The evolution of customer care: AI and the Gen Z effect

With the coming of age of Gen Z—both as customers and new workforce entrants—customer demands are evolving. At the same time, generative AI (gen AI) is transforming how contact centers respond to these demands. Forward-thinking leaders must explore the latest trends, emphasize cohesive support strategies, and take actionable steps to enhance their customer care functions, addressing challenges such as service improvement, cost reduction, and sales function integration.

In this episode of McKinsey Talks Operations, host Daphne Luchtenberg sits down with McKinsey partners Brian Blackader and Eric Buesing. Listen in as they discuss the latest trends, the importance of a cohesive support strategy, and actionable steps contact center leaders can take to improve their customer care functions.

The following conversation has been edited for length and clarity. Dates and statistics correct at time of recording in May 2024.

Daphne Luchtenberg: Every time you buy a product or service, you start or build upon a relationship with the company that stands behind it. And when something goes wrong or you just need help, the ease with which you’re able to get the support you need can have a big impact on how you feel and whether you choose to continue the relationship. With the arrival of more communication channels than ever before and the onward march of gen AI, how should organizations be thinking about where to improve their customer care functions? Throw Gen Z into the mix—with perhaps surprising preferences about how they want to engage with companies today—and you’ve got a complex landscape to navigate.

I’m delighted to be joined today by two of the people behind our recent research, “Where is customer care in 2024?,” Eric Buesing is a partner in our Charlotte office, and Brian Blackader is a partner based in Düsseldorf.

Eric, what do contact centers look like at the moment, and what are the challenges that they are facing?

Eric Buesing: The customer care function of the contact center is currently in the spotlight more than ever before, discussed even at the board level. Contact center leaders face unprecedented pressure in various forms: operational pressure to be efficient and reduce costs, enhance the customer experience, manage employees in increasingly complex environments, and expand the contact center’s role to include more advisory or consultative selling to build loyalty.

Customer expectations aren’t getting easier. With more platforms available for sharing information, disgruntled customers can amplify their dissatisfaction more loudly and broadly.

Eric Buesing: I don’t know if there’s any one organization that gets it all right all the time. At its core, good service involves excelling in the moments that truly matter—those critical times when customers are most in need. In these moments, the goal is to delight them in a way that impresses, garners loyalty, and resolves their issues, while generally maintaining good service overall.

Good service is characterized by several key aspects: the ease of resolving issues, the accessibility of information, and the integration of communication channels so that every interaction contributes to a cohesive resolution process.

Brian Blackader: Adding to that, what good looked like a few years ago, especially during the pandemic, has changed. Back then, simply being available was often enough. Now, we’ve returned to fundamental principles like solving problems effectively and knowing the customer across different touchpoints. Expectations have risen; customers now expect not just solutions, but also personalized understanding and engagement.

Eric Buesing: Absolutely, Brian. The principles of, “Know me, know my issue, and understand me,” are easily said and very difficult to achieve. The organizations that manage to do well in this area invest considerable effort in understanding how to meet these expectations. It’s not a game you win. It’s a game you play. You’re always trying to get better.

Daphne Luchtenberg: It’s interesting to see leaders turning to gen AI tools across various business operations, particularly in business services and customer care. Could you elaborate on the potential for adopting these tools in these areas and how they might enhance the services you described?

Eric Buesing: We’re about 16–17 months into the era of gen AI being available to the wider public. From my perspective, gen AI promises significant disruption, particularly in service functions. I believe that it could reduce current phone volumes by 50 percent within five years. However, the initial progress has been slower than expected. Many believed that gen AI would quickly reduce call volumes and transform customer interactions, but that hasn’t been the case yet. Few organizations have implemented gen AI at a scale where its impact can be effectively measured, and it’s crucial to understand why.

Despite the technological advances, the need for human interaction remains critical, especially for empathy and connection. I do see gen AI playing a significant role in efficiently resolving complex customer issues. We’re likely to see an increase in interactions with chatbots and virtual voice assistants, which will provide quicker, more accurate responses. However, the moments that truly matter will still require a human touch.

Additionally, foundational elements such as data connectivity, data quality, and the technical systems needed to deploy these AI capabilities are also vital. It’s important to recognize that it’s never just tech; early strategic planning and implementation are key to leveraging these tools effectively.

Daphne Luchtenberg: Eric, considering we’re recording this session, could you discuss the role of recording live conversations and how this might enhance intelligence and optimize the call center experience in the future?

Eric Buesing: First, the concept of speech-to-text isn’t new; organizations have been recording conversations for years. However, there’s been a shift in expectations regarding the quality of insights derived from these recordings, moving toward what’s now often referred to as conversational or voice intelligence. This advancement is crucial as it helps organizations explore the root causes of customer calls. Generative AI plays a significant role here, particularly with the concept of multi-intent. This means recognizing that customer calls are complex and cannot be simply categorized as, for example, a “billing call” or a “policy inquiry.” Conversational intelligence enables organizations to understand the multiple reasons behind a customer’s call, which in turn helps in resolving issues more effectively and proactively sharing information across the organization to prevent future frustrations.

There’s potential to use customer care data beyond traditional confines, such as for improving product design or service delivery to reduce customer friction. This approach involves leveraging voice data more strategically than just for compliance and quality assurance.

Brian Blackader: Adding to Eric’s point, while many discuss using these insights for training models, the reality is that many organizations still have a basic understanding of why customers call. Often, the primary reason logged is simply the first option an agent selects from a dropdown menu. It’s vital to understand not just the primary reason for a call but also the second-, third-, fourth-, or fifth-level intent. This understanding is crucial for two reasons: it helps address root causes throughout the organization and enables more targeted training for agents on specific recurring issues, rather than a general overview of a category like billing. We can really be specific on the issue that they’re struggling with.

Daphne Luchtenberg: With the technological advancements in customer care, there’s also a growing need for new skills. Brian, could you expand on the talent challenges that customer care leaders are currently facing?

Brian Blackader: There are two main challenges that care leaders face regarding talent. First, in countries like Germany where I am, or even in the US, there’s a general labor shortage. This makes it difficult to recruit people who can handle increasingly complex issues, especially as simpler tasks become automated. The challenge is not only to find frontline talent but also to enable them to address these complex queries effectively, all while striving to provide excellent customer service amid rising expectations.

Second, the traditional customer care path, where an agent progresses to a team leader, and then to a business unit manager, has been effective for developing people managers for the past 25–30 years. However, this pathway doesn’t necessarily produce the specialized skills needed today, such as data scientists, engineers, or developers. Leaders need to consider how to attract individuals with these skills to the agent level, perhaps targeting students with backgrounds in these areas. Additionally, they must make roles in customer care appealing compared with opportunities in big tech and other industries, where demand for these skills is also high.

Daphne Luchtenberg: That’s interesting. Let’s talk more about the talent pipeline. As Gen Z matures into consumers and the workforce of the future, their perspectives and behaviors might differ from previous generations. I found your insights in the blog post “Why your kids aren’t calling you, but they are calling their bank” particularly interesting, where you noted that some expected trends aren’t necessarily holding true. Could you expand on that?

Brian Blackader: Our research revealed some surprising findings about Gen Z’s communication preferences with companies. Contrary to what might be expected, their behavior isn’t drastically different from millennials, Gen X, or even boomers. When facing an unsolvable problem, about 70 percent of Gen Z individuals prefer to make a phone call, a share similar to older generations. This preference changes when it comes to personal communications, such as contacting friends or family, where they favor texting or messaging apps. However, for serious issues with services like banking or telecommunications, they still turn to phone calls. This indicates that companies that can effectively resolve issues through voice bots and provide excellent experiences will likely outperform their competitors.

Eric Buesing: Adding to that, our research also touched on email preferences across different customer segments. Surprisingly, about 70 percent of customers still prefer using email to resolve issues, despite its decreasing popularity among organizational leaders. Leaders often consider email a challenging channel to manage because it’s hard to track and measure compared with phone or chat interactions. This creates a disconnect, as customers appreciate the asynchronous nature of email—it allows them to send a message at their convenience, while someone else works on the issue later. This discrepancy poses challenges for organizations as they plan future communication strategies.

Brian Blackader: Exactly, and there’s an additional layer to this when considering people’s preferences during work or school hours, where email is particularly favored for its convenience. Additionally, our work in financial services highlighted another unique aspect of Gen Z, especially in the premium segments. Unlike millennials, Gen Z individuals in these segments expect high levels of service, akin to what baby boomers expect. They view phone service as a justified expectation for the fees they pay, demanding quality assistance and a positive experience as part of their service package. This insight is crucial for businesses aiming to cater to this demographic effectively.

Daphne Luchtenberg: It seems like some aspects of customer service are evolving significantly, while others remain unchanged. What do you envision for the future of customer contact centers?

Eric Buesing: As I’ve noted before, I expect a significant shift toward self-service options, predicting that 50 percent of current phone volumes will transition to these channels within the next five years. This shift will likely be driven by improvements in how customer issues are addressed, enhancing interactions with chatbots and virtual assistants to a more meaningful level. Some enthusiasts even believe that virtual voice assistants will become more empathetic than humans, as they won’t carry frustrations from previous interactions. Looking ahead, I’m optimistic about the improvements in service quality. There’s a prevailing acceptance of mediocre service when people call in, often expecting delays and potentially unhelpful responses. However, I foresee a future where service excellence becomes a hallmark of distinguished brands, significantly influencing customer loyalty and brand preference.

Simultaneously, the importance of human interaction will not diminish, especially for critical service moments. If phone volumes reduce by half, the quality and impact of the remaining interactions will become more crucial. I envision a future where customer service agents evolve into “superagents” or “journey managers,” equipped with advanced tools to provide informed, accurate, and empathetic support.

Daphne Luchtenberg: That sounds promising. Brian, would you like to add anything?

Brian Blackader: To summarize, I believe that leading organizations will focus on three key areas over the next five to ten years. First, they will streamline resolutions and enhance self-service capabilities for simpler issues, leaving more complex matters to customer service. Second, echoing Eric’s point, these organizations will empower their agents—whom we might call super agents—with sophisticated tools that aid in resolving customer issues effectively, fostering loyalty, and delivering exceptional experiences, possibly even with minimal training.

Lastly, the concept of an omnichannel experience will be crucial. While this has been discussed for over a decade, truly successful organizations will offer a seamless customer experience across all platforms—whether in-store, over the phone, through chat, or even via underused channels like video, and potentially augmented or virtual reality for specific scenarios. This consistency will ensure that no matter how a customer chooses to interact with a company, the great ones will be able to make sure that that experience is consistent across all the different ways you might contact them.

Eric Buesing: Brian, I really appreciate the concepts of omnichannel and optichannel, which refers to using the optimal channel for resolving issues. Currently, customers face a confusing array of options—social media, YouTube, websites, apps, calls, chats, and more. It’s not transparent which channel is best for their needs, leading to random choices. However, with the optichannel approach, it will become clear to customers which channel is most effective for their specific issues.

Daphne Luchtenberg: So, this would also mean that customers will grow more sophisticated at selecting the right tools for their needs, correct?

Eric Buesing: Exactly. It boils down to whether it’s simpler to handle an issue ourselves or to call for help. As long as calling remains the easier option, that’s what people will choose.

Daphne Luchtenberg: We’ve discussed many important points today. Before we conclude, Eric, where should leaders look for inspiration as they move forward?

Eric Buesing: Leadership in this area really requires courage. I’m often underwhelmed when we are asked, “Hey, do you have a North Star vision? What do you want out of your customer care, your servicing function?” The answers are often very incremental: “I’d love to see a 5 percent improvement in this. I’d like our budgets to be down, our handle times to go down, and our customer satisfaction score to go up slightly.”

We need to think bolder than that. Being a courageous leader means having a plan and setting an aspiration that is difficult and makes people uncomfortable, and then seeing it through. It’s one thing to say, “Hey, we want to cut our volume by 50 percent.” It’s another challenge to actually go after it.

In many ways, it requires collaboration outside of the contact center. The contact center is the receiver of somebody else’s problem. There has been a breakdown somewhere else in the customer journey, either by a product that didn’t deliver, a service that didn’t meet expectations, or an experience that was subpar. That drives volume.

So how do we look upstream and tackle those issues? How do we bring together the organizations or business units within an organization that need to come together to resolve them?

Daphne Luchtenberg: Yeah, I love that. Brian, what do you think?

Brian Blackader: In my interactions with customer care leaders, I’ve noticed they typically align with one of two approaches. The first group is action-oriented; they want to start immediately and tackle tasks head-on. The second group prefers to strategize, aiming to develop a North Star vision and a detailed road map, as Eric mentioned. It’s crucial to combine both approaches.

Creating a North Star vision and a road map is essential to avoid merely making incremental changes and to thinking in the long term. This involves making necessary investments and managing change over time. However, it’s also important to recognize that presenting such plans isn’t new to boards, and there might be limited patience for long-term results. Therefore, I advise leaders to also focus on achieving quick wins. By demonstrating early successes, you can build credibility within the organization and show tangible progress.

Additionally, I want to emphasize the importance of voice communication. Despite advancements in technology like chatbots, many customers still prefer calling. If these calls go unanswered, customers might escalate issues to regulators. With today’s technology nearing the capability to automate voice interactions effectively, there’s a significant opportunity to enhance customer experiences through this channel.

Eric Buesing: Adding to Brian’s points, another aspect we briefly touched on is transforming the role of contact centers from purely service-oriented to also encompassing sales. While “sales” can sometimes be perceived negatively, it shouldn’t be feared. Customers expect a high level of service that not only addresses their immediate issues but also anticipates their needs. This could involve better use of current products or introducing superior ones. The contact center is uniquely positioned to not just solve problems but also to provide valuable advice and recommendations. This shift from aggressive selling to thoughtful consultation can significantly enhance customer satisfaction and loyalty.

Daphne Luchtenberg: Fantastic, Eric. I couldn’t have said it better myself. Thank you so much.

Here’s a few things that I loved about the conversation today to think about as we close: first, this idea that customer service and contact centers are not a game you win, but rather a game you choose to play. Secondly, that gen AI is changing that game, albeit not as quickly as we might have expected, including through ways such as voice automation. And finally, there’s no better place in the contact center to build and deepen customer relationships and to give them better experiences during those moments that really matter.


Discovering the multi-level contribution of AI to the NHS

Following the recent announcement of increased funding for artificial intelligence within the NHS by the Chancellor in the Spring 2024 programme highlights the importance of stabilising the healthcare system and securing the leading position in healthcare delivery on a global scale. In order to maximise the patient benefit and staff satisfaction through the full utilisation of the use of AI, it is useful to develop an action plan with proactive next steps.

Step 1: Focus on the right priorities

There are many high-impact use cases such as waiting list management. By developing AI algorithms and data-driven decision support tools to predict patient demand, optimize scheduling, and efficient allocation of resources, healthcare facilities can significantly reduce wait times and enhance patient satisfaction. Through our work with NHS Trusts it has been shown that the development of AI-based programming tools has resulted in An increase in patient preference within imaging. Artificial intelligence can also help to enhance the support of  office services. Experience so far has shown a significant reduction in the time to review a contract with the use of artificial intelligence.

Step 2: Cultivating staff acceptance

An important aspect of any AI initiative is cultivating trust and acceptance from frontline staff. As clinicians focus on refining their clinical judgment and providing personalized care it makes sense that they approach the integration of AI with caution. To avoid this hesitation it is important that strict trials of an evidence-based implementation. Furthermore, the syndrome of ”that it was not manufactured here” prevents and forces individual executives to actively engage and convince their clinical communities of tangible evidence of AI adoption. One approach to fostering staff buy-in is active involvement from the outset in the design of the programme design.  The use of the “Net Promoter Score”, which measures staff enthusiasm for a particular technology, is a strong incentive for engagement and could potentially help. Also in cases where staff know that the technology is supported by their colleagues, after a pilot project, it is more more likely to want to participate themselves. Another useful approach is for the clinician to present his or her own prediction alongside any AI prediction, allowing the staff to make their own prediction to immediately see how the AI compares. Using this method, we can show that an AI algorithm was more predictive of the day a patient would be ready to leave than the clinician’s own estimate.

Step 3: Integrating the technology into the standard

Considering a user-driven approach to process redesign has the dual impact of bring the affected parties – for example, staff, patients and carers – together on the journey, while also helping to ensure that change is not just a digitisation of existing processes. THE NHS will need to fund the effort so that by supporting staff to trust and find the budget to deliver the necessary change programme.

Looking forward: A collaborative imperative

Vital to the whole effort will be the collaboration between government, the NHS leadership, frontline staff and the technology partners. Latest research has shown that 74% of organisations recognize that AI can make their operations more efficient, and a staggering 84% do not believe they are equipped to do so to make it a reality. While the Chancellor’s investment in AI represents a significant moment, the result is testament to how capable we are of navigating the complexities of implementation effectively and provide frontline organisations with the support they need.

Read more: Transforming through Data,page 116 Article from Jenny Lewis under the title ”  Unlocking the Potential of AI in the NHS: A Path Forward’

H.M._2-vol 24-2024 (1)


We dreamed it, we organized it and we finally accomplished it!

Kapa3, always thinking and implementing actions whose main priority and beneficiaries are the patients with cancer, overcoming barriers, social, economic, and social and cultural characteristics! Cancer has no gender, no country, no color, no religion!!!

The team of Kapa3 could not ignore the challenges and needs of people who are forced to leave their countries of origin and, having the problems of their disease out of their priorities, put themselves in danger, crossing the borders of our country, hoping for a better and safer future.

Thus, studying the needs of these people, the group of professionals of KAPA3, being active and present in the wider region of Macedonia and Thrace, submitted a proposal for the implementation of actions in these areas, targeting the refugees and migrants of the region.

With great pleasure, we received the response of the King Baudouin Foundation, which recognized in this proposal our vision and approved funding to support and develop the Cancer Patient Guidance Centre-Kapa3, to provide immediate assistance to refugees and migrants crossing the borders of our country.

Together we can achieve the impossible! Looking cancer in the eye and fighting every day together, is a small but important battle for life, against cancer!

More specifically: The development of the existing network, the addition of mental health professionals, and the development of actions and activities in new places, with new partners, will allow us to help much more in the process of better and more complete treatment of the incidents and difficulties we face.

With funding from the King Baudouin Foundation, over the next 6 months, we will strengthen our network of psychologists, sociologists, and social workers, with a focus on the 15-24 age group, to continue providing primary care and support throughout their treatment. Part of the funding will be used to translate the Kapa3 online portal into at least two languages, in addition to English, with Ukrainian being the first, so that our citizen’s accessibility to any portal of the Public Health System is immediate and seamless.

The Organization has a website and an app where it provides general support and information as well as personalized support to each beneficiary. The staffing of the network with permanent personnel will become the basis for the successful targeting, which is, No One Feels Alone! The activation of psychological support for patients, the categorization of patients by age and the activation of actions to solve additional problems related to each of these age groups are some of the actions that we are ready to take to support these vulnerable groups!

We are well aware that the Greek health system and the support of medical care for cancer patients provided mainly in the country’s public hospitals, given high care costs and economic conditions, are not chosen by a significant number of patients, mainly immigrants, and refugees. The fact that Kapa3 operates in the structures and departments of hospitals that exclusively support cancer patients allows us to be able to record cases and extract qualitative and quantitative data and results to improve and create new actions in this direction.

Our vision has inspired and found support beyond borders! Cancer can control the body of patients for a while, but the soul, which strengthens the power in the battle with cancer, cannot be controlled!!!

Δελτίο Τύπου EN Δελτίο Τύπου EN

Cancer is on the rise in under-50s – a key task is to work out why

Nine in 10 of all cancers affect people over 50 but research shows a worrying rise in early onset cases

There are many upsides to growing old, but one of the downsides, unfortunately, is a higher risk of developing cancer. Increasing age is a key risk factor. And with more of us living longer worldwide, millions of older people will have to contend with the disease

Now a new study adds weight to previous work warning of a grim trend in global health: cancer in people under the age of 50 is becoming more common.

In the study, researchers led by the University of Edinburgh in Scotland and Zhejiang University School of Medicine in Hangzhou, China, found that the number of under-50s being diagnosed with cancer worldwide rose by 79% between 1990 and 2019, from 1.82 million to 3.26 million. Cancer deaths in the same age group grew by 27%, and more than 1 million under-50s a year are now dying of cancer, the research published in BMJ Oncology reveals

The study is not the first to show the trend. A review in 2022 of cancer registry records from 44 countries found that the incidence of early onset cancer was rising rapidly for 14 types of cancers, and this increase was happening across many middle- and high-income nations.

The new research adds meat to the bone. Examining data from 204 countries, it found a striking increase in the global incidence of early onset cancers. It also showed the highest incidence rates of cancer in the under-50s was in North America, Oceania and western Europe.

Researchers worldwide are only just starting their next task: working out why.

The authors of the 2022 review, led by Harvard University, said any uptick in testing or checks could not account for the rise in diagnoses. They suggested the rise was most likely due to an unhealthy mix of risk factors that could be working together, some which are known and others of which need to be investigated.

Many of these risks had established links to cancer such as obesity, inactivity, diabetes, alcohol, smoking, environmental pollution and western diets high in red meat and added sugars, not to mention shift work and lack of sleep. Experts have speculated that ultra-processed food may also be partly to blame

The researchers behind the new study echoed those observations. Genetic factors are likely to have a role, they say. But diets high in red meat and salt and low in fruit and milk, as well as alcohol consumption and tobacco use, are the main risk factors underlying the most common cancers among under-50s, with physical inactivity, excess weight and high blood sugar other contributory factors.

As worrying as the increase in early onset cancers is, caution is required. Cancer in people under 50 is still uncommon. With breast cancer, the most common type in under-50s, there were 13.7 cases per 100,000 people in 2019. Nine in 10 of all cancers affect people over 50.

Until experts unlock definitive answers, there remains plenty that people young and old can do to reduce their risk of cancer. Not smoking, maintaining a balanced diet and a healthy weight, getting plenty of exercise and staying safe in the sun are among them.


Andrew GregoryHealth editor

September has been established as Childhood Cancer Awareness Month.

Childhood Cancer Awareness Month.

It is a rare disease, according to the Hellenic Society of Pediatric Hematology – Oncology (EEPAO), but with serious consequences for both patients and their families. A disease that can be defeated but often with painful and long-term efforts and serious immediate and delayed complications.

The numbers are indicative: 300-350 new diagnoses every year in Greece, 35000 throughout Europe with 6000 children dying due to cancer. The Pediatric Oncologists-Hematologists, Elena Solomou and Antonis Kattamis (Professor NKUA) report that in early 2020, the COVID-19 pandemic resulted in the research community turning to a new path of research approach.

In Lancet Oncology, the work of Sheena Mukkada and partners has shown that the scientific community is united for the common good at this difficult time.  This prospective study analyzed data from children and adolescents (<19 years) with cancer and COVID-19 around the world.  Typically, data from approximately 1500 patients from 131 hospitals in 45 countries, including patients from Greece, were used. 259 (19.9%) of the patients had a severe or critical infection, while 50 (3.8%) patients died.  Comparing the data with adults, mortality in adults with cancer is 28%, much higher than in children.

Childhood cancer must be a priority for any strategic planning of each country’s health system. These diseases in childhood are treatable, with overall survival at 80% in high-income countries. But when the right resources are lacking, such as in low-income and middle-income countries (where about three-quarters of the global number of childhood cancer is recorded),  only 20-30% of individuals have long-term survival. Delays in early detection, poor access to diagnostic services in the absence of full access to required cancer medicines, higher rates of comorbidity (e.g. malnutrition, infections and poverty) as well as refusal or abandonment of treatment are common, resulting in increased morbidity and mortality. All these factors result in lower survival rates and higher morbidity rates than in high-income countries.

The COVID-19 pandemic has exacerbated inequalities in access to each country’s health system despite efforts to tackle childhood cancer. With the mandate given by governments in the 2018 cancer resolution, the WHO, together with major international childhood cancer hospitals, set a goal of treating at least 60% of all children with cancer worldwide and reducing pain for all children.

The data from this study enable us to understand that during the pandemic there is a unique opportunity to develop and implement strategies tailored to specific health systems and to reduce inequalities in diagnosis and access to medication in children with cancer globally.

The scientific community makes concerted efforts to achieve high cure rates, with the best possible quality of life and the minimum possible long-term complications. Genetic and molecular biology are now the necessary element of diagnosis and treatment in a large part of neoplasms of children and adolescents. Personalized treatment, which will further increase the chances of cure for young patients, reducing immediate and ultimate toxicity, is a goal that may become a reality in the near future.

In this context, HSPHO has taken initiatives to strengthen cooperation between the oncology departments of the Territory and the recognition of our country as an equal member of European scientific organizations. It participates in international collaborative treatment protocols, thus ensuring access to innovative medicines and therapies under proper and organized supervision. Of course, the process of Greece’s full, equal access to each of these protocols comes at a high cost. Fortunately, however, in the long, arduous struggle of the children and their families, over the years, valuable helpers and supporters, associations and volunteers have stood by.

The understaffing of the Pediatric Hematology / Oncology Departments in medical, nursing and paramedical staff, the lack of public structures for targeted molecular tests, the lack of financial coverage of specialized tests and the difficulty of access to innovative medicines are problems for which we have repeatedly informed the competent bodies.

Each of us can help to the best of our ability! You can become a volunteer blood donor, or volunteer bone marrow donor, or help associations and organizations supporting children and their families, either through sponsorships or by donating some of his time.

Any effort to improve the care of children with cancer is welcome and important!

Learn more:

Conceptualizing the Mechanisms of Social Determinants of Health: A Heuristic Framework to Inform Future Directions for Mitigation

A large body of scientific work examines the mechanisms through which social determinants of health (SDOH) shape health inequities. However, the nuances described in the literature are infrequently reflected in the applied frameworks that inform health policy and programming.

We synthesize extant SDOH research into a heuristic framework that provides policymakers, practitioners, and researchers with a customizable template for conceptualizing and operationalizing key mechanisms that represent intervention opportunities for mitigating the impact of harmful SDOH.

In light of scarce existing SDOH mitigation strategies, the framework addresses an important research-to-practice translation gap and missed opportunity for advancing health equity.

Conceptualizing the Mechanisms of Social Determinants of Health!

Health inequities are most often understood as associated with the social determinants of health (SDOH)

II. Opportunity
A practical, heuristic framework for policymakers, practitioners, and researchers is needed to serves as a roadmap for conceptualizing and targeting the key mechanisms of SDOH influence

  • Unifying principles

1. SDOH are underlying causes of health inequities
-> Meaningful community engagement in data generation and interpretation for understanding and mitigating underlying health inequity drivers and multilevel resilience factors

2. SDOH shape health inequities through contextual influences
-> Development, evaluation, and scale up of multilevel interventions that address the mechanisms of SDOH at the structural, psychosocial, and clinical/biomedical levels

3. SDOH contextual disadvantage is not deterministic
-> Adoption of individualized/differentiated, decentralized, and community-based service delivery models

4. SDOH shape health over the life course
-> Proactive intervention focused on prevention and health promotion as well as restorative care to maintain and improve physical, mental, and psychosocial functioning and quality of life

5. SDOH operate through biological embedding
-> Greater prioritization of harmful SDOH mechanisms and mitigation of their biological impact in clinical education and practice, including investment in biomarkers for early detection of and intervention on emerging disease trajectories

6.SDOH operate intergenerationally
-> Prioritization of family-based approaches to restorative health care, prevention, and health promotion

7. SDOH shape clustering and synergies of health inequities
-> Greater integration of comprehensive, interdisciplinary, team-based health services delivered within a value-based framework and at the top of providers’ licenses

8. SDOH mechanisms to produce health inequities
-> Departure from vulnerability- and deficiency-focused paradigms for understanding health inequities toward multilevel resilience-focused paradigms for reducing health inequitiess

An Organizing Framework of SDOH Mechanisms

1. Underlying causal factors
-> Two distinct classes of social influence: SDOH capital and SDOH processes

2. Mediating factors
-> Two mechanisms: environmental and behavioral exposure and biological susceptibility

3. Moderating factors
-> Resilience – as collective action that supports the ability of communities to thrive when confronted with structural challenge

4. Health inequity outcomes
-> The impact of SDOH mechanisms on health inequities is dependent on the broader patterns of morbidity within the community of interest

Check out the article by Marco Thimm-KaiserAdam Benzekri and Vincent Guilamo-Ramos here:

Cancer Effects on Caregivers and Work

A CANCER DIAGNOSIS RESULTS IN A LOT OF CHANGES for both the patient and the caregiver.

For the caregiver, those changes can include adjusting work schedules, which, in turn, can affect their finances.

The unexpected expense of cancer treatments coupled with the lack of paid leave can be a one-two punch to caregivers’ financial resources. “For many caregivers, keeping debt low or nonexistent may not be possible,” says Cathy J. Bradley, a health economics researcher and co-author of a study titled “Working, Low Income, and Cancer Caregiving: Financial and Mental Health Impacts,” published online April 12 in the Journal of Clinical Oncology. “The Federal Reserve reports that many households would have difficulty absorbing $400 in unexpected costs. Cancer treatments are among the most expensive treatments in the United States.”

In many instances, caregivers can take paid leave to care for their loved one, which can mitigate financial hardship, but that’s not always the case. Often, caregivers are faced with taking unpaid leave or having to stop working altogether—both of which negatively impact their finances.

According to Bradley’s study, 35% of cancer caregivers stopped working and 30% saw their household debt increase. Those in households earning less than the median household income were more likely to experience decreased income and stop work than peers in similar financial situations who were caring for people with conditions other than cancer.

“Data on reasons for stopping work was not part of this study, but we speculate that caregiving demands are greater for cancer patients,” says Bradley, an associate dean of the Colorado School of Public Health and deputy director of the University of Colorado Cancer Center. “We also speculate that lower-income households cannot pay for additional help so that the caregiver can continue working.”

A key element forcing caregivers to stop work is no paid leave at their workplace. According to the American Cancer Society Cancer Action Network (ACS CAN), studies show that cancer patients with paid leave have higher rates of job retention and lower rates of financial burden. However, 48% of caregivers report experiencing problems related to financial pressure caused by not being able to work or having to reduce work hours to care for their loved one.

“Cancer treatment is so all-consuming for the patient but also for the family and anyone who is caregiving for the patient,” says Jennifer Hoque, associate policy principal on access to care for ACS CAN. “And that includes all-consuming with finances and time. Time is money. The more time you have to spend caregiving for the cancer patient, the more potential for lost wages and other money you’re spending. And it’s not just time caring for the patient. It’s also transportation, taking the patient to and from their treatments. Sometimes it’s lodging because sometimes you have to stay overnight.”

To help cancer caregivers, ACS CAN supports legislation providing for paid leave in the workplace so everyone has access to it and can help their family members. The Family and Medical Insurance Leave (FAMILY) Act was introduced in Congress on May 17. If passed, it would provide workers with a maximum of 12 weeks of financial support during a family or medical leave from work. In addition, 11 states and Washington, D.C., have enacted paid leave laws.

Finding assistance is crucial for cancer caregivers. “Caregivers provide a tremendous service to their families and society at large with very few supports,” Bradley says. “As a result, they suffer not only physical and mental consequences, but they also suffer financial consequences that last for years. Lower-income households take on the greatest financial burden and may never recover.”

If you’re caring for a cancer patient, it’s important to find out what type of leave is available. For instance, the Family and Medical Leave Act currently in effect provides 12 weeks of unpaid leave during a one-year period. Although leave is unpaid, the law protects your job while you’re away from work. Also, find out how flexible your employer is in allowing remote work or changing your work hours for doctor appointments and treatments.

Other assistance may be available through local, state and national programs such as the CancerCare Co-Payment Assistance Foundation, HealthWell Foundation, and the Leukemia & Lymphoma Society. Patient navigators at your loved one’s hospital or cancer treatment center can also be a valuable resource in advising you about financial assistance.

Cancer Effects on Caregivers and Work

A Difficult Duo: cancer and mental health

MOST PEOPLE DIAGNOSED WITH CANCER experience some level of anxiety and grief. However, with an estimated one in five U.S. adults living with a mental illness, many people with cancer will also have preexisting mental health conditions.

People living with conditions such as depression, anxiety or bipolar disease often take drugs like antidepressants, anti-anxiety medications, stimulants or antipsychotics. They may regularly see a psychiatrist or counselor. Thus, the mere thought of more doctors’ appointments and cancer treatments that might interact with their current drug regimen can be a significant source of stress.

By being completely honest and forthcoming with oncology providers, people who have mental health issues and cancer can get help to manage both health conditions.

The following tips can help to set a foundation for support:

1) Expect that news of your cancer diagnosis and necessary treatments could exacerbate preexisting mental health issues. You may feel more depressed or anxious than your baseline. While this can be part of normal adjustment, speak up if your symptoms interfere with your ability to function or to adhere to your cancer treatment regimen.

2) Ask to connect with your hospital’s behavioral health or oncology social work professional at the start of your treatment or as soon as possible. It can help to have someone who can help you process the experience. That person, with your permission, can also communicate regularly with your psychiatrist or counselor, if needed.

3) Tell your oncologist if you are taking medications for your mental health condition. If your medication list is complex, ask for a referral to a psychiatrist who is trained in psycho-oncology and is well versed in potential interactions between cancer drugs and mental health drugs. Many cancer centers have staff with this expertise; others can refer you to someone in the community.

4) Some cancer drugs interact with psychiatric medications and vice versa. For example, many women with estrogen receptor-positive breast cancer are prescribed a type of hormone therapy called tamoxifen, which reduces the chance of cancer coming back after treatment. However, some antidepressants, such as Prozac (fluoxetine) and Paxil (paroxetine), can inhibit an enzyme that is broken down by tamoxifen, which would make treatment less effective. You may need to switch to a different antidepressant or cancer drug.

5) Fatigue is a frequent companion of both depression and cancer treatment. Psychiatrists can prescribe drugs that are safe to use during treatment and can increase energy.

6) Enlist the help of your existing mental health support community and explore additional resources to ease the months of cancer treatment. If you have been attending a support group or day program, try to keep going to meetings. If you are already receiving mental health support, continue your relationship with your therapist, who should also speak occasionally with someone on your cancer care team.

7) Keep in mind how much you’ve already overcome as you approach this new challenge. Rely on the tools you’ve learned along the way and be open to asking for help. 

A Difficult Duo

Essential cancer screening and diagnosis services must be included in UHC schemes to reduce mortality

The earlier a cancer is detected, the easier it is to treat successfully, often with fewer side effects, and at a lower cost. In many high-income regions, such as Europe and the United States, survival rates for cancer have risen in past decades, in part thanks to routine screening that detects cancers at an early stage. It’s especially true for common cancers like cervical, breast, colorectal, and prostate, where routine screening offers a clear test and methodology for early detection.

Investing in routine screening programmes for asymptomatic cancers as well as the early detection of symptomatic cancers and diagnostic and referral services is, therefore, a cost-efficient approach to mitigate the public health costs of cancer. These are estimated to reach USD 458 billion globally by 2030, and cut the projected global economic cost of cancers, estimated at USD 25.2 trillion for the period 2020-2050.

Such investments in services must be accompanied by clear communication about the necessity and benefits of such measures. It is also critical that the general public have access to reliable information on possible early signs of certain cancers (notably, breast, cervical, lung, prostate, ovarian and testicular) and primary healthcare staff must be equipped to spot signs of cancer – with rapid referral options for screening and then treatment.

Unfortunately, many people around the world still lack access to these essential services. In low- and middle-income countries in particular, cancer prevention, diagnosis and care remain a luxury that is out of reach for many.

A significant number of people, particularly those from low-income communities, face barriers that prevent them from accessing necessary health services, such as the distance to healthcare facilities and costs of healthcare – with the risk of financial toxicity if they must be paid for out of pocket.

A weak health system and an absence of knowledgeable healthcare providers can also stand in the way of timely cancer detection and diagnosis.

To close these gaps, routine screening, cancer diagnosis and referral services must be included in health insurance benefits packages.

UHC cannot be achieved unless everyone has access to affordable cancer care. At the same time, without the benefits offered by UHC, access to potentially life-saving screenings remains limited. This means someone may die of a cancer that could have been detected and treated at an earlier stage, but either an early detection programme was not available or that person could not access it, for financial or other reasons. A cost-efficient national cancer control plan with essential services – including routine screening and diagnosis – covered by national health insurance schemes available to everyone – can break down these barriers to accessibility, availability and affordability.

Indeed, often cancer treatment by national health insurance schemes but not screening. Issues of stigma that surround many cancer tests (for instance, those that concern sexual organs) therefore compound concerns about cost or fears of a diagnosis (e.g. cancer may be considered a death sentence, so why get tested?) to prevent high numbers of people getting a timely diagnosis, resulting in many patients presenting with late-stage cancers.

At the second High-level Meeting on Universal Health Coverage taking place on 21 September 2023, Governments are expected to adopt a set of new commitments to accelerate UHC implementation. This meeting will provide an opportunity for UICC to advocate for including comprehensive cancer prevention and control measures in UHC benefits packages.

In preparation for this pivotal meeting, UICC reached out to its members to learn about their concerns and inform its advocacy strategy in the lead-up to the UN HLM on UHC.

UICC is also organising a series of Virtual Dialogues intended to facilitate discussions around UHC and its impact on cancer control. The first dialogue organised in early May looked at UHC and prevention. A second Virtual Dialogue on UHC and early detection will take place on 20 July, and look at examples of successful advocacy to include screening and early detection in UHC benefit packages (for instance, mammography reimbursement in Algeria) and the use of legislation to support screening and early detection programmes and referral to treatment.

Read more :


Empowering patients through medical technologies for a healthier future

By constantly investing in existing and future technologies, the medical technology sector contributes to a healthier Europe. The 2023 MedTech Forum looked at some key trends in legislation and business and the role that EU policymakers can play to bring medical innovations to patients in a timely manner.

Europe takes great pride in its robust social security systems and the fundamental principles of equitable healthcare access. Data indicates however that significant efforts are still required to ensure that all patients across the continent enjoy top-tier quality care and unfettered access to medical services and technologies.

Medical technologies empower early diagnoses, timely interventions, and remarkable outcomes. Medical technologies mend, revive, and improve body functions, while telemedicine and connected devices bring patient monitoring to new frontiers. Innovations speed up recovery, safeguard well-being, and equip healthcare workers with vital insights for optimal decisions and fewer complications. By relieving strain on healthcare systems, fostering social and economic vitality, averting complications, and advancing efficiency through cutting-edge data and machine learning, medical technologies are high-tech, high-value game-changers in healthcare. Diagnostic technologies also act as a first line of defence against disease outbreaks and help support their management.

Because of its innovation power, and its positive impact on patients, healthcare professionals, and health systems, the medical technology sector has developed into a key industry with an important economic and societal impact in Europe.

European leadership for the benefit of patients 

Europe’s 34,000 medical technology companies invest heavily in improving existing and innovating breakthrough technologies for the benefit of patients. These companies, 95% of which are SMEs, drive economic growth, provide employment in Europe, and boost EU exports. In doing so, the sector adheres to strict regulatory standards that ensure safe devices which live up to their performance claims. Patient health and well-being in mind, no other region in the world sets such high standards to guarantee that medical technologies are safe for patients and healthcare professionals to use.

Despite Europe’s fundamental strengths in health and medical solutions, there are growing indicationsthat new and existing products will struggle to reach European patients and health systems in a timely manner: 17% of today’s in vitro diagnostics are expected to be discontinued in Europe, particularly among SMEs and approximately 50% of medical device manufacturers are deprioritising the EU market (or will do so) as the geography of choice for first regulatory clearance of their new devices.

MedTech Europe, the leading European medical technology trade association, believes that there are persistent, system-level issues within the European regulations for medical technologies which lead to unpredictability and delays, dampen innovation, and undermine confidence in the long-term viability of the regulatory framework.

To remain a global leader in medical technologies, the EU must deliver a more patient-centred and innovation-friendly regulatory framework that addresses the system-level challenges of today while preparing for the opportunities of tomorrow.

Getting through the maze 

Beyond the medical technology industry’s sector-specific developments, fundamental changes have been brought about in the last decade by the mega trends of digitalisation and sustainability. Such trends contribute to a revolution in the way innovation in medical technologies is happening, driving the need for a more forward-looking regulatory mentality to allow innovation to thrive.

Legislative activity of the EU in this area has been, rightly, immense – and much more needs to be done to ensure that all the rules-in-development which will impact medical technologies will actually work together to deliver products to patients. The EU’s Digital Strategy, driving regulation on artificial intelligence, cybersecurity, and data, including the European Health Data Space and the European Green Deal will legislate tectonic changes, including in the area of product design, are coming with a substantial set of new or updated requirements for medical technologies.

Against this background, substantial legislations are also being revised, such as the ones on Product Liability and Corporate Sustainability Due Diligence. It is paramount to include principles that ensure patients across the EU can benefit from a high level of protection and businesses are provided with legal certainty.

These new rules will significantly impact the way and speed in which technologies can be brought to market and accessed by those who need them. Getting medical technology innovations to European patients and healthcare systems in fact can often feel like navigating a complex and ever-shifting maze.

As a result, whether for R&D investment, clinical research, manufacturing or new product launches, Europe slowly losing ground to other geographies on innovation, because the maze seems to be getting harder to navigate. The EU thus has a big task ahead to further its efforts towards driving harmonisation and creating an environment of legal certainty for businesses.

The slowly approaching end of the EU legislative cycle is a unique opportunity to reflect on what has been achieved and what is still to be done. It is not a time to rush to the finish line but to stay level-headed and look for effective solutions to ensure medical technologies reach patients on time. We need to solve existing challenges in a comprehensive, sustainable manner, setting the tone for a future environment that will allow patients to continue benefiting from first-line, quality medical technologies and more equitable access to healthcare, and health systems to build the long-term resilience they need. The medical technology industry in Europe stands ready to contribute and collaborate to make this a reality.

This article was produced in partnership with Medtech Europe. MedTech Europe is the European trade association for the medical technology industry including diagnostics, medical devices and digital health.