Health Disparities Have Deep Roots

During the conversation, ADA's Henderson noted that health inequities were already impacting diabetes care long before the pandemic. COVID-19 amplified the issue and forced many people with diabetes to make tough choices about their health, including missing regular doctor visits and rationing their insulin.

"Forty percent of people who died from COVID diagnoses had diabetes. And people of color are 60% more likely to get diabetes, which is why we have to do something now," said Henderson.

"We've been treating symptoms…but we need to treat the root cause."

Henderson asserted that to meet the health needs of everyone will require intentional change and rebuilding trust with the communities that have been traditionally left behind. The ADA's Health Equity Now initiative was formed to do just that – bring together industry and community partners to find new solutions for treating and preventing diabetes, a chronic condition that has reached epidemic proportions. One step will be broadening access to technology to help people track their condition so they can learn how to manage it better.

He spoke to some of the work they've started in Columbus, Ohio, with Abbott and the National Center for Urban Solutions (NCUS). As part of the program, NCUS will provide up to 150 Black adults living with diabetes in the Columbus community with health education and access to Abbott's FreeStyle^® Libre flash glucose monitoring technology. By removing existing barriers to tools and technology, this program aims to demonstrate how continuous glucose monitoring can help improve diabetes management and quality of life for Black people living with diabetes in the Columbus community.

Innovation Without Access is Meaningless.

Earnhardt said Abbott is committed to creating technologies that are not just effective but are also affordable and accessible to more people who need them. And that means designing health technologies that embed access and affordability at every stage of development through delivery to the patient or healthcare provider.

She said innovators like Abbott have a key role to play in making their innovations more accessible. "At Abbott, we're shifting our thinking about innovation as outlined in our 2030 Sustainability Plan. Our focus is on designing devices to deliver on the three Ds: democratization, decentralization and digitization of care."

Beyond product innovation, she said there are other ways medical device companies can help push for change to reach more people.

“Accessible, affordable innovation is just one piece of the equation. Innovation alone is meaningless. There are many stakeholders we need to engage to really make a difference, including patients themselves and what they say they need, healthcare providers, community advocacy groups, and policy makers," she said.

Earnhardt used the example of Abbott's work to create greater diversity in clinical trials, which “are the foundation of innovation and where health equity starts."  She said the company is investing in future generations of diverse clinical trial leaders through scholarships and by creating an advisory board made up of industry thought leaders to drive advocacy and change in clinical research to ensure trial participants represent all people who could benefit from the technology.

Treat the Person, Not the Patient

In addition to spotlighting barriers to technology access, the pandemic revealed longstanding disparities in food security and other social determinants of good health – challenging the industry to look beyond traditional understanding of what it means to be healthy and collaborate with on-the-ground, patient centric organizations to co-create solutions.

"We can't address the issue of access directly if we don't address the broader social issues that stand in the way," said Dr. Pastakia, who spent time during the pandemic reflecting on his work in Kenya and how it could be applied here in the U.S. in under-resourced communities. 

He said we have to meet people where they are and deliver care in new ways that work for them. He gave the example of how the pandemic resulted in a loss of jobs and income for many already disadvantaged people and led to food insecurities in areas of Indianapolis, Indiana. This prompted his team to set up pop-up COVID-19 vaccination clinics at food banks, where people stood waiting in long lines that wrapped around the facility to get food for their families – a priority that trumped the need for healthcare in these communities.

He urged fellow clinicians to change the way they work: "If you're only focusing on clinical care, data is pretty clear in showing that you can only impact 20% of someone's health outcomes. That whole other 80% – you are basically leaving on the table. The big change that has to happen is that we, as healthcare providers and as healthcare systems, need to respond to people and communities – not just patients."

You can see a video of the full panel above – and access more of the engaging sessions from Aspen Ideas: Health here.

And for more on these discussion topics:

• Abbott's 2030 Sustainability Plan

  ADA's Health Equity Now page

  Abbott-ADA Health Equity Now partnership

  Abbott health tech at CES

  Success of the AMPATH program in Kenya

  Last year's Aspen Ideas event