People are much less likely to trust the medical system if they are from an ethnic minority, have a disability or identify as LGBTQ+, according to an unpublished study by Sanofi

When it comes to trust in our global healthcare system, the sad truth is that there are two very different worlds. The first is populated by people who are more likely to trust our medical institutions to treat them fairly. They are predominantly male, non-disabled, white, and identify as straight. Most don’t expect to be judged or stigmatized for who they are.

The rest of the world does not have this luxury. Women, ethnic minorities, people with disabilities, and people who identify as LGBTQ+ are much more likely to distrust their healthcare providers and the healthcare system as a whole.

Their views may be shaped in part by an understanding of historical biases and abuses of power. But an alarming number of people from these marginalized communities also report personal experiences that eroded their confidence: experiences where providers didn’t listen to them and made them feel unwelcome, judged, and even unsafe. And unfortunately, patients believe they received this abuse because of who they are: their age, income, ethnicity, gender, disability, or sexual orientation.

This glaring disparity has emerged in a new poll commissioned by Sanofi. The global survey of 11,500 people from anywhere in the US, France, UK, Japanand Brazil offers a unique insight into how people from very diverse backgrounds experience the healthcare system.

The results are worrying. In the United States, 77% of people with disabilities, 69% of people from minority ethnic groups, and 70% of people from the LGBTQ+ community report having had experiences that have damaged their confidence in the healthcare system.

The survey also showed the cumulative effect of marginalization: people from more than one of these groups were much more likely to have had a bad experience seeking care. For example, in the United States, 80% of people with disabilities and who identify as LGBTQ+ said they lost faith in the healthcare system because of their personal experience, compared to 56% of people without this background.

This is unacceptable. These disparities can cost lives: people who do not trust the system may be less likely to present for preventive care or seek treatment for a chronic condition. Pervasive distrust also makes it extremely difficult for public health officials to reach vulnerable communities with life-saving information, as the COVID-19 pandemic has made clear.

It doesn’t have to be that way. Here are three steps to start bridging the trust gap:

Diversify our healthcare workforce

Patients from all walks of life need providers from all walks of life. Studies have shown, for example, that black patients have better health outcomes when treated by black doctors. Yet only 5% of American doctors are black. Every stage of the pipeline – high schools, colleges, medical schools, residency programs – must be committed to supporting a diverse healthcare workforce. And it’s not just about frontline providers: hospitals, research centers and companies involved in healthcare need to engage and invest in diversifying their ranks.

In a promising initiative, the American Medical Association is work in close collaboration with medical schools across the country on recruitment, admissions and retention strategies in various classes.

Invest in prevention

Much of our medical system is focused on treating disease. This is why it is extremely important that clinical trials include patients from diverse backgrounds so that we can understand how drugs work for different populations. But focusing only on treatment is insufficient. Healthcare companies and hospital systems also need to invest heavily in disease prevention by tackling the upstream health drivers–all the factors in our homes, workplaces and neighborhoods that can affect our well-being.

Kaiser Permanente, for example, has in partnership with a kindergarten in Hayward, California to provide integrated wellness and medical care to low-income families in California and provides free resources to other schools to meet the physical and mental health needs of staff and students. Working with communities in this way can build trust.

Listen, listen, listen

The main reason given by patients for losing trust was that they did not feel listened to by their provider. Certainly, providers need more training on how to communicate with clarity and empathy. However, this is not enough. They must also listen. It means acknowledging and overcoming unconscious biases, seeing each patient before them as a worthy and dignified individual, and taking the time to understand why each patient came to seek care.

Healthcare companies and hospital systems can advance this work by creating a platform for marginalized groups to share their experiences and ensuring those in positions of power listen.

These steps are neither easy, quick, nor inexpensive. Changing the system will require research and action by a large number of institutions, decision makers and individuals. But the potential gain is huge. Restoring trust will help close the huge disparities in health outcomes and move us step by step towards a more equitable and healthier world for all.

Paul Hudson is the CEO of Sanofi. Michelle A. Williams is Dean of the Harvard TH Chan School of Public Health.

The opinions expressed in comments are solely the opinions of their authors and do not necessarily reflect the opinions and beliefs of Fortune.

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