Ensuring Inclusive Language Dominates Drug Information to Close Health Equity Gaps

As the healthcare system continues evolving, a greater emphasis is being placed on health equity and social determinants of health (SDOH). Defined by the National Committee for Quality Assurance (NCQA) as everyone having “a fair and just opportunity to be as healthy as possible,” achieving health equity requires removing obstacles such as poverty and discrimination.

It also requires eliminating the consequences of these barriers, including powerlessness, lack of access to good jobs with fair pay, quality education and housing, safe environments, and healthcare.i To that end, provider organizations, regulatory agencies, and payers are all seeking ways to effectively identify and close areas of weakness to achieve parity across race and ethnicity, gender, sexual orientation, socioeconomic status, and other factors. We see this in new and emerging care models that require providers to have a health equity plan and a data collection system that enables monitoring and incentivizes provider outreach to underserved communities. Health plans and clinically integrated networks have also recognized the impact of health equity on health outcomes, resulting in initiatives and programs that meet their populations’ SDOH needs. For example, the Centers for Medicare and Medicaid Services (CMS) in 2022 released its Framework for Health Equityii and proposed rule to advance health equityiii, while NCQA introduced Health Equity Accreditation for health plans focused on the foundation of health equity work.^iv

A solid business case

These developments are backed by a sound business case, as inequitable access to healthcare and unaddressed SDOH result in increased medical expenses, higher death rates, and uneven resource distribution.^v Consider that the elimination of health disparities — which contribute $93 billion in excess medical care costs — by 2050 would reduce the need for more than $150 billion in medical care.vi What’s more, the U.S. Census projects that racial and ethnic minorities will constitute the majority of Americans by 2024^vii, exacerbating the impact of racial disparities that currently cost the U.S. an estimated $135 billion in excess medical costs and lost productivity each year — as well as additional economic losses due to premature deaths.^viii Behind these figures are disparities ranging from lack of health insurance to higher prevalence of chronic conditions.

There is also a strong business imperative driving the push for health equity. In general, 65% of consumers say it is important that the companies they buy from actively promote diversity and inclusion.^xi Within healthcare, payers are finding that mitigating inequities can increase Medicare Star ratings and drive business growth; one payer organization reported that 80% of the national account requests for proposals (RFPs) and 90% of Medicare RFPs it received in 2022 had at least one question on health equity.^xii

With so much on the line, it is easy to understand why health equity and SDOH have emerged as high priorities for providers — including pharmacy — and payers. One aspect that should not be overlooked in health equity strategies is the role language plays in creating barriers to care.

10.6% of the African American population did not have health insurance in 2017 versus 5.9% of the white population.

26.4% of American Indian or Alaska Native adults aged 18–64 did not have health insurance in 2021 compared to 7.8% of white adults.

21.5% of the Hispanic population aged 20 years and older have diabetes versus 13% of the white population in the same age range.^ix

46.9% Hispanic and 47.5% non-Hispanic Black adults aged 20 and over were most likely to have obesity in 2015–2016.