While most organizations have health equity strategies, it's still early days

The top barrier to implementing a strategy is a lack understanding of what health equity entails

The pandemic exposed already existing inequities in our healthcare system when it comes to race, sex, and socioeconomic status as Black, Hispanic, AIAN, and NHOPI people experienced higher rates of COVID-19 cases and deaths than White people. They were at about one and a half times greater risk of COVID-19 infection, and about twice as likely to die from the virus, than their White counterparts.

That has forced companies to put a greater emphasis on health equity, making sure that everyone has the same access to care, no matter their circumstances.

That's easier said than done, of course, as exposed by a new survey from Ernst & Young, in which it asked 500 healthcare leaders, including providers, payers, those in public health and life sciences, not-for-profit, and community organizations who are responsible for developing or executing efforts related to health equity or disparities within their organizations, about how they planned to address these challenges.

The first EY Center for Health Equity Annual Survey found that while the vast majority of organizations have a health equity strategy in place, many are still early on in tackling the problem.

In all 98%, of the organizations surveyed reported have a health equity strategy, and 82% said that strategy was being enterprise-driven, the initiation of a health equity strategy is fairly new for most of them: 34% initiated their strategy during COVID, meaning at some point in the last three years, while roughly 60% of organizations developed their health equity strategy within the past five years.

As such, the top barriers to setting and implementing health equity goals and initiatives are sometimes fairly simply: the top answers, with 16% each, were a lack of common understanding of what health equity entails, and a lack of financial commitment. So, while these organizations obviously want to support these initiatives, they seem hesitant to spend money until they can clearly define what they will look like.

Other barriers included a lack of leadership commitment as well as a lack of available data, with 14% each, while 13% said lack of a business case to align health equity to a tangible return on investment, lack of dedicated resources, and lack of technology enablement capabilities. 

In terms of who is actually leading these strategies, the majority, 58%, have put a chief health equity officer in charge, with 79% of life sciences organizations having done so, while 20% of all organizations having designated a health equity director. In 21% of cases, though, the organizations have not created a new role, but have folded those responsibilities into an already existing C-suite or executive-level leader.

While 85% organizations surveyed have a health equity data and analytics strategy in place, and 89% have defined KPIs to track progress toward health equity goals, there is variability in what stage these companies are at in terms of their strategies. 

Almost half, 45%, of public health companies, and 39% of non-profits and providers, are in what the report designates as stage 1, which means they are collecting data to identify health equities. 24% of payers and 12% of life science companies are still in this stage.

The second stage, which means they are utilizing data to inform strategic priorities in health equity, is where most companies are, including 45% of nonprofits, 41% of providers, and 38% of public health companies.

Very few are at the third stage, which is driving improvement through health equity analytics: only 20% of life sciences companies and payers, 18% of providers, 14% of public health companies, and 13% of nonprofits have gotten to this point so far. 

In terms of diveristy, equity, and inclusion (DEI) initiatives, which the report notes "have played a critical role in health care for over 20 years," and which have "served as a launching pad for health equity" in recent years, only a little over one-quarter of all surveyed organizations put DEI as their top priority in health equity, though 42% of health systems and behavioral health organizations have done this.

"Health care organizations have a unique opportunity to address social determinants of health for their own employees, given they often play a dual role of both employer and health care provider — further solidifying DEI as an enabler of health equity," it says in the report.

Meanwhile, despite the aforementioned lack of understanding of what health equity is, only 55% of organizations, said they provide education to employees on health equity and disparities, while 60% direct that education toward leadership.

When it comes to education, life sciences organizations are at the forefront, providing it to 62% of leadership, 61% of employees, and 59% of customers.

"As organizations now invest to deepen their capabilities in health equity strategy, data and analytics, education, DEI, research and community engagement, it is clear there is significant work to be done to align efforts and amplify impact," the report concluded.

"With new regulations from the Centers for Medicaid and Medicare Services (CMS), National Committee for Quality Assurance (NCQA) and the Joint Commission creating renewed urgency around health equity activation in 2023, the cost of doing nothing continues to rise."

(Image source: mtm-inc.net)