Close the Gap initiative expands to treat more patients and help combat racism in healthcare

Sep 16, 2020

The COVID-19 pandemic has taken a disproportionate toll on marginalized communities, particularly among Black, Latinx and Hispanic people, and exposed the severity of health disparities in the United States. Over the next few months, Close the Gap, our Boston Scientific health equity initiative, will focus on raising awareness in four cities—New Orleans, Detroit, Minneapolis and Dallas—empowering healthcare providers to reach more patients of color, fight long-standing inequities, and address barriers to care.

“Everyone deserves access to lifesaving care,” says Paige Bingham, director of Close the Gap. “Providers can effect real change because they’re on the front lines, but often they’re unaware of care disparities in their communities. Our goal is to give them the information and support they need to increase people’s access to care and improve health outcomes for all.”

Through Close the Gap, hospitals and health systems are provided with zip code level data that highlight the disparities in treatment between white and non-white patients in their communities. The information will allow health care administrators and providers to zero in on underserved populations within the community surrounding the center. For example, the team is currently working with a major health system in Detroit, and they have found that white males were receiving care for coronary artery disease at a far higher rate than Black patients. Using data, they learned that if the providers were able to reach and care for non-white patients at the same rate as white males, that health system could treat and improve the lives of more than 1,000 additional patients.

“There are many reasons why marginalized groups may avoid seeking care, including simple logistical challenges like not being close to a health care facility or being unable to schedule an appointment during normal business hours because of work,” says Trish Solliday, a health equity consultant for Close the Gap. “Then there’s the issue of trust. Black, Latinx and Hispanic people are very underrepresented at the doctor level, which can create communication barriers between doctor and patient. And doctors, like everybody else, carry implicit biases that can exacerbate the mistrust marginalized groups often feel—mistrust that deters them from getting the care they need.”

Building on 15 years of experience partnering with advocacy and provider organizations, the Close the Gap team develops action plans to help hospitals and health systems remove those barriers and create more equitable care settings.

The action plans often include recommendations to offer unconscious bias training for providers and staff. “Once there is a general understanding of the local disparity, it’s critical for clinicians and administrators to understand how their interactions with patients may affect a person’s willingness to seek care. Everyone has biases, and the sooner we recognize that, the sooner we can check them at the door,” says Solliday.

Close the Gap is also focused on increasing diverse representation in clinical trials to better reflect the demographics of the country’s actual patient population. For example, the PLATINUM Diversity study, one of the first of its kind in the medical device industry, enrolled 1,501 patients from understudied populations, including women, Black, Latinx, Hispanic, Indigenous Americans and Alaska Natives. 

The findings are helping physicians create tailored treatment plans that reflect patients’ individual demographic and socioeconomic profiles. In addition to clinical insights, the 2016 study and subsequent analyses of its data shed light on the extent to which factors like income, education, proximity to healthcare services, and having a provider who speaks your language affect health outcomes.

Watch now: How do we treat what we cannot see?