Health and Healthcare Systems

Businesses can play a key role in advancing health equity worldwide

Health equity must be achieved by pursuing equal access to healthcare services, as well as by tackling social, environmental and financial factors that directly impact health.

Health equity must be achieved by pursuing equal access to healthcare services, as well as by tackling social, environmental and financial factors that directly impact health. Image: REUTERS/Eric Gaillard

Ty Greene
Project Lead, Health Equity, World Economic Forum
Shyam Bishen
Head, Centre for Health and Healthcare; Member of the Executive Committee, World Economic Forum
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  • Access to the highest attainable standard of healthcare is a right enshrined by the UN — but today, health inequity prevents many from accessing the care they need.
  • Health inequity is linked to financial losses of trillions of dollars every year, the world over.
  • To reach health equity by 2050, public, private and philanthropic institutions must coordinate and act now.

The right to the highest attainable standard of health is enshrined in the UN’s 1966 International Covenant on Economic, Social and Cultural Rights and the WHO Constitution. And yet, not everyone enjoys equal access to the goods, services, systems and environments that contribute to good health.

The COVID-19 pandemic underscored the challenge health inequity poses to global health. Disparities around race, class, gender and age caused immense inequality. Despite growing recognition and attention, health inequities — the systemic differences in health outcomes between different populations — persist.

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The costs of health inequity

Low- and middle-income countries (LMICs) bear the brunt of systemic health inequities. There is a 31-year gap in life expectancy between the Central African Republic and Japan, while LMICs account for 99% of annual maternal deaths globally. Within countries, marginalized and vulnerable populations — including black, Indigenous, and people of colour (BIPOC); refugees; and those living in extreme poverty — endure unequal opportunities for good health.

In the U.S., age-adjusted mortality rates from COVID-19 for Indigenous, Latino, Pacific Islander and Black Americans were significantly higher than for White or Asian Americans. In India, the chance of a child dying before the age of five is three times higher for the population in the bottom 20% by income than the top 20%.

The moral imperative for addressing health inequities is clear — but the economic imperative is equally robust.

Lost productivity, increased medical care and welfare costs due to health inequities take a serious toll on countries’ economies. The European Parliament estimates losses linked to health inequities cost close to €980 billion per year within the EU, while in the U.S., inequities cost approximately $320 billion annually — that figure could surpass $1 trillion by 2040 if not addressed. Africa loses $2.4 trillion annually to poor health and premature mortality.

As the primary funders of health and social services, federal, regional and municipal governments have a major role to play in advancing health equity. Mexico and Brazil have made strides in addressing health inequities by extending public insurance or cash transfer programs to families living in poverty or not covered by employer-based insurance programmes. Local administrators in Sweden, Bulgaria and Belgium have made health equity a central pillar of their development strategies. Nonetheless, there remain major gaps within public health systems. In the U.S., for example, up to 25% of spending is dedicated to administrative issues, duplicative or unnecessary treatments and high drug prices.

The business case for advancing health equity

There is a strong economic incentive for businesses to take action. Healthy workers avoid productivity losses due to absenteeism and the financial burden of treating illnesses. Investing in health equity within local communities promotes a rich environment and value chain for businesses.

Consumer and investor expectations increasingly include social benefit, while jurisdictions around the world are implementing mandatory reporting on social impact — all captured within the evolving ESG space.

Healthcare businesses — equipment and services, pharmaceuticals, biotechnology and related life sciences — have an obvious role to play in advancing health equity. By improving quality and access to care and medicines for marginalized populations via equitable pricing models, innovative care and delivery solutions and inclusive product development, healthcare companies are already leading the charge on addressing health inequities.

For example, through its Medtronic LABS health systems innovator, Medtronic is developing community-based, tech-enabled solutions that provide last-mile delivery of healthcare essentials. Kaiser Permanente’s Division of Research is examining the factors that contribute to health disparities and identifying evidence-based interventions to eliminate them. Johnson & Johnson has committed $100 million to closing the racial mortality gap by investing in culturally competent community care models that generate better health outcomes for people of colour.

Health inequities are not only driven by access and quality of care. Up to 70% of disparities are due to non-medical drivers of health — financial security, housing and other social, economic and environmental pressures. As such, companies have levers of influence over health equity not just within their offerings, but across their workforce, communities and broader ecosystems. Understanding the interplay of various medical and non-medical drivers of health, CVS Health, for example has invested $185 million into affordable housing to support health equity in underserved communities, while Novo Nordisk has partnered with more than 40 cities worldwide to address the systemic issues underlying the rise in obesity and type 2 diabetes and reduce health inequities.

Every company is a healthcare company

Given the immense effects of non-medical drivers on health outcomes, companies outside the healthcare sector can also advance health equity.

By providing the benefits necessary to live a healthy life, ensuring their offerings lead to equitable outcomes, working with the communities in which they operate and collaborating with partners to advance polices that drive health equity, every company is ultimately a health company.

Despite the uptick in action against health inequities, there remains a long way to go. Representation of minority racial and ethnic groups in clinical trials for novel drugs is well below the average. 21% of employed people globally live below the poverty line, and we are far from providing universal health coverage. But there is time to act.

The Forum’s Global Health Equity Network aims to accelerate corporate action towards addressing health inequities by equipping corporate leaders with the knowledge, tools and multistakeholder partnerships needed to sustainably invest in health equity across their core strategies, operations and reporting.

With deliberate and creative public-private partnerships, we can achieve the goal of reaching zero health gaps between populations by 2050.

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