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Building healthier communities by addressing healthcare disparities

Ideally, everyone would have access to high quality healthcare. However, even in economically advanced countries, health disparities remain.
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By Hala Helm , 

Strategic Health Care Risk Advisor

01/24/2024 · 5 minute read

Ideally, everyone would have access to high quality healthcare, irrespective of gender, race, ethnicity, or socioeconomic status. However, even in economically advanced countries, health disparities remain.

In the US, for example, the Centers for Disease Control and Prevention estimates that in 2021 the maternal mortality rate among Black women was 2.6 times the rate for white women, irrespective of income or education. Hispanics and Latinos have a 50% chance of developing diabetes, higher than the 40% chance for all US adults. Hispanic women are more likely to develop cervical cancer, and have the second highest chance of dying from the disease.

Social determinants of health — the conditions and environments in which people are born, live, learn, work, play, worship, and age — can significantly impact an individual’s well-being, the way they are able to perform daily activities, and their overall quality of life. And they also effect the cost of healthcare — a study released in May 2023 found that racial and ethnic health disparities cost the US economy more than $450 billion in 2018, a 41% increase from estimates for 2014.

Guidelines aim to address social determinants of health

Identifying inequalities and taking action to address them is instrumental to healthcare organizations’ ability to better diagnose health conditions early and to help ensure that patients receive needed treatment and care. Further, minimizing unfavorable health outcomes can help reduce costs, in part by potentially lowering the risk of medical malpractice lawsuits.

Concerns about the impact of health disparities on patient outcomes led the Centers for Medicare & Medicaid Services (CMS), The Joint Commission, and other health authorities to issue guidance to address social determinants of health and help improve health equity. Implementing the standards — which could impact an entity’s accreditation — helps healthcare organizations provide high quality care and treatment for patients, allowing them to achieve the best outcomes possible.

Taking action to improve health equity

The CMS issued a five-point framework to improve health equity:

  • Priority 1: Expand the collection, reporting, and analysis of standardization data.
  • Priority 2: Assess causes of disparities within CMS programs and address inequities in policies and operations to close gaps.
  • Priority 3: Build healthcare organizations’ capacities and workforce to reduce health and healthcare disparities.
  • Priority 4: Advance language access, health literacy, and the provision of culturally tailored services.
  • Priority 5: Increase all forms of accessibility to healthcare services and coverage.

The Joint Commission’s new and revised requirements intended to reduce healthcare disparities came into effect on January 1, 2023. All ambulatory healthcare organizations, behavioral health and human services organizations, critical access hospitals, and other hospitals are required to:

  1. Designate a leader to spearhead activities intended to reduce healthcare disparities for patients.
  2. Assess patients’ health-related social needs and provide information about community resources and support services.
  3. Identify healthcare disparities in patient populations.
  4. Develop a written action plan outlining how the health entity will address at least one of the identified healthcare disparities.
  5. Take action if the goals outlined in the action plan are not achieved or sustained.
  6. Inform key stakeholders about progress to reduce identified healthcare disparities at least once a year.

Addressing human resources constraints can help improve health outcomes

The challenging nature of healthcare jobs often leads to high worker turnover, leaving remaining employees stretched and potentially leading to burnout. Data from the Bureau of Labor Statistics shows that in 2022 the total recordable injury rate for general medical and surgical hospitals was more than two times higher than the average of the entire US private sector.

This could significantly impact health outcomes, and healthcare entities are being encouraged to build their workforce capacity to be better positioned to identify and address health disparities.

Further, employees may be among the populations impacted by health disparities, and therefore be at greater risk of unfavorable health outcomes, including longer recovery rates or even the inability to return to work. In addition to the negative effect on employees’ personal lives, disparities could also impact healthcare entities’ ability to provide the best quality care to other patients.

3 actions to address social determinants of health and improve patient outcomes

Healthcare entities strive to provide the best care for their patients. Addressing social determinants of health is instrumental for these organizations to do so and also maintain their accreditation to continue operating. Further, reducing unfavorable outcomes tends to lessen medical malpractice costs. The following actions may help healthcare entities better address health disparities and improve patient outcomes.

1. Focus on your employee population

A recent Mercer survey shows that the majority of employers (78%) are acting to improve health equity, while another 10% plan to develop a strategy.

As a starting point, employers should take action to understand potential problems by collecting employee demographic information. It is also important to help employees that use the organization’s health plan identify the providers that are best suited to their needs, including addressing potential language barriers.

Further, healthcare entities can look at potential issues that create barriers for advancement for their people, such as transportation issues that make it challenging to access the healthcare they need, and consider ways to provide them with the needed assistance.

2. Understand and implement accreditation requirements

Guidelines issued by CMS, The Joint Commission, and others are intended to improve quality of care, which should lead to better patient outcomes. Measure where you stand and develop a strategic plan aimed at improving your metrics.

Consider the impact of unfavorable outcomes on the entity’s reputation and how they could affect employee recruitment and retention, as well as charitable funding, which tends to account for a significant percentage of income for many not-for-profit hospitals. Measurements of quality outcomes also drive healthcare organizations’ ability to negotiate reimbursement rates with insurers. 

3. Consider costs of healthcare

Social factors often influence whether healthcare is affordable to a patient; research from Mercer has shown a significant difference between individuals (see graphic). Employers can help address health inequities by providing healthcare plan options that meet the needs of diverse employee populations.

Some health insurers are taking action to improve the affordability of care and reduce the impact of social inequities. For example, most carriers responding to a Mercer survey said they were attempting to combat COVID-19 vaccination hesitancy by waiving member cost-sharing or improving access for patients with transportation limitations or other difficulties.

When researching health plan providers, healthcare entities and other employers should consider each plan’s commitment to reduce health inequalities. Consider whether the plans provide inclusive benefits, such as access to family planning and gender-affirming care.

On an ongoing basis, work with employee resource groups to collect and analyze employee feedback on benefit options.

Social determinants impact the perception of healthcare affordability

How confident are you that you can afford the healthcare you or your family need?

Healthcare disparities often result in suboptimal quality of care. By improving the care they provide to their patients, healthcare entities can take an important step towards reducing disparities and helping their communities become healthier.

For more information on how Marsh and Mercer can help you identify potential challenges impacting your quality of care, contact your representative.

Featuring contributions from Candice Gary, Senior Health & Benefits Consultant, Mercer

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