The impacts of health disparities are far reaching and directly affect access, adherence, outcomes, and overall health. A session at the 2024 AMCP Nexus provided an overview of health disparities related to obesity and sickle cell disease (SCD).
Health disparities are driven by social and economic inequalities related to the community, education, economic stability, and health care system. The economic burden of health disparities in 2018 US dollars is estimated to be $1.03 trillion for excess morbidity and $975.7 billion for mortality among adults aged 25 years and older.
Addressing health disparities is essential and should focus on individualizing needs, engaging and rebuilding trust in the medical community, and expanding insurance enrollment, specialty coverage, and networks.
Obesity impacts 42.4% of the adult population, an increase from 30.5% in 2000. Black women have the highest rate of obesity, and Black men have the highest mortality rates from obesity-related illness. Obesity is often stigmatized as a “choice” rather than a disease, despite data supporting genetic and environmental factors associated with the condition.
The geographic distribution of obesity medicine specialists further contributes to disparate access. The median travel time to a specialist is 9 minutes in high-income counties versus 43 minutes in low-income or rural counties.
SCD is an inherited disease, with more than 90% of cases occurring in non-Hispanic Black or African American populations. Many patients with SCD require several visits to the emergency department (ED) for acute events each year. According to 2017 Medicaid data, 43.8% of patients aged 0-5 years with SCD had 2-5 ED visits a year compared to 16.5% of those without SCD. Among those aged 21 to 45 years, 33.0% versus 18.0%, respectively, had two to five ED visits each year.
In addition to comparatively limited funding for the condition, there is a lack of standardized care coordination and transition planning for individuals moving from a pediatric to adult care setting. Patients with SCD often rely on the ED for acute management, rather than accessing a specialist. The cost of care and undertreated pain further contribute to the disparities associated with SCD.
The researchers concluded with actionable STEPS that can be taken to combat health disparities:
- Set a path for learning: Analyze plan- and patient-level data to address gaps, social factors, and at-risk populations
- Teach and disseminate: Report data trends and bring awareness to policy makers
- Establish and engage partnerships: Lean into specialty care providers, coordinated care, advocacy, and group resources
- Promote patient-centered care: Advocate for enhanced benefits, eliminate barriers to care, and evaluate and broaden specialty networks
- Specify routine intervals for evaluations: Analyze data and continuously address ongoing needs
Reference
Lenz K, Pomfret TC. Navigating health disparities: a case study approach. Session M3. Presented at the 2024 AMCP Nexus; Oct. 14–17, 2024; Las Vegas.
