If we are looking to impact the health and health care issues of those enrolled in our company's health and welfare programs, we must consider social determinants of health. (Photo: Shutterstock)
Health care continues to evolve with a greater emphasis on value through new payment models and new partnerships. If we are truly going to impact the health care system, there is one key area that requires a revolution rather than evolution. That is the issue of social determinants of health (SDOH). According to the World Health Organization, SDOH are defined as social and economic influencers that can impact one's health and health status. This includes income and social status, employment and working conditions, education and literacy, safe and consistent living conditions, food and nutrition, and adequate transportation.
While many of these areas are outside of the traditional health care environment, SDOH are conditions in which people are born, live, learn, work, play and worship. And many people all over the world have vulnerabilities in one or more of these areas.
|Why should employers care?
One misconception that must be addressed is the population impacted by SDOH. When most people think about those struggling with various issues, they most commonly think about the unemployed and socio- economically challenged. And while it's true that many people impacted by SDOH have these attributes, what's often overlooked is the impact to employees and their family members. In fact, many struggle with one or more of these issues.
At a recent client meeting an employer shared the demographic, financial and educational profile of their employee base. It was a real eye-opener, as 82 percent of their employees looked more like an individual on Medicaid than what we would consider the traditional profile of an employed individual. What this means is that SDOH are not someone else's problem. It is our problem if we are looking to impact the health and health care issues of those enrolled in our company's health and welfare programs.
|What can employers do?
Most employers want to improve the health and health care of their employees and family members. They invest in their workforce for a variety of reasons—to attract and retain high quality employees, provide cost-effective benefits, and remain competitive in a global market. Regardless of the reason, it's important to remember that it's not that employees don't want to take care of their health, but they may not know how or what to do.
Consider the employee asked to follow a heart healthy diet that may have little or no food for themselves or their family. Or an employer with a plan design that requires an employee to travel across town to get their care when they must rely on public transportation. And the worker that needs to exercise, but the neighborhood where they live isn't safe to walk.
Here are several recommendations that employers should consider when embarking on the journey of addressing social determinants of health:
- Know who your audience is when targeting action and interventions to ensure resources are offered to those most impacted by negative social determinants of health as this will vary based on the employee population. Needs across the workforce will differ from that of an employee facing a temporary or situational need such as cancer or transitioning out of the hospital or skilled facility, to those identified through risk assessments. Additional factors that should be considered include the needs and obstacles of low wage employees, employees in food deserts and dual income families without time to plan their meals.
- Determine the goals of what you are looking to achieve by addressing social determinants of health. The goals that you are trying to achieve will depend on the population that you are targeting. Goals can be concrete such as financial savings due to reduced hospital and emergency department use or more clinically focused such as reduction in risk for chronic disease. Objectives can be even more general such as reduction in stress, employee satisfaction or retention of employees.
- Thoughtfully consider the what types of programs and initiatives to launch and potential partners such as non-profit community organizations, employee assistance program and other vendors.
Focusing on social determinants of health is not easy or a "check the box" type of initiative. One needs to be realistic as to what can be achieved and within what timeframe. As an employer you do not have to attempt this on your own. There are several organizations that can help employers in this revolution including private, public and community organizations.
The good news is that you can make a difference for both you and your employees. When you're focusing on lifestyle, chronic diseases and other health-related factors, don't forget to also focus on social determinants of health—it matters and makes real sense for employers.
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