The DEI of workplace healthcare: Social equity in action

Author: Georgie Williams

The importance of workplace healthcare benefits should never be underestimated - particularly as access to healthcare disproportionately affects workers across the breadth of the intersectional identity spectrum, says gender and sexuality consultant Georgie Williams.

Our increasingly interconnected world requires businesses to respond to the needs of an increasingly globalised workforce. The mainstreaming of company-sponsored healthcare was a necessity born from the socioeconomic climate of the US, where affordable healthcare is inaccessible to the majority. However, as healthcare systems such as the NHS buckle under increasing pressure, equitable and human-oriented approaches to business management are becoming essential.

A diversification of needs

Recognising the benefits of workplace healthcare means acknowledging the sheer number of communities affected and how workers within those communities stand to give more when supported in their health and wellbeing by progressive employers.

The further our work expands into global markets, the more globalised our workforce becomes, bringing with it a diversification of worker needs. Workers across the world face varying challenges accessing essential healthcare. Like all matters of inequality, these access issues impact the workplace. Research suggests that "organisations that see health and wellbeing as an indicator of organisational success have lower levels of work impairment due to absenteeism". Mitigating the costs of sickness-related absenteeism may require investing in employer-subsidised healthcare services.

Healthcare systems under increasing pressure

Naturally, when considering who might benefit from private healthcare, we may first think of disabled and neurodiverse workers. Many countries across Europe and beyond are facing increasing demands on their national or subsidised healthcare services. The NHS is a prime example of a healthcare system in jeopardy. For disabled workers, the ever-extending wait times for treatments can lead to complications, both physical and psychological. In 2013, research indicated that chronic pain or illness correlate strongly with decreased mental wellbeing and morale, and these impacts can spill over into working lives.

Access to functional healthcare is also becoming an increasingly salient issue for neurodiverse workers. As awareness of conditions such as ADHD increases, so do wait times for diagnosis and allocation of ADHD-managing medications and support. Neurodiversity can be an asset to a workplace and the Harvard Business Review recently described it as a competitive advantage in workplaces. Ensuring neurodiverse and disabled workers bring their best selves to work means ensuring they have access to the healthcare support they fundamentally need.

Natal healthcare

However, the argument for providing private healthcare is more intersectional than we are often led to believe. In 2023, a report from the House of Lords found that black women faced a far higher maternal mortality rate than white women in the UK. In 2016-18, this risk was considered four times higher. The causes were complex, ranging from socioeconomic disparities to the impact of racial bias.

Providing access to private healthcare grants pregnant workers from minority ethnic backgrounds greater agency and control over their natal experience. Research unequivocally bolsters the claim that workers who feel supported by their employers during their pregnancy are much more likely to return to their company after parental leave. Pregnancy and maternity are matters protected under the Equality Act 2010, but protection from discrimination does not ensure adequate support during this challenging time. Natal healthcare is an area where racial inequality presents itself profoundly and employer-subsidised healthcare can help redress that balance.

Gender-affirming surgeries

Finally, it would be remiss to not mention how essential accessible healthcare is to transgender and nonbinary workers. Trans and nonbinary gender-affirming surgeries are often misunderstood. These treatments are often presumed to be cosmetic in nature instead of grounded in physiological health.

Even if we were to ignore the undeniable mental health benefits of these affirming healthcare treatments, we cannot deny the role that gender-affirming therapies play in keeping transgender and nonbinary workers safe. Writing as a transgender, nonbinary DEI specialist, I have witnessed first-hand how friends and colleagues who do not "pass" as a cisgender man or woman navigate a far more dangerous world.

Although some transgender and nonbinary individuals do not want gender-affirming therapies, many who seek them out do so in order to assimilate more effectively with cisgender men or women. When a transgender person's identity is less obvious to strangers, the risk of them being subjected to hostility and violence drops. Furthermore, LGBTQ+ individuals have also been found to be significantly less likely to have access to workplace healthcare insurance. Naturally, we can also assume that LGBTQ+ individuals stand to benefit less from healthcare packages which prioritise biological relatives or married spouses.

Supporting LGBTQ+ workers serves to rebalance some of the inequities we see in wider society. Supporting access to a healthy and efficient medical transition in transgender and nonbinary workers ensures increased psychological and physical safety, in the workplace and beyond.

The workplace as refuge

Although the above examples do not paint a fully comprehensive picture of who benefits from employer-subsidised healthcare, their breadth and variety convey just how expansive the effect of workplace health and wellbeing support can be. Central to all the examples is how the power of workplaces can be harnessed most effectively in creating an equitable and just microcosm of the outside world. Where the shift to providing employee healthcare coverage can be made, the impact of this accessible and inclusive healthcare on worker retention, wellbeing and engagement can be seismic.

Undoubtedly, organisations can influence and steer wider social issues, with impact correlating almost directly with a company's size. Workplaces can also serve as a refuge. The most effective way to extend those branches of inclusion and equity into the outside world is through the healthcare people have access to in their external lives.

The "leaving your home life at the door" fallacy

If you are interested in making private healthcare accessible to your employees, the kind of group insurance policy you are eligible for will depend on the size of your company. In line with the guidance above, inquiries should include questions around what medical services may be excluded from a standard policy. For example, does the policy include gender-affirming healthcare for transgender and nonbinary employees?

The fallacy of "leaving your home life at the door" of one's workplace has receded, with an acknowledgement of how our welfare in our personal lives inherently influences our ability to deliver at work. At the core of our ability to be productive, engaged and focused is an assurance that our personal wellbeing and welfare are protected. Where external systems of inequality propagate harm beyond the control of companies and organisations, much can still be done to turn the tide of equality within the workplace.

There is perhaps no initiative more impactful than one that protects the most fundamental prerequisite to living productive lives - our health.