Five sectors that can help advance health equity 

Identifying the sectors and their roles that could accelerate the health equity goal. 

In brief

• Cooperation among the five sectors is critical to closing the health care gap.
• Learn about the five sectors and how they contribute to health equity.

After more than two years of the pandemic, our collective need to accelerate health equity¹ has never been clearer. From rural communities to major cities and beyond, vulnerable populations across the US have faced devastating impacts from COVID-19 (including disproportionately high hospitalizations and deaths). These groups have long endured barriers involving their education, gender identity, race, sexual orientation, ethnicity, ZIP Code and many other socioeconomic factors. Collectively, these social determinants of health impact health outcomes and access to quality health care, costing the US economy billions per year.² While these issues are not new, the pandemic has brought them into sharper focus. This has prompted renewed calls for action by not only government and the public sector but also the health care ecosystem and the business community.

We’ll examine several health equity challenges with a lens on five key stakeholder groups, highlighting where each can improve health disparities

Government and the public health sector

In early 2021, the White House established the COVID-19 Health Equity Task Force, elevating health equity to the presidential agenda. The majority of health care programs targeting underserved and high-risk populations are delivered by county and state governments via public health departments. In addition, funding for Medicaid and Medicare is delivered by state and federal governments (comprising in total more than 30% of total national health care spending in 2020³). As such, the public health sector is at the forefront of efforts to overcome health inequities. New public health business models must be better positioned to proactively prepare for and manage public health priorities. They should be primed to monitor and evaluate the health, wellbeing and risk vulnerability of patient populations through partnerships that drive accountable management of the social determinants of health.

Health care in private sector

The private sector funds a major portion of health care, accounting for nearly 20% of total health care spending in the US in 2020.⁴ The sector also develops technologies that are innovating care delivery and connected health care, while also leading in creating personalized engagement experiences for people. Employers in the private sector can have significant impact on the health and wellness of their employees, serving as change agents for health equity in the communities in which they work. To date, the private sector’s role in this space has been underleveraged. This is partly because the business case for advancing health equity is not well understood and health equity only recently emerged as a priority for the private sector. As a result, corporate leaders have a significant opportunity to leverage their influence across all industry players by embracing health-equity delivery as part of their larger environmental, social and governance (ESG) mission.

Provider industry

Providers deliver care within a fragmented ecosystem of hospitals, physicians, nurses, advanced care providers, and community-based organizations. In addressing the challenges around meeting the needs of diverse patient populations, most providers lack the tools and training needed to overcome foundational issues driving poor outcomes in underserved groups. In addition, there are minimal incentives for today’s providers to prioritize health equity. Community-based organizations often provide complementary trusted resources and services to people where they live and work. They are critical to solving health-equity challenges and helping to bridge care gaps. Rather than functioning in silos, provider organizations and community-based organizations must work in tandem to achieve measurable progress in tackling health inequities.

Payer industry

Collaborations between payer and provider organizations to accelerate equitable care are essential to uncover and close disparity gaps and drive efficiencies in care. Funding interventions and care pathways that provide specific support to patients at high risk of inequitable outcomes can provide meaningful incentives for stakeholders across the care continuum. However, aligning coverage and payment with health equity outcomes has not been prioritized by many payers, and variation exists across payers. Moving forward, incentives within value-based care models need to evolve to enable health-equity delivery.

Biopharma industry

The biopharmaceutical (biopharma) industry creates an enormous amount of patient education materials, digital engagement tools and content on specific therapeutic areas to support the sales of its products. Each of these initiatives should be developed with a health-equity lens, with more resources aligned to overcoming care gaps and targeting those most in need. In addition, clinical research, drug development and the commercialization of pharmaceuticals and biologics should include proportional representation of all demographics in society. Many therapeutic innovations in development target areas where health inequities persist. Through meaningful representation of all demographics in these and other clinical trials, biopharma organizations have a significant  opportunity to change outcome trajectories. Likewise, demographic representation must be embedded throughout the product development lifecycle to advance overall health equity.