Health equity begins with access to care. When people can’t easily see a clinician, they don’t have the opportunity to achieve their highest level of health.
In the United States, care access is a major challenge. Today, over 100 million people live in Primary Care Health Professional Shortage Areas (HPSAs), and the average wait time to see a physician is 31 days.
With modern workforces dispersed across geographies, access gaps leave many employees struggling to get the care they need to stay healthy. When care is hard to reach, organizations also feel the effects—through lost productivity and unpredictable healthcare costs.
But the reality is that access issues aren’t felt equally. For some groups of workers, barriers to care are far higher than for others.
The care access divide: Why some workers face higher barriers
Equitable healthcare access in the workplace is about more than availability; it’s about designing care for different lifestyles and needs. In our current healthcare system, whether care is out of reach depends heavily on factors such as where people live, how they work, what they earn, and if they have transportation.
Three workforce groups are especially impacted by lack of access to care:
- Rural communities
- Shift workers
- Marginalized populations
Rural communities
In the U.S., 66% of Primary Care HPSAs are rural, even though rural residents make up a minority of the country’s population. Many rural communities have fewer local clinicians and specialists, meaning people must travel long distances just to receive care. Additional barriers can include lack of access to transportation, the need to take extra time off work, and difficulty navigating unfamiliar systems to find appropriate providers. Even when people do receive care, out-of-town providers aren’t usually familiar with the local culture, economic realities, and social factors that shape people’s health.
These barriers can take a real toll on health outcomes. Rural Americans experience higher premature mortality rates from heart disease, cancer, stroke, unintentional injury, and chronic lower respiratory disease than people living in urban areas.
Shift workers
Most care appointments, labs, and pharmacy pickups are built around traditional 9 am to 5 pm workdays. That model doesn’t hold up for those who work evenings, early mornings, and rotating schedules—or for the 21 million U.S. adults with overnight shifts.
These populations typically aren’t salaried but are paid based on the number of hours they spend working or standing by to accept a job. For them, clocking out for a doctor’s appointment means losing out on pay. When care isn’t flexible enough to fit their schedules, they’re forced to choose between their paycheck and their health.
Night and rotating shift work are associated with increased risk of type 2 diabetes and cardiovascular disease, as well as worsening sleep and mental health outcomes. Without convenient access to healthcare, these issues can compound.
Marginalized populations
Achieving health equity depends on inclusivity for multiracial and multicultural communities. Yet cultural gaps and systemic bias continue to affect outcomes. For example, Hispanic, Black, and Indigenous people in the United States fare worse across a variety of health and care measures than white people.
Care access plays a big role. Facilities in underserved communities are often limited or lower quality, and many people lack reliable transportation to reach care farther away.
But access isn’t just about proximity to quality care. Thirty-seven percent of U.S. adults with limited English proficiency say fewer than half of their recent care visits were with a provider who spoke their language.
Organizations need providers who all of their employees—at every level—can communicate and connect with to build trust and feel safe, understood, and respected.
Advanced primary care can improve health equity for employees
Organizations don’t have to settle for the current system that leaves their people without adequate care access. There is a model that can make a world of difference in health equity for employees: advanced primary care (APC).
At the highest level, APC focuses on three core principles.
- Managing health at the population level: An APC team manages the health and risk of an entire population over time while personalizing individual care. They are accountable for outcomes, not just encounters.
- Continuous, proactive care delivery: APC is designed to engage people earlier and more often for preventive care by creating continuity across time, touchpoints, and care settings. This consistency breeds familiarity and trust.
- One place for nearly all health needs: In APC, primary care acts as the coordinating hub, addressing physical, behavioral, and lifestyle needs directly and actively coordinating additional services. It removes the burden of navigation from members.
By design, APC works across the realities of workforces in the real world. The care model is built to support employees whose roles, locations, or schedules make care harder to reach. It offers:
- Multiple access points: Onsite, nearsite, and virtual care work together to help distributed teams get quality care whether in urban, suburban, or rural settings.
- Population awareness: Care teams use local and organizational insight as well as population data to understand the needs of the people they serve, helping to guide tailored outreach and care strategies.
- Flexible scheduling: Same-day or next-day appointments, extended hours, and asynchronous care make it easier for employees to get care when it’s convenient for them—even if they work nights, rotating shifts, or long hours.
- Culturally responsive care: Providers are selected to reflect and understand the populations they serve and often offer multilingual communication and outreach.
- Whole-person care: Providers look beyond symptoms to consider the underlying factors that shape health, such as lifestyle, stress, and ability to afford medications.
For many organizations, APC is the answer to improve health equity for their distributed and diverse workforces.
Briggs & Stratton reduced injuries and costs for shift workers
Getting the most out of APC starts with understanding the unique challenges specific employee groups face. For Briggs & Stratton, shift workers on production lines across eight U.S. facilities were dealing with frequent injuries that were driving up workers’ compensation costs, slowing productivity, and impacting workers’ health and quality of life.
Briggs & Stratton partnered with Marathon Health to implement a Total Worker Health® approach that integrated occupational health, physical therapy, and APC into a coordinated, whole-person model of preventive care. Using detailed analysis of workplace claims data and physical therapy records, the approach tailored interventions to the population. For example, the approach introduced job rotations to reduce overuse injuries and offered athletic training to prepare new hires for physical job demands.
This holistic, proactive strategy helped create a healthier, safer workplace for Briggs & Stratton and delivered a measurable impact on costs. The organization saw a 40% drop in OSHA recordables, a 47% lower DART (days away, restricted, or transferred) rate, and over $1.5 million in savings from reduced injuries, presenteeism, lost time, and turnover.
Is advanced primary care right for your organization?
Fostering a more equitable workplace isn’t about a single initiative—it’s about removing the barriers that keep people from getting care in the first place.
For rural employees, shift workers, and marginalized populations, access challenges make it harder to stay healthy. Advanced primary care helps organizations close those gaps with care that's easier to reach, more culturally responsive, and more aligned with how employees live and work.
Does your organization want to improve health equity in the workplace and care access for every employee? Download The ultimate guide to advanced primary care from Marathon Health to find out more about the model, why organizations are choosing it, and how to get started.
