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The changing demographics of the U.S. workforce raise questions about how the workers compensation industry can adapt to provide care for a diverse population of injured workers.
While diversity remains a topic that is prevalent when it comes to inclusion in employee populations, experts say the workers comp industry has been slow to consider changes to address these differences.
More people of color and of different cultures and ethnicities have entered the U.S. workforce. The U.S. Department of Labor projects that minorities will rise from one in every four Americans to almost one in every two by 2050, including an increase in the Asian, Pacific Islander and Hispanic populations.
“The big thing that is important to understand is that the amount of people of color are increasing in the United States,” said Ericka DeBruce, Memphis, Tennessee-based vice president, engagement, inclusion and social responsibility at Sedgwick Claims Management Services Inc. “This is important because when we are talking about employees and workers compensation, the dynamics of that has changed. We need to think about the differences of the people we are trying to serve and not administering a ‘one size fits all’ way of doing things.”
Health care disparities when it comes to race and ethnicity are important, experts say. African American and Latino people receive care that is 40% worse than white Americans, according to a report from the Rockville, Maryland-based Agency for Healthcare and Research Quality.
Language barriers can contribute to health disparities, and expanding the amount of resources for injured workers that speak other languages is key, experts say.
“I know that a lot of organizations have English and Spanish, but we are finding that Mandarin (and) French Creole are languages that are starting to become requested from employers,” Ms. DeBruce said. “It’s a lot, but it’s all about preparation and getting our colleagues prepared.”
Currently, there are no major studies that have looked at the direct correlation between ethnicity and workers comp costs, but experts say there are indirect correlations between chronic health, ethnicity and the ability to heal. Chronic health conditions and their connections to ethnicity are important for workers comp costs. For example, Latino and African American populations have a higher prevalence of diabetes, according to the Centers for Disease Control and Prevention.
“When we are looking at the workforce for manufacturing, construction and a lot of other hard physical labor jobs, these groups make up a large part of those employee populations, certainly not 100%, but those populations tend to be more diverse,” said Alexandra Leone, Chicago-based assistant vice president of workforce productivity at Hub International Ltd.
“When you have a workers compensation claim where someone needs surgery, it can be something simple like an employee twisted his knee and needs a meniscal repair, which is a straightforward and inexpensive surgery where he could be back on his feet in a week or two, working full duty within a month or six weeks,” said Ms. Leone. “But if that employee has diabetes, now we have to get them cleared by their endocrinologist before they are able to have the surgery, to make sure that the blood sugar levels are appropriate to be able to withstand surgery. After the surgery, diabetes ... can really delay the progress of an employee because if your blood sugar is not in control, then you’re going to have a hard time in physical therapy or participating in other treatments.”
Conditions like heart disease and high blood pressure are prevalent among African American populations and can affect their overall ability to heal and recover.
Being aware of these chronic health conditions can affect return to work and claims costs, said Ms. Leone.
Addressing these populations of injured workers will require the workers comp industry to look at nuances of race and ethnicity, according to experts.
“We haven’t necessarily prepared our workforce (claims handlers) for those changes,” said Ms. DeBruce. “When we see those types of demographic changes, not only is it happening just from a race perspective, but what I’m finding interesting is also ethnic diversity (country of origin). So, there are some differences between African-American and white, but when you start looking at the ethnic diversity amongst black individuals: African-American, Haitian, Caribbean, Bahamian. We are starting to see that some of the trends that we associate with race aren’t really working anymore. It’s really happening across more of an ethnic divide,” she said.
Employers, third-party claims administrators and workers comp insurers can begin implementing “cultural competency” into claims management best practices by hiring people from cultural backgrounds that make up the incoming worker population, according to experts.
“When businesses and TPAs really match up the cultural needs within their book of business ... it’s going to save time, paperwork and produce higher employee engagement,” said Christina Lincicome, Salem, Oregon-based director of diversity and inclusion at SAIF Corp., Oregon’s state-chartered workers comp insurer.
“If you are not understood and you don’t feel like you have a voice at the table, imagine the amount of time and the emotional response,” said Ms. Lincicome. “Most people don’t go out and cause an injury ... When individuals have injuries it disrupts every aspect of their lives. When they are not understood based on cultural background, they really feel isolated ... and it could affect healing time and costs. In addition, there is a community element: ‘Why should I pay attention to this insurance company who doesn’t even value having someone speak my language or understand my culture?’”
“Being able to in that initial contact understand the injured worker’s dynamic ... being sensitive to people’s desires, to have their health needs met in unconventional ways. It’s having an understanding for what people are thinking, what their background is and applying what you can to the claims adjusting process,” said Amy Newton, Denver-based assistant vice president of claims for Pinnacol Assurance.