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Employers can address the racial disparities exposed by COVID-19

By Jeff Levin-Scherz, MD and Rachael K. McCann | April 24, 2020

Employers can lead the way in helping reduce racial disparities by creating a culture of inclusion and diversity.
Compensation Strategy & Design|Health and Benefits|Inclusion and Diversity
COVID 19 Coronavirus

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About our COVID-19 coverage

In our ongoing coverage of the COVID-19 outbreak, experts from across Willis Towers Watson share insight into what you need to know to manage your business and employees and reduce your risk.

African Americans and Hispanics are suffering a disproportionate number of infections and deaths from COVID-19 because societal disparities make these groups more likely to have high-risk conditions and less likely to have ready access to high-quality health care. This pandemic shines a bright light on the impact of social determinants of health, which lead to reduced productivity, increased medical costs and premature deaths. It also illustrates the importance of robust inclusion and diversity (I&D) strategies to support the diverse needs of employees.

Public health agencies across the country are reporting disproportionate death rates for African Americans. We’ve seen this before. The difference in death rate for blacks compared to whites doubled during the 1918 influenza pandemic.

Morbidity and mortality rates across various diseases, including COVID-19, are not “race blind.” People of color will represent over half of the U.S. population by 2050, and yet make up a disproportionate share of the low-income population.

People of color have more chronic disease; 40% of those with HIV are African American compared to 11% of the population, and the rate of diabetes among Hispanics is almost twice that of whites. But people of color are less likely to have consistent sources of care or a primary care physician, and they receive less preventive care and are less adherent to prescribed medications. Employers must increase their focus on engagement strategies to address the diverse health needs of their employees.

African Americans suffer disproportionate death rates from COVID-19
African Americans: Percentage of population and percentage of death due to COVID-19

The Washington Post, April 7, 2020

Pandemics can also bring out xenophobia, bias and stigma. Hate crimes against Asians have increased with the current pandemic, much as African Americans were inaccurately blamed for spread of the 1918 influenza pandemic. Our COVID-19 Readiness Assessment showed that 47% of companies are currently taking actions to reduce stigma, and 21% are planning to take such actions, but almost a third of respondents have no such plans. Unconscious bias and anti-discrimination training are key elements of I&D strategies, and their importance is greater in the context of this pandemic.

We believe this is an ideal time for employers to take action to address health care disparities in their population. Here are nine specific actions employers can take to improve health and business outcomes by addressing social determinants of health during and after this pandemic.

  1. 01

    Improve access to health care.

    Our survey found that 86% of employers are now promoting access to virtual health care, and 58% are increasing access to telebehavioral health. Employers can increase access to onsite and/or near-site health care when employees are back in the workplace, and can help employees gain access to and navigate health care options.

  2. 02

    Use choice architecture to encourage healthier behavior.

    Employers have led the way to improved health by supporting tobacco cessation and taking steps to provide employees with healthy food and places to exercise. This is all the more important for people of color, who are more likely to lack access to urban parks and fully stocked grocery stores.

  3. 03

    Evaluate affordability of care in available insurance plans.

    Health care costs, both premiums and out-of-pocket payments, are a major cause of financial insecurity. Employers can consider salary bands for contributions or benefit design and high-value networks to lower out-of-pocket costs. Our data show that value-based insurance design dramatically diminished racial disparities in medication adherence after heart attack, and decreased subsequent heart attack and death.

  4. 04

    Demand reporting from health care carriers

    about disparities in care. Even when carriers do not have racial identification of members, they can provide data based on small geographic areas highly correlated with race and poverty. We will know if we are decreasing disparities of care only if we are measuring them.

  5. 05

    Offer and expand sick leave to all employees

    to encourage those who are sick to stay home. Whites have higher levels of paid maternity, parental and sick leave than nonwhites. Making sick leave universal will help diminish racial disparities.

  6. 06

    Use inclusive and nonbiased language in all communications.

    Communicating in a linguistically sensitive manner reinforces the I&D strategy and helps to reduce bias and avoid stigma.

  7. 07

    Evolve unconscious training.

    Most supervisors and managers don’t discriminate intentionally or even consciously. Employers should redouble their training and hands-on follow-up efforts to address unconscious bias training. Inclusive leaders and a culture of belonging can best support health needs of a diverse group of employees.

  8. 08

    Eliminate unconscious bias in recruitment and promotion.

    Discrimination in hiring and promotion continues to limit careers of many African Americans. Some companies have implemented a version of the National Football League’s “Rooney Rule,” which requires that leadership searches are only concluded after a qualified diversity candidate is considered.

  9. 09

    Pay employees a living wage.

    Poverty leads to diminished health, and the emotional toll of employees facing financial insecurity can lead to poor productivity. The pandemic is making income inequality clearer – and employers can arrange to pay their employees and contractors enough to afford necessities during this unprecedented time.

COVID-19 has further exposed the discrimination and disparities of our health care system. Employers that understand the value of a diverse workforce, and the social and economic benefits of reducing disparities, can lead the way in creating a culture of inclusion and addressing these concerns.


Population Health Leader, Health and Benefits, North America

Jeff is a practicing physician and has led WTW’s clinical response to COVID-19. He has served in leadership roles in provider organizations and a health plan, and is an Assistant Professor at Harvard Chan School of Public Health.


Senior Director, Integrated & Global Solutions,
Global DEI Solutions Leader

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