Our nation’s lack of health equity has serious implications for our well-being.

An individual’s life expectancy can vary by as many as 25 years1 between neighborhoods in some U.S. cities, with similar outcome gaps in infant mortality, obesity, violence and chronic disease also occurring in these areas.

Rural communities have higher rates of preventable conditions — which include diabetes, some cancers and obesity — compared to urban residents.2 And, racial and ethnic minorities have greater proportions of chronic disease and premature death compared to whites.3

Unfortunately, these are just a handful of many existing examples of U.S. health disparities that affect a broad range of people.

Health also impacts the economic well-being of our communities. Lost productivity from illness-related employee absenteeism, for example, costs employers a total of $530 billion per year, according to the Integrated Benefits Institute. And, as we mentioned in a previous blog, direct medical care expenses from health disparities have cost $230 billion from 2003-2006 (in 2008 inflation-adjusted dollars).4

Health is foundational to a healthy and economically vibrant society.  

To increase opportunities for everyone to be healthier — including those for whom obstacles are the greatest — we must work toward achieving health equity or ensuring that all individuals receive the tools and resources they need to achieve health and well-being.

Since only 20% of our health is determined by clinical care, that means that we must go beyond medical efforts to prioritize health equity: We must combat poverty, discrimination, and lack of access to quality education, housing and health care, among other social inequities – the factors that ultimately have the biggest say in our health and disproportionately affect certain groups.

Hospitals and health systems are already responding by applying a variety of value-based strategies that prioritize health equity — strategies that focus on reducing cost, improving outcomes and enhancing the patient experience.

In Cleveland, where African American families experience infant mortality at three times the rate of Caucasian babies, the city’s three largest health systems worked together to reduce the area’s infant mortality rate from 10.5 infant deaths per 1,000 births to 8.3 deaths in three years. Collaborating with community leaders and engaging in grassroots efforts — including listening to frontline caregivers and sharing best practices — was crucial to the turnaround.

Baylor Scott & White Health in Dallas created a safe environment for patients who couldn't afford health care, were food insecure and otherwise lacked basic commodities. Through the volunteer-run Community Advocates program, clinicians screened more than 1,621 patients, 80% of whom had social needs. As a result, the 30-day readmission rates of enrolled patients dropped by 87.5%.

And Charlotte, N.C.-based Atrium Health used race, ethnicity, language preference, sexual orientation and gender identity data to identify gaps in outcomes across populations and better target their interventions. After learning that male Hispanic/Latino patients were not being screened at the same rate as other groups, Atrium scheduled more than 200 more screenings with this population, some of which revealed major cancers.

When hospitals address the social factors that drive health outcomes, they repeatedly show that patients, hospitals and the health care delivery system all experience tremendous value.

This is health equity at work.

To hear more examples like these and to learn more about how you can promote better health, especially where disparities exist, and enhance value in your organization, visit http://www.diversityconnection.org and https://www.aha.org/value-initiative.

And please stay tuned for our final blog in this series on health equity and value. Listen to our podcast about how health equity affects the length and quality of our lives, and read our blog about making a business case for health equity.

Priya Bathija is vice president of AHA’s The Value Initiative and Duane Reynolds is president and CEO of the AHA’s Institute for Diversity and Health Equity. 


1. Evans BF, Zimmerman E, Woolf SH, Haley AD. Social determinants of health and crime in post-Katrina Orleans Parish: Technical report. Richmond, VA: Center on Humans Needs, Virginia Commonwealth University; 2012. [October 21, 2016]. http://www​.societyhealth​.vcu.edu/media/society-health​/pdf/PMReport​_Orleans_Parish.pdf

2. Crosby RA, Wendel ML, Vanderpool RC, Casey BR. Rural populations and health: Determinants, disparities, and solutions. San Francisco, CA: Jossey-Bass; 2012.

3. Lara M, Health R, Rand C. Acculturation and Latino health in the United States: A review of the literature and its sociopolitical context. Santa Monica, CA: RAND Corporation; 2005. [PMC free article] [PubMed

4. NCBI: Estimating the economic burden of racial health inequalities in the United States: https://www.ncbi.nlm.nih.gov/pubmed/21563622

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