To Improve Health Equity, Healthcare Must Meet Mistrust and Misinformation at the Front Lines

Human beings all share a fundamental need for compassionate, high quality healthcare. But we don’t all speak the same language, receive information from the same sources, or place our trust in the same institutions. Healthcare leaders must address these realities if they want to meet diverse patients’ needs.

But how can they do it? We explore answers to that question and more in the first episode of Health Equity Now, the show that’s dedicated to highlighting and solving the problems created by health inequities. 

In this inaugural episode, Salesforce’s Dr. Geeta Nayyar joined co-hosts Abner Mason, founder and CEO of ConsejoSano, and Vik Bakhru, chief medical officer of Circulo Health, to examine how healthcare can address inequities in care by catering to the individual patient. 

 

Inequities Foster Mistrust and Misinformation

For many Americans, zip code is a more important determinant of health than their genetic code. For example, the life expectancy gap between two neighborhoods in Chicago is larger than the gap between the United States and Honduras

Mason pointed out, social determinants of health such as race and income underpin those chasms. And while health inequities may become more widely recognized as the COVID-19 pandemic disproportionately harms low-income and minority populations, they existed long before this renewed attention took hold and will likely exist long after. 

Combating health inequities means making healthcare more affordable and accessible. At scale, it also requires healthcare leaders to fight misinformation and customize their messaging and care in culturally relevant ways that meet the needs of diverse populations.

Nayyar noted that Black and Brown people have many reasons to distrust the healthcare system, thanks to the Tuskegee experiments and other historical examples of disturbing ethical violations. But distrust creates hesitancy to engage with the healthcare system—leading to preventable complications—and allows misinformation to take hold, which can further harm marginalized communities. 

Distrust, misinformation, and poor access to care led to an early COVID-19 vaccine rollout that favored less-vulnerable and higher-income communities, rather than those who were disproportionately affected by the virus, who were typically residents of lower-income and diverse communities.

“What we really need to do is go into these communities and meet these communities where they’re at, whether it’s in their churches, their recreational areas or their homes,” Nayyar said. “That’s really been the biggest barrier to reaching these communities.” 

 

The Best Messenger Is a Familiar One

The healthcare community can also build trust and increase engagement by abandoning what Mason calls “one-size-fits-all” healthcare, where messaging and standards of care are not tailored to the unique populations they’re meant to serve. Not only does this approach hurt outcomes, it deepens mistrust. 

“What that approach says is that who that person is doesn’t matter: ‘We don’t care what your journey is, how you got here…you’re all going to be treated the same.’” Mason said. “When you treat people that way, it’s not surprising that they don’t engage and don’t trust.” 

Healthcare organizations and leaders should instead look to reach patients where they are by delivering public health messaging to vulnerable populations through culturally relevant voices. If men respond better to advice from other men, or if diverse Americans respond better to members of their community, so be it, Nayyar said—if the best messenger is a familiar one, that’s okay.

 

Limitless Engagement

An emphasis on trust and engagement should not end once the patient presents in the clinic or via remote care. Each patient must be understood—and must understand how their care journey is progressing—so that they can receive the highest quality care. Clinical teams must lean in on culturally relevant communication and empathy, and also reevaluate clinical care standards for different populations.

“We know that personalized care improves outcomes,” Nayyar said. “The dream is that we’re not just treating a 50-year-old Caucasian male for heart disease, but we actually know what it’s like when a 55-year-old African-American woman has heart disease but is having abdominal pain rather than chest pain.” 

Bringing diverse patients and their families into the health system comfortably, communicating with them to learn their specific needs, and treating them based on evidence specific to their populations will go a long way toward improving health outcomes—and stemming cycles of mistrust and poor engagement, one family at a time.

 

Want to learn more about how your payer organization can help reach underserved, low-income, and diverse member populations? Connect with us.