Closing the Gap: Using Quality Management and Culture Education to Tackle Healthcare Disparities

Healthcare disparities aren’t new, but they are increasingly impossible to ignore. From uneven outcomes in chronic disease to unequal access to care, these gaps in the healthcare system impact not only patients but also the providers who care for them. Cultural factors often deepen these divides, with language barriers, mistrust of the medical system, traditional health beliefs, and differing attitudes toward care all playing a role.

Addressing these disparities requires more than awareness—it demands action. Leaders in compliance, human resources, and quality management are uniquely positioned to drive real progress toward health equity. By combining robust quality improvement practices with intentional cultural competency training, healthcare organizations can move beyond compliance checklists to build better systems for everyone—patients and providers alike.

So, how do you move from recognizing disparities to actively reducing them? Start here. We will walk you through the current challenges and explore practical steps that you can take to close the gap.

Defining the Problem: Healthcare Disparities and Why Addressing Them Is Imperative

Healthcare disparities are differences in health outcomes and access to care that exist between various groups—often rooted in broader social and economic inequities (also known as social determinants of health). When social and economic inequality exists, a patient’s health can be negatively impacted, leading to variations in outcomes such as life expectancy, mortality rates, overall health status, and the prevalence of certain conditions, such as heart disease and diabetes.

These disparities can be seen across many dimensions, including race, ethnicity, income, age, geographic location, language, gender, disability, citizenship status, and sexual orientation or identity. Because people’s identities often intersect, many face disparities on multiple fronts. According to KFF, “The U.S. has a long history of exclusionary policies and events that have driven and continue to contribute to racial and ethnic disparities in health today.”

And with the U.S. Census Bureau projecting that racial minorities will comprise 57% of the U.S. population in 2060 (in 2012, minorities made up 37% of the population), addressing healthcare disparities, particularly as they’re related to race and ethnicity, is imperative.

Tackling healthcare disparities is not only a matter of equity—it’s also essential to improving the nation’s overall health and supporting long-term economic prosperity. A JAMA report from 2023 found that the financial burden of health inequities for racial and ethnic minority populations was more than $400 billion in 2018, while the economic burden of health inequities for adults without a 4-year college degree was about $950 billion in 2018.

Understanding the Problem: Where Healthcare Disparities Persist Today

The first step toward solving any problem is understanding it—and when it comes to healthcare disparities, the numbers speak volumes. Data reveals clear and persistent gaps in health outcomes, access to care, and patient experiences across different populations. These disparities are shaped by race, ethnicity, income, geography, language, and more.

By examining the statistics, we can see the full scope of the problem—and identify where efforts to promote health equity are most urgently needed. The following data from KFF highlights some of the most pressing inequities in today’s healthcare landscape.

Black infants were more than two times as likely to die as white infants in 2022.

• American Indian and Alaska Native (AIAN) and Native Hawaiian or Pacific Islander (NHPI) infants were roughly twice as likely to die as white infants in 2022.
• NHPI, Black, and AIAN women had the highest rates of pregnancy-related mortality between 2017 and 2019.
• In 2022, the age-adjusted mortality rates for diabetesfor NHPI, AIAN, and Black people were about twice as high as the rate for white people.
• AIAN and Black people have consistently had a shorter life expectancythan white people, with gaps widening during the COVID-19 pandemic. Based on preliminary data for 2022, life expectancy for Black people was about five years shorter than for white people (72.8 vs. 77.5) and nearly 10 years shorter for AIAN people.
• Nonelderly AIAN, Black, Hispanic, and NHPI people are more likely to be uninsured than their white counterparts. In 2022, the uninsured rate of white Americans was 6% compared to 10% for Black Americans, 18% for Hispanics, and 19% for AIAN people.

Understanding the Problem: Why Current Efforts Fall Short

Despite growing awareness of health inequities, efforts to address healthcare disparities remain fragmented and insufficient—mainly because the problem is so widespread, deeply rooted, and unjust.

Many disparities are preventable, yet they persist across nearly every dimension of the healthcare system. Organizations face a host of structural and operational challenges that slow progress. These include a lack of standardized data to pinpoint care gaps, measure outcomes, and develop effective, targeted interventions.

Unconscious bias and limited cultural competency continue to affect care quality, while scarce resources make it difficult to launch or sustain meaningful initiatives. Inconsistent policies and the absence of comprehensive equity programs further complicate the landscape. Issues around equitable recruitment, retention, training, fragmented education efforts, and legal and ethical concerns add to the strain. Most crucially, low patient trust and limited stakeholder engagement can hinder the very partnerships needed to drive sustainable change.

In other words, it’s a whole host of barriers—not a single one—standing in the way of making meaningful progress on the issue of healthcare disparities.

“Those inequities are not generally being driven by individual bad actors … they are being driven by systems, by policies, by practices, by culture,” according to Karthik Sivashanker, MD, the AMA Center for Health Equity’s vice president of equitable health systems and innovation, in this AMA article. “They are structural in nature, and so they require structural solutions.”

Addressing Healthcare Disparities With Quality Management

Quality management offers a structured, data-driven approach to tackling healthcare disparities by embedding equity into healthcare delivery.

At its foundation is the collection, analysis, and transparent reporting of data to identify disparities, highlight best practices and measure progress. Strengthened regulatory oversight can help ensure accountability and consistent standards across different units and locations. Training initiatives—including ongoing education in cultural competency and efforts to recruit and support providers from diverse backgrounds—are essential to delivering more empathetic, effective care.

Just as critical is the coordination of additional resources to support patient populations most impacted by disparities, bridging gaps in access, navigation, and continuity of care.

When applied intentionally and consistently, quality management can serve as a powerful lever for change—shifting equity from aspiration to operational reality.

Addressing the Problem With Cultural Competency

Cultural competency training is a vital tool for reducing healthcare disparities by helping providers and healthcare workers respond to all patients' diverse values, beliefs, behaviors, and barriers. Cultural competency training can help hospitals and healthcare organizations close this critical care gap by raising awareness among staff about how cultural differences influence health behaviors, communication styles, and care preferences and increasing staff’s cultural knowledge and practical skills.

Beyond individual awareness, systemic changes can help ensure care is accessible and aligned with the needs of the populations served. Examples of these changes include:

• Offering interpreter services
• Incorporating culture-specific values and attitudes into health promotion tools
• Recruiting and retaining a diverse workforce
• Engaging community health workers and alternative healthcare practitioners

When woven into the fabric of healthcare delivery, cultural competency can drive better outcomes, increase patient trust, and foster increased equity.

Reducing Healthcare Disparities With Training 

As healthcare organizations strive to deliver more equitable care, many realize that good intentions must be backed by concrete action. Addressing disparities in health outcomes and fostering a sense of belonging among patients and staff requires more than policy statements—it demands intentional training that equips teams with the knowledge, skills, and tools to make systemic change.

HealthStream has developed a powerful training solution to help your organization bridge the gap. HealthStream Health Equity & Belonging can help you stay current on regulations and compliance, optimize employee engagement, and elevate the quality of culture and the health of the communities you serve.

Grounded in expert-backed content, this solution covers critical topics to foster equity within healthcare settings, from understanding individual differences to confronting racism and creating welcoming environments for LGBTQIA+ patients and staff.

Dive into issues like bias in recruiting, gender identity, and microaggressions in micro-learning modules, which allow healthcare teams to build critical skills without sacrificing productivity. For managers, the training offers data-driven insights to help identify outstanding assignments. Learn more.