Over the past year, especially during the pandemic, we’ve seen an increased number of employers interested in having conversations about health equity and disparities in care. And everyone needs to have those conversations … even if they’re uncomfortable.
A recent white paper by the Health Action Council and UnitedHealthcare, “Finding the Uncommon,” finds companies that implement deliberate strategies around their employees’ most common chronic health conditions may improve overall employee health and achieve cost-savings over the long-term.
The findings are based on a study of five chronic health conditions — hypertension, diabetes, back disorders, mental health and substance use, and asthma — across more than 280,000 HAC members insured with UnitedHealthcare. Many of us will suffer at least one of these conditions during our lifetime, with a real impact on healthcare costs. The study also revealed a number of important disparities in care, which can be improved through a combination of lifestyle modifications and targeted wellness programs.
Care Disparities Revealed
- Among HAC members, African Americans are 63% more likely to have hypertension than other races or ethnicities. Also, the study found women are sub-optimally treated across all age groups versus men, who were typically administered more prescription drug treatments.
- Men over 50 in lower income groups have the highest prevalence of diabetes, while those of Asian ethnicity have a 43% higher than average prevalence of the condition, largely driven by genetics and diet.
- Typically, employees with back disorders skew older and are in lower income brackets, with factory work identified as one of the top jobs linked to back pain. Despite a strong case that physical therapy or chiropractic care helps reduce reliance on muscle relaxants and other drugs, our study found 6 out of 10 obese employees with a back disorder are foregoing or not being offered physical therapy or chiropractic care.
- Those with mental health and substance use challenges tend to be female, younger and in lower-income Caucasian groups. Rural areas are often unable to meet mental healthcare needs due to inadequate services, leading to a higher than average number of emergency room visits and hospitalizations.
- African Americans have a 20% higher prevalence of asthma than other races and are more likely to experience a flare-up that requires treatment, yet they are less likely to have been prescribed asthma steroids.
Tips for Tackling Healthcare Disparities in a Company’s Workforce
To address care disparities and ensure all employees have access to proper care, we recommend employers consider their population’s demographic and geographic profile and then create simple, targeted wellness programs to address the most prevalent common conditions.
The following are some of the suggestions in the white paper:
- Evaluate the company’s current benefit plan design for opportunities to implement a care program that evolves with the patient over time — for example, making chiropractic care or physical therapy mandatory for back disorders before moving to more aggressive treatments.
- Cover medications as preventive care for specific chronic conditions or promote the use of patient assistance programs for specific types of medications. The latter may require exclusion of some medicines from the company’s benefit plan design.
- Institute an exercise, stretch or meditation program at the beginning of work shifts to improve safety and decrease injuries. These types of practices are preventive and may decrease the severity of an injury if one occurs.
- Create targeted communications for specific regions and demographics. Consider sharing success stories or appointing a program champion from the target audience. Understand and reflect on cultural differences when developing each communication.
- Promote virtual care to improve access to treatment for specific conditions — for example, mental health support in rural areas.
- Work with the company’s third-party administrator or medical expert(s) to identify opportunities for provider outreach and education on best-in-class approaches.
Employers can reach and help those who may be at greatest risk of these common conditions and yet least likely to take action on their own.
The full white paper is available on the Health Action Council website.
Patty Starr is president and CEO of Health Action Council, a not-for-profit organization representing large employers to enhance human and economic health through thought-leadership, innovative services and collaboration; and Craig Kurtzweil, vice president of UnitedHealthcare Center for Advanced Analytics; UnitedHealthcare is dedicated to helping people nationwide live healthier lives by simplifying the healthcare experience
This article is part of the cover story section, which includes the main story:
And three accompanying articles:
Reduce Healthcare Disparities among Employees