Trust is one of the most important factors in healthcare, according to a panel at Northwell Health’s Raise Health Forum. However, due to current health inequities and a dark history of racism and bias, the medical system has often lost this component in many underserved communities.

“We have been treated in many respects as lab animals, where in marginalized communities the only access to help we really had was to be a part of the latest study that some medical researcher or some teaching hospital was conducting,” said Rev. Malcolm Byrd, pastor and chief of protocol at Mother AME Zion Church.

“But there really wasn't an interest in providing necessary services to assist marginalized Black and brown people, as those of us here in Central Harlem, to be on a full path towards health and wholeness. That did not exist.”

Byrd said the future needs to have a more long-term and sustainable system. 

“What we have discovered is that healthcare entities, if I can plug Northwell Health, has been very interested in building what Dr. King called beloved community – where we just don't want to put a band-aid on the issue we want to address as a community, stakeholders in the community and large healthcare groups, to address the systemic issues that have brought these health disparities to the table.” 

Today we are seeing an uptick of large retail giants and tech companies entering the healthcare space looking to address some of the biggest challenges in healthcare inequities. Transportation, for example, is often a major barrier for folks with less resources to get to care. 

“Five point eight million Americans can't get to medical appointments every year because they physically can't get to those appointments,” Megan Callahan, president of Lyft Healthcare, said. “Even outside of the healthcare segment, we have 30% of Lyft riders – consumer riders – using Lyft to go to medical appointments every year. And 40% of our rides overall either start or end in areas of low socioeconomic status. So transportation is a key barrier.”

COVID-19 complicated the transportation issue, since many public transportation services were disrupted or limited during the pandemic. Callahan said that provider organizations reached out to the ride-share company about getting patients to their appointments. Transportation was also key to COVID-19 vaccination efforts. 

“So we very quickly mobilized, realizing the scale of the problem, realizing the unique role that Lyft could play in that. … So we immediately started calling some of our largest partners, ... asking them for donations into our vaccine access program. And I have to say, the response from corporate America and partners of Lyft I felt to be completely overwhelming, and their need to really do something to help and pitch in.”

“We established over 150 partnerships where we had donations, and then we worked with the United Way, who in turn was working with many faith-based organizations to reach out into the community, with CVS in particular, to get people in to these vaccine sites.” 

“And you put that all together – the lack of affordability, lack of accessibility, the complexity – and particularly you think about communities where there is deep inequity, that is even more –. Those issues are even more of a challenge."

Financing care and accessing care are also major hurdles for individuals to access services. Retail giant Walmart is focusing on this space. 

“I think the challenge that we're trying to address is how do you attack those core fundamental challenges of affordability, of accessibility, of making things simpler for people, particularly for those communities that had the greatest need,” Marcus Osborne, senior vice president of Walmart Health, said on the panel. 

Osborne gave the example of the company's $4 generic prescription program. He said this program allowed folks who were unable to fill their prescriptions to access medication. 

COVID-19 has also changed the landscape of healthcare. Telehealth has come into the spotlight and has often been hailed as a way to expand access to healthcare. However, Osborne said that it's important to make sure that the communities you are trying to reach can access these new modalities of care. 

“You look at the rise of telehealth, for example. Certainly we saw significant movement in that direction. But, you know,  I was just in the community in Chicago, where if the community doesn't have smartphones and doesn't have access to Internet, tell her how it doesn't do you any good if you don't actually have the tools, ... the mechanisms, and the communication capabilities to reach people.”

While health equity is a hot topic in the medical world today, Bryd said the key to earning trust from under-resourced communities is to become engaged in community life. 

“So I would suggest for healthcare groups all over the country: If you are truly interested in building a beloved community, you've got to get in the community, and you don't just get into the community wearing your white coats and saying we're going to do COVID-19 testing. We're going to do diabetes screenings. You need more than that. Get involved in that local school district. Here in Central Harlem, there are 14,000 people over the age of 25 who don't have GED or high school diploma.”

Osborne said that design is important. Instead of creating the design around the health system, design the service around the patient’s wants and needs.  

“I think trust is paramount, and I think one of the ways that I believe that we earn it is in trying to address challenges in the healthcare system is around being very deliberate in our design approach.

"And what I mean by that is: I often hear people bandying about this term. We need to be more consumer-centered in healthcare. And I almost laugh at that. Healthcare is about people. It's not about what I think are our needs, how do we actually do when we design,” Osborne said.

“How do we actually create solutions that are about putting the person, the individual, the family in the community as the sole basis for design?”