Executive Summary

The US health care system has historically overemphasized the importance of clinical care in efforts to improve health outcomes, yet Americans fare worse than peer countries across many measures of health, including maternal mortality, life expectancy, and infant mortality. As our health care system shifts towards value-based care, leading provider organizations are studying non-clinical risk factors (e.g., social circumstances, physical environment) and building new models for social care delivery in partnership with owned and community resources in an effort to improve patient outcomes.

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What are social determinants of health?

What are social determinants of health? Social Determinants of Health Educational Briefing for Suppliers and Service Providers Health Care Industry Committee. According to the World Health Organization, the social determinants of health (SDH) are “the conditions in which people are born, grow, live, work and age,” which includes security in food, housing, income, environment, and social context. SDH data can be used to give health care providers a more comprehensive view of the health status of individual patients and populations.

Socioeconomic factors are far stronger determinants of health outcomes than medical care, and addressing SDH has been shown to be effective in improving outcomes. For example, investment in community health workers has been consistently shown to improve costs, quality, utilization, access, and patient satisfaction with care. When combined with traditional clinical and claims data, SDH data permit more effective care planning, interventions for individual patients, and population risk assessment.

A Framework of the Social Determinants of Health

How do social determinants of health affect providers?

Although SDH are non-clinical risk factors, they play a large role in the overall health of a patient. SDH are linked to:

• Medication non-adherence
• Delays in seeking care
• Lack of a primary care provider
• Toxic stress

For example, 74% of the 41.2 million Americans living in food-insecure households have to choose between paying for food and medicine, often leading to medication non-adherence. Addressing SDH can improve care effectiveness, reduce emergency department utilization, reduce readmissions, and improve the overall health of a patient population.

SDH are strongly associated with increased utilization and cost to a hospital. For example, the annual health-related costs that can be directly attributed to food insecurity in the US amount to $155 billion. Additionally, 80% of emergency department visits by patients experiencing homelessness could be prevented with primary care treatments. For many patients affected by SDH, hospitals must provide high-cost care for lower reimbursements, whether that be from Medicare, Medicaid, or uninsured patients.

As new regulations continue to push providers from volume-based to value-based care, there will be increased pressure to improve care quality for the entire patient population. Without addressing SDH, hospitals could struggle on reimbursement-linked metrics such as readmissions. Investing in SDH interventions is a strategic investment option with measurable ROI for providers.

Because SDH are so varied, strategies to address them will vary by hospital or health system. In areas where food insecurity is the most pressing concern, hospitals may open food pharmacies; other hospitals may partner with ridesharing services like Uber or Lyft to address a lack of transportation.

How can suppliers address SDH to help providers achieve strategic goals?

Use this chart to think about where you can best support your provider customers as they invest in SDH interventions. Each check mark represents an area where the listed intervention focus has a documented impact. For example, facility firms may be best poised to address housing instability, while food services companies could focus on food insecurity.

Additional Advisory Board research and support is available

If you would like to learn more about SDH, please contact your institution’s Dedicated Advisor. To see how hospitals are handling SDH data, see our Connected Care Series: Social Determinants of Health research report.

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