In a Shrinking Economy, Health Equity Is Not Just a Moral Imperative—It's an Economic One

OECD predicts US growth to fall

As the Organisation for Economic Co-operation and Development (OECD) rings the alarm bells on the global economy, forecasting U.S. growth to fall to just 1.6% in 2025—a staggering 43% drop from 2024’s 2.8%—the gravity of this moment cannot be overstated. Bloomberg’s report traces the decline to rising tariffs, waning consumer confidence, and protectionist trade policies. But while economists debate geopolitics and inflation curves, those of us working toward health equity must ask: what do these numbers mean for the people behind them?

Because here's the truth: economic downturns don't hit everyone equally. And if we don't shift the narrative and strategy now, health systems will be yet another casualty in a cycle of inequity we’ve seen before.

Economic Turbulence Doesn’t Just Strain Wallets—It Strains Lives

Let’s connect the dots: Retaliatory tariffs and reduced immigration (both noted contributors to the slowdown) don’t just weaken the labor market—they chip away at the very infrastructure of health care. Fewer workers means fewer caregivers. Tariffs increase the cost of imported medical supplies. And when federal layoffs arrive, it's often public health programs and safety nets that take the hit first.

It’s not just macroeconomics—it’s maternal mortality, delayed cancer screenings, and overworked nurses. It’s the lived experience of underserved Black and Brown communities that are already weathering the long storm of systemic neglect.

Health Equity as Economic Resilience

This moment demands more than triage. It demands transformation. And health equity is not just the ethical path forward—it’s the economically sound one.

When we talk about health equity, we’re talking about designing systems that work because they recognize difference—not in spite of it. It's understanding that one-size-fits-all solutions are often one-size-fits-none. Equity-centered care helps organizations not only improve outcomes, but also reach untapped markets, reduce wasteful spending, and improve workforce satisfaction and retention.

For example, clinics that expand telehealth access for those in rural or linguistically diverse communities are building new patient bases. Health systems that invest in culturally and linguistically appropriate services (CLAS) are preventing readmissions and improving trust. And care teams trained in structural competency and cultural humility are not just delivering care—they're healing broken relationships with historically excluded communities.

From Surviving to Reimagining

So, what does a strategy rooted in health equity look like in a shrinking economy?

• Targeted Investment: Allocate funding to programs serving those hit hardest by layoffs and inflation—especially Black, Indigenous, Latinx, LGBTQ+, disabled, and immigrant communities.

• Culturally Responsive Innovation: Shift away from top-down Western medical models. Embrace community health workers, Indigenous healing practices, and trauma-informed design.

• Inclusive Market Expansion: Treat equity as a driver of innovation, not a compliance box. Different markets have different needs—recognize, respect, and respond to them.

We must reframe health equity from being “nice to have” to being absolutely essential for sustainability. Because as growth slows and economic anxiety rises, it will be the organizations that understand and respond to systemic disparity that endure—and lead.

A Call to Act with Courage and Conscience

At Conscious By Us, we know that meaningful change isn’t built in boardrooms alone—it comes from the margins, from the lived experience of those who’ve too often been overlooked. The road ahead is not easy, but it is navigable. And health equity is not just a compass—it’s a lifeline.

Let’s not wait for another crisis to remind us that equity is the foundation, not the fringe.