Healthcare access is not created equal, and with lives on the line, it’s clear workers need more from their
While COVID-19 dropped the average American life expectancy by a year to 77.8 years in 2020, Black Americans’ life expectancy fell by nearly three years to 72, according to the CDC. And as women, people of color and the LGBTQ community continue to face discrimination in their healthcare experience, companies need to step up before employees step out.
“The real challenge has been access to more culturally centered solutions, whether it be through an employer or more broadly in the marketplace,” says Dan Miller, founder and CEO of Spora Health, a virtual-first primary care provider. “That’s why we’re taking into account the social linguistics and cultural norms of different populations.”
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Spora Health offers medical and behavioral health services with an eye to cultural competence and equity. The telehealth company requires all of its providers to train at the Spora Institute, where they practice handling disparities within healthcare, such as the higher maternal mortality rate faced by Black women, or the improper mental health diagnosis faced by Black men, explains Miller.
“Providers in the United States are frankly set up to fail in this aspect,” he says. “Doctors typically only have one class around health equity, and classes aren’t really focused on giving them the tools to apply to an actual clinical encounter.”
However, many employers may not be aware of this when finalizing their healthcare offerings, instead thinking that they can take a one-size-fits-all approach. Miller advises employers to take a step back and reassess who is benefiting from their benefits. If the diverse talent within their workforce are under-utilizing their benefits, it may be time for a change.
Miller suggests employers look to primary care access first, noting that primary care providers are usually the first touch point with the healthcare ecosystem and are less costly than seeking help from a specialist or urgent care.
“Primary care providers are the folks routing patients across the entire system,” he says. “Once you facilitate engagement, it allows us to take preventative measures and manage your care, which builds relationships and trust across the entire healthcare system.”
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Primary care platforms like Spora can offer services across an array of needs, from depression and anxiety screening, mammograms and colon cancer screening, to help with hypertension, diabetes, upper respiratory infections and STI concerns. Spora is also placing heightened importance on the issue of Black maternal health, as Black women are over three times more likely to die from pregnancy-related causes than white women, according to the CDC. Those numbers — and overall health outcomes for people of color and other underrepresented groups — won’t change without seeing programs with culturally trained providers, explains Miller.
“The status quo today is perpetuating at best worst health outcomes and lower quality of life,” he says. “If there isn't any attempt to provide more culturally centered benefits, then we're going to continue to see these sorts of outcomes, which will raise rates of absenteeism and presenteeism and raise costs for employers.”
While it’s not easy to find primary care providers that care for culturally diverse patients while offering plans from large carriers, the payoff is worth the effort, Miller says. Partnering with newer healthcare companies that focus on culturally centered solutions can lower costs, as greater use of primary care can reduce hospitalizations and emergency department visits, according to research published in the Journal of the American Medical Association.
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Miller also encourages employers to ensure there are telehealth options within their health benefits. While virtual care does not solve healthcare inequities on its own, it does lower financial and physical barriers to access. And ideally, virtual care options would go beyond primary care, with offerings in the mental health space as well.
For Miller, culturally centered healthcare solutions save money and lives, but it’s up to employers to decide if it’s worth the investment in better access and better-educated providers. Regardless, that choice will be reflected in the employer’s values and benefits.
“Benefits should help employees live more productive and healthier lives,” says Miller. “Thankfully, we’re in a place where folks are starting to get more targeted care."
