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Spotlight Session - Health Equity

Session: Spotlight Poster Session B

(BSPOT03) Advancing Health Equity in Europe: A Framework of Diversity and Fairness in Pharmacoepidemiologic Research

Tuesday, August 27, 2024
8:00 AM – 6:00 PM CEST
Location: Foyer 3
Background: Pharmacoepidemiologic (PE) research should represent and benefit populations equitably, embracing diversity and equity, and ensuring fairness. However, there is lack of consensus on operational definitions of these concepts for PE in the European context.

Objectives: This framework seeks to describe health equity and fairness in PE, and to comprehensively describe key diversity domains (relevance, enablers, barriers) and provide operational recommendations and call for action for implementing them in PE research in Europe.

Methods: This framework was developed by an international taskforce of pharmacoepidemiologists, health equity and diversity experts, patient-research partners and patient/community representatives. It was based on scientific evidence, applicable regulations, and expert opinion.

Results: From a health equity perspective (absence of unfair and avoidable health disparities), fairness in PE studies should target equal opportunity, diversity and inclusion, and equal benefit for everyone in the population. To implement/evaluate health equity and fairness in PE, we defined the following diversity domains: biological sex, socially constructed gender, age, life phases (e.g., menopause), ethnicity and related variables (language, migration, nationality), socioeconomic status, education, health literacy, and health status/capabilities. All of these are determinants of health, either through biological pathways (e.g., sex), or through social norms, discrimination, and barriers to health care or research participation (e.g., gender, ethnicity, socioeconomic status, health status).
Implementing diversity domains in PE enables researchers to assess generalizability of findings, identify and address health disparities, account for determinants of health, and ensure fairness of algorithms, implementations, and recommendations. These domains are interlinked (intersectionality) and their impact in PE is study- and context-specific. Due to their sensitive and evolving nature, these data should be collected, stored and handled with caution.

Conclusions: We recommend researchers to explore the role/implication of the determinants (diversity domains) in their PE studies, tailor them to the study context, and implement and/or evaluate them appropriately (e.g., disease modifier, confounder, discriminated group). In interventional studies, accessibility and engagement are key to ensure diversity and inclusion. In real-world evidence (RWE), when there is lack of relevant data, acknowledge the consequent limitations and need for action. Support from stakeholders (e.g., data holders and regulators) is essential to raise this effort.