Taking Action on Health Equity: A Business Group on Health Viewpoint

A strategic overview of health equity and how socioeconomic status, geography and other social determinants of health impact access to care.

January 30, 2025

Introduction

Employers are increasingly addressing inequities in health and health care as a vital component of human capital strategies, with the goal of improving employee well-being. According to Business Group on Health’s 2025 Employer Health Care Strategy Survey, 90% of employers expect to have implemented health equity strategies by 2025.1

Health equity is the principle that everyone, regardless of their circumstances, should have the opportunity to achieve their highest level of health. It recognizes that disparities—based on race, socioeconomic status, geography and other social determinants of health—impact access to care.2 For employers, this is relevant because marginalized groups within the workforce often face significant barriers to accessing health care, resulting in poorer health outcomes and higher costs.3 Addressing these inequities is essential for creating a healthier, more engaged workforce that drives productivity.

Amid increasing health care costs and heightened demand from employees for support tailored to meet their individual needs, employers’ commitment to health equity has never been more essential. That’s because in times of rising health care trend, many marginalized groups are more likely to be exposed to affordability challenges that exacerbate inequities. Maintaining a commitment to health equity in the face of mounting cost pressures requires both a short- and long-term approach that balances addressing inequities with immediate budgetary concerns. While reducing health equity-related efforts may seem necessary to manage near-term cost constraints, the consequences of such decisions have long-term negative impacts. These include deepening disparities, increasing overall costs due to worsened health outcomes and diminishing employee engagement and productivity, all critical to workforce strategy. Employers must keep this in mind when setting and evaluating their strategies to reduce health care costs.

The discussion about the importance of promoting health equity comes at a time when companies are evaluating their organizational approach to formal diversity, equity, inclusion & belonging (DEIB) programs. There can be a tendency to sweep “health equity” into the broader DEIB paradigm; however, regardless of an organization’s stated DEIB positions, it serves the organization and its workforce well to address inequities in health. Those inequities contribute to rising health care costs and worsening population health.

The Value of Investing in Health Equity

Addressing health equity effectively will require employers to first understand the needs of their workforce. To assess these needs, employers should analyze information beyond surface-level data to identify specific health disparities and address underlying factors, such as socioeconomic conditions or geographical limitations, that may affect employee health. For instance, economic stability directly affects employees' ability to access health care, nutritious food and stable housing, which are essential for maintaining health.4 By focusing on these social determinants and considering how they impact employees’ health and engagement, organizations can design initiatives that more precisely address disparities and deliver measurable improvements to workforce well-being. To advance these efforts, organizations should focus on initiatives structured around the four pillars of health equity:

  • Health care access: Increasing access to high-quality affordable physical and mental health care through a range of strategies, including conducting a benefits equity assessment;
  • Equitable engagement: Ensuring that employees feel seen and represented in their benefits promotes engagement and can have a positive impact on inclusion;
  • Inclusive experience: Inclusion in work, benefits and health care experience is critical to helping all employees reach their highest health and well-being potential; and
  • Social determinants of health: The circumstances in which people are born and live affect their health; by addressing negative circumstances, employers and the communities in which they operate have an opportunity to improve the health and well-being of those individuals.

By aligning their strategies with these pillars, employers can design comprehensive programs that address disparities and drive measurable improvements in workforce health and well-being.

Successful implementation of these initiatives will require ongoing collaboration with partners, including health plans, providers and community organizations. Employers must establish clear, measurable goals and integrate equity-focused performance standards into their partnerships and vendor selections. Monitoring and evaluating these efforts through the collection and analysis of relevant data will be crucial to determine the effectiveness of health equity strategies. By regularly assessing outcomes, such as disparities in health care engagement and treatment adherence, employers can identify areas for improvement and adjust their strategies as needed to enhance the impact of their initiatives and ensure that all employees are moving closer to achieving their full health potential.

Key Strategic Considerations

In the face of economic pressures, as highlighted by an expected increase of 8% for health care costs in 2025, cost-containment measures have become paramount. However, it is critical to understand how these measures can disproportionately affect marginalized groups. Historically, these populations face greater financial burdens and barriers to accessing quality health care. Reductions in funding for crucial services can exacerbate existing disparities, particularly for those already vulnerable. Services that address specific disparities—such as mental health care, maternal health and chronic disease management—should not be considered for elimination or reduction during budgetary reviews. By proactively supporting initiatives that address inequities in health care, employers have a unique opportunity to lead in addressing these challenges.

These tactics include:

  • 1 | Conduct audits: Assess benefit design, focusing on employee health outcomes through medical claims or similar data to identify and address gaps in coverage and care.
  • 2 | Prioritize preventive care and well-being initiatives: Focus on promoting programs that prevent illness and promote health, particularly for vulnerable populations.
  • 3 | Foster innovation in benefit design: Aim for flexible benefits that cater to the diverse needs of your workforce. Programs that promote culturally competent care and targeted health interventions are useful to address health disparities effectively.
  • 4 | Promote global consistency: Ensure that initiatives designed to eliminate inequities are consistent and integrated across all major geographic locations.
  • 5 | Hold your partners accountable: Consider integrating health equity-related questions as well as outcomes-based contractual requirements into vendor selection, negotiation and renewal processes. Encourage health vendor partners to equip health care providers with the skills, such as cultural competency training, needed to address the diverse needs of the workforce.
  • 6 | Evaluate the long-term impacts of program reductions and eliminations: Work with consulting partners to assess how scaling back efforts focused on health benefits affect health equity and overall costs.
  • 7 | Leverage technology: Use virtual capabilities to address inequities by creating programs that remove rather than create new barriers.
  • 8 | Engage with diverse employee groups: Foster open dialogue with employees through employee resource groups (ERGs) representing different populations to understand and address their specific health needs.
  • 9 | Monitor health equity progress: Regularly track the organization's efforts and achievements in promoting health equity.

Conclusion

In this time of escalating health care concerns, organizations need to recognize health equity initiatives as an investment rather than an expense. Employers can play a pivotal role in leading the charge for improving access to care for marginalized communities. Taking a broad lens to develop targeted interventions that prioritize affordability, culturally competent care and high-quality services, employers can realize the value of addressing inequities and becoming an employer of choice. Implementing a holistic approach—and when possible, a global approach—is an effective way for employers to promote equity and consistency throughout their organizations.

Related Resources

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TABLE OF CONTENTS

  1. Introduction
  2. The Value of Investing in Health Equity
  3. Key Strategic Considerations
  4. Conclusion