How Payers can Advance the Top 5 Social Determinants of Health
A comprehensive healthcare system looks at our total health, not just the outcomes.
Social determinants of health are the environmental factors of where we live, work, play, are born that affect our health. Social determinants are all the factors that contribute to our mental, emotional and physical health, and therefore our health as human beings.
The 5 social determinants of health are: Healthcare access and quality, neighborhood and built environment, social and community context, economic stability, and education access and quality.
An individuals’ economic resources severely impact their health physically, emotionally and mentally. If you do not have access to quality care, if your healthcare systems are overburdened, if you are uninsured and cannot receive routine care, your health is going to suffer. Often people receive health insurance through their employers, but if you are underemployed or unemployed (as meany are during the Pandemic) you will not be able to receive the quality of care (or care at all) if you need it.
Payers can help by connecting members with employment programs, career counseling, supporting childcare so parents can work. Also, providing grace periods for payments, lowering premiums and allowing for more cost sharing. Some payers extended special enrollment periods for people who lost their jobs and therefore lost their health insurance. Additionally payers invested and can continue to invest in employment organizations providing training pathways to jobs.
Access to a good education improves our long-term economic outcomes, but it also improves our health outcomes. If you’re able to receive a good education, you’ll be able to afford better healthcare. You’ll also be able to navigate the healthcare system with more literacy than those who do not. Aside from long-term outcomes, in the short-term, if kids do not have access to a quality education where they feel safe to learn, they will be bound for poor health outcomes. Bullying, overpopulated schools, lack of educational materials can all deteriorate a student’s mental health and lead to poor health outcomes down the line. Poverty is arguably the most common and one of the worse “health conditions” for any individual as it deteriorates human beings’ way of life.
Payers can assist with these educational access issues by coordinating with schools to understand the needs of students in specific areas. Payers can connect students with opportunities for attending university and funding it, contributing toward internet and technology access (more relevant during the Pandemic than ever before.) Payers can also work with the school systems to provide preventative care in the form of vaccinations and education that will improve health outcomes in the long-run not only for the individual, but for the community as a whole.
Access to quality healthcare is as essential as it sounds. What are some barriers to quality care? The list is very long, but to start things such as lack of transportation, health literacy, not having a primary care provider, living in a community with overburdened hospitals, and lack of culturally-sensitive communications are just a few. On top of that there’s the issue of uninsured individuals. If you don’t have insurance, you will most likely not be able to afford healthcare at all. Then if you do get sick, you won’t be able to pay the bills.
Reducing the number of uninsured individuals and increasing access to comprehensive benefits, health plans will be able to address social determinants of health. The first step would be to offer the services at an affordable price. Innovations such as artificial intelligence, telehealth and other technological solutions will also help to increase access while reducing barriers. Millennials are a perfect example of a demographic that needs all of the above. Often they are underinsured and therefore do not have a primary care physician that can integrate and understand the social determinants of health. They often lack resources such as transportation, cash and have busy schedules that make routine healthcare difficult. Once payers can understand the needs for this generation, and many others to come, we can reduce the level of underinsured people and see a healthier population.
Neighborhoods and built environments have been left out of the healthcare system for a long time, but often contribute to an overwhelming quantity of health issues. Some neighborhoods are simply unsafe whether it’s due to crime, pollution, poor building quality, exposure to drugs and addictive substances, the list can go on and on. Low income areas perpetuate many of the poor conditions mentioned above, significantly affecting residents’ health. If payers were able to partner with with the local community as well as housing organizations or those address food insecurity, they would be able to create plans that accommodate the unique needs of these populations. Arguably low-income populations are the most in need of sensical healthcare that takes all their challenges into account.
The social and community aspect of health is essential, as we’ve all felt challenged by the pandemic and know what isolation can do to our mental, emotional and physical health. Having a strong social network or community is essential to behavioral and mental health no matter what age you are. Communities are large groups of people often sharing similar characteristics. So imagine that you have a large non-english speaking community, if their healthcare systems do not communicate in any language other than English, how are they going to be able to navigate the healthcare system? Well simply put, they won’t.
Payers can get involved by creating health centers and community resources that increase culturally-appropriate access to care, information and health literacy. These centers can create community in a positive way by offering diverse groups of people a safe and friendly environment to prioritize their health and find access to resources. Digital communities are now sprouting up in the wake of the pandemic, and attempting to offer a similar level of personalized help, but there’s so much more work to be done.
Social determinants of health look at individuals not by their conditions or symptoms but as members of the communities in which they live and all the aspects of health that accompany our daily lives. This is the future of comprehensive healthcare and payers have the unique opportunity to bring forth the future of care.
Source: https://healthpayerintelligence.com/news/top-5-social-determinants-of-health-domains-for-payers-to-address