Can Health Care Organizations move Beyond Lip Service and take the Steps Needed to Improve Health Equity? | Deloitte US has been saved
By Wendy Gerhardt, senior manager, and Leslie Korenda, manager, Deloitte Center for Health Solutions, Deloitte Services LP
Health equity is the fair and just opportunity for every individual to achieve their full potential in all aspects of health and well-being. While all health care should be equitable, it often isn’t. Some health care organizations have been focusing on health equity for years, yet the care patients receive (and the outcomes they experience) can still vary widely by race, age, income, ethnicity, gender, and even ZIP code.
Early this year, the Deloitte Center for Health Solutions conducted nearly 30 in-depth interviews with chief equity officers, chief diversity officers (CDOs), and other executives from health systems, health plans, and biopharmaceutical companies who are in charge of their organization’s health equity efforts. We asked what they’ve done to get their leaders and board members to recognize the importance of health equity. Some interviewees seemed frustrated that health equity is often discussed as an afterthought rather than a business imperative. One of our interviewees said that a Black executive at a health system shouldn’t have to explain to white male leaders or board members that not all patients are treated the same. Another asked why anyone should have to prove that providing everyone with a high level of care is the right thing to do. Executives across industries, including the health care executives we interviewed, said that hiring a CDO—or individuals dedicated to drive diversity, equity, and inclusion efforts—is an important step, but more action is needed. CDOs across FORTUNE 500 companies often lack power or resources to effect real change, according to recent reporting from Axios.1
In addition to our interviews, we also surveyed 20 CEOs from health systems and health plans to find out how their organizations were prioritizing and addressing health equity. Half of the respondents listed health equity as one of their top three organizational priorities for 2021, and nearly all of them said they have a dedicated team, task force, or committee (and a budget) dedicated to health equity. Ten CEOs said they have a C-suite leadership position dedicated to health equity, and nearly all of them agreed that health equity does not mean equal treatment. Instead, they said equity means that some individuals need additional or different support or interventions due to the effect of racism on institutions, the drivers of health, and the multiplier effect of those factors.
Health equity is gaining momentum, but can it be sustained?
The idea of health equity is nothing new. Many health systems and health plans already have missions to ensure the health of their communities. Some have had health equity leaders, diversity departments and/or teams in place for years. What is new is the momentum. The combination of the COVID-19 pandemic and demonstrations over social injustice have spurred many organizations to enhance their diversity, equity, and inclusion efforts. Some have created new leadership roles devoted to equity and have hired dedicated staff. However, some interviewees acknowledged that an individual or team will likely not be able to effectively and sustainably enhance equity on their own. Some interviewees voiced their concerns that the importance of health equity could wane if priorities and resources shift with new leadership or changing market dynamics.
The executives we interviewed shared the following strategies to help drive change throughout the organization to ensure that health care becomes, and remains, equitable:
Our research highlights a disconnect between the leaders who have designated health equity as a top priority and the executives who have seen little improvement in recent years. However, most interviewees were optimistic. Some executives told us their leaders were having real conversations, many for the first time, about systemic racism, social justice, and the implications of each on health equity. They described organization-wide townhalls and board/leadership meetings dedicated to the topic. They also said it appears that their leaders are truly listening to problems, looking at data, and designing solutions. According to the executives, this contrasts with past discussions at their organizations that were more narrowly around quality of care or hiring, and solutions rarely incorporated direct feedback from those impacted. Many organizations appear to be taking bigger steps to move beyond lip service and toward solutions.
Acknowledgement: Jessica Overman
1. The chief diversity officer hiring frenzy, Axios, May 20, 2021
2. Caner disparities, National Cancer Institute, accessed April 28, 2021.