Distrust appears a recurrent theme in the gap between provider and those who would benefit from healthcare support. Previous experience of discrimination is clearly not going to help trust and it is critical this is addressed in healthcare systems, aiming to eliminate discrimination both towards the user and towards healthcare professionals (HCPs). However, we know the way we communicate can help build trust and, as communicators, that is our speciality.

Perhaps the first step here is that we stop talking about ‘patients’ as if they are all one homogeneous group. Every patient is unique and the more we can communicate to the individual, the greater our opportunity to build that trust. In supporting HCPs, we need to help arm them, or complement their work, to communicate most effectively with people from different ethnic or socio-economic backgrounds. In reality, it isn’t practical to create information for each individual, although perhaps using personalised non-clinical data entry and then sophisticated algorithms, digital could take us closer to personalised communication. However, we can stratify our audiences much more forensically, considering factors such as ethnicity, social mobility and disability. 

If we are truly to make a difference, it is then about so much more than translating or writing in plainer language.

We need to be considering every step of seeking and receiving healthcare and how that differs for individuals based on their specific circumstances. Then we need to provide not just information, but understanding, practical advice and, where possible, practical support from either the health system or industry/third-party partnerships.
  
Most of all, whatever we communicate needs empathy. For example, the barrier to early presentation and identification may not be the knowledge, but the balance of that with the cost or practicality of a train and four different buses needed to get to the healthcare provider.

Dietary information for a vegan is going to be different than for somebody who eats meat and fish; similarly dietary habits may change at certain times due to religious or cultural traditions. Advice on medication adherence for a shift worker will be different than for somebody working from 9am to 5pm. I could go on ad infinitum but hope I have painted the picture.

Underpinning all this is insight. Only when we understand the life of the individuals, their friends and family, and the real barriers to not receiving the healthcare they deserve, can we hope to effectively engage with them, and the healthcare system, in the most effective way to achieve change. We need to encourage much more diversity in healthcare in general, and healthcare communications specifically, and this will help some aspects of cultural and socio-economic understanding. But we must also recognise that the very fact individuals have made it into those roles may differentiate them from the audiences we need to target. In insight gathering we therefore need to partner closely with patient groups and other charity organisations, as well as the HCPs managing patients in the communities we are targeting, to facilitate introductions and help us gain true representative participation. This is also important for testing our proposed communications. We need to resist the easy option of using the ‘professional’ or educated patient and instead engage directly with those who better representative our target audience. Of course, this all takes more time, and therefore money, but the right investment upfront to gain these insights can pay dividends in terms of the success of the outputs.