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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.


© 2010 Health Resources Publishing