(Nearly 24 million Americans are living in food deserts.
When fresh produce is not available, residents turn to unhealthier options.)
Cardiovascular disease and diabetes are leading causes of death in the U.S., but according to the Centers for Disease Control and Prevention (CDC) Health Disparities and Inequalities Report, all are more prevalent among medically underserved populations. African Americans, for example, are 50 percent more likely to die of heart disease or stroke before the age of 75 than whites. Likewise, African Americans, Hispanics and other races experience higher rates of adult-onset diabetes than whites.
Adults with lower household incomes also face higher rates of these devastating but highly preventable diseases. Overcoming barriers of ethnicity, income or geography isn’t easy, but it is possible. What’s more, psychographic segmentation can help hospitals improve engagement—and ultimately, the health outcomes—of medically underserved patients.
Innovative Approaches to Addressing Health Needs of Medically Underserved Populations
A 2016 study, funded by a grant from the New York State Health Foundation, looked at how 18 hospitals in New York and six others across the country are addressing barriers common to medically underserved patients. A Health Affairs blog post on the study reports, “Through close collaboration with community and government organizations, these hospitals have been successful—even with relatively small financial investments—in creating programs to improve such things as access to housing, availability of healthy food, and improved education in their communities.”
(CINCINNATI - The Walnut Hills Kroger closure has created a food desert for residents in area, some say. Courtesy: WCPO)
“Losing our grocery store is disappointing, particularly because many of our most vulnerable residents will now have limited access to quality food options," said Kevin Wright from the Walnut Hills Redevelopment Foundation."
While it may sound like such programs are out of the normal purview for hospitals, much of a person’s health can be directly linked to “non-medical determinants,” particularly among the medically underserved.
Hospitals that participated in the study came in all shapes and sizes—large and small, urban and rural, public and private. Interviews revealed that hospitals’ reasons for investing in programs also ranged widely, from foreseeing advantages in a value-based payment landscape to community service missions. This is especially true for hospitals that serve disadvantaged communities. Some of the programs implemented by these hospitals included:
- Undertaking neighborhood revitalization projects
- Addressing food deserts through community gardens and grocery store partnerships
- Supporting residents with GED completion and job search assistance
How did they achieve positive results? Hospitals collaborated closely with community organizations so, as the article notes, “… they would not need to ‘reinvent the wheel’ in learning the lay of the land, developing community trust, and building infrastructure.” When possible, they also tapped into outside funding to stretch their investments.
Psychographic Segmentation Helps You Connect on a Personal Level
While these efforts targeted non-medical barriers, hospitals can also realize improved engagement when they target populations based on individual attitudes, behaviors and motivations. Hospitals can leverage psychographic segmentation and healthcare consumer data to gain the insights they need. For example, data from the c2b Consumer Diagnostic for Cardiac Conditions profiles patients with coronary heart disease, high blood pressure and high cholesterol, providing details on:
- How they manage health conditions
- Behaviors and attitudes regarding healthcare professionals
- Prescription and over-the-counter medication shopping habits
- Needs and attitudes regarding health insurance
- Preferences for health information resources
- Attitudes and beliefs regarding the Affordable Care Act
This quantitative study is complemented by c2b’s proprietary psychographic segmentation model that classifies healthcare consumers into five distinct segments, ranging from Balance Seekers and Priority Jugglers to Willful Endurers, Self Achievers and Direction Takers. Each psychographic segment approaches health and wellness in different ways, with varying motivations and communication preferences. Some segments, such as Balance Seekers and Self Achievers, are proactive in handling health issues, while other segments are more reactive and address health issues only when they arise, or are disengaged and are less likely to activate against desired behaviors.
The following chart shows the psychographic segment distribution differences among different races/ethnicities who who reported, in the c2b Consumer Diagnostic, to have high blood pressure (note: the c2b Consumer Diagnostic includes more than 50 diseases or health conditions).
The self-reported incidence of high blood pressure varies among the races/ethnicities, but even within these groups, the distribution of the psychographic segments differ. How one engages a Direction Taker is very different from the way one would motivate a Self Achiever. Thus, a “one size fits all” approach to a patient based solely on demographics will fall short in achieving optimal outcomes.
By delving deeper into what motivates individuals, hospitals and other healthcare providers can customize communications and population outreach to optimize engagement, helping medically underserved populations adopt healthier behaviors and proactively manage existing chronic conditions—despite the other barriers they face. And when hospitals approach the problems from multiple fronts, the outcomes for medically underserved populations could be even greater.