How to address social determinants of health through healthcare benefits

With healthcare costs expected to rise more than 5% in 2022, employers are implementing multi-pronged benefits strategies to rein them in, according to a Willis Towers Watson survey. Employers are working to ensure employees can get the right care at the right cost through affordability measures, network management and efficient benefits designs. They’re also trying to keep employees healthy and well through a wide range of preventative programs targeting physical, mental, emotional, and financial health.

Key to the success of both strategies? Addressing social determinants of health. Not factoring in social determinants of health could reduce the effectiveness of employer investments in workforce well-being as well as healthcare benefits strategies.

What are social determinants of health?

Simply put, social determinants of health (SDOH) are the conditions in which we live, learn, work, play and pray, and how those conditions affect our health. In more technical terms, SDOH are a wide range of social, economic and behavioral factors that impact an individual’s health risks and health outcomes. Transportation, education, housing, job opportunities, income, water pollution, racism and violence are just a few of the factors that affect an individual’s health and well-being and can cause wide health disparities and inequities.

The main social determinants of health categories

The U.S. Department of Health and Human Services groups SDOH into five main categories as part of their Healthy People 2030 Initiative:

• Economic stability, or the ability to have a steady income that allows people to meet their health needs. Stability can be achieved through employment programs, career counseling, and high-quality childcare. 
• Education access and quality, or the ability for children and teenagers to receive high-quality educational opportunities and excel in school. Achieving this goal involves improving the school system, providing early interventions to children who struggle academically, and providing financial assistance for advanced education. 
• Health care access and quality, or the ability to access comprehensive, high-quality healthcare services. Improving this SDOH can involve increasing access to virtual care and encouraging preventative care visits and routine screening.
• Neighborhood and built environment, or the opportunity to live in neighborhoods and environments that promote health and safety. Providing safe and healthy neighborhoods can include increasing transportation opportunities, reducing pollution, and ensuring access to healthy food and clean water. ‍
• Social and community context, or the ability to get support from the community when needs arise. This SDOH can be improved through increasing access to mental health support, improving health literacy, and reducing food insecurity.

Examples of social determinants of health affecting health outcomes

Upstream challenges in the conditions of people’s lives lead to myriad downstream health issues and poor health outcomes. For example:

• Up to 12,000 children in Flint, Michigan were exposed to drinking water with high levels of lead. Their exposure is believed to be linked to an outbreak of Legionnaires’ disease and also puts them at risk for long-term effects of lead poisoning, including possible increased risk of Alzheimer’s disease later in life. 
  

• A pregnant woman who can’t afford to fill a prescription drug to stop preterm labor is at higher risk of having a baby born with immature lungs and other complications.
  

• According to a 2015 study, people living in rural areas often don’t receive the care they need because there are too few facilities and providers, or the services they need are not available. Black women who live in rural areas have a 30% higher maternal mortality rate than Black women living in urban areas. White rural women have a 50% higher maternal mortality rate than white women living in urban areas.  

Social determinants have an outsized impact on health

Employers that focus on narrow networks but not SDOH are missing an important point. Not only do SDOH make an impact on health, but they make by far the most significant impact. According to a report by the American Action Forum, clinical care is estimated to account for just 10-20% of health outcomes; genetics are estimated to account for 30% of health outcomes; and social determinants of health for 60% of health outcomes.

Despite the significant links between SDOH and health outcomes, however, the medical community is not well positioned to address these factors from within the clinic’s walls. Not only do providers lack sufficient time to address SDOH, but the majority also don’t believe it’s their responsibility to do so: the average physician visit is only 17.4 minutes, and the average well-woman visit with an OB-GYN is just 15 minutes.

Considering they provide health insurance to nearly 160 million Americans, employers have a strong incentive to act. According to Business Group on Health, addressing SDOH can improve the health and productivity of your workforce, improve recruiting and employee retention, and improve your company’s brand reputation, among other benefits.

Addressing SDOH through employee healthcare benefits  

Partnering with health systems, public health departments, and community organizations and leaders to address local needs may only be possible for larger employers with significant corporate social responsibility or diversity, equity and inclusion initiatives. But any employer can consider the following steps to help address SDOH and improve the health and well-being of their workforce.

Gain insight about your employee populations

Addressing SDOH begins with identifying them. Survey your employees about SDOH. Find out if they are having difficulty finding a primary care physician or specialty care provider, for example, and educate them about next steps. If enrollment in your 401K plan is lower than anticipated among young employees, find out why and help address issues.

Simplify benefits navigation

‍As a first step, consolidate benefits offerings in one location through a digital engagement hub, making it easy for employees and their dependents to find and access programs. However, digital-only experiences are often not enough to engage employees or help them access the resources that can help them most. Look for solutions with embedded support from people trained in your benefits plan and skilled at building trusted relationships.‍

Build trust through personalized advocacy

‍While technology can play a role in predicting risk in your employee populations, identifying and addressing life factors requires trusted relationships. Healthcare concierge services or care advocacy gives employees access to independent, expert support for any health and benefits issue or question, allowing trust to build over time. Advocates listen actively and help guide employees to the best in-person and virtual care and resources to meet their needs. Through personalized guidance, advocates can learn about the life context of employees they support and remove barriers to care.‍

Embrace and expand virtual healthcare

‍The pandemic exposed the importance of virtual care to improve access to quality primary and specialty care for employees in any location. Provide 24/7 access to mental health professionals, family physicians and primary care doctors, as well as specialists who can support parents and aspiring parents, vulnerable populations in the time of COVID.

Ensure employees can access diverse providers and culturally-humble care

‍According to studies, care matching promotes greater trust and understanding between doctors and patients, contributing to better health outcomes and reduced healthcare disparities for underrepresented groups. Pairing Black patients with Black providers who can relate to their experience and meet them where they are brought several benefits, including more engaged patient-doctor conversations, improved prescription adherence, better patient understanding of health risks, and a greater willingness to pursue preventative treatment.  

Provide more support for working parents

Over the past 18 months, it’s become clear that working parents need more support than parental leave. Consider supporting parents with help finding and accessing affordable childcare as well as parenting coaching resources.  

Incorporate SDOH into your criteria for vendor programs

Be intentional about working with vendors that have a clear commitment and strategy to address social determinants of health. Ask them to describe how their programs uncover and address the life factors that make the most significant impact on employee health and well-being.

Addressing social determinants of health with Maven Clinic

Maven Clinic is the world’s largest digital family health solution for planning, growing, and caring for healthy families. Through Maven, members have 24/7 access to a range of maternity care specialists, resources, and virtual classes to improve health for birthing parents and babies.

Maven is dedicated to addressing social determinants of health by providing culturally-humble care for all, increasing access to specialty providers, and empowering members through care advocacy, clinically-vetted content, and virtual classes. Maven receives a 70 NPS from our members, and members also have 20% lower C-section rates and 32% lower NICU admissions.

As your organization strives to improve equitable care provided to your members, Maven is here to help. Schedule a demo with our team today to see how Maven supports families, improves outcomes for all, and reduces costs.