Abstract
Health inequities manifest differently across countries, shaped by demographics, health system design, and broader social structures. Yet they remain a global reality. Evidence consistently shows that barriers to accessing and using health services contribute to poorer health outcomes and reduced life expectancy among certain populations. These inequities cut across multiple dimensions, including geography, income, race and ethnicity, age, and gender. This workshop highlights concrete examples from around the world and examines how these disparities influence both health outcomes and patterns of care utilization. In this session, we will examine research on health inequities across five key areas of the health system: affordability barriers, provider payment structures, the use of artificial intelligence, gender, and substance use disorders, with three primary objectives:1. Expose disparities in health care experienced by disadvantaged groups and their impact on health systems; 2. Identify lessons and insights that can be adapted across countries; 3. Discuss promising solutions and approaches to improve equity and access to care. The panel will include one moderator and up to five panelists – experts, researchers, and physicians affiliated with the Commonwealth Fund or alumni of the Harkness Fellowship from countries including the U.S., U.K., France, Germany, and Norway. The session will open with remarks from a Commonwealth Fund moderator highlighting the importance of cross-country learning. Munira Gunja, senior researcher in the International Program, will present findings from the 2026 International Health Policy Survey, focusing on how financial barriers shape health care decision-making across 12 countries. William Roberts, a 2025-2026 Harkness Fellow who is based at the Healthcare Quality and Outcomes Lab at Harvard’s T.H. Chan School of Public Health and the Center for Health System Sustainability at Brown University School of Public Health, will discuss approaches to measuring equity and incorporating it into payment models, including the U.K.’s health inequality index within capitation-based funding. Laure Millet, Senior Fellow at Institut Montaigne, will examine the use of remote patient monitoring to inform public health policy and improve outcomes for vulnerable populations in the U.S. and France. Viktoria Steinbeck, Research Fellow at Technische Universität Berlin, will present trends in primary care physician satisfaction, stress, and burnout, with a focus on gender differences across 10 countries over a decade. Ane-Kristine Finbraten, senior physician at the Norwegian Institute of Public Health, will discuss inequities affecting individuals with substance use disorders. Each panelist will present their project. They will each have approximately eight minutes to speak, followed by a 20 minute segment for moderator remarks and audience questions.
Key messages
• Health inequities are widespread and complex, leading to poorer outcomes and reduced access, especially for disadvantaged groups, and are embedded across the health system.
• Cross-country learning helps identify practical strategies, including payment reforms and targeted interventions, that can be adapted to improve equity and access across different health systems.