prescription. To lower the number of new infections, we want to double the number of individuals who get tested for HIV and increase the number of people who start taking PrEP as part of our effort.
We can ensure that we reach the correct target groups with the proper, culturally acceptable messaging through trusted sources by collaborating with local and regional organisations.
Our project is just one of many initiatives that must be taken to eliminate health inequities. This is not a problem that a single corporation or group can solve. However, by putting data to work and collaborating with a wide range of stakeholders, we can better determine the most significant risks and ensure that individuals affected by health disparities have access to the resources and care they require.