Healthcare disparities are defined as avoidable and unfair differences in the health of people or particular groups that negatively impact their quality of life and life expectancy. Research has shown that clear disparities exist in relation to HIV and other sexually transmitted infections (STIs), mental health, and COVID-19, and are often connected by broader overlapping social factors. The report, which focuses on these three disease areas, explores the opportunities that eliminating health disparities over the next two decades could create and what actions are needed to achieve it in the United States and the United Kingdom - two countries with wide-ranging and ongoing health disparities in spite of radically different health systems. Insights in the report were gathered from desk research and a literature review, followed by in-depth interviews with a range of academics, HIV experts, and other key stakeholders.
"The COVID-19 pandemic has further exposed and intensified existing health disparities, while also serving as a wake-up call to leaders, health systems, and other stakeholders to the threat that disparities pose to individuals, communities, and society," said Vanessa Apea, Consultant Physician in Genito-urinary and HIV medicine and Research Lead for Sexual Health, Barts Health NHS Trust, who was interviewed for the report. "Right now, these leaders know that people don’t have access to the same healthcare based on where they live, how much money they make or the colour of their skin - what we are missing is cohesive action. This report provides a roadmap for that action, so that we can move forward from discussing disparities to implementing real change that will improve health equity."
Key findingsThis report revealed several key findings that provide the motivation and the pathway for action on health disparities:
- Disparities in care are avoidable, unfair, and cost us all: Disparities create unfair economic and social circumstances for individuals, communities, and societies alike. They create fragility and add instability to health and social systems.
- Addressing health disparities must be an urgent moral, social, and economic priority that is reliant on a shared vision: Without action, any meaningful progress on societal health and economic goals is at risk and will remain vulnerable to global health threats like COVID-19. A shared, forward-looking vision that shows us what achieving health equity looks like is critical to success.
- Stakeholders and systems can either perpetuate or combat disparities: Inaction can be as powerful as action. This research lays out a clear route for various stakeholders to contribute to the pursuit of health equity, and systems for accountability and measuring progress.
- Systems are slow to promote equity because they are often incentivised not to: Incentives for health and social care are often set up to perpetuate disparities in the US and UK. A greater focus on performance and targets centred on equity, stakeholders and systems would be more likely to both reduce disparities, achieve efficiency, and positive health outcomes.
Keith Rawlings, Senior Medical Director at ViiV Healthcare, said: "If we're going to be successful in our goal of ending the HIV epidemic, a disease that is defined by inequality, it’s essential that we focus on more than just the development of innovative medicines. We must also take a holistic approach towards reducing the disparities encountered by the many communities that are disproportionately impacted by HIV and focus on how society can take action to address them and achieve health equity for all."
Next stepsViiV Healthcare supports Economist Impact’s recommended roadmap to achieve health equity by 2040, as prioritised by the following actions:
- Restructuring the health system to prioritise prevention for both physical and mental health: Healthcare systems are often rewarded for sticking to the status quo - a focus on treating the sick, rather than preventing illness, which contributes to worse outcomes. Payment models should prioritise prevention, equity, and sustainability in car and health systems should develop better reimbursement programs to make preventative care a priority.
- Reimagining investment beyond the upfront cost: Health systems end up spending more in dealing with the consequences of disparities than eliminating them in the first place. Investments in health systems and individual communities should be examined over longer periods of time while developing better measurements of success to understand the social, health, and monetary value of eliminating disparities.
- Making practical changes that improve collaboration: Individuals can make a difference, but their impact alone is limited without the ability to share information with others. Practical changes that improve collaboration, like improved data sharing practices, more efficient referral processes, and better communication between initiatives and health providers could help prioritise and realign goals around improving equity.
- Improving our knowledge of how to best reach certain populations: Many health systems continue to use largely unchanged, outdated methods to engage stakeholders or rely on community partners to pick up the slack. Incorporating new best practices from outside the health sector in planning and organisational structure could expand the current knowledge of how to best reach key populations.
The full detailed findings of Achieving health equity: a roadmap to eliminating disparities, as well as additional resources related to the report can be found at viivhealthcare.com.
About Economist ImpactEconomist Impact combines the rigour of a think-tank with the creativity of a media brand to engage a globally influential audience. We believe that evidence-based insights can open debate, broaden perspectives and catalyse progress. The services offered by Economist Impact previously existed within The Economist Group as separate entities, including EIU Thought Leadership, EIU Public Policy, EIU Health Policy, Economist Events, EBrandConnect and SignalNoise.
We are building on a 75-year track record of analysis across 205 countries and territories. Along with framework design, benchmarking, economic and social impact analysis, forecasting and scenario modelling, we bring creative storytelling, events expertise, design-thinking solutions and market-leading media products, making Economist Impact uniquely positioned to deliver measurable outcomes.
About ViiV HealthcareViiV Healthcare is a global specialist HIV company established in November 2009 by GlaxoSmithKline (LSE: GSK) and Pfizer (NYSE: PFE) dedicated to delivering advances in treatment and care for people living with HIV and for people who are at risk of becoming infected with HIV. Shionogi joined in October 2012. The company’s aims are to take a deeper and broader interest in HIV/AIDS than any company has done before and take a new approach to deliver effective and innovative medicines for HIV treatment and prevention, as well as support communities affected by HIV.
About GSKGSK is a science-led global healthcare company.
1. Economist Impact. Achieving health equity: a roadmap to eliminating disparities. Available at: https://impact.economist.com/perspectives/Achievinghealthequity. Last accessed: October 2021.