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Why Companies Are Making Health
Disparities Their Business
Within
the
next decade, the Bureau of Labor Statistics predicts that 41.5 percent
of the workforce will be members of racial and ethnic minority groups.
That being said, many of these groups experience significant
differences in the diagnosis and treatment of health conditions,
utilization of preventive services, and health outcomes, according to
the National Business Group on Health (NBGH).
"Employers
need to be aware of these demographic shifts and to understand that in
this new environment, a ‘one-size-fits-all’
approach to
employee health benefits will not be effective," reads the report
"Eliminating Racial and Ethnic Health Disparities; A Business Case
Update For Employers," sponsored by NBGH.
The
report is
a component of a two-year initiative set forth by the Office of
Minority Health (OMH) and the NBGH to reduce racial and ethnic health
disparities and to improve the overall quality of healthcare for
minority populations through ongoing partnerships and new
business-community coalitions.
Awareness
of
inequities in the health system is important according to the report,
especially by paying attention to what other companies may have done by
using this information to guide healthcare service purchases.
Many
employers are tailoring programs based upon the diverse needs of their
workforce. For instance, the report mentions that some pharmaceutical
products have actually been proven more effective for certain
populations than for others. The best way to formulate a comprehensive
plan for all employee demographics is to collect appropriate data and
to communicate directly with employees about their needs and
satisfaction.
"Addressing
disparities through a quality improvement framework is promising and
can be viewed as good medicine and good business," stated Aetna,
‘a corporate pioneer in the area of addressing health
disparities,’ according to the report.
The
Institute of Medicine (IOM) has attributed health disparities to three
main categories of factors:
Patient-Level
Variables: These include socioeconomic status, language
barriers, poor health literacy, and cultural norms and beliefs about
healthcare.
Healthcare
Systems-Level Variables:
These are characteristics of healthcare systems that make it difficult
for individuals to navigate their way through the care continuum. Some
examples include organizational complexity, financial complexity, and
geographic location of the healthcare facility.
Care
Process-Level Variables:
This set of variables refers to the characteristics of an individual
provider that may contribute to disparities. For instance, the racial
or ethnic bias of a particular organization may inherently contribute
to the provision of care.
While
research within the past decade has helped to make great strides in the
eradication of racial/ethnic disparities in health status, major
disparities remain.
According
to
a 2007 report, the health disparity between Asians and whites who had a
usual primary care provider was eliminated in 2004; however, cancer was
the top killer of Asians and Pacific Islanders in 2004.
According
to
the same report, the disparity in health status between black and white
hemodialysis patients who were receiving adequate dialysis was
eliminated in 2005, but also in 2005, African-American men were 30
percent more likely to die from heart disease than non-Hispanic white
males.
Although
many
difficult health disparities remain, employer efforts not only help
save human lives, but dollars. In 2006, U.S. businesses spent $496
billion on health services and supplies, according to the NBGH report.
"In
light of
the rapidly diversifying workforce, U.S. employers cannot afford to
continue shouldering the costs and consequences of unnecessary or
unequal healthcare," said the IOM.
Direct
benefits to businesses addressing health disparities are decreases in
both utilization and medical costs and in medical claims costs for
serious conditions avoided by better screenings, treatments and
preventive care.
Indirect
benefits range from increased employee and dependent satisfaction with
healthcare benefits, increased productivity, decreased absenteeism,
increased employee loyalty, workforce stability, competitiveness in
attracting and retaining talent and decreased short- and long-term
disability costs and workers’ compensation claims.
Many
of the
barriers identified by employers in preventing them from directly
addressing these health disparities, span difficulties in accessing the
proper data, limited resources, overcoming cultural sensitivities to
the subject matter, and reluctance to acknowledge the impact that
disparities were having on their organization.
The
steps
employers can begin to take in order to trump this issue for both their
employees’ health and their own business wellbeing are:
- Understand
the Legal Myths and Realities
(around collecting racial/ethnic data) – Don’t be
afraid
that by targeting disparities you are treating people differently or
unfairly in the collection of this data; it is both in line with the
law, and ensures that disparities are quickly recognized and addressed,
according to the report research.
- Know
Your Data
– Include benchmarks, determine what data you wish to
collect,
what to measure, then integrate the data collection with the
company’s operations, and use that data in implementing
appropriate programs and strategies.
- Work
With Employees
– Routinely elicit feedback on access and quality of care,
focus
on health literacy, always communicate appropriately with different
populations of employees, tailor your programs keeping all of these
needs in mind, and above all, instill hope in your organization and the
community.
- Work
With Health Plans and Other Health Vendors
– Work with all healthcare partners to require changes to
plans’ structure, recruitment, training, and tackling
disparities. Inquire about healthplan efforts to reduce disparities,
partner with these health plans on data collection, and tailor your
requests for proposals to serve your needs.
Some
helpful links for reference in addressing your business’s
health disparities are:
Address:
National Business Group on Health, 50 F Street NW, Suite 600,
Washington DC 20001; (202) 628-9320, www.businessgrouphealth.org.
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