Healthcare

Health equity: dismantling disparities to build a more inclusive healthcare system

Published on 16 June 2026 Read 25 min

health equity agency consulting consultancy experts

Despite well-established healthcare systems, particularly in Europe and North America, disparities in access to care persist and, in many cases, continue to widen, including within these countries themselves. In France, nearly three-quarters of the population report having foregone at least one healthcare service within the past five years¹, while certain groups, including economically disadvantaged individuals, minority populations, and residents of underserved areas, remain consistently excluded from the care pathway. On a global scale, these disparities are even more pronounced between high-income and low-income countries, with significant gaps in morbidity, mortality, and life expectancy².

Against a backdrop of growing pressure on healthcare systems and evolving societal expectations, health equity has emerged as a critical priority for all stakeholders, both public and private, including pharmaceutical companies.

In this article, Alcimed explores the underlying drivers of health inequities, their impact on healthcare system performance, and the key levers for building a more inclusive healthcare model.

What is health equity?

Health equity is a fundamental concept aimed at ensuring that every individual, regardless of their social, economic, or geographic background, or any other characteristic (such as sex, gender, ethnicity, disability, or sexual orientation), has the opportunity to achieve their full health and well-being potential.

According to the World Health Organization (WHO), health equity means the absence of unfair, avoidable, or remediable differences among groups of people.

Health equity does not mean an equal distribution of resources, but rather an equitable allocation based on the specific needs of each group. Recognized as a fundamental human right, health equity has become a defining issue for healthcare systems worldwide, although adoption and integration remain gradual and uneven across healthcare industry stakeholders.

Systemic inequalities driven by multiple factors

Universal Health Coverage (UHC)¹ is one of the targets set by WHO member states. Despite progress, certain populations remain consistently underserved within the healthcare system, including immigrants, undocumented individuals, precarious workers, students, ethnic minorities, older adults, and people living in rural areas.

In the United States, emergency department data highlight disparities in care based on ethnicity: Black patients experience longer wait times, longer lengths of stay, and a higher risk of mortality in hospitals or emergency departments compared with White patients.²

These populations face several types of barriers throughout their care journey:

Forgoing or not accessing healthcare services, benefits, and support to which they are entitled. For example, in France, the 2026 FHF x Ipsos BVA Barometer found that 73% of respondents (based on a sample of 2,500 individuals) reported having foregone at least one healthcare service during the previous five years, compared with 63% in 2024.³
Reliance on emergency services as a primary source of care.
Administrative, food, or housing insecurity.

Health disparities are multifactorial and result from a combination of contributing factors.

Individual and social factors

Access to healthcare is strongly influenced by individual and social determinants, which can create significant public health inequalities. Some of the main barriers include:

Financial constraints and the inability to pay healthcare costs upfront.
According to WHO data, children born in the poorest countries are 13 times more likely to die before the age of five than those born in the wealthiest countries.⁴
Social isolation or housing instability.
Limited awareness of healthcare rights and available services. In France, for example, undocumented individuals are eligible for State Medical Aid (Aide Médicale de l’État, AME), which provides access to medical care.
Trade-offs that prioritize essential needs such as food and housing over healthcare.
Language and cultural barriers.

System-level shortcomings

Failures within healthcare systems themselves can also restrict access to care and exacerbate existing disparities. Some of the most significant systemic issues include:

Geographic disparities in access to care and physician shortages, including long travel distances and lengthy appointment wait times. In France, according to a study published by the Directorate for Research, Studies, Evaluation and Statistics (Direction de la recherche, des études, de l’évaluation et des statistiques, DREES) in 2023, 65% of physicians reported refusing new patients seeking a primary care physician, compared with 53% in 2019.⁵
Complex care pathways and a lack of service transparency, including both medical and administrative procedures.
The digitization of services, which can exclude certain groups, particularly older adults and economically vulnerable populations.
Discrimination and denial of care, resulting in differences in treatment and care delivery due to economic status, age, language, origin, or gender.

Climate change

Alongside these social and structural factors, another emerging challenge is climate change, which is further amplifying health inequities.

The increasing frequency of extreme weather events, including storms, heat waves, floods, and droughts, has direct health consequences, such as rising rates of malnutrition, mental health disorders, respiratory diseases, and the spread of infectious and vector-borne diseases. These trends are driven in part by the geographic expansion of vectors such as mosquitoes, as well as increases in waterborne and animal-borne illnesses.

However, these impacts are not distributed equally. Certain populations face greater exposure because of demographic, geographic, socioeconomic, living condition, or health-related factors. Women, children, older adults, migrants, ethnic minorities, and individuals with underlying health conditions are among the most affected populations.⁶

These vulnerability factors are closely linked to inequalities in resource distribution, more limited access to infrastructure and healthcare systems, as well as historically entrenched discriminatory public policies and practices.⁷

Low-income and developing countries are among the most exposed to the health consequences of climate change, despite contributing the least to greenhouse gas emissions. This situation is largely driven by weaker healthcare systems and more limited adaptation capacities, further deepening global health inequities.

Gender

Finally, some populations face multiple, overlapping forms of inequality. Women, in particular, often experience both barriers to care and insufficient recognition of their symptoms.

Gender-related health disparities intersect with the other forms of discrimination discussed above. As a result, women face additional barriers to accessing information, receiving an accurate diagnosis, and obtaining appropriate treatment once a diagnosis has been established.

These inequalities affect both conditions that impact women and men (but may present differently depending on gender), and conditions that are specific to women. In both areassituations, the legacy of a healthcare system historically built around male-centered models continues to limit recognition of women’s specific health needs. Conditions such as endometriosis, polycystic ovary syndrome (PCOS), and hormonal disorders therefore remain underdiagnosed and under-researched.

These disparities stem from biases within healthcare systems as well as from the minimization of symptoms, which may involve healthcare professionals, family members, or patients themselves.

Read also: Women’s health: when gender bias in medical diagnosis delays care and What role should the pharmaceutical industry play in improving women’s health?

Direct consequences for healthcare system performance

These disparities are not solely a social issue; they directly affect healthcare system performance.

Delayed access to care leads to:

Diagnoses at more advanced stages of disease
More intensive and less effective treatments
Reduced opportunities for positive patient outcomes
Worsening health conditions and an increased risk of long-term complications or lasting health consequences

Care pathways are also frequently disrupted, limiting continuity of care and reducing treatment adherence.

In practice, this translates into a reality that is often underestimated:

Real-world treatment effectiveness is significantly reduced by inequalities in access to care.

In the United Kingdom, the prevalence of overweight and obesity varies according to age, geographic location, and ethnicity. Childhood obesity rates are increasing substantially faster in communities facing higher levels of deprivation.

Among the contributing factors is lower utilization of weight management services among certain groups, particularly older men and ethnic minorities. This is partly driven by social and economic inequalities, as well as discrimination, including structural discrimination within healthcare systems. Access to these services also remains uneven because of healthcare funding and organizational choices.⁸

Globally, gender-related health inequalities persist across all healthcare systems but are especially pronounced in low-income countries.

In these countries, women have more limited access to healthcare and receive inadequate treatment for conditions that are more effectively screened and managed in high-income countries. This is particularly true for maternal mortality, HIV/AIDS, and cervical cancer.⁹

Discover how our specialized team can support you in improving care pathways >

Beyond medicines: an expanded responsibility for pharmaceutical companies

Addressing these challenges requires a multidimensional and collaborative approach involving all healthcare stakeholders.

A medicine or medical device can only fully demonstrate its effectiveness if it is accessible, prescribed at the right time, and properly followed throughout the treatment journey.

Healthcare industry players, including pharmaceutical companies, are therefore increasingly being called upon to rethink their role by contributing beyond treatment development and helping deliver more effective patient care while supporting public health objectives.

Several key levers are emerging:

Better understanding health disparities by generating data that help identify underdiagnosed or underserved populations. For example, Bristol Myers Squibb France contributed to the TERRITOIRE study (2011-2013), which highlighted regional and socioeconomic disparities in the management of patients with lung cancer. This work went beyond documenting inequalities and helped identify concrete actions to improve patient pathways, including reducing diagnostic delays, strengthening post-discharge follow-up, and developing digital coordination and patient support solutions.¹⁰
Developing solutions tailored to real-world needs by simplifying access to information, supporting patients throughout their care journey, adapting Patient Support Programs (PSPs) for vulnerable populations, and implementing targeted prevention initiatives.
Working across the healthcare ecosystem in collaboration with public authorities, healthcare professionals, and patient associations to develop solutions tailored to local needs. Through its AccesS Diabetes initiative launched in 2023, Sanofi has partnered with several low- and middle-income countries, including Ghana and Nigeria, to improve access to diabetes care through awareness campaigns, screening programs, healthcare professional training, and the provision of appropriately priced insulin analogs. In Ghana, 250 general practitioners and 340 additional healthcare professionals, including nurses, pharmacists, and dietitians, have received training since the program’s launch. In Nigeria, 100 general practitioners and 216 healthcare professionals had been trained by the end of 2025.¹¹
Fully embedding health equity into corporate strategies, particularly through ESG initiatives and market access approaches.

Health equity is now emerging as an increasingly important priority for all healthcare stakeholders, from public authorities to pharmaceutical companies. Historically driven by public policy, the topic is becoming more prominent within pharmaceutical industry strategy discussions as healthcare systems face growing pressure.

Reducing inequalities is not only an ethical imperative; it is also a strategic priority for companies committed to improving real-world access to care and innovation. Doing so enables them to better address underdiagnosed populations, anticipate evolving healthcare needs, and strengthen the credibility of their ESG and access commitments.

In this context, healthcare companies have a significant opportunity: to evolve from a product-focused role to that of an active stakeholder committed to ensuring meaningful access to care.

At Alcimed, we support healthcare stakeholders in understanding and integrating health equity challenges, helping transform these issues into tangible opportunities for impact and differentiation. Feel free to contact our team.

About the author,

Clara, Consultant in Alcimed’s Healthcare team in France

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