Across the United States, people are experiencing health inequities due, in large part, to social determinants of health (SDOH)—environmental conditions that impact a wide range of health, functioning, and quality-of-life outcomes and risks. A growing body of research demonstrates racism is a primary driver of differences in SDOH; it amplifies disparities in housing, economic stability, education, and healthcare, particularly among historically marginalized and minoritized communities. As a result, people from racial and ethnic minority groups throughout the United States experience, on average, lower access to and quality care, higher rates of illness—including diabetes, hypertension, obesity, asthma, and heart disease—and increased mortality.

As we recognize the racial and social disparities that exist and persist within our nation and its systems, there is an imperative to ensure those with the greatest need can realize the benefits of precision health, including better outcomes. To start, we must try to create inclusive and equitable research processes. 

Outcomes Research Health Equity Commitment

At One Drop, we are committed to conducting outcomes research to the best of our abilities that investigates program effectiveness within historically marginalized and minority communities in a way that provides benefits to individual participants, does no harm, and generates meaningful insights for continuous program improvement. 

We intend to help close the health equity gap by providing culturally competent, accessible, effective, and engaging support to people from racial and ethnic minority groups and groups experiencing disadvantage because of social determinants of health without exacerbating existing disparities. 

Our Approach

To achieve this objective, we must first aim to ensure diverse representation in One Drop research. We will approach this in prospective studies in the following ways:

• We will look to include measurements of race, ethnicity, income, education, access, and other characteristics that put people at higher risk for discrimination; these variables will appear in subgroup analyses wherever possible. 
• We will identify the necessary steps to recruit from diverse populations concerning race, ethnicity, income, education, and access. To achieve this, we will build and leverage relationships with local, regional, and national organizations as needed that have direct access to or provide support to subpopulations.
• We intend to adopt a “root causes” approach to measuring and analyzing underlying environmental, economic, social, and psychological factors leading to differences in behaviors and outcomes to understand root causes and potential application for intervention. 
• We will ensure that insights our research generates about intervention adoption, access, and effectiveness within key subpopulations are fed back into the product, operations, and marketing teams when appropriate to help address any areas of opportunity we uncover.
• We will put forward proposals for outcomes research that focus specifically on the effectiveness of One Drop's support program for people from racial and ethnic minority groups and groups experiencing disadvantage because of social determinants of health (e.g., income, education).

Such studies will look to incorporate the following guiding principles and tactics:

• Institutional review board (IRB) approval and oversight of all studies materials and procedures to ensure good clinical practice and human subjects protections according to federal regulations. This includes transparent communication to research participants of study risks, benefits, and data reporting as part of informed consent in ways that are accessible and easy to understand. 
• The collection of qualitative data to regularly check our assumptions and to more deeply understand and improve, over time, the program experience, engagement, outcomes, and considerations for life context. 
• Active recruitment of diverse participant pools both virtual and nonvirtual, geographically focused, enabled via trusted relationships with community centers, practitioners, and researchers.
• Longer-term access to the One Drop support program beyond the typical three- to six-month study durations.
• Waitlist control groups, where applicable, to ensure all participants will ultimately receive the One Drop support program.
• Compensation for participation in research. 

What is most promising about precision health is its potential to empower people to take charge of their health by eliminating barriers to care access and offering continuous, personalized support. At One Drop, we have a unique opportunity to address health inequity in our outcomes research and help ensure the precision health support we provide to our members is, at a minimum, inclusive, accessible, and effective.

We will keep you abreast of our latest outcomes and continue to use our platform to bring awareness to health inequities and offer actionable advice when appropriate. Together, we can transform the future of health for everyone.

Co-authored by vice president of evidence generation at One Drop, Lindsay Sears, PhD and clinical pod manager for cardiovascular disease, Lisa Graham, RN, BSN, CDCES, with support from Jeff Dachis, Dan Goldner, PhD, Jamillah Hoy-Rosas, MPH, RDN, CDCES, Sara Huneke, Steven Imrisek, Andrea Lagotte, Lindsey Lavaysse, PhD, Harpreet Nagra, PhD, Carrie Siragusa, and Michael Tomback.