- Health disparities persist. Less access to healthcare due to cost, location or discrimination leads to poor health outcomes, increased illness and lower life expectancy for certain groups.
- Employers have a role to play. Offer targeted solutions by understanding health challenges that affect various populations differently.
- Focus on affordability and culturally competent care. Incentivize preventive appointments and cover diverse care providers and services.
This is part one of a two-part series examining health disparities and the workplace. Part two explores mental health.
Even when they are offered access to the same healthcare, some groups of people experience higher rates of illness or are less likely to utilize preventive care. The disparities facing these populations affect not only their health but their work — and there are steps employers can take to help.
A recent report from Morgan Health highlighted health disparities as they relate to employer-sponsored insurance. The analysis used data from three nationally representative surveys — the National Health Interview Survey, the National Study on Drug Use and Health and the National Vital Statistics System. Health disparities refer to inadequate care and worse health outcomes for specific populations based on race, ethnicity, gender, sexual orientation, socioeconomic status, geographic location or other factors.
Related to physical health, the report found:
- Lower-income individuals are less connected to basic healthcare and report greater challenges with paying for care.
- Black, Hispanic and Asian populations seek and use healthcare at lower rates, report varying levels of affordability and had notable gaps in preventive care.
- Black and Hispanic individuals had higher rates of cesarean sections, even for low-risk pregnancies.
These findings parallel other research related to health disparities showing barriers to care and lower health outcomes for individuals of color and LGBTQ+ individuals.
“Some aspects of the American healthcare system deepen these disparities,” said Dan Mendelson, CEO of Morgan Health, in the latest report. “In turn, healthcare disparities create downstream impacts on employee productivity and businesses’ success.”
Addressing Affordability
Social determinants of health (economic stability, education access, healthcare access and quality, neighborhood and environment, and social and community factors) play a key role in different populations' physical well-being.
“There are broader social reasons for disparities in physical health,” said Jeff Levin-Scherz, M.D., population health leader at WTW. “Employers can make a difference through paying living wages and offering inclusive health benefits with affordable premiums and affordable cost-sharing at the point of care.”
Employers need to focus on equity rather than equality, said Kathleen Schulz, global innovation leader, organizational well-being at Gallagher.
"You may have a rural population struggling with food insecurity, and they may need something different than an urban population struggling with transportation,” she said. “The benefits they need may be different because the people are different. One-size-fits-all, we've realized, is really hard to make work.”
High-deductible plans or those with high co-pays mean that low-wage earners are less likely to be able to pay for care. Not accessing preventive care can lead to increased health problems, delayed diagnoses and higher levels of emergency room utilization.
“If you take a person who is struggling with basic human needs,” Schulz said, “it's almost unrealistic to expect that they're going to be fully leveraging preventive care.”
Women are also about three times more likely than men to feel that they can’t afford health care, according to Mercer’s Health and Benefits Strategies 2024 Survey Report.
The Morgan Health report suggests offering financial incentives for lower-income workers to access preventive and primary care.
“Enhancing and incentivizing preventive health, along with understanding and addressing the reasons why people are not receiving preventive care, could go a long way toward changing the behavior and encouraging people to get care,” Schulz said.
Acknowledging Diverse Needs
Covering culturally competent providers under a workplace plan may increase the likelihood that historically marginalized groups will seek the care they need, Schulz said. Doing so can be especially helpful for those whose trust in the health care system is damaged, she noted, such as women, ethnic minorities and people with disabilities.
Bolstering certain benefit offerings also can address specific issues highlighted in the Morgan Health report, such as the gaps in pregnancy and delivery care.
“Clearly, there is a crisis of maternal quality and safety in the United States,” WTW’s Levin-Scherz said. “This is worse for Black birthing people.”
Morgan Health recommends covering midwife care and doula services during pregnancy and delivery. Less than a quarter of employers currently provide this type of coverage, according to Mercer's report, which also recommended covering robust fertility and reproductive care.
Vikki Walton, health equity leader at Mercer's Health Equity Center of Excellence, recommends sharing data about existing disparities with all employees, such as statistics on maternal mortality rates among certain racial and ethnic groups, and pairing that data with information about resources and benefits that can help.
Another example of targeted solutions is developing an LGBTQ+ benefits guide for employees that acknowledges existing difficulties around finding accepting and culturally competent care, while also providing specific information on available resources and gender-affirming services, Walton said.
Addressing health disparities starts with understanding the demographics of your workforce, including geographic factors, Schulz said: “The zip code people live in can be more telling and have a greater impact on their health than their genetic makeup.”
It's vital for employers to utilize available data and gather their own, and to look at it through the lens of diversity, equity and inclusion, Walton said.
“Despite the ability to identify and analyze disparities across different populations, with some employers, little to no action is being taken,” she said. “It is only when we fully capture and comprehend the extent of these disparities that we can begin to have meaningful discussions about implementing effective solutions.”
Closing gaps in care means improved employee health and increased productivity and satisfaction — a key goal considering the fact that the biggest pain point for HR leaders continues to be effective employee retention, Schulz said.
“Employees are less willing to compromise on the things that are important to them, and health and well-being are right at the top of the list,” she said. “If you're not prioritizing well-being as an employer, it will be difficult for you to attract, retain and engage your talent.”
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