Reduce health disparities by understanding what makes the patient tick
By Dr. Seleem R. Choudhury
National Public Radio (NPR) recently did a story on how, for the first time in 100 years, life expectancy in the U.S. has dropped for two straight years. In 2019, someone born in the U.S. had a life expectancy of 79 years. As a result of the pandemic, life expectancy dropped to 77 years in 2020, and dropped again in 2021 to 76.1 years (Greenhalgh & Simmons-Duffin, 2022). The Centers for Disease Control and Prevention (CDC) reports that in some instances, depending on age, race, and sex, the expected length of one’s life can be even lower (Arias, Tejada-Vera, Kochanek, & Ahmad, 2022). In fact, one of the most dramatic drops in life expectancy in 2021 was among American Indian and Alaska Native peoples. Between 2019 and 2021, the life expectancy for this population fell by 6.6 years, to 65.2 (Marcus, 2022).
However, the CDC claims that only about half of the decline in life expectancy in 2021 can be attributed to COVID. Other contributors have been issues plaguing communities for much longer, including drug overdoses, heart disease, suicide, and chronic liver disease (Associated Press, 2022). The data repeatedly indicates that whether the cause of death is COVID or other longstanding issues, Social Determinants of Health are important contributors to mortality disparities in U.S. The healthcare industry must address these health disparities and distinguish “factors within the community that lead to persistent differences in mortality outcomes, to improve population health and longstanding disparities for minority populations” (Glenn, 2022).
This begins with the relationship between the patient and their provider and community healthcare team (American Academy of Family Physicians, 2018).
Authentic relationship matters
A recent study found that U.S. adults are the least likely population in the world to have a “regular physician, place of care, or a longstanding relationship with a primary care provider” (FitzGerald, Gunja, & Tikkanen, 2022; Kreimer, 2022). This is largely due to an “eroding of primary care infrastructure” in the U.S. (Phillips, Haft, & Rauner, 2022).
In a 2021 General Practitioner article, Professor Martin Marshal, chair of the Royal College of General Practitioners, said that relationships with patients were as “important as a scalpel to a surgeon” (Bostock, 2021). Marshal emphasized that improved patient satisfaction and experience, compliance with medical advice, improved health outcomes, and lower mortality rates are all rooted in continuity of care. Relationship-building and trustful relationships between primary care professionals and their patients matter and help improve health outcomes (Bossche, Willems, & Decat, 2022; Vittorio, 2022).