Workers of color and LGBTQ employees face healthcare inequity regardless of income

It’s undeniable that biases and ignorance rooted in racism, sexism, homophobia and transphobia — just to name a few — systematically exist within the U.S., impacting everything from community safety to healthcare access. That’s left millions of workers struggling to have their basic needs met, often regardless of job title or income level.

Management consulting firm McKinsey and Company’s report on healthcare inequity in the workplace found that 69% of employees of color and 66% of LGBTQ employees who earn up to $100,000 a year experienced two or more unmet basic needs, such as personal safety, social support and food security. Meanwhile, only 49% of white employees felt similarly. Workers with one or more unmet basic needs were around 2.4 times more likely to have not received needed physical healthcare while focusing on immediate concerns like housing and safety.

“A lot of HR leaders we spoke with thought that if their employees are relatively high paid, they wouldn’t have to worry as much about unmet needs among their workforce,” says Jeris Stueland, an associate partner at McKinsey and co-author of the report. “But income alone does not solve problems when it comes to differences in social needs as well just differences in healthcare experiences.”

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And when these workers are seeking effective healthcare, they often encounter a fresh set of hurdles. The McKinsey report notes that employees of color were 1.5 times more likely to find benefits resources and education tools unhelpful when compared to their white counterparts, even at higher income levels. Since these resources often assume a general understanding of the U.S. healthcare system, those with parents who did not have employer-provided health plans, along with immigrants and first-generation workers, may have trouble understanding their benefits, let alone accessing them, Stueland explains.

“These tools assume that the employees know what a deductible and copay are, and never explain those terms,” she says. “Employers need to provide tools that explain benefits to those who have never been exposed to this system.”

However, benefits education is just the tip of the iceberg — Megan Greenfield, the report’s co-author and a McKinsey partner with a focus on DEI and healthcare equity, says many of these tools do little to guide LGBTQ employees and employees of color towards positive healthcare experiences.

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“It’s difficult to find a medical professional that looks like you and has your experiences,” says Greenfield. “For example, a pediatrician may ask a two-mother household about the father, or employees may face challenges with the use of pronouns on medical forms.”

Stueland recalls that an employee in their focus group was told they had a low pain tolerance because of their race, while another’s disability was discounted due to their race and gender.

Employees of color and LGBTQ employees were 3% to 10% more likely to report experiencing stigma around accessing healthcare than white employees, according to McKinsey. This is exacerbated by the fact that many of these employees may need to take more time off from work just to find a medical professional that will care for them properly.

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“It's more challenging to find a provider that they feel confident is going to validate their experiences,” Stueland says. “And oftentimes it may take more work for that employee to get the same amount of healthcare just because of the lack of resources and expertise.”

Greenfield believes the stigma itself is less rooted in the physical act of receiving care and more so in the heightened focus — and hence, heightened pressure — placed on an individual who is not white and male. McKinsey’s 2021 “Women in the Workplace” report found women, and especially women of color, are often the sole diversity within their professional environments, standing out in a majority white and male team. In fact, one in five women are often the only woman or one of the only women in the room at work, according to LeanIn.org and McKinsey.

“If you have 10 people in the room and nine of them are white men while the other is a Black woman, that woman does not get to be an individual like Joe, Jim or John,” says Greenfield. “There’s increased focus on that person because she is Black and she is a woman. So when she takes time off, she has to worry about being stereotyped as lazy or difficult.”

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While many employers need to up their efforts to ensure their workforce is genuinely diverse, Stueland also encourages employers to destigmatize the use of benefits and PTO for everyone within the company as an effective first step to healthcare equity. This means leaders need to model putting their health before work, explains Stueland.

“Leaders and managers need to make time off an accepted norm, and even an expectation of the work culture,” she says. “As a leader, tell employees you’re taking time off because you have a doctor’s appointment.”

Greenfield also recommends that leaders take the time to understand the challenges their particular workforce faces — stigmas vary across locations, races, genders, sexual identities and more. But once leaders know their workers, they can tailor benefits that meet their needs. In today’s tight labor market, that will be crucial to employee retention. McKinsey found that over 30% of Black, Hispanic/Latino, LGBTQ and younger employees have considered leaving their job because of their healthcare benefits.

“It's especially important for employers right now to ensure they're not losing out on opportunities to have great employees as a result of health inequity,” says Greenfield. “We need to be aware of the systematic racism and racial violence that exists and step up. It’s not hard — just be aware and be thoughtful.”