Inequities in health care are often rooted in community-level factors like where we live, work, and play; lack of adequate coverage and access to providers; and systemic racism and discrimination. For example, 28% of adults living in rural areas lack access to broadband internet, nearly half of the households in Native communities (48%) lack access to reliable clean water and over 40% of US counties are pharmacy deserts, where most people have to drive more than 15 minutes to reach nearby pharmacies. These factors influence how patients interact with the healthcare system and can significantly impact their ability to access and adhere to necessary medications and treatment.
To illuminate factors impacting patients' ability to access life-saving medicines, PhRMA created a Social Determinants of Health (SDOH) simulation designed to allow users to walk through a patient’s journey and experience the role structural and social factors play.
Access and adherence to medicines are key drivers of improving patient health outcomes and can significantly reduce health care costs. Nationally, $3.8 trillion could be saved in reduced medical costs and lost work productivity if the U.S. health care system committed to providing evidence-based health care guidelines and tools to empower patients in communities of color and committed to redressing social and structural determinants of health, including:
- disproportionate impact of insurance design scheme
- access to preventative care and timely screenings
- pharmacy deserts in their communities
One study estimates that differences in colorectal cancer screening rates are responsible for 19% of the disparity in colorectal cancer deaths between Black and white patients. Evidence has shown that the downstream consequences of the inability to access health care and maintain treatment plans include increased health care costs, poor health outcomes and increased risk of mortality. These intersecting systemic social and structural barriers drive disparate health outcomes.
Further, in a recent PhRMA survey, more than one-third of insured Americans said that they spend more on out-of-pocket costs than they can afford, 63% of insured Hispanic Americans reported concerns that a medicine their doctor recommended or prescribed wouldn’t be covered by their insurer and 64% of insured Black Americans expressed concerns about affording out-of-pocket health care costs.
Poor insurance coverage reduces access to care, including the ability to receive a prescription from a health care provider and fill it at the pharmacy. Recent research has shown that Black Americans (24%) and Hispanic Americans (21%) with insurance are much more likely to report that they would not be able to afford their out-of-pocket costs if they had a major medical event or became seriously ill, compared to 17% of white Americans.
These factors only reflect a fraction of the effects of social determinants of health. PhRMA’s new simulation sheds light on these drivers of health outcomes that patients of diverse abilities, race and economic status face. Explore the simulation and what stands between a patient and their medicines: https://phrma.org/Equity/SDOHandMedicines