Health equity remains a business imperative in the life sciences and health care industries

Integrating health equity strategies across business operations may be essential for meeting executives’ goals of improving margins and promoting community well-being

Jay Bhatt

United States

Drew Wilkins

United States

Heather Nelson

United States

Mani Keita

United States

Christine Chang

United States

Integrating a health-equity perspective into organizational strategies, operations, financial metrics, and quality initiatives could help life sciences and health care organizations meet their business goals while also improving Americans’ health.1 Recent surveys by the Deloitte Center for Health Solutions reveal that 75% of life sciences executives and 64% of health care executives anticipate an increased focus on health equity in 2025.

Most survey respondents recognize the positive impact health equity investments can have on their businesses. Nearly 90% said they expect last year’s investment levels to either increase (40%) or remain about the same (49%) in 2025. These investments can help ensure that more consumers have access to affordable health care services, medical devices, and pharmaceuticals, while positioning organizations for growth.

Health inequities add $320 billion annually to health care spending in the United States, a figure that could surpass $1 trillion by 2040 if left unaddressed, according to research conducted by the Deloitte Center for Health Solutions and Deloitte US actuaries. These inequities also add substantial costs to businesses. For example, Deloitte’s research on the economic burden of mental health inequities indicates that disparities can lead to significant productivity losses due to increased absenteeism, presenteeism, and unemployment. Productivity loss alone was projected to cost $116 billion in 2024, likely disproportionately affecting certain demographics. Eliminating these inequities could add $2.8 trillion to the US gross domestic product and boost corporate profits by $763 billion, according to Deloitte’s economic modeling.

These findings illustrate that helping everyone reach their potential for health and well-being is more than just a moral objective: It is an economic and business imperative. However, 43% of surveyed life sciences executives and 48% of health care executives said integrating health equity into strategic, financial, and operational processes is challenging. One reason for these challenges could be the limited involvement of health equity leaders. Just 34% of the health equity leaders we surveyed said they are highly involved in organization-wide strategy, and only 24% participate in product design. In 2025, however, 72% of health equity leaders expect their role will become increasingly important within their organization.

The new presidential administration and Congress could introduce new complexities for health equity initiatives through legislation and regulations. However, life sciences and health care organizations that are dedicated to improving health outcomes for all, especially historically vulnerable populations and communities, might be well-positioned to achieve their revenue and growth objectives this year and in the years to come.

The Deloitte Center for Health Solutions surveyed 140 US-based C-suite executives from health plans, health systems, biopharmaceutical companies, and medical device manufacturers between August and September 2024, asking them about the challenges and opportunities they anticipate in the year ahead. We also surveyed 50 US-based health equity leaders across the health care, life sciences, and regulatory sectors, and community-based organizations between September and October of 2024.

Understanding the business case for health equity

We define health equity as the ability for everyone to reach their potential in all aspects of health and well-being. The business case for health equity is compelling, but its implications can vary across the life sciences and health care ecosystem. For life sciences companies, health equity initiatives help ensure that products are accessible, affordable, and meet the needs of all who can benefit from them. For health care organizations, health equity involves providing people with the health care services or medications they need, when they need them. While the specific business cases might differ by stakeholder, the overall benefits to health care consumers are aligned (figure 1).

Show more

Equitable access to affordable care and medications could help improve margins and growth

Health inequities can be exacerbated when people can’t afford health coverage, health care services, prescription medications, or medical devices. Ensuring equitable access could give life sciences and health care organizations a competitive advantage. Strong health equity initiatives, for example, could make it easier to attract and retain a workforce that reflects the communities they serve. This could help organizations build loyalty and trust among a broader group of customers, reduce disparities in health outcomes, and improve access to treatments. These factors can lead to significant savings and value creation for these organizations.

Consider health disparities related to gender: Deloitte’s 2024 Health Care Consumer survey found that women are 35% more likely than men to skip or delay medical care due to cost or access issues. This could be a missed opportunity for health systems. Additionally, Deloitte’s health actuarial team estimates that employed women in the United States incur $15 billion more in annual out-of-pocket health care costs than employed men. In response, health plans could consider product designs that help address such gender inequities.

Similarly, life sciences companies might be losing market share if their products don’t reach every population that could benefit. Breakthrough drugs often come with a steep price tag, which could make them less accessible to some populations that need them. For example, people who have sickle cell disease might have access to fewer resources—and often experience worse health outcomes—than people who have other chronic diseases.2 Life sciences organizations should continue to find ways to make drugs accessible, including those for cell and gene therapies. Additionally, biopharmaceutical manufacturers should show the value of their innovative therapies compared with the existing standard of care to illustrate the value of their products.

By addressing inequities, life sciences and health care organizations could have an opportunity to enhance their financial performance while helping to improve the health and well-being of consumers. This approach may not only benefit their bottom line but is also likely to have a positive impact on the people and communities they serve.

Integrating health equity leaders into business decisions may lead to better products and solutions

Including the experience, perspective, and expertise of health equity leaders can help life sciences and health care organizations identify and address unmet needs. However, just 24% of surveyed health equity leaders said they are highly involved in decisions related to services or product design. Even fewer (14%) are highly involved in technology and IT decisions, and just 12% are highly involved in decisions related to artificial intelligence. Moreover, only 36% of health equity leaders reported significant involvement in business growth decisions (figure 2).

Health equity leaders often operate either independently or as part of a small team, which can limit their influence on organizational decisions. In some sectors, the role of the health equity leader is more externally focused, while internal activities might be managed by workforce or human resources leaders. Despite these limitations, integrating a health equity perspective into functional teams and decision-making processes can be important, especially when it comes to the business case for health equity (see sidebar, Understanding the business case for health equity).

The absence of a health equity lens in key decision-making processes can introduce significant challenges. Here’s why: Health care consumers have diverse needs and expectations, and some populations experience disproportionately poor health outcomes due to drivers of health. These drivers include access to healthy food, good-paying jobs, high-quality education, reliable housing,3 meaningful social connections, and safety. Systemic inequities and racism can also impact health outcomes.

Businesses and organizations have a stake in health equity. If employees can’t afford healthy food, face transportation or housing challenges, or are unable to seek medical care or access pharmaceuticals when needed, they likely won’t be able to perform their best work, or work at all. For example, people living in urban areas have an average of life expectancy that is 2.4 years longer than those living in rural communities.4 More than 60 million people in the United States live in rural areas where access to health care services may be limited.5 Moreover, many rural hospitals have reported decreasing margins.6 While virtual health could help improve access for rural populations, some areas lack reliable broadband. Meeting the health care needs of rural populations could enhance the overall health and well-being of the broader United States, according to a Deloitte report on rural health.

Benefits of equity-centered design

Reliable data and evidence that accurately reflect diverse populations could help life sciences and health care organizations develop services and products that meet the needs of all individuals, regardless of race, ethnicity, gender, or sexual orientation. An equity-centered approach could help ensure that leaders have the data and insights they need to enhance their products and services.

Equity-centered design is a process that incorporates the lived experiences of end-users, particularly those disproportionately impacted by health disparities.7 In maternity care, for instance, equity-centered design can provide culturally informed care, amplify patient voices, and equip families and providers with relevant data, according to the Deloitte Center for Health Solutions’ research on maternal digital health and equity. Health equity leaders who are involved in decision-making processes can help executives when making decisions about products or services.

Four domains of action to put health equity at the center

More than 40% of life sciences and health care executives reported difficulties in tracking the progress of initiatives aimed at reducing health disparities. This highlights a gap between executives who are focused on their return on investment (ROI) and health equity leaders who need to make a compelling business case for their initiatives. Additionally, 32% of health equity leaders said they are either not measuring, or are unaware of, the impact that health equity initiatives have on their organization’s financial indicators.

Tracking the progress and outcomes of health equity initiatives could become increasingly important. Surveyed health equity leaders said they intend to focus on several internal and external efforts to improve health equity (figure 3). Internally, 56% of respondents are prioritizing a well-defined research, evaluation, and measurement strategy and the same percentage of respondents are also working to improve the quality of their organization’s health equity data. Externally, 52% are focusing on community initiatives to address the drivers of health while 70% are planning to collaborate with other stakeholders to advance their health equity efforts.

Life sciences and health care organizations should consider developing a strategy that places health equity at the center and expands across four domains of action: the organization, its offerings, its community, and its ecosystem.

1. Organization domain: Measurement and evaluation

Having a well-defined strategy to measure and evaluate health-equity initiatives is a top priority, according to 56% of life sciences and health care executives. Health equity leaders should work with executives to assess their organization’s health equity status, establish goals, and outline the steps needed to achieve them, with an eye toward improved outcomes and financial returns.8

Organizations should also ensure that their measures are specific and realistic. For example, health equity leaders can differentiate between short-term and long-term goals. Combining both quantitative and qualitative data can help organizations identify trends and uncover deeper insight into outcomes. It is also important to highlight both direct (monetary) and indirect benefits (improved trust and brand recognition) and assess a range of data points, including clinical outcomes and social, economic, and environmental factors.

2. Offerings domain: Data and outcomes

Reliable and unbiased data is important for measuring progress and determining if health equity initiatives are helping to make health care services, pharmaceuticals, and devices more accessible to underserved populations. Data can also help illustrate the impact that addressing unmet needs—through more inclusive products and services—can have on margins and market share. For example, virtual health can improve health care accessibility by overcoming challenges such as stigma, mobility issues, and travel constraints. Expanding care options to include virtual health could help attract new customers or strengthen existing relationships. High-quality data is also important for developing effective AI algorithms that reduce, rather than increase, inequities.9

Increasing clinical-trial diversity can help build trust in medical research, promote greater access to new treatments in underserved populations, and help researchers understand how therapies work across various patient groups.10 Clinical trials should include a diverse patient population that is representative of the people most likely to benefit from a treatment. And trial sites should track enrollment data in real time to ensure diversity goals are being met. In addition, collecting data can help understand why some participants drop out of trials and engaging those providers and community members who have not previously participated can enhance diversity, speed recruitment, and lead to better outcomes.

3. Community domain: External initiatives

An external focus on health equity initiatives should include a deep understanding of community members and their health needs. According to our survey, 52% of health equity leaders are developing initiatives to address the social, economic, and environmental drivers of health within their communities. Tapping into existing initiatives might provide insights into a community’s health equity challenges, helping organizations develop initiatives that address the specific needs, attract new consumers, and foster organizational growth. For example, nonprofit health systems could find value in their community health needs assessments (CHNAs) or in the data collected for community health strategies.

To help effect meaningful change,11 health equity leaders should consider focusing on sustained community presence and prioritize the inclusion of community voices.12 This may involve multiple organizations in the community working toward shared goals, ensuring accountability, and having a long-term plan linked to broader system priorities.13

4. Ecosystem domain: Collaboration and sustainability

From a larger ecosystem perspective, 70% of health equity leaders said collaborating with partners within the health care system continues to be their highest priority. While 44% of respondents expressed interest in collaborating with the public sector, only a few of them said they are thinking about working with tech or retail sectors even though they could bring new approaches to the work.

Health equity and organizational leaders should consider several questions to inform and demonstrate the impact of their community and ecosystem work:

  • How is equity integrated into our process for understanding the socioeconomic and environmental needs and challenges affecting the health of our community?
  • To what extent do we invest in the social, economic, and environmental drivers of health within our communities?
  • How can we shift the broader narrative to emphasize the importance and benefits of health equity?
  • How do we advance public policies and advocacy efforts to improve health equity?
  • How do we hold our collaborators and supply chain partners accountable for promoting health equity?
  • How do we create long-term sustainability and transition strategies to ensure the ongoing impact of our community investments?

Regulatory considerations that may impact health equity strategies

The new presidential administration has not articulated its policy positions on several health care issues. However, several provisions could potentially be in play when Congress considers tax legislation this year. Republican leaders have said they intend to use budget reconciliation to extend expiring tax provisions in the Tax Cuts and Jobs Act (TCJA). Reconciliation is a tool that allows the Senate to consider bills under expedited procedures if certain rules are met.

In addition to extending TCJA provisions that are set to expire at the end of 2025, Congress could consider additional tax cuts. During his 2024 campaign, President Trump proposed excluding certain income from taxation and lowering the corporate tax rate for domestic manufacturers. Trump has not said whether he intends to extend the enhanced premium assistance tax credits, which are used to purchase health coverage through the marketplaces established under the Affordable Care Act. The enhanced credits are set to expire at the end of 2025. Failure to extend these enhancements could cause more people to enroll in Medicaid and increase the uninsured population. It is uncertain how states plan to address a likely increase in Medicaid enrollment once people lose access to premium subsidies.

In addition to these issues, Congress has been working on bipartisan legislation that could impact pharmacy benefit manager (PBM) regulation, site-neutral payment policies, and drug-pricing limits under the Inflation Reduction Act. Public health, community benefits, and price transparency will likely be debated, potentially accelerating the use of AI in health care decision-making and expanding access to data on various health care costs and outcomes.

New regulations and policies will depend on final appointments to key agencies including the Department of Health and Human Services (HHS), the Centers for Medicare & Medicaid Services (CMS), and the Food and Drug Administration (FDA). Given the crucial role state and local efforts play in driving and implementing health policies, health equity leaders should follow not only federal, but also local and state initiatives.

It is possible that executive, regulatory, and legislative action could have positive, negative, and unintended consequences for populations disproportionately and historically impacted.

The implications for health care organizations from the Trump administration could likely continue to evolve throughout 2025. To navigate this dynamic environment, health care organizations should:

  • Monitor presidential appointees and confirmations: Keep an eye on presidential picks to lead HHS and CMS, as they could signal how those agencies are likely to approach health policy.
  • Evaluate legislative control: Assess how control within the House of Representatives and the Senate could influence health policy.
  • Strengthen regulatory strategies: The Supreme Court’s decision to overturn the Chevron doctrine is already putting the FDA’s regulations under scrutiny.14 Organizations should continue to watch this space and think through regulatory and compliance strategies at the federal, state, and local level that may be impacted by this. 

Integrating health equity for organizational growth and community well-being

Addressing health inequities is a moral and economic imperative and can be addressed using business solutions to advance growth and meet mission and purpose goals for life sciences and health care organizations. By prioritizing equitable access for everyone to high-quality, affordable health services, therapeutics, diagnostics, and medical devices, organizations might be able to enhance their financial performance while helping to make care more accessible and equitable. This approach can help boost employee productivity and expand market reach.

The integration of health equity leaders into critical decision-making processes is important to help ensure that products and services meet the diverse needs of all populations and drive business objectives. Furthermore, an equity-centered design approach that incorporates the lived experiences of end-users can drive positive change and help organizations achieve their goals. This is likely to be particularly true as organizations move to new technologies, including generative AI, to help ensure that any existing biases aren’t being exacerbated.

To help effectively track the progress and outcomes of health equity initiatives, organizations should develop robust measurement and evaluation strategies that combine quantitative and qualitative data. This can help them identify trends, assess the direct and indirect benefits, and prioritize future investments. By improving the quality of health equity data and focusing on patient and community needs, organizations can enhance outcomes, attract new customers, and foster organizational growth. Integrating health equity into organizational strategies can generate economic benefits, both for individual organizations and for the broader economy.

By

Jay Bhatt

United States

Drew Wilkins

United States

Heather Nelson

United States

Mani Keita

United States

Christine Chang

United States

Endnotes

  1. Department of Health and Human Services, “Community health and economic prosperity: An initiative of the Office of the Surgeon General,” January 2021.

    View in Article
  2. CDC Foundation, “Sickle cell disease health disparities”.

    View in Article
  3. American Hospital Association, “Housing and health: A roadmap for the future,” March, 2021. 

    View in Article
  4. Isabel P. De Ramos, Amy H. Auchincloss, Usama Bilal, “Exploring inequalities in life expectancy and lifespan variation by race/ethnicity and urbanicity in the United States: 1990 to 2019,” SSM - Population Health 19 (2022). 

    View in Article
  5. US Government Accountability Office, “Why health care is harder to access in rural America,” May 16, 2023.

    View in Article
  6. Zachary Levinson, Jamie Godwin, Tricia Neuman, “Hospital margins rebounded in 2023, but rural hospitals and those with high Medicaid shares were struggling more than others,” KFF, Dec. 18, 2024. 

    View in Article
  7. Julius Tapper, “All for one, not one for all: The power of equity-centered design,” Deloitte Digital, Aug. 9, 2022; Heather Nelson and Julius Tapper, “Can equity-centered design narrow the digital health divide?” Health Forward blog, Deloitte, April 5, 2022.

    View in Article
  8. American Heart Association, “Health equity in the workforce,” accessed Oct. 11, 2024. 

    View in Article
  9. Alicia Janisch, Wendy Gerhardt, Maulesh Shukla, “2025 US health care outlook,” Deloitte Insights, Dec. 12, 2024; Jay Bhatt et al., “Rethinking when and how to use race appropriately in care delivery,” Deloitte Insights, May 19, 2022.

    View in Article
  10. Dawn Anderson et al., “Broadening research participation through community engagement,” Deloitte Insights, Nov. 13, 2023; Aaron L. Schwartz et al., “Why diverse clinical trial participation matters,” The New England Journal of Medicine 388, no. 14 (2023): pp. 1252-1254. 

    View in Article
  11. Hannah Blackman-Mack et al., “Closing health gaps through collaborative action,” World Economic Forum, September 2024.

    View in Article
  12. Jay Bhatt et al., “Advancing health equity through community-based ecosystems,” Deloitte Insights, May 5, 2022. 

    View in Article
  13. Blackman-Mack et al., “Closing health gaps through collaborative action.” 

    View in Article
  14. Rich Gold et al., “What's next for the regulatory landscape post-Chevron?” Holland & Knight, alert, July 2, 2024.

    View in Article

Acknowledgments

The authors would like to thank the many contributions to the paper.

Project team: Wendy Gerhardt for her support in operations and helping review the paper; Nivedha Subburaman and Gargi Khandelwal supported the research design, analysis of the key findings, and writing key sections of the paper; Pavan Bhoslay for helping in data management; and Nefertiti Wade for helping with project operations.

The authors would also like to thank Dr. Kulleni Gebreyes, Andrew Davis, Alicia Janisch, Neil Lesser, Jennifer Radin, Joshua Lee, David Rabinowitz, Sarah Shier, Nicole Kelm, Anne Phelps, and Shahira Knight for their subject matter expertise and review.

The authors would also like to thank Rebecca Knutsen for her significant contributions to the messaging, structuring, and editing of the paper. Additional thanks go to Prodyut Ranjan Borah, Julie Landmesser, Melissa Williams, Christina Giambrone, Daniela Bain, and many others who contributed to the project.

Cover image by: Sofia Sergi; Adobe Stock; Getty Images