TL;DR
- Inclusive healthcare ensures everyone can fully participate in their healthcare journey regardless of background, identity, ability, or financial status
- Health equity differs from equality by allocating resources based on need rather than providing identical resources to all
- Effective inclusive care requires cultural competency, physical/communication accessibility, financial accessibility, and a diverse healthcare workforce
- Implementing inclusive healthcare improves outcomes, reduces costs, and increases patient satisfaction
Table of Contents
I’ve witnessed firsthand how barriers to care can dramatically alter a person’s health journey. At Qualify Health, our focus on inclusive healthcare addresses these barriers directly. Our healthcare system leaves people behind because of gaps in how we deliver care, not for lack of medical knowledge or abilities.
The idea of inclusive healthcare isn’t just a nice-to-have; it’s essential for creating a system that truly serves everyone. And it’s a big reason why I started Qualify Health, to help deliver inclusive healthcare.
Inclusive healthcare means every person can fully participate in what’s needed for their healthcare, regardless of:
- background
- identity
- ability
- financial status
Patients can feel genuinely welcome, respected, and empowered to engage with the healthcare system. This is a shift from theoretical access to services to accessing services in an environment where they feel on equal footing to everyone else.
How do you move beyond equality to healthcare equity?
Let’s differentiate between health equality and health equity. If equality is giving everyone the same size shoe, equity is giving everyone a shoe that fits.
Equality means providing everyone with the same resources and opportunities. This approach sounds fair, but fails to recognize the differences in needs.
On the other hand, health equity creates a level playing field to accessing what patient needs. Health equity allocates resources based on need and:
- acknowledges differences in need and the ability to access needed service
- ensures everyone has a fair opportunity to be as healthy as possible
These differences in patient need and their ability to access needed services aren’t random. They are shaped by social determinants of health, the conditions in which people are born, grow, live, work, and age.
The CDC organizes these determinants into five key categories, and are estimated to affect 80% of health outcomes.
- economic stability
- education access and quality
- healthcare access and quality
- neighborhood and built environment
- social and community context
What is the human cost of healthcare disparities?
- Black Americans have a life expectancy nearly five years shorter than white Americans (72.8 years vs. 77.5 years).
- People with disabilities may die up to 20 years earlier than those without disabilities.
- LGBTQ+ individuals report higher rates of poor health and are more likely to delay care due to fear of discrimination.
Behind these statistics are real people facing preventable suffering. Consider
- a woman who skips her mammogram because the imaging center isn’t accessible for her wheelchair; or
- a transgender person who avoids preventive care after experiencing judgment from healthcare providers;
- or the family that chooses between filling a prescription and putting food on the table.
What is anticipatory trauma and how does it affect care?
- 55% of Black adults feel they must be very careful about their appearance to be treated fairly by healthcare providers, and
- 29% actively prepare for possible insults before appointments.
Anticipatory trauma isn’t just about discomfort; it directly impacts whether someone seeks care at all.
How do financial barriers impact healthcare access?
Financial barriers remain one of the most significant obstacles to healthcare access. Even among insured individuals, out-of-pocket costs can be prohibitive. Nearly one-third of insured people report skipping needed care due to cost concerns. These financial challenges don’t just impact access; they create ongoing stress that itself becomes a health risk.
Qualify Health works hard to ensure underinsured and uninsured patients alike receive equitable care by working with hospitals to source and secure grants, copays and free drug funding. Read the Forrest Health patient story that helped one Mississippi child get life-saving care by covering gas costs.
What are the essential building blocks of inclusive care?
Inclusive healthcare is a multifaceted approach that addresses four interconnected components:
- Cultural competency and humility is the foundation.
- Cultural humility recognizes that becoming “competent” in someone else’s culture is an ongoing journey, not a destination.
- Healthcare professionals must commit to ongoing self-reflection, recognizing their own biases, and approach each patient interaction with humility and a willingness to learn.
- This isn’t about checking boxes or memorizing facts about different cultures, it’s about developing a genuine orientation of respect, curiosity, and openness.
- Physical and communication accessibility ensure that healthcare facilities and information are usable by everyone.
- More than 70 million Americans have a disability. And barriers to physical or communication access means the difference between receiving care and going without.
- Accessibility includes ramps and accessible exam tables along with providing materials in multiple formats and languages, offering interpreter services, and creating sensory-friendly environments.
- The Americans with Disabilities Act (ADA) mandates these accommodations but compliance remains inconsistent. .
- Financial accessibility is critical to receiving care.
- If patients can’t afford care then they can’t receive care. Even with the most culturally sensitive and physically accessible care, it’s out of reach if patients cannot pay to receive treatment or reach their treatment.
- System-level changes and innovative approaches to financial assistance programs that reduce administrative burdens on both patients and providers are required.
- A diverse healthcare workforce to represent diverse communities.
- Reflects the communities being served.
- Builds trust and improves communication.
- Representation matters. When patients see providers who share aspects of their identity or experience, they’re more likely to engage fully in their care.
What are successful models that can be used?
- Culturally tailored disease management programs
- Community Health Worker (CHW) model
- Technology solutions
- Culturally tailored disease management programs
- demonstrate success across various communities.
- Two case studies:
- HealthPartners in Minnesota
- Developed a diabetes education program specifically for the local Ethiopian community.
- It incorporated traditional Ethiopian meals and respected cultural practices.
- The results were better patient engagement and improved clinical outcomes.
- Aetna
- Launched a targeted asthma program for African American and Hispanic Medicaid members with higher rates of emergency room visits.
- Used culturally appropriate educational materials, specialized disease management, and home environmental assessments.
- HealthPartners in Minnesota
- Community Health Worker (CHW) model
- one of the most effective strategies for bridging trust gaps
- studies show CHW programs improve chronic disease management, increase use of preventive services, and reduce unnecessary hospitalizations.
- effectively navigate cultural nuances and build authentic connections.
- are trusted members of their communities who share similar backgrounds with the patients they serve
- Case study:
- One CHW-led intervention addressed families’ social needs in pediatric clinics
- reduced risk of hospitalization by 69% for children over 12 months.
- Technology solutions
- Are expanding access to inclusive care.
- Telehealth can overcome transportation barriers.
- Apps with multiple language options and accessibility features can make health information more widely available.
What’s the business case for inclusive healthcare
- Productivity losses due to health inequities were projected to cost $116 billion in 2024.
- Eliminating inequities could add $2.8 trillion to the U.S. gross domestic product and boost corporate profits by $763 billion.
Minority populations continue to grow and healthcare organizations that can effectively serve diverse communities gain a significant competitive advantage. Patients who feel respected and well-cared for are more likely to remain loyal to providers and health systems.
Plus, inclusive care often leads to better health outcomes. This helps control costs. We can prevent costly complications and emergency interventions down the line by making care more accessible and effective upfront.
For example, providing interpreter services (a core component of inclusive care):
- improves communication
- leads to more accurate diagnoses
- reduces medical errors
- improves treatment adherence
- adverse patient events
- poor outcomes
- patient dissatisfaction
Example of Bias in Diagnosis
Diagnostic overshadowing is when a patient’s physical symptoms are incorrectly attributed to a mental illness. In one documented case:
- a patient with severe eye pain was repeatedly dismissed as having psychosomatic symptoms related to anxiety, delaying treatment and eroding trust.
How Do We Start Implementing Inclusive Healthcare?
Every healthcare organization can take concrete steps toward more inclusive care:
- Systematically collect demographic data on Race, Ethnicity, and Language (REAL) as well as Sexual Orientation and Gender Identity (SOGI) to identify disparities in care access and outcomes
- Provide ongoing training in cultural humility and implicit bias for all staff, making it an integrated part of professional development rather than a one-time event
- Evaluate physical spaces and communication materials for accessibility, ensuring compliance with ADA requirements
- Partner authentically with community organizations to co-design services, moving beyond tokenistic “outreach” to true collaboration
- Implement and simplify financial assistance programs that reduce barriers to care
- Consider adopting the National Standards for Culturally and Linguistically Appropriate Services (CLAS) as a comprehensive framework for organizational change
Importantly, organizations must hold themselves accountable and:
- set specific goals
- measure progress
- transparently reporting results
How Do We Apply Intersectionality for Inclusive Care?
To be truly inclusive, healthcare must recognize that people don’t fit into single, neat categories. The concept of intersectionality: how a person’s various social and political identities combine to create unique experiences of discrimination, is essential for moving beyond one-size-fits-all approaches.
For example, the healthcare experiences and barriers faced by a Black transgender woman are fundamentally different from those of a white cisgender woman or a Black cisgender man due to the intersecting nature of racism, transphobia, and sexism. Without this nuanced understanding, interventions designed to address a single axis of disparity may fail to meet the needs of individuals who face compounded barriers at the intersection of multiple marginalized identities.
What’s the End Goal?
Creating truly inclusive healthcare isn’t a destination but a continuous journey of improvement. It requires sustained commitment, resources, and humility. But the potential rewards make it well worth the effort:
- better health outcomes
- increased patient satisfaction
- increased patient satisfaction
At Qualify Health, we’re committed to playing our part in this transformation, particularly by addressing the financial barriers that prevent too many patients from receiving the care they need. By automating and simplifying financial assistance matching, we’re working to ensure that financial constraints never stand between patients and necessary care.
I believe that inclusive healthcare isn’t just the ethical choice. It’s the smart choice. When we design systems that work for those facing the greatest barriers, we create better systems for everyone. The path to health equity may be challenging, but it’s one we must walk together.
