As the U.S. workforce grows more diverse, employers should ensure that their standard approach to providing employee health benefits is not contributing to gaps in care. In an e-mail interview, Audrietta C. Izlar, benefits manager at Basking Ridge, N.J.-based Verizon Communications Inc., told Business Insurance Senior Editor Joanne Wojcik why employers should be concerned with health disparities and how they might address them. Ms. Izlar recently chaired the Racial/Ethnic Disparities Advisory Board for the National Business Group on Health, supporting a partnership with the U.S. Office of Minority Health to help employers address racial and ethnic health disparities within their workforces. She also served on a panel with the National Committee for Quality Assurance that recognized health plans for implementing steps to combat disparities among members.
Q: What are health disparities?
The term “health disparities” refers to gaps in the quality of health and health care across race, ethnicity and gender. Too often, these disparities are present even when access to care and comparable benefits are available, according to the Institute of Medicine's 2003 report: “Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare.”
Q: Among which populations are they most prevalent?
Research shows that minorities suffer from certain diseases at significantly higher levels than white Americans. Over the past decade, research has revealed striking differences between the health status of majority and minority groups in the United States, regardless of economic and health insurance status. On average, racial and ethnic minorities are in poorer health, suffer worse health outcomes, and have higher morbidity and mortality rates than Caucasians. Certain conditions, however, show specific minority populations, which are already predisposed, at higher risk or experience worse outcomes than others. For example, African-American women are more likely to die from breast cancer than white women, in part because of lower screening rates and are diagnosed at later stages of the disease. American Indians and Alaska Natives die at higher rates than other Americans from tuberculosis (750% higher), alcoholism (550% higher), diabetes (190% higher), unintentional injuries (150% higher), homicide (100% higher) and suicide (70% higher). Both of these statistics, and more, are documented in the National Business Group on Health's issue brief published in 2009, "Eliminating Racial and Ethnic Health Disparities; A Business Case Update for Employers," www.businessgrouphealth.org/pdfs/Final%20Draft%20508.pdf.
Q: Why should employers be concerned about health disparities?
Because of an increasingly diverse workforce, employers want to ensure that their standard one-size-fits-all approach to health benefits is not contributing to the gaps in care. Many companies value having a diverse workforce, but need to also account for the variances in consumption and outcomes of that care.
Disparities interventions should have the same resources allocated to them as structured wellness and benefits plan design, because it's another way of arriving at the same desired results: getting employees to early detection and prevention services. Research has shown that preventive, diagnostic and treatment-related services may be effective in deterring serious, costly health problems before they develop or in treating them more appropriately once manifested. Some examples include coronary heart disease, cancer and other expensive chronic health conditions. Early detection of some chronic conditions may reduce the amount of care needed, improve quality of life, increase the chances for survival and helps you better manage your costs.
Q: What strategies can employers adopt to address them?
Partner with ethnic affinity groups, like Verizon's Employee Resource Groups, to disseminate information and promote health and wellness initiatives relevant to and within their culture. Add voluntary race/ethnicity questions to secure health vendor Web site registration and health risk assessments to capture data. Work with health plan and other vendors to identify programs and initiatives that address health disparities. Target on-site health and wellness events and preventive care services to address the needs of diverse employee populations.
Q: Describe some of the work that NBGH's Committee on Health Disparities has been doing to assist employers in this area.
Verizon chaired the National Business Group on Health's Racial/Ethnic Health Disparities Advisory Board, sponsored by the Department of Health and Human Services Office of Minority Health in their initiative for action, the National Partnership for Action for Eliminating Racial and Ethnic Disparities in Health. The NPA is a national effort led by the OMH and intended to mobilize a public/private partnership network to implement a systems approach to coordinating activities at the community, state, regional and national levels.
The advisory board, comprised of employers, researchers and experts on disparities, completed several projects during its two-year tenure, including the following resources to help employers identify and address disparities within their own environment:
Q: What, specifically, has Verizon been doing to address health disparities within its workforce?
In addition to the measures I've already mentioned, Verizon partnered with Aetna's Breast Health initiative to identify African-American and Latina women in the Verizon population who have not obtained their annual screening mammograms as recommended by the American Cancer Society. As a result of this outreach initiative, 44% of the women identified received their mammogram.
At last year's Verizon Multi Employee Resource Group conference, Verizon provided free on-site biometric screening and conducted women's and men's health workshops addressing health disparities.
Verizon is expanding their on-site mammography screening to specifically target work locations with a large number of African-American and Latina women over age 40.
Verizon's annual medical plan renewal process includes questions regarding the health plans disparities strategy. These responses are used as part of the criteria in evaluating the renewal of the health plan.
Q: What impact have these efforts had?
Verizon continues to raise awareness of the issue of health care disparities. Through our work with health partners, we continue to put measures in place to capture the appropriate aggregate data to better target programs, services and initiatives to narrow the health disparities gap in our population. Addressing disparities is a priority for how we manage health care.
Q: What other resources should employers consider when addressing health disparities?
Employers should first leverage the resources that already exist within their organization for managing a diverse workforce. In addition to health care and benefits partners, those resources can include diversity and staffing departments, to name a few. However, they can also leverage resources that manage their diverse customer bases as well, especially in terms of marketing and communications. These resources can provide insight as to strategies that best reach diverse populations.
The NBGH Racial/Ethnic Disparities Advisory Board also produced a resource document that provides a listing of additional sources available for employees (patients), providers and employers. Each category holds a unique group of stakeholders with varying requirements of information.
Results of the many studies can be applied across all of these groups. For example, the Agency for Healthcare Research and Quality Web site provides a Spanish-language subdirectory page with resources and links for Spanish speakers about quality of care, health plans, prescriptions, smoking cessation and preventive care, among other topics, www.ahrq.gov/consumer/espanoix.htm.
Loading comments...
