By Patrina Pellett, PhD & Tracy Wilson, DNP, MSN-Ed., MBe (c), FNP C, RN

Health disparities and social determinants of health (SDOH) significantly impact health and access to healthcare. This results in people not getting access to the care that they need. It is the job of everyone, especially those of us working in pharma, to work towards closing these gaps and creating better patient outcomes. 

Because Medical Affairs serves as the voice of the healthcare providers (HCPs) for their companies, they are well-positioned to have a significant impact on health equity and ensure that all patients have access to life-changing therapies. The key is having deep and often uncomfortable conversations around health equity issues and then bringing this info back to their organizations (gather insights). 

Keep reading to learn how Medical Affairs teams can gather better health equity insights. 

Health Equity Insight Gathering Challenges in Medical Affairs 

When it comes to gathering health equity insights, not being able to speak the language is a major challenge for Medical Affairs teams. When interacting with an HCP, it’s important to be knowledgeable in this area to have deeper conversations and understand the why (i.e. gather insights). If an MSL is engaging with an HCP and he or she doesn’t know how to speak the language, they will shy away from the conversation. 

When Medical Affairs teams know how to have the conversation, then they are equipped to gather better insights. With this info, medical leadership can help create opportunities to improve health equity and create better outcomes for patients and improve better conversations with HCPs.

Here are common terms and definitions everyone should be aware of to have conversations about health equity.

Speaking the Health Equity Language

SDOH

Social determinants of health (SDOH) are conditions in people’s environments where they are born, live, learn, work, play, and worship that affect health, functioning and quality-of-life. When Medical Affairs teams are interacting with HCPs, it is important to understand all these factors and discuss how they are impacting the HCP’s patient population. These underlying factors could be the reason why a patient is not being compliant with their medication or treatment regimen, and it is beyond reasons besides just race or genetics alone.  

Do you know all the SDOH factors that are particularly impactful in your TA?

Health Equity vs. Equality

For equality, this is ensuring that everyone receives exactly the same thing, despite their needs. Equity is ensuring that everyone gets exactly what they need according to their own specific needs. When interacting with HCPs, understanding the difference means being able to drive the conversation around the needs of different patient populations. Gathering insights around health inequity is a major impact area for Medical Affairs teams. When MSLs gather this type of insight, Medical leadership is armed with critical info to share with cross-functional stakeholders and develop initiatives to address health inequity.

DEI

According to McKinsey & Company, diversity, equity, and inclusion can be defined as “three closely linked values held by many organizations that are working to be supportive of different groups of individuals, including people of different races, genders, religions, ethnicities, abilities, and sexual orientations.” Diversity is defined as looking through the eyes of different groups, as mentioned above. Equity, as defined above, is ensuring that all individuals receive fair and equitable treatment, regardless of the difference they may have, and that each person’s unique circumstances is taken into consideration. Inclusion is defined as shared-decision making, welcoming environment in which everyone feels valued, heard, and seen. 

Understanding these definitions allows MSL teams to start looking out for these situations in the field. Do you see DEI gaps in your TA? What are the opportunities that your organization should be aware?

Health literacy

Health literacy is the ability to find, understand and use information to make healthcare-related decisions. This impacts all aspects of receiving care, from understanding the HCP’s instructions to taking medication and navigating the complex health system. 

A great opportunity for Medical Affairs is to understand if the resources HCPs to help educate patients are using are culturally sensitive. Are resources in the language of the patient’s choice? It’s even bigger than just the language, is it culturally appropriate to that patient population? Are the people in educational materials reflective of the community that it serves?

Racial bias

As we know race is a social construct and was created only for a class system, therefore racial bias is something we have been taught through our environmental conditioning. According to Juliette Blount, The Health Equity NP, there are three types of racism:

• Structural/systemic
• Institutional
• Individual

Structural/systemic is the type that goes across society. Institutional racism is the discriminatory/biased policies or treatment that occurs within institutions. Lastly, individual racism is those racist beliefs, attitudes, and actions that occur by a person in a conscious or unconscious way. 

Medical Affairs should be aware of the different types of racism and how they may be impacting patient populations. Don’t forget about your and HCPs’ unconscious/implicit biases. Is this affecting your ability to gather HCP opinions? Are patients not receiving the care they need because of these biases?

Cultural awareness

According to Evolve Communities, cultural awareness is being sensitive to the differences and similarities between different cultures. As our world is changing, we have to look for ways in which we are the same, but also in moments of differences find how we can collaborate together.  

For Medical Affairs teams and when it comes to gathering Health equity insights, be curious about others. Ask questions to understand what is important for different cultures. Learn about cultural differences and make sure medical leadership is aware of them. This can make a huge difference when developing strategy or building initiatives.

How Medical Affairs can gather insights to address Health Equity gaps

When armed with the ability to speak the language and be comfortable with talking about health equity issues, Medical Affairs teams are able to gather insights that make a difference in underrepresented and underserved populations. Here are areas that Medical Affairs can focus on:

🩺How to develop programming that looks like the patients they are caring for

• • Get the community involved -ask the community what do they need?
  • Pull in community leaders

❤️‍🩹Create health literacy tools

• • Sixth-grade level
  • Available in the learning and language preference of the patient
  • Teach Back

🏥Implicit bias and structural racism in healthcare (training)

• • Differences in treatment and care

🥼Tools to increase patient confidence and enhance patient-HCP conversations

🪙Policies to remove financial barriers and improve equity

Conclusion

Medical Affairs are experts at building relationships with HCPs and understanding their opinions. Bringing this info back to the organization is what makes Medical Affairs so valuable. Insights about health inequities are no different. It is our responsibility to ensure we are having these conversations to impact patients’ lives. 

Being aware of health equity issues and being able to speak the language will enable Medical Affairs teams to gather great insights to help address health inequities. What other function is better positioned to identify opportunities and act on them? Be curious and courageous. You now know more about key health equity terms. The best way to get better at something is to get out there and try it!

Additional Resources

1. https://www.rwjf.org/en/insights/our-research/2019/11/what-can-the-health-care-sector-do-to-advance-health-equity.html
2. https://www.stkate.edu/academics/healthcare-degrees/racism-in-healthcare
3. https://www.cdc.gov/healthliteracy/shareinteract/TellOthers.html
4. https://gheli.harvard.edu/news/racial-disparities-and-social-determinants-health

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