December 10, 2019

What Are The Social Determinants of Health?

Artemis Health

If you’ve been to a benefits industry conference lately, you likely heard someone mention the social determinants of health. It’s a trending topic among benefits industry professionals, but what does it really mean for employee benefits? Does this social science term apply to enterprise businesses? Let’s find out.

What does social determinants of health mean?

Think about the conditions you face each day as you go about your life. What kind of neighborhood do you live in? What’s your work environment like? How does your financial situation affect your daily health?

Social determinants of health are a set of conditions that affect your health based on where you live, work, learn, play, and experience life. Sometimes abbreviated as “SDOH,” social determinants of health include things like income level/poverty, access to education, access to healthcare, access to healthy foods, safety and security, and more.

We know from social science research that people living in impoverished areas have poor health outcomes compared to people living in middle class or upper middle-class neighborhoods. Lower income individuals and families may experience higher instances of chronic conditions, poor nutrition, increased likelihood of childhood diseases, and inconsistent access to medical care and coverage. Recognizing, measuring, and addressing social determinants of health not only helps improve population health as a whole, but also helps address health equity.

The word “determinants” can be controversial in some circles. Many anti-poverty activists feel that health is not determined by social status and conditions, but the equal access to healthcare system would lead to equal outcomes for those born into or living in poverty.

How are social determinants of health being used in benefits?

So why do social determinants of health keep coming up at benefits conferences? Artemis Health gets questions from enterprise clients about how to measure these factors and how they influence population health. Our clients come from all industries and their employees come from all backgrounds and parts of the country. You’ll see very different health profiles for populations from white-collar offices in San Francisco than you would at, say, an industrial manufacturing plant in rural Appalachia. 

Benefits program managers want to get a sense for population health over time, over geography, and compared to other populations so they can implement the right programs for the right people. Here’s an example. 

We worked with an Artemis client, a large trucking and logistic company, to look closely at the top health conditions affecting their population. Since many employees are professional drivers, the “social determinant” affecting them is a sedentary work environment with long hours and sporadic access to healthy meals. 

The benefits team suspected they had a growing problem with Type II diabetes, a chronic condition that affects nearly 10% of the U.S. adult population. They partnered with Artemis to find insights into their population’s diabetes prevalence and costs and make plans to help these members get the care they need. 

When we analyzed the demographics of their population, we found that the majority of subscribers were male, and their home states stretched all over the country. 72% of the diabetes claimants in the population are male, and the largest age group is 50-59 years old. 

Additionally, we calculated the costs associated with members who have either a medical diagnosis of Type II diabetes or were taking a prescription for Type II diabetes. 

Members with diabetes are often suffering from comorbid conditions as well, which contributed to our finding that these folks are incurring costs 2.5 times higher than other members. 

The client teamed up with their benefits consultant and a diabetes care management program to help these members with managing their disease. The program engages members through testing, monitoring, frequent check-ins, and nursing staff to help direct appropriate care. It’s a flexible program that also takes into account the lifestyles of the members, helping them stay in touch with a care management team while on the road. In this way, social determinants of health helped the employee benefits team find a gap in their benefits program and better serve their population. 

What role does healthcare data analytics play in the social determinants of health?

Healthcare data analytics can help benefits teams measure, track, and plan for social determinants of health. In the example with the trucking company above, Artemis helped the client look across multiple data feeds to find the information they needed to address employee health. Here are some common metrics to look for in your data analytics platform related to social determinants of health:

  • Demographic metrics like age, geography, gender, and income level
  • Diagnoses per thousand for common conditions associated with poverty
  • Distance to healthcare centers or hospital systems
  • Financial wellness like 401(k) contributions, HSA contributions, etc.
  • Frequency of preventive care visits
  • Childhood wellness checkups and vaccinations
  • Regular dental and vision preventive care visits

A robust data warehouse and analytics tools can help benefits leaders keep track of social determinants of health like those listed above and many more. It’s especially important to look at these metrics in combination with one another; if your data analytics platform doesn’t allow you to compare both dental and medical in one report, you should be shopping for a new tool.

While social determinants of health are trendy and buzzing in our industry right now, this isn’t the “Holy Grail” of benefits analytics. There are lots of trusted measures for population health, like risk scores and benchmarks. Plus, these metrics will constantly shift as members of your population improve their lives, move to new neighborhoods, float between income levels, and change their circumstances.

Additionally, some employers are using other non-traditional data to keep up with their population’s needs. This recent case study is a great example — we look closely at one employers efforts to determine employee health via on-site factory floor visits. While social determinants of health are certainly an interesting new avenue for health measurement in the benefits industry, it’s just one tool in a larger toolbox of techniques and strategies that successful benefits leaders are using to create healthier, happier members.

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