• Sherri Zink is senior vice president and chief data officer at BlueCross BlueShield of Tennessee.

The Centers for Disease Control and Prevention defines health equity as “the state in which everyone has a fair and just opportunity to attain their highest level of health.”

What seems like a simple concept actually has layers of complexity. We can only make sense of that complexity through data. 

In 2023, we launched our annual health equity report to build awareness about health inequities in our communities. Our first report revealed what measures we should focus on and where we needed to work more closely with the community, our medical partners and our leaders to tackle some of these barriers to care.

Our 2024 report is again driven by analytics and informed by the unique role we can play by leveraging secure and anonymized member data that tells a story.

We’ve also put our lessons learned into action. 

Here are key health questions to ask

For example, when studying chronic conditions, we worked with providers and labs to look at high blood pressure, in good control and sugar levels — the type of information that doesn’t come through on a claim. Early on, we also worked with research institutions like Meharry Medical College to help us assess the impact of social risk factors in our communities.  

• Where are there language barriers?
• Where do we see financial burdens and economic instability?
• Which communities are experiencing food insecurities?

The data shows certain areas across Tennessee where health care disparities look worse for different populations based on these social risk factors.

Compiling this information allows us to see what’s happening on the public health front across Tennessee.

Three important findings from the equity report

Our recently released 2024 report found: 

• Maternal health disparities persist, and they play a role in maternal mortality. For example, substance abuse contributed to 39% of all pregnancy-related deaths. 
• Hispanic members are the least likely of all racial groups in Tennessee to be screened for colorectal cancer at the recommended age. 
• One in four Tennesseans had a mental illness in 2021, and Black members were less likely than members of other races to receive follow-up care within 7 days of a hospitalization. 

Maternal health presents a disparity challenge

The biggest disparities we’re now seeing are in maternal health. What we see in our data is low immunization rates among pregnant women, too few women accessing prenatal care in a timely manner, and too many mothers dying during delivery. This is unacceptable and has to change. 

We’re starting by addressing social drivers of health for these women, and we feel this is an area where we can work with providers to make sure moms have access to culturally competent care.

This type of care involves a deeper understanding of diverse people that results in specific standards and practices created to help improve their health outcomes. We’ve purchased modules on culturally competent care that we share for free with any provider who wants that training. We want this to be a two-way street.

Childhood immunizations is another area of concern. We continue to see a decrease across all racial and ethnic groups, which we believe is partially attributable to lingering hesitancy post-pandemic. We don’t want children to suffer from preventable diseases like measles, so we’re focused on sharing the importance of these treatments and getting people back into a relationship with primary care providers. 

Creating value-based programs for providers around some of these metrics has helped move the needle in a positive direction across all racial and ethnic groups. Moving forward, our hope is to include more self-reported data from our members. We’ve made significant progress by working with providers and our BlueCare partners.

We’re also encouraged by our employer group customers asking what they can do to get more accurate information when it comes to race and ethnicity to better support the health needs of their employees. 

As my colleague Dr. Andrea Willis says, our data tells a story, but we realize it’s only a piece of the story. Our hope is that we can continue to bring other narrators to this story so we can write a better future together. 

Sherri Zink is senior vice president and chief data officer at BlueCross BlueShield of Tennessee.