Greater Washington Partnership Blueprint Report

Collecting and analyzing accurate race and ethnicity data is crucial to both understanding disparities in health outcomes and developing targeted interventions to promote equity. However, flaws in data collection and lack of transparency in reporting may foster or perpetuate mistrust. Historic efforts to standardize race, ethnicity, and language (REaL) data have not been comprehensive. Further, when collected, REaL data has not been used to drive equity, but rather has often harmed historically underserved populations through biased AI and race-based algorithms; these algorithms routinely deprive Black patients of necessary treatment, such as adjusting risk scores for race, leading to lower risk scores than white counterparts and delayed access to some types of care.²⁸¹

While sharing REaL data is optional for employees, businesses can foster trust with employees by encouraging self-reporting, being transparent with how data will be used, and normalizing data collection. Increased data sharing within the business community can help strengthen health equity; this may include working with insurers to pair REaL and health outcome data to predict and respond to health deficiencies or population health risks or creating a repository to inform an organization’s health equity strategy. When adopted broadly, improved data infrastructure and data management practices can drive the cross-sector agenda for health equity and support key performance indicator (KPI) measurement of existing interventions.

The business community can offer pro-bono professional services to community-based health clinics and well-being service providers to address key operating needs, such as data analytics, technology, marketing, troubleshooting, legal support, and more. Providing these services will enable community health workers and nonprofits to focus on service delivery rather than back-end operational functions. As of September 2021, 53% of nonprofits are experiencing increased demand for services, but one-third have had to cut programming, and 47% have seen a decrease in funding.²⁸³ Within the nonprofit realm, community care providers are particularly important, as they provide care to uninsured and underinsured community members.²⁸⁴

To maximize effectiveness, organizations that understand the local healthcare nonprofit and business landscape can collaborate to best connect needs from community clinics and nonprofits with businesses that have the appropriate assets to support them (e.g., employee or technical expertise, funding, etc.). To maximize efficiency, organizations could consider developing or leveraging an existing technical platform to supplement matchmaking.

Babies of mothers who do not get prenatal care are five times more likely to die and three times more likely to have a low birthweight,³⁰⁰ and mothers without prenatal care are five times more likely to die during pregnancy than those who receive prenatal care.³⁰¹ Health screenings play a vital role in the early identification and treatment of issues associated with adverse maternal and infant health outcomes. The underutilization of health screenings and services can negatively impact progress toward improving maternal and infant health outcomes (e.g., infant and maternal mortality, low birthweight, preterm birth).

Despite the benefits of screenings, 26% of women report needing additional time off for prenatal visits, but not asking their employer due to fear of repercussions.³⁰¹ Health services for mothers and infants account for one-fifth of large employers’ medical spend, with higher costs for mothers who do not have early prenatal care (on average $1,000 higher hospital costs).²⁰³ The business community is positioned to address the key barriers that prevent their employees from accessing these services and to tailor policies and incentives to mitigate logistical barriers, enhance workplace culture, and remove stigma.

Roughly 90% of mothers do not feel supported by society³⁰³ and approximately 70% of parents believe “being a good parent” is their biggest challenge.³⁰⁴ Cohort support is a proven model for navigating pregnancy and early childhood. Group perinatal care has been shown to improve patient education and provide opportunities for social support while promoting risk screenings and physical assessments necessary for individual prenatal care.³²⁸

66% of mothers and 89% of fathers work outside the home.³⁰⁶ Both mothers and fathers (50% and 39% respectively) say being a working parent makes it harder to advance in their careers.³⁰⁷ Employers can establish partnerships or develop internal resource groups to offer cohort support to pregnant employees and new caregivers, creating a supportive and inclusive environment that improves both health outcomes and employee satisfaction.

Public food benefits are critical interventions that are proven to help lift people out of poverty.³²⁰ Research shows that food benefits are highly effective at reducing food insecurity and, for low-income children receiving benefits, food benefits improve long-term health, academic performance, educational attainment, and economic self-sufficiency.³¹⁹

Food insecurity is a significantly larger challenge for underrepresented communities—Black residents are 93-187% more likely to be eligible for and receive SNAP assistance than white residents
³

Even with the October 2021 increase to SNAP benefits, there is still a gap between the provided per meal allocation and the cost of a moderately-priced meal in the Capital Region—ranging from 11% in Richmond and Baltimore to 26% in D.C.³²⁰ Furthermore, key population groups are ineligible to receive benefits or can only receive benefitsII for a limited period of time, including most students,³²¹ unemployed adults without minor children,³²² and in Maryland, individuals with former drug convictions.³²³ Yet, these populations demonstrate high levels of need—roughly 1 in 3 university students³²⁴ and 91% of recently released felons³²⁵ are food insecure.

Research suggests that nationally 1 in 9 full-time workers may live in poverty.³²⁶ Increased funding and expanded eligibility can scale the impact of public food benefits, further alleviating food insecurity and closing the benefits gap for historically ineligible individuals. Businesses can engage in coordinated advocacy to support expanded eligibility and financing of food benefits to improve food security—and thereby productivity and health outcomes—for their employees and community.

Residents of the Capital Region are less likely to live within 5 miles of a hospital than their national peers.³ To enhance access to healthcare and wraparound services, communities need flexible care models with physical locations that are accessible and trustworthy. These locations can be alternatives to traditional hospital and provider locations, which are not always easily accessible to all employees and community members due to location, proximity to public transportation, and operating hours, among other factors.

Businesses can leverage their physical footprint and available spaces to expand access to care in underserved communities through on-site healthcare and well-being services (e.g., vaccinations, basic primary care services, fitness activities), or the provisioning of space outside of operating hours to provide such services via partnerships with care delivery organizations.

Employers
lose
productivity time when employees must travel to seek medical care during working hours; an average patient visit results in roughly 2
hours of lost working time³³²

Social determinants of health (e.g., health-related behaviors, socioeconomic factors, and environmental factors) can account for 80% of individual health outcomes.³³⁶ Identifying and navigating services can be a persistent challenge for community members, especially those who lack access to a primary care provider, such as low-income and front-line workers. While there is an abundance of resources available, lack of awareness and complexity of enrollment present barriers to utilization. Amplifying and extending existing care coordination solutions to create a region-wide network can better connect individuals to local services and resources and improve their autonomy in managing their own health.

The business community can support this effort by pooling investment funds and/or contributing employee expertise to scale up the development of a single unified, robust, technology platform to support both community members and community health providers with care navigation. The platform will enhance health and community-based organization’s understanding of available offerings by inventorying resources, ease navigation barriers by allowing organizations to make referrals between service providers, and facilitate better understanding of community members’ support networks by tracking patient outcomes across service providers. When employees are able to access these services, their overall health and well-being improves, leading to productivity gains at the employer level.