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HOST: DOUG SIMON

GUEST: KRISTIE KUHL

DOUG: Broadly, is health equity good for business?

KRISTIE: Health equity is the right thing to do, it’s the ethical thing to do, and it is good for business. We have to really support health equity because when you look at America specifically, we see there are massive differences in lifespan and health span for people of different races. And we see that Black Americans are living an average of six fewer years than White Americans. There are also differences among other races. And while all people in the US lost life expectancy between 2019 and 2020, we see that Hispanic Americans and Black Americans lost it a faster rate. So, from the simple perspective of helping people achieve health so they can live long healthy lives, if your employees, if your customers have a shorter life expectation, that’s bad for business.

DOUG: Yeah, and that also obviously is important for companies who are in the health arena, as many of your clients are that you work with. How can they promote and provide increased equity?

KRISTIE: Yeah, health equity is so important because what we’re really talking about is how do you remove obstacles that prevent people from achieving optimal health in their life. And we used to look at differences in outcomes and say, “well, there are just certain diseases that are more prevalent in certain races.” And while that may be true in certain things, we have discovered that many of the things that we attributed to race are really attributed to racism. And so, when we’re looking very specifically at how we remove obstacles and how do we create opportunities for all Americans and all people around the world to achieve their optimal health, we have obligations, whether we’re looking at designing a clinical trial, whether we are a hospital and making sure that we’re hearing. We see massive differences in maternal mortality based on race. We want to make sure that we’re helping our clients remove obstacles that are creating hindrances to people living long lives and that are having horrible implications during it. So, people who are dealing with racism have higher blood pressure, they have all kinds of cardiovascular risks, they have weight issues. While they literally are taking years off people’s lives, they’re also robbing them of quality of life, and that’s something as a society that we’re all responsible for. And so, helping our clients, helping companies in the health space remove some of those barriers is essential, but being aware of them is the first step.

DOUG: Yeah, one of the challenges, obviously, of COVID has been communicating about health and public health has become such a challenging environment and contentious environment. So, given your role, how are you working with companies to help try and address this and communicate it effectively, whether or not they end up getting caught in this firestorm, given that it’s so important?

KRISTIE: It’s a great insight, and really what we have to do is make sure that we are reaching people where they are and how they want to receive information. So, people often talk about multicultural marketing. I think that is a bit of a misnomer because we live in a world that’s multicultural. So, any audience you’re trying to reach, you want to do a lot of research. We are very driven by data, so we dig deep into what did the data tell us, how do people want to receive information, what is it they’re looking to learn, and studying the behavior and then providing them with the information in the manner in which they are accustomed or open to receiving it.  So, that doesn’t mean, what does my client want to tell people, it means, okay, we’re trying to address a health issue, here’s where the audience is, here what their preconceived notions are, here is the person who’s going to be the decision maker generally in that audience, and then, what information do they need? You mentioned COVID, and we saw very specifically that people who said, “As soon as there’s a vaccine, I’m getting vaccinated,” people who said, “I want to get vaccinated, I first want to see how people do and then I’ll get vaccinated,” and then the third audience of “There’s no way I’ll get vaccinated,” they all did what they said they were going to do, right? The people who predicted, “I’ll get it right away,” did. The people who said, “let me wait and see,” they waited, they saw, “Okay, it’s going well,” they got vaccinated and the people said, “There’s no way I’ll get vaccinated,” didn’t. And so, that’s a great lesson for us as well because we have to think about what is the emotional component of the communications that we’re doing as well as the scientific and intellectual.

DOUG: Yeah, and there’s also a risk, I would think, to treating every different group based on a label as homogeneous when they’re clearly not, there’s huge differences within. What are some approaches you take to strategize and are clients open, I’m sure, I think they would be these kinds of discussions?

KRISTIE: Yeah, I think that people are very aware. In the health space, not even too long ago, maybe 10-20 years ago, people used to be identified by their disease state. People used to say things like, oh, an epileptic or a diabetic. We would never say that now. They are humans, they are people living with ALS, they are people living with epilepsy, they are people living with diabetes. It doesn’t define who they are, it’s not an identifier. Even though every company today is a health company because of the world and the environment in which we live, making sure that they’re able to keep their employees, their business family healthy is essential, specifically in the biotech and the pharmaceutical area and in the wellness area. It is very important that we’re communicating with people in the manner in which they want to be communicated with.

DOUG: You’ve been talking about how people receive information. Could you maybe shed some light on your role and with your clients you’re trying to get information to them in a different way?

KRISTIE: There are a few factors that go into this. There’s the literal where, where do they receive the information? Are they seeing this on social media, reading it in the news, listening to it in a podcast? But there’s also that the who? Our clients often are doing work with the exact patient types that they are going to be speaking with. So, having panels, having boards where you’re getting the input of people who have lived experience, it’s really important that some information comes from the company. It’s very important that a lot of information comes from people who have experience, and are living it, and are objective. It’s also very important that certain audiences really hear it from the healthcare provider. And certainly, within the healthcare provider, there are different audiences within that—the pharmacist, the nurse, the physician, and they all have a role to play in this. So, while it used to be that pharmaceutical companies would just put the information out there and think the science speaks for itself, that’s really outdated. And we know, first of all, the science doesn’t speak for itself. But second of all, we have an environment today where people do not have a relationship with the company that makes a life-saving medication. People will talk a lot about their doctors. You’ll hear people who have cancer, and they love that physician because they know that physician, but they may not know the name of the medication they were on, maybe that immunotherapy that changed their lives and helped them beat a horrible disease. And so, we do want to try to create those bonds and create a relationship so that there is a two-way conversation there.

DOUG: And we are actually seeing from the media itself that they’re looking more to speak to people who are at the companies than third party spokespeople, sort of seems like the doctor-patient combination, one that historically been used is probably still going to be there. Another piece that I should bring up is that you have a law degree.

KRISTIE: I do.

DOUG:  There’s so much talk in health care about regulatory, what you’re allowed to say. I have my own bias that regulatory is an excuse for bad PR. Not everybody loves that who does health communications, but can you still do good communications within the legal framework, and what are the things that you really need to keep top of mind?

KRISTIE: What we do have to think about is making sure that we understand medical, legal, and regulatory are assessing risk. They’re not the enemy. What they’re doing is assessing risk for the company. The reason we have guideposts there is to say we don’t want to make claims that are misleading, are confusing, aren’t helpful, that would make people have inappropriate expectations. And so, it’s really important to have those. At the same time, we don’t want to get into that sort of legal paralysis where we are going to be protected if we’re using this complex language, that’s not great. We’ve talked about health equity, but health literacy is important. Now, people with rare diseases, people with cancer, people often will become incredibly, deeply knowledgeable about things, but we shouldn’t assume that about everyone. We want to make things clear, and it’s always great, I think, to partner early with MLR to talk about, look, this is our goal. Our goal is that we want to be able to help audiences understand this information, and here are some of the ideas we are thinking about, what guidelines can you give us and then building your plan with that, rather than building out a plan and having MLR saying like, “no, yes, yes, no”, it’s better really to start with that early. This is what we want to do. What are our guidelines and what risks would we be facing?

DOUG: Yeah, that’s great advice, and I know the lawyers might not like me saying this, but I’m going to go out on a limb and guarantee that there’ll be no adverse events to anyone who takes your great advice that you’ve shared with our audience today. Thanks so much for being with us.

KRISTIE: Thank you so much. It’s always such a pleasure to talk with you.