Social determinants of health impact employers and their health care spend

Even with the advancements of modern medicine and technology, health care costs continue to rise as many people struggle to maintain healthier lifestyles. In response, public health strategies increasingly are aimed at addressing social determinants of health (SDoH) – conditions in the environments in which people are born, live, learn, work, play, worship and age – that affect a wide range of health, functioning and quality-of-life outcomes and risks.¹

Focusing on SDoH recognizes the fact that clinical care, while vital, is responsible for only 20% of a person’s health. The other 80% is attributable to health behaviors, the physical environment and socioeconomic conditions.² While these social factors have long presented challenges in commercial health populations, the COVID-19 pandemic exacerbated and further exposed how they can significantly impact overall population health as well as outcomes for individuals.

An internal analysis of employer populations has found:³

• 3% – 5% of employees are at risk for homelessness
• 15% – 25% of employees have high levels of financial insecurity
• 15% – 25% of employees have high levels of food insecurity, with limited overlap of financial insecurity
• 20% – 30% of employees are highly socially isolated

“SDoH significantly impacts population health status and health care costs. When we operationalize SDoH solutions for employers within our products and services, we add the underlying theme of sustainability as well,” says Seth Serxner, PhD, MPH, Chief Health Officer and Senior Vice President Population Health at Optum.

UnitedHealthcare in partnering with Optum has developed a solution framework that involves three elements to help employers address SDoH within employee populations. Capabilities that identify and assist employees with needs related to SDoH are embedded in UnitedHealthcare advocacy and clinical programs.

Create a foundational infrastructure. The first component of the foundational solution involves analytics at both the community and individual level. This leverages advanced analytics capabilities of UnitedHealthcare to identify risk factors for each community as well as which social risk at the member level to determine which programs and services may address their social needs. 

Other elements involve assessing member needs, referral to relevant resources and follow-up. Follow-up steps may involve benefit design review and modifications as well as review of existing programs available to address social needs such as financial insecurity. Continuous monitoring and follow-up then help measure outcomes. Specific worksite locations can also be identified for employers to address food insecurity and other needs by creating an on-site food pantry and clothing room.

Expand interventional elements. Shared investments, partnerships and commitments with the employer and local organizations in transportation, housing, food, finances and environmental conditions to further build upon the foundation. Since 2000, UnitedHealth Group has contributed $1.1 billion to over 4,600 communities across 50 states in areas such as housing, access to care and building a more diverse workforce.

Enhance efforts with sustainability approaches. Adapt programs and solutions within communities to create long-term changes. For instance, food insecurity solutions can promote sustainable food sourcing when program vendors work with local farmers.

“We’ve been applying our resources to tackle these issues across the country, and we’re seeing the increasing need for everyone to come together to tackle SDoH on an even larger scale,” Serxner says.

To dive deeper into the UnitedHealth Group approach to Social Determinants of Health, download this white paper from Optum.

For more information on specific programs and solutions that address SDoH, contact your UnitedHealthcare representative.