Tips to Improve Health Equity in the Workplace

Research shows that health equity at work can benefit both employees and their employers. Conversely, poor employee health can be bad for business and lead to negative outcomes in workplaces around the world.

A 2021 study assessing health conditions among workers in South Korea found that:

• Employees experience a 21.5 percent decline in productivity if they experience depression.
• They experience a 13 percent loss in productivity if they have chronic pain.
• Employees with physical health conditions, such as diabetes or heart disease, are at increased risk of absenteeism.

Gerald Johnson
Chief Diversity Officer, American Heart Association

Gerald Johnson, chief diversity officer at the American Heart Association, spoke with SHRM Online about how employers can play a key role in promoting health equity and offered tips for tackling health disparities in the workplace.

SHRM Online: Each February, American Heart Month brings about conversations around heart health and health equity. In what ways does health equity impact the workplace?

Johnson: At the American Heart Association, we are working to advance health and hope for everyone, everywhere, which requires working to remove barriers to health through every means available. Evidence has shown that there are consistent and persistent health disparities among workers, particularly in under-resourced and historically marginalized populations, even when they are covered by an employer-sponsored insurance plan.

In 2023, we launched the Health Equity in the Workforce initiative in collaboration with the Deloitte Health Equity Institute and the SHRM Foundation, with the goal of bringing together the latest research and insights to help employers advance health equity in the workforce. Our aim is to equip leaders to embed health equity in their organizational culture and operations to promote optimal health and well-being for all employees and bolster business outcomes.

There are over 130 million full-time employees in the U.S. For many of us, our social lives, physical and mental well-being, and financial health are inextricably linked to our work. Workplace stressors can be as harmful to health as secondhand smoke, increasing an individual’s risk of having a heart attack or stroke by as much as 40 percent.

Recent studies have also found that negative workplace experiences can impact factors such as risk of heart disease and high blood pressure. By intentionally eliminating practices and policies rooted in bias and discrimination and placing equity at the root of business, we believe that employers have a unique opportunity to help advance health equity for workers nationwide.

SHRM Online: Can you talk about the relationship between good business and good health?

Johnson: We know that health inequities pose a serious danger to individuals, but what many leaders may not realize is the toll these disparities can take on their business. A recent Deloitte study estimated that health inequities cost the U.S. $320 billion in health care spending each year—and that number could increase to $1 trillion by 2040.

Employer costs for health insurance are expected to rise by more than 6 percent in 2024, and that’s not accounting for the additional burden of factors like absenteeism, presenteeism, lost productivity and turnover. Working to close gaps by increasing access to and utilization of quality health care that is affordable and comprehensive, as well as addressing structural flaws in the system through education and resourcing, has the potential to help mitigate many of these costs.

Your business is only as healthy as your employees. And when all employees are supported in their well-being—mind, heart and body—that pays dividends. Healthy employees are more productive, less likely to miss work and often more satisfied in their jobs. And there’s a growing expectation from consumers and job seekers that employers prioritize factors like workforce well-being and diversity as well as taking a stand on important social issues.

Creating a comprehensive, science-backed health equity strategy is not just a social imperative, it’s also a clear business and economic imperative.

SHRM Online: Different groups of people seem to have different health outcomes. For example, a 2021 McKinsey & Company survey of large U.S. employers found women of color and LGBTQ+ employees have the highest share of unmet basic needs. Why do you think this is the case?

Johnson: Unfortunately, despite progress in recent years, there are still many areas of our health system and our country as a whole that are plagued by inequities. Structuralized discrimination, racism and bias, and other forms of oppression have historically and continuously perpetuated these disparities, and in many cases, the gaps are widening.

In 2021, the American Heart Association surveyed over 1,200 U.S. workers and found that more than a third (37 percent) said they believed structural racism existed in their workplace. Two-thirds (66 percent) of Black, Asian and Hispanic respondents indicated that practices and policies at work negatively impact their health and well-being a great deal or moderately, and over half (59 percent) of LGBTQIA+ respondents indicated their work environments have made them feel marginalized.

Up to 80 percent of someone’s ability to live a healthy life is driven by nonmedical factors, such as their financial security, education, social support, and access to housing and food. What is encouraging to me is that we, as employers, can influence many of these factors by:

• Offering comprehensive benefits.
• Paying living wages.
• Fostering psychologically safe workplaces.
• Intentionally uplifting underrepresented groups through our culture and practices.

The roots of this issue are complex. We can’t expect any one group to solve these problems alone. Rather, it takes collaborative, sustainable and meaningful interventions at the systems level to remove barriers to health and create a future of health equity.

SHRM Online: What does a company with strong health equity look like?

Johnson: Equity is truly about centering our people in every decision we make and ensuring that no one gets left behind. To me, that’s a company that listens to the needs of its employees and actively involves them in organizational decision-making where feasible.

Ensuring that individuals are seen, heard and valued can go a long way in improving employee well-being in the workplace. That’s a company that looks at health from a whole-person, whole-organization perspective, including mental well-being, and considers what systemic factors may play a role in those outcomes. That’s a company that doesn’t stop at checking the boxes but instead continues to ask questions and explore how they can improve their workplace through sustainable, incremental change. By prioritizing our people, we build trust. And when we build trust, we thrive together.

SHRM Online: Can you give a few examples of effective company policies and benefits that support health equity in the workplace?

Johnson: We’ve evaluated a number of health equity interventions in collaboration with industry experts and practitioners, both for their effectiveness and their feasibility for employers to implement. Some of the strategies that frequently rise to the top are things such as:

• Offering comprehensive health care coverage that is affordable and accessible.
• Ensuring pay equity and promoting a living wage.
• Building a leadership team that is comprised of diverse perspectives that truly represents your workforce and community.

Many employers may feel that they are already doing these things effectively, which is why solutions need to be tailored to the individual needs of our organizations and our employees. By prioritizing health equity as a strategic business imperative, embedded in everything from mindset and operations to talent strategy and resource allocations, employers have an opportunity to create lasting impact for their people.

I think what I’d communicate to any leader who is interested in advancing health equity is that you do not have to do this work alone. Through efforts like the Health Equity in the Workforce initiative, the American Heart Association and its collaborators are committed to providing evidence-based resources for addressing these issues that can be applied broadly across the marketplace.

By creating space for these conversations among peers and sharing our learnings with one another, we can multiply the impact of this work on a truly meaningful scale. I’d encourage you to be curious and vulnerable in your conversations and ensure that the voices at the table are representative of your entire community, from your employees to stakeholders and consumers. Even incremental progress can make a difference—so don’t hesitate to start from where you are.