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Health Disparities Hidden in Your Benefits Plan

Last Thursday (January 19th), we did a webinar on health literacy-meets-health equity. Included in that webinar were some polling questions. We posited that many organizations – even those with robust health equity initiatives – were unaware that some of their very well-intentioned benefits and programs ignored, or even created, health disparities.

The first polling question explored the financial aspect of health equity:

The thesis of this webinar was to show that, notwithstanding your best efforts, you have more health disparities that you would expect...but that, notwithstanding these preconceptions in the poll results, closing them can actually save money. We explored six examples. We'll review four here, and then elaborate on the other two in our February 22nd webinar, when we reveal Release 2.0 of Quizzify2Go. Disparities don't stand a chance against Release 2.0.


Colon Screening

Colons are the only body part where cancer screening substantially reduces mortality, as you can see from this chart showing the decline in colon cancer incidence and mortality over a period that coincides with the, uh, penetration of colon screening.

Despite the compelling case, a large percentage of eligible employees don’t get colon screening. Not one, but two health disparities discourage hourly workers from getting screened.

First, you need to take at least one day off from work, if not more. If you are salaried or work from home, you can usually arrange that. But what if you are paid hourly? Do you get compensated separately for that day or does it count against your PTO? We asked that polling question and were not surprised to see this answer:

So even if you offer an “incentive” to get a colonoscopy, it still costs hourly employees money. Hence, if you want employees to get colonoscopies, the free test should be accompanied by a “free” day off.

Second, hourly (and salaried) employees also may not realize that there are three almost-as-good colon screens that do not require time off.

Quizzify teaches that in our screening quiz. An attendee pointed out that colonoscopies find polyps, while the others find only cancers. True indeed. On the other hand, the others are performed much more often, so that whatever cancers they find by screening every year (FIT) or every three years (Cologuard) are much more likely to be Stage One. Hence the rates of avoided deaths below are similar (see the last line, where the red arrows are.) Only the ones with the highest avoided deaths and no radiation are taught by Quizzify.

Also, most importantly, our quizzes can be tweaked so that these non-invasive screens are proposed only to eligible employees who haven't screened at all.


Dental Benefit and Cavities

Next, let’s look at our old friend, the dental benefit. Employers aren’t gener