Ensuring Equity in Healthcare

With an increased focus on racial and economic disparities in recent years, more attention has been paid to social determinants of health (SDOH). The Department of Health and Human Services defines SDOH as conditions in the environments where people are born, live, learn, work, play, worship and age that affect a wide range of health, functioning, and quality of life outcomes and risks.[1] This can impact people’s access to healthcare, which Ryan Croteau, director of client services for Health Dialog, sees as one of the largest areas of concern in the healthcare industry today.

“Over the past few years, there has been increased visibility of social inequities and under-served populations and people are trying to proactively mitigate that,” Ryan stated. “You have people that speak different languages or have disabilities and it’s important to ensure that everyone is in a position where they can access and utilize healthcare services.”

Having received a master’s degree in Public Policy shortly before starting his career at Health Dialog over 14 years ago, Ryan has an appreciation for addressing issues like SDOH and healthcare accessibility. He was always interested in politics and public policy, which he sees as closely tied to the work Health Dialog does.

“Public policy is about managing things on a population level and finding the best way to produce positive outcomes. In population health, you have similar goals with clients, supporting individuals with their unique healthcare challenges, but also looking at trends to improve health across the entire population,” Ryan explained. “The populations Health Dialog works with are from across the country. They span different economic strata, different cultures, geographies. It’s a diverse population reflective of society in the U.S. and we have the opportunity and tools to help them proactively manage their health.”

Before joining Health Dialog, Ryan had a firsthand experience with a family member who was sick and facing a difficult time. Fortunately, his loved one had access to medical information and could educate herself on her condition and treatment. “If we didn’t have the access, means or education to do the research, I’m not sure how it would have turned out,” Ryan said about his family member who has now fully recovered. “After going through that and seeing how important having access to information and resources is to your personal healthcare journey and knowing that was part of the mission of Health Dialog, they became the top of my list of places to work.”

Having moved up the ranks from a Program Manager to Director of Client Services, Ryan now works with clients utilizing our Chronic Care Management and Shared Decision Making solutions as a single point of contact for program operations. He manages all of the pieces and acts as a liaison with the various teams at Health Dialog to ensure we’re running efficiently and producing positive outcomes.

Meeting the Needs of Diverse Populations

Ryan explained that there are a number of things to consider when serving diverse populations, such as Health Dialog does, and ensuring equitable access to healthcare services:

  • Cultural Competency and Sensitivity – Health Dialog has a cultural competency plan that ensures all employees are trained and adherent to certain processes, procedures, guidelines and tools related to cultural competency services, linguistic access and disability awareness. “Health Dialog requires all coaching staff and leadership teams to complete Cultural and Disability Awareness training upon hire and annually thereafter,“ Ryan said. “Additionally, employees must adhere to our Code of Ethics and guidelines for Integrity-based Coaching and Members Requiring Support.” Health Dialog also provides its coaching staff with a self-paced educational tool to broaden and deepen their knowledge about the unique healthcare needs of our diverse member population.
  • Educational Resources – Health Dialog provides a number of educational resources to members, including decision aids for those with multiple viable treatment options that explain tests, treatments and care options. “All educational materials are written at an eighth-grade level in plain English and laymen’s terms so they’re easily understood,” Ryan explained. He has seen firsthand how educating people about their treatment options builds trust, particularly for those who typically don’t trust the healthcare system from past experiences, and helps them feel they are part of their care decisions. Additionally, many of our materials are available in multiple languages and our coaches utilize a telephonic interpretation service that supports over 200 languages.
  • Personal Barriers - Health Dialog’s main focus is empowering and educating members to make healthcare decisions. As such, a key component of our coaching methodology is to work with members to identify barriers to effective care and strategies to overcome them. “People are unique individuals; you cannot treat everyone the same. When our Health Coaches work with someone, they try to determine what that person’s dealing with in their life, what their healthcare goals are and the barriers impeding them from achieving those goals. If there are any social determinants of health, if they don’t have access to food, are in an unsafe neighborhood, if they can’t pay for their prescriptions, what types of benefits and resources are available, such as if they have private insurance, Medicare or Medicaid,” Ryan explained. “We’re not just saying, ‘you should eat healthy to better manage your diabetes.’ We’re saying, ‘here’s what you should eat,’ and determining what barriers there might be to that. If money is an issue, we can direct them to their local food pantry. If it’s knowledge, we can provide recipes. It’s fact finding to figure out what someone needs to help them get where they should be.”
  • Meeting Regulations – There are many government regulations that impact healthcare, particularly when working with Medicare and Medicaid members. With an interest in politics and public policy, Ryan has always enjoyed following these developments. He finds keeping up with the changes an interesting challenge and appreciates how you can see something on the news and figure out how it will impact your work environment and the diverse members we serve.

“We don’t offer a one-size-fits-all approach,” Ryan said. “We treat our members like individuals, listening to them, assessing where they are, what they need and helping them get there.” And that is how Health Dialog and people like Ryan are making quality healthcare more accessible to everyone.

Ryan Croteau PhotoName: Ryan Croteau
Title: Director of Client Services
Tenure with Health Dialog: 14.5 years
Education: Bachelor’s degree in Urban Studies from the University of Connecticut and master’s degree in Public Policy from the University of Southern Maine, Muskie School of Public Service
Family: Married to wife Jasmine for 14 years



[1] U.S. Department of Health and Human Services. Social Determinants of Health. https://health.gov/healthypeople/priority-areas/social-determinants-health.

Topics: Getting to Know Health Dialog