Reducing Health Disparities: A Grassroots Approach

bonnie-ward reduce disparity gaps

Q&A with Bonnie Ward
Market Director, Marketing and Communications
CHI St. Vincent

Healthcare providers everywhere are having to develop multiple strategies to address complex health disparities – the inequities in health outcomes that affect people of different races, genders, and socioeconomic backgrounds. As a result of unequal access to healthcare and preventive services, health disparities have a significant impact on a person’s overall health and well-being. Bridging this gap is critical to meeting healthcare systems’ access and quality goals and to improving the overall health of their patient populations.

The Q&A that follows is derived from a Hello Healthcare Podcast interview with Bonnie Ward, Market Director of Marketing and Communications at CHI St. Vincent headquartered in Little Rock, Arkansas. Here, Bonnie discusses some of the different strategies CHI St. Vincent’s marketing team has deployed to bridge the health disparity gap. Through their marketing campaigns, CHI St. Vincent has been able to reach more patients of different backgrounds and increase access to preventive care.

Tell us about your role at CHI St. Vincent.

There's a lot encompassed within my title. My team is very small, and we handle both internal and external communications. We handle crisis communications and public relations, but we also handle everything digital – from our websites and everything else in between. Sometimes we even get involved with things that really don't fall in our scope, but we're a good collaborative partner.

What is CHI St. Vincent doing to address health disparities?

Prior to COVID-19, we had been talking about health disparities for probably five or six years. But we really saw it come to light during COVID. Many people of color did not return to care during or after COVID, and we kept seeing that gap get bigger and bigger as time went by. For a lot of reasons, there was a lot of fear.

Many people weren't quite sure about the safety of the COVID vaccinations when they came out. So, we really had to pause and say, what is the most effective way to reach this audience? And what's the most effective way for us to look at the images we use, the words that we use, and the places we target our communications – whether they are digital or otherwise – so everyone felt like they could trust us as a healthcare partner? We really started the journey a couple of years ago to bridge that gap.


What have you learned about the root of these health disparities?

One of the big things we learned is that this audience was in fact receiving the information. But the information they received wasn’t resonating with them. That's when my team did a very large brainstorming session, and we gathered focus groups from our social channels and physicians in our practice. We asked them, what is a good way to reach this audience? How can we make people feel and understand our message? We started with those focus groups and tested the pictures and words that we used.

What are the most effective strategies you’ve used to reach audiences with health disparities?

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We did a cool campaign during American Heart Month. We developed a new program where anyone who has heart condition concerns can pay a small fee instead of going through their insurance to get a comprehensive heart screening. I worked with our compliance team to be able to offer this at a discounted rate during the month of February. So even those who fall around the poverty level or are lower income or on fixed incomes could afford to participate.

We learned that we needed to meet people where they already were. For example, on Friday evenings and on Saturdays, we developed a digital campaign where we targeted several major barbershops in the area with ads about heart health. And we created some fun and unique taglines that resonated with the focus groups. One was, "Your hair should fade, but your heart health shouldn't."

Tell me more about the channels used for the Heart Health campaign.

Our healthcare system is in Arkansas, and here we are still internet poor. But one thing we do know is that no matter what your income level is, and no matter your background, everyone has a cell phone. So, we utilized a lot of channels and geotargeting where we knew people would have their cell phones. We didn't just lean on a digital web banner on ESPN or things of that nature. We made sure that we put the ads on and near where they're searching on their cell phone. The response and performance were very impactful.

The other thing we did, especially for our older demographics, was send direct mail postcards. It really was a multichannel approach. And we also put one of our leading African American cardiologists on radio stations doing public service announcements, talking about whether heart attack symptoms are the same for African American men and women as they are for other ethnicities.

healthcare disparities channels

Are you employing SMS?

We did not employ SMS as part of this campaign because we wanted to see if we targeted our audience and made the information available, would they even interact with it? The last thing we wanted to do was utilize texting and have our audience unsubscribe right away. That would just shut the door for us to be able to get the message out in a personal way. What we found was that people were extremely engaged.

We had a creative headline that said, "It's okay to have heartburn, but your heart shouldn't hurt." And there’s a picture of an African American couple watching a football game and eating some pizza. We wanted to make sure that they understood what the symptoms meant. Do you just need a Tums, or do you need to get it checked out? We wanted to deflate some of those myths like, "Eh, my chest hurts, but I'm okay. I don't need to do anything about it."

How did you identify your target audiences?

I'm a huge advocate of a CRM (customer relationship management) platform for health systems. Individuals that I run across from other health systems will tell me, "I just can't afford a CRM. How do you pay for it?" And I say, "Well, I can't afford NOT to pay for it." While it can be pricey, you can track downstream revenue and show the return on investment to your executive leadership. You can show actual conversions from your campaigns, what I call “bodies in beds” or “patients in the door”. While it can be expensive, utilizing our CRM to pull data is essential.

We started with existing patients that hadn’t returned in a while. Then I went to our CRM and asked to pull a list of individuals with insurance information who weren’t our patients and may have been in need of a heart checkup. It could be because they have Type 2 diabetes or they have a family history, or maybe they've been diagnosed at some point with uncontrolled high blood pressure. Those are the individuals that we wanted to target.

We were able to be very specific. We could pull a list of African American individuals with a household income of less than $30,000 a year. Including blue collar workers, people who don't have commercial insurance, or are a government-insured patient.

You can get very targeted if you have a CRM system. If you don't have a CRM system, it's not impossible to do. You can still pull the data if they're your patients. For example,  if they're in your EMR (electronic medical record), they're already going to be a patient. You can still segment by race and zip code. You just can't add on a lot of the other lifestyle factors like you can if you have a CRM.

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How do you balance communications and leveraging potentially sensitive patient data?

That's certainly something that marketing and communication teams really need to have at the forefront when they build these kinds of custom campaigns. Because you can do it very wrong and get in trouble.

What my team did (and the focus group was a big part of this) is ask, how we could make our communications not personal? Which sounds backwards to everything that you know about marketing, where personalization is better. But we did not want people to be offended. So instead of including a name on communications, we put "to anyone at this address.”

Also, while the imagery on the postcards we sent was targeting the audience it was going to, it still looked like our brand and felt like our brand. We wanted the postcard to be applicable to anyone who lived at the address.

Does it matter how you deliver the content?

Absolutely. A lot of it is human nature. I certainly don't like to get a postcard that says, "Oh, you need to sign up for AARP because you're old.” I'm not old enough to sign up for AARP, I just want to throw that out there! You don't want to make anyone feel embarrassed or demeaned by your communications. So that is where you must get creative and deliver something that is actionable without being offensive.

That's also why we used digital tactics with cell phones. Someone could be shopping for shoes online and they would be served an ad that they did not have to interact with. But what we found was that if we made the ad fun and relevant, people were actually more apt to interact with it.

How do you measure campaign effectiveness and the impact of reducing health disparities?

For the heart campaign, we went beyond clicks and form fills. We measured who actually came in for a heart screening, because that was our call-to-action. Our goal was to obtain 100 registrations for our HeartSmart screening program over the course of a month. And actually February is a short month, so we had 28 days.

We had over 100 registrations in the first week! We capped out in February at just over 300 registrations for the HeartSmart screening program. But we didn't stop there. We did a pro forma of how many patients that came through the screening actually converted and needed services from a cardiologist. Eighteen percent of patients who came in actually needed follow-up cardiology care.

Sometimes, as marketers, we check the analytics box and we're like, "Done." This many impressions, this many clicks. But we really have to move beyond those statistics and show our senior leaders what those clicks mean from a downstream revenue perspective.

Anytime my team and I can move beyond impressions and clicks and show “bodies in beds” or conversion to services, that's the number I like to focus on. A CRM can build that bridge for you so you can see that data. You don't have to lean on your clinic managers or someone in the hospital for the data. We know they're already overworked and the last thing they want to do is pull numbers for you. A CRM will take that work off their shoulders and give you that information in an intuitive dashboard.

It was a great learning experience. This was not a one and done. And if people are telling us they want to see more people in healthcare that look like them, talk like them, feel like them – then we can't just do one campaign in February. Addressing health disparities has become an ongoing part of what we do. We have to be very purposeful in the voices we use in radio and the imagery we use in ads.

How would you recommend other health systems get started in addressing health disparities?

Use the plan you already have. It doesn't take a lot of extra strategy, it just takes thoughtfulness. If you're already doing a digital campaign, allocate a portion of your budget to reach people of color.

A lot of folks that are in your organization will walk alongside you and help you learn how to talk to consumers, how to use imagery that resonates. They're very willing to help, and they want to be heard. So be very collaborative and bring your peers to the table.

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What has your impact been on social media compared to other mediums you’ve used?

Social media is a great tool. However, not all platforms are equal, so it depends on who you're trying to reach. Most people, no matter their age, are using some type of social media. Know who your current followers are on various social media channels and look at the research for your area. And then think of some out-of-the-box opportunities.

Frequency is important. Frequency, frequency, frequency. Just because you don't see huge engagement doesn't mean that people are not interacting with your content. And you have to ask yourself, what's the goal?

What's next on your initiative list?

This month we are launching a new blood pressure e-newsletter. In the state of Arkansas, heart disease is the number one killer. And it really starts with blood pressure. So, we are doing a monthly campaign that is going to be delivered through social channels and also through a digital e-newsletter, targeted at individuals that we have identified across all ethnicities.

Again, we're going to put that extra layer of thoughtfulness and customize it to our Spanish-speaking audiences and our African American audiences. The content will teach the basics. How often should you check your blood pressure? What should your blood pressure be? You'd be surprised how many people do not know what a normal blood pressure is. These campaigns will provide tools so that people can make better-informed decisions. Listen to the full Hello Healthcare podcast interview with Bonnie Ward on your preferred streaming platform or watch the full video interview below.

About Bonnie Ward

Bonnie Ward has nearly 15 years of experience in advertising and brand marketing development. She has expertise in generating advertising recall and actionable brand loyalty across various mediums including a variety of digital channels, broadcast television, and product catalogs. She has been working in marketing and communications at CHI St. Vincent for more than 6 years. Connect with Bonnie Ward on LinkedIn.