There’s no question that socioeconomic factors such as access to food, shelter and transportation, social determinants of health (SDoH), have a huge impact on patients’ wellbeing. They are responsible for up to 80 percent of a person’s health.
These factors greatly influence health:
- Food insecurity
- Housing instability
- Early childhood education and development
- Enrollment in higher education
- High school graduation
- Language and literacy
Social and Community Context
- Civic participation
- Social cohesion
Health and Health Care
- Access to healthcare
- Health literacy
Neighborhood and Built Environment
- Access to healthy food options
- Crime and violence
- Environmental conditions
- Housing quality
In the coming weeks, we will explore each of these five areas in depth at Health Ideas.
Social determinants are a web of interconnected issues. Unemployment can lead to poverty, which can lead to housing instability, food insecurity and a lack of access to health care. These are not standalone problems.
SDoH must be addressed if we are to improve patient outcomes and reduce costs.
The first thing to do is identify those at risk. One way to do this is simply by asking. Use a population health platform to conduct a survey of your members. Use every opportunity you can to collect information about their needs, monitor responses over time, analyze behaviors and offer immediate assistance when barriers are identified.
Another way to identify problems is through your claims data. While ICD-10 codes for SDoH are available, they are often underutilized. A collaboration between the American Medical Association (AMA) and UnitedHealthcare aims to increase the number of codes available, and standardize their use to provide a more holistic view of each patient’s unique situation. This initiative promises to allow healthcare organizations greater insight into all the factors that affect a member’s health and enable care managers to take impactful actions to address them.
Once barriers are identified, there are many ways that healthcare payers can help. Some get involved in an Accountable Community for Health (ACH), defined by The Prevention Institute as:
"…a structured, cross-sectoral alliance of healthcare, public health, and other organizations that plans and implements strategies to improve population health and health equity for all residents in a geographic area. Designed to strategically leverage resources across sectors, the ACH model presents tremendous opportunities to reduce costs, enhance quality of care, and improve population health."
An ACH brings together healthcare providers in a specific location — a person’s zip code is a stronger predictor of their health than their genetic code—and encourages them to team up to face their common challenges, rather than act as competitors. They partner with many community resources outside of the healthcare system and coordinate assistance with housing, job training, transportation and many of the other determinants that are so important to a person’s wellbeing.
Another approach is for a payer to partner with an organization already working to improve social determinants. For example, Humana uses NowPow’s community service referral platform to create personalized resource lists to assist patients when barriers are identified.
Addressing these problems is an evolving process. It’s not easy, but it is imperative. If healthcare professionals, innovators and lawmakers work together and keep our eyes on the goal, we can make a real difference in the lives of people who are struggling.