Patient Center Engagement and Empowerment Research Core
In the United States, patients of color still have significantly worse health outcomes related to disease morbidity and mortality than white patients. According to the Centers for Disease Control and Prevention (CDC), the achievement of health equity is when every person has the opportunity to “attain his or her full health potential” and no one is “disadvantaged from achieving this potential because of social position or other socially determined circumstances.”
Despite the recognition and documentation of disparities for decades…many disparities have persisted, and in some cases, widened before the COVID-19 pandemic showed that people of color fared worse compared to their White counterparts across a range of health measures, including infant mortality, pregnancy-related deaths, prevalence of chronic conditions, and overall physical and mental health status. As of 2018, life expectancy among Black people was four years lower than White people, with the lowest expectancy among Black men.
Ndugga and Artiga (Kaiser Family Foundation 2021)
Many patients of color have low health literacy demonstrating difficulty obtaining, understanding and following health information. Consequently, they have a higher risk of poorer health outcomes. Low health literacy is an escalating source of health disparities among patients of color. Of the nearly 77 million Americans who struggle with health-related reading tasks, 65% are patients of color. In our team’s work with patients in communities of color, we have heard,
“I don’t know what my doctor is saying and I’m afraid to ask and look dumb…I didn’t understand what pills they wanted me to take and how they would affect me…I don’t know what my diagnosis is…and I don’t know what I’m being treated for.” Numerous health care systems now provide patients with printouts to accompany verbal discharge instructions – the mean readership of the instructions is, on average, two grade levels above patient literacy levels.
Our Solution: Be Healed Virtually©
AsthmaAsthma is a global public health problem affecting over 6.8 million children and adolescents in the U.S. The prevalence, morbidity, and severity of asthma are higher in children who belong to are lower SES and are part of populations of color. The burden of asthma in the United States falls disproportionately on Black, Hispanic and American Indian/Alaska Native people. These groups have the highest asthma rates, deaths and hospitalizations. (Asthma and Allergy Foundation of America)
CancerCancer affects all population groups in the United States, but due to social, environmental, and economic disadvantages, certain groups (including populations of color) bear a disproportionate burden of cancer compared with other groups. Blacks/African Americans have higher death rates than all other racial/ethnic groups for many, although not all, cancer types. (National Cancer Institute)
DiabetesPopulations of color have a higher burden of diabetes, worse diabetes control and are more likely to experience complications. Among Hispanics, the death rate from diabetes is 50% higher than for non-Hispanic whites. (Office of Minority Health and Health Equity)
Heart DiseaseCardiovascular disease (CVD), including heart disease and stroke, remains is the primary killer of Americans and places an undue burden on populations of color that have higher rates of CVD and its risk factors. Moreover, populations of color live with more barriers to CVD diagnosis and care, receive lower quality treatment, and experience worse health outcomes than their white counterparts. (American Heart Association)
Mental HealthMost populations of color overall have similar — or in some cases, fewer — mental disorders than whites. However, the consequences of mental illness in these populations may be long lasting. Lack of cultural understanding by health care providers may contribute to underdiagnosis and/or misdiagnosis of mental illness in people of color. (American Psychiatric Association)
Substance UseMany populations of color in the United States face well-documented challenges, such as higher-than-average rates of poverty, homelessness, and incarceration, which may contribute to increased rates of alcohol use disorder as well as other substance use disorders. Differences in worldviews, cultural traditions, and upbringing mean that populations of color may not respond well to a treatment intervention that has demonstrated success in the general population. (Blume, 2016)
We envision a suite of mHealth patient educations apps.
APPS to Help, Educate and Advance Life (HEAL)
General functions of the apps include:
- An iterative and user-centered design process that engages end-users and stakeholders in the development process.
- A personalized, integrated digital space for patients, providers, payers and other pertinent stakeholders.
- Low literacy adapted content.
- Culturally- intelligent content (values, beliefs, language and communications styles).
- Content and messages stratified by identifying patient risk on a disease continuum.
- Content and messages tailored to the risk.
- Content that focuses on disease knowledge, treatment options and possible disease complications.
- Social network and interactive component to allow for engagement and communications with providers and other users.
- Real time local resources and support.
- Accessible across multiple platforms (Android, IOS and PC).
- Responsive to the FDA’s Digital Health Innovation Action Plan by ensuring that patients have timely access to a high-quality, safe and medically accurate digital health product tailored to their individual risk level.