To improve health equity, leaders need to make it ‘the center of your strategy’

Other health systems say they aim to close disparities in health care. EY’s Susan Garfield outlines steps to help move the needle.

Susan Garfield has been working on health equity issues for 25 years.

“The problems are not new,” he says.

Still, Garfiled, chief public health officer at Ernst & Young (EY), says she’s pleased that health equity issues are gaining more attention from healthcare leaders. Many of these issues have been vividly illustrated in the COVID-19 pandemic.

“COVID has brought the challenges of health equity and health disparities to the fore,” she says. “It showed the impact that persistent health inequalities and health inequalities have.”

“It’s always been a real, prevalent topic,” she says. “It has emerged as a priority for healthcare organizations.”

EY recently surveyed 500 healthcare leaders representing providers, payors and life sciences about health equity. Nearly all of these leaders (98%) said their organizations had health equity strategies in place, and nearly four in five (82%) said they had organization-wide strategies in place. EY noted that survey participants needed to have a role in health equity efforts, so participants are more likely to come from organizations with established strategies.

Garfield spoke about health equity efforts and steps health care leaders can take to close the disparities. Many health systems have different ideas about strategies for health equity, and that’s a good thing, he says.

“We are in a period of opportunity, learning and building the foundation for additional and future collaborations,” says Garfield. “It’s not something we will achieve by doing just one thing.”

Hospitals and healthcare systems can focus on issues like transportation and connectivity, she says, while payers could be looking at affordability and access to care.

‘Put it in the center’

Healthcare leaders who are interested in improving equity in their communities need to recognize that it should be an organization-wide effort.

“This is an issue that should be at the heart of your strategy,” he says. “When you put that at the core, you can start winning on all fronts.”

Health systems that can move the needle on closing disparities can build deeper and more sustainable bonds with their community. They will also improve their own reputation in their communities.

“Health equity at its peak is an ambitious goal. But bridging health disparities and addressing root causes along that continuum…is a significant way for healthcare leaders to change the lives of patients and improve their communities,” Garfield says.

In the EY survey, healthcare leaders most commonly cited a lack of understanding of what health equity actually entails as the biggest obstacle they are facing.

Other organizations are appointing a chief health equity officer to lead efforts to close the disparities. More than half (58%) of leaders surveyed by EY said their organizations have a chief health equity officer.

Some organizations have entrusted those responsibilities to members of their executive team. But Garfield said she’s “thrilled” to see many organizations investing in health equity officers.

“It’s certainly helpful in any big transformation like activating health equity to have someone in charge… It’s not necessary but it’s really an accelerator and can help organizations achieve their goals more effectively,” he says Garfield.

Investments are essential

Healthcare leaders can empower health equity leaders by collaborating with other senior leaders to be aligned around key goals. Leaders should agree on what equity efforts will entail, and organizations need to develop a data analytics infrastructure to support those initiatives.

While most organizations say they have strategies to close the disparities, many health systems lack specific budgets for health equity programs, according to a study by Accenture and HIMSS Market Research released last year.

Garfield suggests that organizations aiming to make progress need to budget for such equity initiatives.

“Budget and investment are really key to supporting these leaders,” she says.

“The investment needs to be tied into those efforts so organizations can see the ROI, communities see the value, and there’s an incentive to continue the investment,” Garfield says.

Healthcare organizations need to engage with their communities to understand the key issues that are driving inequality. Virtually all respondents (99%) said they recognized the need to work with community members and ensure their involvement in health equity efforts.

“No one should think in isolation from the people they’re trying to serve,” Garfield says.

Data challenges

Healthcare organizations need data to close the gaps. While hospitals and health care systems have massive amounts of information about their patients, many lack the ability to analyze that data to see where disparities are emerging, such as procedures where members of minority groups may have worse outcomes, says Garfield .

“Most organizations lack the analytic infrastructure to capture that data and address the root causes of health care disparities,” he says.

A hospital may know that the Hispanic community lags behind other groups in cancer treatments, but the organization may not know what to do with that information, she says. Getting more data can help with interventions.

Less than half (47%) of healthcare organizations say they have reliable data on health equity, according to the EY survey. Systems that don’t have the capability to analyze their own data might consider partnering “to build capabilities they don’t have internally,” Garfield says.

The EY survey also found that 10% of taxpayers said they do not collect and review data to track disparities in their populations.

Enhance diversity

Systems that aim to close disparities in minority groups must make every effort to enhance the diversity of their organizations, Garfield says.

“Embedding diversity, equity, and inclusion efforts is critical on many levels,” she says.

“It also supports your health equity initiatives.”

A diverse clinical workforce can help improve interactions with communities, says Garfield.

Garfield notes the lack of diversity in the physician workforce. Only 6.9 percent of physicians identified as Hispanic, while 5.7 percent identified as Black or African American, according to data from the Association of American Medical Colleges. Much of the challenge is a pipeline issue.

However, healthcare organizations must make every effort to improve diversity in order to reap gains from reducing disparities, Garfield says.

Healthcare organizations need to recognize that the effort to improve health equity goes a long way.

“This is a big challenge that will take a lot of time, a lot of effort, a lot of collaboration,” Garfield says.

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