For the first time since WWII, the average life expectancy in the United States dropped, decreasing by 2.3 years from 2019 to 2021. With higher maternal mortality rates than most other developed countries, along with obesity, pre-diabetes, and diabetes rates continuing to soar, the proportion of Americans reporting fair to poor health has climbed over the past 15 years.
With 80% of an individual’s health outcomes driven by outside factors of traditional healthcare, benefits leaders are narrowing in on Social Determinants of Health (SDoH) to change the trajectory of the health of their populations. SDoH are the external environmental conditions, such as inadequate access to housing, proper nutrition, transportation, education, employment, and exercise, that considerably impact countless Americans' health.
Social determinants of health further exacerbate health disparities and inequities in the United States. For example, areas with high poverty rates often overlap with “fast-food swamps” or “food desserts.” People who live in these areas are less likely to have access to good nutrition. That raises their risk of health conditions like heart disease, diabetes, and obesity and even lowers life expectancy relative to people with easier access to healthier food options.
Life expectancy gaps of up to 30 years have been identified between different neighborhoods within the same city. In 2015, diagnosis codes were added for social determinants of health, which zip codes were a significant factor in pinpointing. Just promoting healthy choices won't eliminate these or other health disparities. Instead, public health organizations, governments, and health benefits stakeholders need to take action to improve the conditions in people's environments.
Poor health related to SDoH impacts not only the quality of life but also the quality of work in the United States. In dollar amounts, lower productivity and absenteeism related to financial stress cost an estimated $1,900 per employee and an estimated yearly loss of 1 million dollars for a mid-sized employer. Employees with chronic conditions with at least one SDoH characteristic cost 10% higher PMPM, driven in part by the fact that they visited the emergency room significantly more.
According to the NFP Benefits Trends Report, 45% of employers in 2022 see SDoH as having a big influence on their benefits strategy.
Disparities in any of the five domains of SDoH can be a significant cost driver for self-funded employers. The challenge across the broad SDoH domains is that a consensus definition of exactly how to track and improve SDoH has not been made, causing employers to feel overwhelmed with where to start.
Leveraging the insights derived from social determinants of health may be overwhelming and require coordination between various stakeholders, including IT, analytics, clinicians, social workers, community partners, and leadership. Developing a solid SDoH business case can help you overcome this challenge, and harnessing your data with Artemis can help in the development of impactful interventions.