February is American Heart Month & Black History Month

By Kulleni Gebreyes, M.D., chief health equity officer for health care consulting, Deloitte Consulting LLP, and Brittani Spaulding, program officer, the Deloitte Health Equity Institute, Deloitte Services LP

American Heart Month¹ and Black History Month² take place each February, and there is a profound connection between the two. While heart disease is the leading cause of death in the United States, Black adults are twice as likely as white adults to be hospitalized for it… and three times as likely to die from it.³

A year ago, the American Heart Association (the Association) collaborated with the SHRM Foundation and the Deloitte Health Equity Institute to launch the Health Equity in the Workforce Initiative. Part of this collaboration included the development of a roadmap and a set of resources to help employers make quality health care more accessible and equitable for their employees and their families.

We recently spoke with Gerald Johnson II, executive vice president, health equity & chief diversity and inclusion officer at the American Heart Association, and Wendi Safstrom, president of the SHRM Foundation, about the Initiative. The Association relies on more than 35 million volunteers worldwide who are dedicated to improving heart health and reducing deaths from cardiovascular diseases.⁴ SHRM represents nearly 340,000 human resources professionals worldwide.⁵ Here is an excerpt from our conversation:

Kulleni: Heart disease impacts all Americans, yet Black adults are much more likely to die from it. Why is that and what do you think can be done to change this?

Gerald: When you follow the science, you see that structural racism, discrimination and bias, and systemic flaws in the health system have all contributed to health disparities among Black Americans. The ability to live a longer, healthier life is largely driven by social factors like housing, access to healthy food, reliable transportation, and income. The ability to take care of yourself and have access to affordable health care is essential. (See Addressing the drivers of health.)

Wendi: There is a long history of discrimination and bias in the U.S., which has led to inequities when it comes to access to resources, education, jobs, and upward mobility. Biases can affect hiring decisions, promotions, and access to leadership positions…all of which contribute to the health disparity gap. These health inequities can also contribute to higher levels of stress at work, which can contribute to heart disease and other health issues. Collaborations between health care providers, community-based organizations, government agencies, and employers could help address [social drivers of health] like poverty, food insecurity, and limited access to quality health care.

Kulleni: What are the American Heart Association and the SHRM Foundation doing to reduce health disparities and improve health and life span for all Americans?

Gerald: Our mission is “to be a relentless force for a world of longer, healthier lives.” We are doubling down on that mission. My job is to embed equity into everything we do—from fundraising to advocacy to our strategic collaborations. We try to leverage advocacy to focus on the factors that affect heart health, like tobacco use and vaping, poverty, the notion of food as medicine, and the impact of stress in the workplace. We are funding research and science to address those social determinants of health. We are also addressing the access-to-capital barrier for women and entrepreneurs of color by providing funding to businesses that are addressing the social drivers of health. These are entrepreneurs that are often passed over by more traditional venture capital platforms.

Wendi: One of the most important things we can do as HR professionals is to address policies that can lead to inequities. We also need to educate ourselves, our teams, and our colleagues about health disparities in the workplace. One area that can drive inequity is employees’ lack of access to affordable health insurance. High-deductible health plans, for example, can make health care unaffordable and keep people from seeking care. Employees who don’t have paid sick time—particularly low-wage employees—might not seek necessary treatment or preventive care. Limited access to culturally competent health care providers can also contribute to health inequities. Cultural gaps can create communication challenges that discourage utilization of available services. Workplaces, overall, are starting to take more accountability for addressing societal challenges like health inequities, particularly when it comes to mental health and wellness. 

Brittani: It has been a year since the American Heart Association announced its collaboration with the SHRM Foundation and Deloitte. What has taken place with the collaboration since then?

Gerald: The collaboration looks at the environment and the conditions in which people work. More than 160 million people are in the U.S. workforce, and about $1.3 trillion a year is spent on private health insurance for those workers.⁶ Health inequities cost employers an additional $320 billion a year (see Deloitte’s projected cost of inequities). There is a compelling business case for CEOs and leaders of organizations to figure out how to remove those costs. But there is also a human story. Workplace stress is akin to secondhand smoke, which can lead to a 40% greater chance of having a heart attack or stroke.⁷ Being heard at work and feeling valued can help reduce stress.

Wendi: We are helping HR professionals prioritize health care access and health equity by helping them create more equitable and inclusive workplaces and by helping employees understand their benefits. We launched the Health Equity for the Workforce Employer Resource Guide last November. It gives employers and HR professionals an actual blueprint for addressing health inequities. It also explains the positive impact they can have on the health and well-being of their workforce. The goal is to help employers create an employee-centric, equity-minded culture of health and well-being where all employees can reach their full potential.

Gerald: The Guide is a living, breathing document that will be continually updated with case studies and success stories. We're all leveraging our channels to distribute it to our members and to volunteers. It’s free via our websites. We want to democratize effective tools and resources that can impact health equity, which could lead to improved workplace outcomes.

Kulleni: Employers are well-positioned to help ensure the health and well-being of their employees (see Employers can spark healthy aging). The moral imperative is also clear. What is the case for employee health and wellbeing as a business imperative?

Wendi: As health inequities are reduced, employers could see firsthand how it can lead to a more engaged and productive workforce. Employees will likely feel more empowered to manage their own health. They are likely to feel that they are being heard and that their health needs are being met. You can get there by measuring progress and by having conversations with employees. Some HR professionals have employee resource groups where they discuss the importance of health equity.

Gerald: A healthy workforce is a productive workforce, and that can mean a more successful business. We would like to see employers focus on offering comprehensive, understandable, and affordable health care coverage, including mental health coverage, to all employees. We also want to help employers design and view their health and wellbeing policies and programs through an equity lens. Employers should also understand the difference between a living wage and a thriving wage. A living wage is just enough to survive, and financial stress can affect health. People should be able to earn enough money to run their households, save for unexpected expenses, and invest in their future.

Kulleni: We live in a world of economic uncertainty, and some employers may be managing significant cost pressures. Does this create potential challenges for efforts focused on advancing health equity? 

Gerald: There are headwinds. There is often a perception that this issue is too big to solve. Where do we start, and what resources are needed? Our collaboration is trying to address those issues. There are short-term gains that employers can achieve, such as making sure that employees understand the benefits that are available to them. They might not understand the nuances of their benefits, or how to take advantage of the resources the employer offers. This is something employers can address right away, and it could have an impact on productivity.

Wendi: Like a lot of major initiatives, businesses tend to operate with a short-term focus. They might need to demonstrate profitability and quarterly earnings. But health equity is a long-term investment. It can seem less urgent compared to other issues that have an immediate return on investment (ROI). We are trying to build a business case that addresses the immediate ROI as well as the importance of staying the course and committing to measuring a longer-term return. Some organizations might not be collecting or analyzing data as effectively as they should be, which can hinder their ability to measure progress. A lack of data-driven insight can weaken the organization’s commitment.

Brittani: Where do you see health equity 10 years from now?

Wendi: I think we are on the right track. If we stay the course and HR professionals continue to focus on educating employees, we will continue to make progress in eliminating health inequities. But it is going to take everyone to make a difference. There is no short-term fix.

Gerald: I'm incredibly excited and optimistic about this. There is a business/financial component and a human component to health equity. There are qualitative and quantitative things we can measure, like turnover and productivity. Most people want to work for organizations that are committed to the health and well-being of their workers. The lack of equity in health didn't occur overnight, and we are not going to solve it overnight. Removing obstacles to care is essential. Success would mean employees feel like they can thrive, they can take care of their families, and they're not losing days of productivity because of poor health. I’m optimistic because our strategies are grounded in science.

Conclusion

It has been 60 years since President Lyndon B. Johnson declared February as American Heart Month.⁸ That same year, he signed the Civil Rights Act. In 1976, President Gerald Ford formally recognized February as Black History Month.⁹ Heart health has long been an unfortunate part of Black history, but employers can play an important role in removing health inequities and helping to ensure that their employees stay healthy and productive.

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Endnotes:

^{1_{American Heart Month, The White House, January 31, 2024}}

^{2_{National Black History Month, The White House, January 31, 2024}}

^{3_{Heart disease and African Americans, U.S. Department of Health and Human Services Office of Minority Health}}

^{4_{History of the American Heart Association, American Heart Association, 2024}}

^{5_{SHRM celebrates 75 years of driving workplace change, SHRM Foundation, January 3, 2023}}

^{6_{U.S. health care spending hits $4.5 trillion, Medical Economics, December 14, 2023}}

^{7_{Stress at work is just as bad as secondhand smoke, September 3, 2015}}

^{8_{American Heart Month, American Red Cross, February 2, 2024}}

^{9 _{Recognition of Black History Month, National Archives, February 1, 2024}}

The executive’s participation in this article is solely for educational purposes based on their knowledge of the subject and the views expressed by them are solely their own. This article should not be deemed or construed to be for the purpose of soliciting business for any of the companies mentioned.

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