Does medication marketing contribute to health care disparities in community health centers in New York City?

Poor health care access and quality for immigrant and ethnic minority populations is a major US health policy concern. Community health centers (CHCs), which are located in medically underserved neighborhoods and provide comprehensive primary care to residents regardless of their ability to pay, have made significant contributions toward reducing health/health care disparities for these populations. However, particularly for the treatment of common chronic conditions such as diabetes, hypertensio nand depression, access and adherence to necessary medications remains a significant challenge in CHCs. One contributing factor is pharmaceutical industry marketing practices, which may encourage inappropriate and inefficient medication use. This study reports several mechanisms by which marketing practices have negative influence in the CHCs, including promoting provider reliance on pharmaceutical representatives for information about new medications and on free medication samples for underinsured patients. We also report reassuring findings that indicate consumer-directed advertising may activate some ethnic minorities and immigrants to initiate care for conditions common to this population, but further research is needed to determine if this results in increased necessary versus unnecessary provider visits. Addressing these issues is crucial for CHCs to make further progress in addressing health/health care disparities.