Maureen is senior vice president, director of Value Transformation for PRECISIONvalue. Maureen has extensive experience as a C-level executive, clinician, academician, innovator, and coach in managed, integrated care. Nationally, she has developed innovative products and strategies for industry executives and access decision makers. Under her leadership, organizations have received recognition from eValue8, NCQA, and the National Academy of Medicine for innovative strategies that have reduced hospital readmissions, improved patient safety, and enhanced patient engagement. Since joining Precision, she has led more than 500 strategic quality and population health initiatives with 35 clients in 17 therapeutic areas. Her expertise includes adherence, behavioral health/social wellness, crisis management, patient engagement, population health, quality, social determinants of health, and value-based care.
The coronavirus disease 2019 (COVID-19) pandemic has exposed and further exacerbated the fractures in our healthcare and social delivery systems. There has never been a more urgent time for manufacturers to develop or evolve their strategic frameworks to address adverse social risk factors that have been exacerbated by the COVID-19 pandemic and contribute to health inequities glaringly evident during the pandemic. This article describes strategies pharmaceutical manufacturers must adopt to address social determinants of health and population health management challenges, supporting patients, families, and clinicians during this pandemic and beyond.
The World Health Organization has noted that social determinants of health (SDOH) are responsible for most health inequities.1 Because health and wealth are often connected within the United States, low-income populations are expected to be particularly vulnerable to the severe effects of COVID-19 or the novel coronavirus.2 For example, black residents of Cook County, historically impacted by adverse social risk factors including poverty and poor care access, are dying from COVID-19 at disproportionately high rates, prompting Chicago Mayor Lori Lightfoot to declare a public health red alarm requiring multi-stakeholder community intervention.3
Furthermore, because of the legitimately rising anxiety about social, health, and financial disruptions associated with COVID-19, it is essential to anticipate, screen, and support efforts to reduce the impact of SDOH. For patients already grappling with social risk factors such as limited access to care and medications, financial distress, loneliness, and food and housing insecurity, the isolation, health, and financial stressors caused by COVID-19 will precipitate crises for unprecedented numbers of patients.
This situation is compounded by a surge of new individuals with serious social risk factors due to the pandemic-related economic downturn. American Enterprise Institute’s Matthew Continetti has warned of a global recession and possible depression, and New York University’s Eric Klinenberg has projected economic and social order collapse without government intervention, guaranteeing income for millions of workers at risk for job loss.4 These predictions signal the likelihood of millions more Americans and others around the globe experiencing severe hardships and health consequences from escalating social risk factors. Collaboration as a coping style has never been more important among all members of our healthcare community, extending to our broader communities.
New strategic solutions will be necessary to promote social stability, a prerequisite foundation for individual and population health. Harvard’s Archon Fung believes success in grappling with this pandemic will be more likely among American states in which government, civic, and private-sector leaders join their collective strengths for the common good.5 Pharmaceutical manufacturers, with their extensive biopsychosocial resources and global reach, have a unique opportunity to forge new solutions to address social risk factors and promote the social stability vital to population health, but they must act with a sense of urgency. Here are steps manufacturers can take to address SDOH.
Plan for the Future
SDOH have a cyclical relationship with the COVID-19 pandemic. Failure to address poor health literacy exacerbates noncompliance with safe behaviors that mitigate the viral spread. Further, social risk factors, such as inadequate access to therapies, care, food and shelter, also exacerbate viral spread. In turn, the spread of COVID-19 will create additional economic and social instability, placing Americans at risk for adverse SDOH and associated deterioration of individual and population health. With that in mind, pharmaceutical manufacturers should consider the following:
The COVID-19 pandemic has exposed and further exacerbated the fractures in our healthcare and social delivery systems. There has never been a more urgent time for manufacturers to develop or evolve their strategic SDOH frameworks, supporting multistakeholder collaborations to mitigate social risk factors, integrate biopsychosocial care, and advance population health, so we will be better prepared for the next pandemic. Pharmaceutical manufacturers have the opportunity to participate with plans, clinicians, health systems, IDNs, and other private and public stakeholders to reinvent our delivery system to expand value, close disparity gaps, and attain the Quadruple Aim. Finally, isolation and uncertainty are the hallmark stressors associated with social distancing,13 and manufacturers have opportunities to support both patients and clinicians with connection and credible information.