Advancing Health Equity Within the Veterans Health Administration

Case Study - Creative Design - Findings Analysis and Insights - Program Evaluation and Measurement - Research Design and Execution - Stakeholder Engagement - Veteran Health

Advancing Health Equity Within the Veterans Health Administration

Posted on 12.17.22

Varying health outcomes among diverse Veterans

The Executive Order not only instructed VHA to advance racial equity but also to conduct an internal review and develop plans to increase opportunity and ensure equity based on sexual orientation, gender identity, minority religious beliefs and people with disabilities.

VHA provides care to a diverse population of Veterans. Our nation’s Veterans reflect all people and backgrounds within our country, including many different races, ethnicities, abilities and disabilities, genders, religions and sexualities. Different populations may experience different health outcomes depending on social or economic advantages or disadvantages. Health equity means every Veteran is valued equally and that VHA makes efforts to address avoidable inequalities and historical and contemporary injustices and eliminate health inequities. VHA partnered with Aptive to assess its current health equity operations and create recommendations to improve enterprise-wide practices.


Assessing VHA’s health equity through a diversity, equity and inclusion lens: Aptive has vast experience conducting assessments on various VHA strategic initiatives. With certified diversity, equity and inclusion (DEI) subject matter experts (SMEs) and a thorough understanding of VHA’s health care system and the different interdependencies of Veteran populations and families, Aptive was uniquely positioned to assist VHA.

Assessing VHA’s Current Health Equity Operations

The team adapted a Government Accountability Office methodology to conduct a program assessment. The assessment’s purpose was to:

  • Identify program fragmentation, overlap and duplication
  • Identify the effects of program fragmentation, overlap and duplication
  • Validate effects and assess and compare programs
  • Identify options to increase efficiency and reduce fragmentation, overlap and duplication

The assessment focused on identifying the current situation through stakeholder interviews, quality audits, qualitative and quantitative research and literature reviews. Aptive’s DEI SMEs conducted 44 virtual stakeholder interviews with VHA leaders and program offices. In addition, the team consulted seven external health systems to learn industry best practices in establishing health equity operations. Finally, the literature review of 42 health equity-centered publications helped further identify best practices.

Developing Actionable Recommendations

Once the assessment was complete, the team analyzed the results and developed initial findings. The analysis yielded themes that would inform effective and proven solutions to improve health equity, including:

  • Leadership engagement and accountability through a comprehensive, enterprise-wide national strategy
  • Uniform awareness and understanding of health equity and social determinants of health through a new Champion Network
  • Standardized data collection tools to address health disparities
  • Improved cultural competency through more training, recruiting, retention and performance management
  • Community partnerships to engage with the entire Veteran patient population

These solutions were incorporated into a recommendations report and implementation plan.


Increasing employee understanding of health equity and establishing beneficial partnerships

With recommendations for best practices and the accompanying implementation plan, VHA had the tools to improve health equity.

VHA has a better understanding of where disparities exist across its health system and is equipped with change management methodologies to address them, including:

  • Defining health equity so VHA employees can understand their role in advancing equity among patients and colleagues
  • Identifying community champions to serve in an advisory capacity to work within their communities and connect Veterans at different intersections of society with VA health care
  • Establishing meaningful private health care partnerships

Through these practices and initiatives, VHA can implement health equity strategies across its medical centers, ensuring Veterans from all walks of life receive health care that reflects their individual needs.