According to a recent article in the Chicago Tribune, public health experts have coined the phrase “pharmacy deserts.” A researcher at the University of Illinois has identified locations in Chicago where there was no pharmacy within one mile.
Tragically, most of these pharmacy deserts are located in the poorest neighborhoods of Chicago with primarily minority and low income residents. Similar to a “food desert” where citizens lack access to healthy and affordable food, residents in pharmacy deserts experience negative health consequences due to the additional distance burden to obtain prescriptions and other pharmaceutical services. In the December 2017 edition of Pharmacy Times, we cautioned that the Chicago City Council’s plan to regulate pharmacies could have a disparate impact on Chicago’s most vulnerable residents. Pharmacy deserts are an additional impact on consumers due to closures of retail pharmacies and ultimately, corporate decisions as to where to locate new stores.
Another report from the Chicago Tribune dated Feb. 24, 2017, revealed that one major pharmacy chain planned to close about 70 locations in 2017, including 11 stores in the Chicagoland area, thereby exacerbating the prevalence of pharmacy deserts and negative impact on select populations of Chicago. The problem of pharmacy deserts is not unique to Chicago and can present major obstacles to pharmacy consumers nationwide.
While most pharmacies are for-profit businesses that need to generate sufficient revenue to cover their costs, the business decision to close pharmacies highlights the tension between generating profits and serving people. Several large pharmacy chains articulate that the purpose of their business is to help people achieve health and well-being. The challenge lies when providing pharmacy services in low-income areas does not meet some internal threshold of revenue generation. Residents and leaders in pharmacy deserts can rightfully ask pharmacies to consider how the corresponding negative impact on the health of the community factors into their business decision to shutter stores. While the decision might make sense based on short-term financial projections, it fails to consider the long-term costs to the community and the business.
Corporate social responsibility has become part of the business conversation across all industries. Many retail pharmacy chains have joined this chorus publicly claiming a commitment to society with colorful examples of their community programs, charitable partners and expanding health services. Unfortunately, some of these pharmacy companies do not appear to engage in social responsibility in all communities equally. Residents in vulnerable populations that deliver thin profit margins appear to be excluded from the company’s desire to promote healthy people.
Pharmacies, like other businesses, have to meet the financial requirements of their owners and shareholders. However, socially responsible businesses have been proven to out-perform less socially responsible business over the long-term. Short-term financial pressures can lead to decisions such as closing less profitable pharmacy locations. A longer-term perspective could lead to pharmacies remaining in low-income neighborhoods out of a responsibility to the community and then realizing the financial benefits in the future as the pharmacy is best positioned to capture any economic benefit from redevelopment and growth in these neighborhoods.
Shareholders and the public like to hear companies talk the talk of social responsibility, but businesses need to also walk the walk of social responsibility by demonstrating their commitment to their under-served pharmacy customers even in the face of short-term business pressures. We should examine our continuing effort to insure that all communities have ready access to prescription medications and essential pharmaceutical services. Let’s face it. Social responsibility is good for the community and good for business.
Richard E. Custin, University of San Diego
Abigail Berk, University of San Diego