Employers Have a Role in Creating Health Equity

​The COVID-19 pandemic, the economic downturn and the nation's reckoning over social justice have shed more light on health equity. Part of employers' responsibility in creating health equity is guaranteeing that all employees have equal access to health care and that health care plans go beyond taking care of basic needs.

Communication and education are key to ensuring health equity, according to Sean Sullivan, SHRM-SCP, chief human resources officer at the Society for Human Resource Management (SHRM).

In an episode of the Movement Is Life podcast, Sullivan said HR professionals should make sure open enrollment materials are accessible in a range of formats and languages to meet employees' needs. Photos featured in those materials should equally represent an employer's workforce and affirm a commitment to health care accessibility for all employees.

Stepping up employees' knowledge of their health benefits constitutes "a vital part of the HR mission."

"It's not enough to say, 'Hey, we've got great benefits,' " Sullivan said. "Helping people understand how to maximize those benefits and how to be the best [health care] consumers they can be really advances overall health care and wellness for all employees." 

Sullivan made those comments in a conversation with podcast host Bill Finerfrock. Finerfrock is president of health care policy firm Capitol Associates and a steering committee member of the Movement Is Life Caucus, which seeks to overcome disparities related to musculoskeletal diseases (such as osteoarthritis and rheumatoid arthritis).

HR professionals shoulder a "very special responsibility" in making certain that employers tackle health equity, Sullivan said. Facets of this include examining access to health care networks, structuring co-pays and fees, and communicating about health benefits.

Geography is one of the complexities of health equity. While small employers may be able to easily navigate local or regional health care networks, Sullivan said, large employers may encounter hurdles collaborating with health care networks scattered across several regions.

"Because it is such a large investment and because it is such an expected part of the competitive offering from a company, HR professionals do spend a lot of time trying to think through what the design of a [health benefits] program should be," Sullivan said.

Among the employer-provided benefits that can encourage health equity are:

• Health risk assessments. Sullivan noted that the Kaiser Family Foundation found that among businesses offering health benefits, 42 percent of small employers and 60 percent of large employers offer health risk assessments. These assessments include posing questions about an employee's medical history, health status and lifestyle. More than half of large employers with a health risk assessment program provide incentives to participants, such as gift cards, merchandise or cash.
• Biometric screenings. A biometric screening measures a person's risk factors, such as body mass index, cholesterol levels and blood pressure. At businesses that offer health benefits, 33 percent of small employers and 50 percent of large employers enable employees to undergo biometric screenings.
• Health and wellness programs. These programs may supply ways to quit smoking, lose weight or change lifestyle behaviors. Sullivan said more than half of businesses that extend health benefits offer at least one health and wellness program.
  

According to the U.S. Centers for Disease Control and Prevention (CDC), health equity is achieved when every person has the opportunity to "attain his or her full health potential" and no one is "disadvantaged from achieving this potential because of social position or other socially determined circumstances." The CDC says health inequities are reflected in differences in longevity; quality of life; rates of disease, disability and death; severity of disease; and access to treatment.

"Across the nation, gaps in health are large, persistent and increasing—many of them caused by barriers set up at all levels of our society," according to the Robert Wood Johnson Foundation, a nonprofit that focuses on health. "After all, it's hard to be healthy without access to good jobs and schools and safe, affordable homes. Health equity means increasing opportunities for everyone to live the healthiest life possible, no matter who we are, where we live or how much money we make."

Much remains to be done to close those gaps. A study published in 2019 in the journal JAMA Open Network examined the last 25 years of CDC research and found a lack of progress on health equity during that period, despite public health initiatives aimed at tackling it.

"Greater or different efforts than those tried in the past will have to be mustered if health equity is to improve," researchers concluded in the study.

John Egan is a freelance writer based in Austin, Texas.