HEALTH EQUITY

A health disparity is defined as having a worse health status within a distinct group of people as a result of systematic disadvantages due to differences in gender, race, ethnicity, education, literacy, income level, language, culture, age, sexual orientation, disability or geographic location.

Health equity is the pursuit of the elimination of such health disparities.

Factors Contributing to Health Disparities

Some of the factors that contribute to health disparities are low health literacy, language barriers, cultural beliefs and practices, access to quality care, bias in the medical profession and social determinants to care such as physical environment or educational achievement. Individually and collectively these factors can present preventable health care barriers to certain populations from achieving optimal health status and outcomes.

Despite significant improvement to overall health outcomes over the past decade, many subpopulations, including low income communities, continue to experience substantial health disparities. As the U.S. population becomes more diverse, it is increasingly important to address health disparities.¹

Health Disparities and our Business

Most of the U.S. population growth since 1960s has been non-white.² And, currently there are more Hispanic, Black and Asian babies being born than white babies.³

Which States Will Become Majority Minority?

Health Equity Minority Map 2010

2010

Health Equity Minority Map 2020

2020

Health Equity Minority Map 2030

2030

Health Equity Minority Map 2040

2040

Health Equity Minority Map 2050

2050

Health Equity Minority Map 2060

2060

Majority Minority Country

As the U.S. becomes increasingly more diverse, it’s no surprise that Cigna's clients reflect this diversity within their workforces. This demographic shift requires different health service models to offer culturally-responsive care. We know that to be a more effective health advocate for our customers, we need to understand cultural differences, recognize changing population demographics and address gaps in care relative to health disparities. In addition to the rise of ethnic/racial minority populations, Cigna is aware of how health disparities may affect lesbian, gay, bisexual and transgender (LGBT) populations, and we are working to minimize these disparities through education and awareness as part of our Diversity and Inclusion programs.

Working to eliminate health disparities is the right thing to do from both a social justice and business perspective. Disparities can result in worsened health outcomes, added health care costs, lost work productivity and premature death.

It is estimated that 30% of direct medical costs for Blacks, Hispanics, and Asian Americans are excess costs due to health inequities. Overall, the economy loses an estimated $309 billion per year due to the direct and indirect costs of disparities.⁴

Cigna's Response

Many opportunities exist for the public and private sectors – including Cigna as a leading health service company – to help close the gaps between health disparity and health equity in the United States. Our company is committed to cultivating a state of health equity in the marketplace – deploying strategic and operational resources to improve access to high-quality health care.

For nearly 10 years, Cigna has been a key stakeholder at the national level with active participation in the National Health Plan Collaborative (NHPC) sharing best practices related to health disparities and equitable health care with other health plans, employer groups and clients. Cigna also works closely with employers, consumers and health advocates in the public and private sectors to eliminate the health disparities that continue to plague far too many people and populations.

Close to a decade ago, Cigna formed our Health Equity Council. This Council is led by over two dozen influential leaders across the enterprise who commit to over 50 new actions each year to improve health equity. The Health Equity Council’s strategic plan is based on the following five pillars: Awareness, Leadership, Data/Research & Evaluation, Health Care Services and Cultural and Linguistic Competence.

Cigna’s efforts have been recognized by the National Business Group on Health with their Award for Innovation in Reducing Health Care Disparities and the U.S. Surgeon General’s Medallion of Honor for exceptional achievements that advance the cause of public health and medicine.

Key Goals and Milestones in 2016

  1. Awareness
    Increase awareness of the significance of health disparities, their impact and the actions necessary to improve health outcomes for racial, ethnic and underserved populations*
  2. Leadership
    Strengthen and broaden leadership for addressing health disparities at all levels
  3. Data, Research and Evaluation
    Improve data availability, coordination, utilization and diffusion of research and evaluation outcomes
  4. Health Care Services
    Improve health and health care outcomes for racial, ethnic and underserved populations
  5. Cultural and Linguistic Competency
    Improve cultural and linguistic competency of a diverse workforce

Focus Areas for 2017

In 2017, we are focused on:

1 U.S. Department of Health and Human Services. Minority Population Profiles, Office of Minority Health

2 Pew Research 2015

3 Brookings Institute Dec. 2014

4 Focus on Health Care Disparities, Henry J. Kaiser Family Foundation, December 2012

5 Incidence: NAACCR, 2015. Mortality: US mortality data, National Center for Health Statistics, Centers for Disease Control and Prevention. American Cancer Society, Inc., Surveillance Research, 2015.