Data and COVID-19: Understanding risks and population health

COVID-19 has made “data” part of the consumer lexicon. Models. Peaks. Flattening the curve. News headlines have captured these phrases and more in covering the pandemic. Given the amount of information available, it’s critical for employers to not focus only on the data itself. They also should consider the story it may be telling about the health of their employee populations.

“In times like these, you need access to a full range of factual data, and a trusted advisor who can help you discern it,” says Craig Kurtzweil, UnitedHealthcare’s Vice President of Healthcare Economics. “I’m proud that we can play that role for employers, and that we have the ability and the opportunity to respond and to be that trusted advisor. This is especially critical during moments of crisis, and as a company we’re meeting that challenge.” 

Kurtzweil and his team have been keeping employers apprised of these COVID-19 key indicators, among others, via aggregated data:

  • Prevalence (active cases)
  • Testing rates
  • Percentage of positive cases
  • Hospitalizations
  • Mortality rates

In analyzing these indicators, 3 items emerge for employers making more informed decisions as they find their way forward in their continued response to COVID-19:

  1. The importance of populations and sub-populations when assessing COVID-19 risk and decision-making, including cultural differences among employees.
  2. How social determinants of health may inform decision-making related to COVID-19.
  3. Strategies for returning to the worksite grounded in analytical insights.

Digging deeper into populations and sub-populations

Having developed tools and models to track SARS and Zika virus — long before the emergence of COVID-19 — Kurtzweil says his team was poised to address an outbreak such as this. UnitedHealthcare’s analytical innovations have provided important insights to employers as COVID-19 evolved and spread, helping Kurtzweil evaluate crucial next steps along the way.

3 Key Takeaways

  1. One of the most important insights is how a virus may affect segments of an employee population differently based on geography, gender and cultural background.
  2. Identify vulnerable or at-risk populations through social determinants of health and employers’ own population health data and build a strategy to care for sub-populations based on their specific needs.
  3. Real-time data on the health of a population, including employees’ use of tools to check and report their own symptoms before going into the workplace, also may inform strategies for returning to work.

One of the most important insights is how a virus may affect segments of an employee population differently based on geography, gender and cultural background. First, regarding geography:

“From what we’ve seen in the data so far, it’s important to recognize that COVID-19 is highly variable, and sub-populations matter a lot,” Kurtzweil says. “The way the coronavirus has impacted one geographic area or demographic group has been very different than how it has impacted other areas or other groups.

“For example, the way COVID-19 played out in China was not the same way it played out in Italy. And the way it affected Italy did not match its effects in New York. COVID-19 also looks very different when you compare the New York tristate area versus middle America. It’s a highly local phenomenon, and the way communities are responding to it varies immensely.”

Kurtzweil further explains that there’s a high degree of variability beyond locality alone. The data reveals that certain demographics may be at greater risk than others when it comes to COVID-19. The virus has more adversely impacted those with chronic conditions, the elderly, those in nursing home settings, certain minority groups — such as African Americans — individuals working in certain industries, and those with low income.1

Regarding industries, this chart with mid-May 2020 data illustrates COVID-19 inpatients by sector. Overall rates per 1,000 members for admissions are highest for the service, public sector and transportation industries. It’s possible many businesses in those sectors were deemed essential and lack the opportunity for employees to work from home.2

Bar chart showing variation by industry of COVID-19 inpatient admissions.

Regarding data focused on the African American population, deaths in that community represent a disproportionate percentage compared to the percentage of African Americans in a given state. Further, an Axios/Ipsos poll from June 2020 found 75% of African Americans say they are extremely or very concerned about the pandemic doing greater damage to people of color compared to 42% of Hispanic Americans and 30% of white Americans who say the same.3

Analyzing social determinants of health

What might employers glean from these insights? Identify vulnerable or at-risk populations through social determinants of health and employers’ own population health data. Once trends become clear, build a strategy to care for sub-populations based on their specific needs. Part of that strategy may include communication strategies specific to sub-populations to drive engagement.

“While statistics have shown that social and even cultural determinants may significantly influence health outcomes, COVID-19 has magnified these issues,” Kurtzweil says. “With the pandemic, we’re seeing determinants play out in a condensed timeframe.”

COVID-19 also has emphasized the need to focus on employees with chronic conditions, as those with underlying conditions have been identified as more at-risk to contract the coronavirus. Already a costly segment among employee populations, managing chronic conditions may command a strategic approach.

It starts with a combination of technology and 1:1 coaching designed to improve outcomes, increase engagement and, ultimately, lower costs for the employer. Predictive modeling and proactive outreach — grounded in data analysis from health assessments, pharmacy and medical claims, lab data and biometrics — are 2 key outputs of the data-led approach.

Data informing strategies for returning to worksite

As the pandemic continues and state stay-at-home restrictions in some states begin to lift, many employers may be looking to data to help build a strategic plan for returning to work that keeps employees and their families productive and safe. This is precisely the kind of situation where employers may be able to leverage highly specified population data sets and skillful analytical tools for optimal benefit.

 

Looking at claims or other data from last month or last year may no longer be relevant in today’s environment. To be meaningful and actionable, data must be fresh and as recent as possible.

Kurtzweil and his team have been communicating frequently with many employer groups to evaluate evolving COVID-19 data. Consultations go far beyond examining claims data alone. Kurtzweil’s team can go as far as overlaying an employer’s census to a geospatial view of COVID-19 exposure. It’s all about providing employers with detailed specifics around where cases are trending and for whom, even going so far as to scrutinize supply chains. For example, analyzing potential COVID-19 risks by looking at factors such as where stores are located, where employees live, where trucks are going.

Real-time data on the health of a population, including employees’ use of tools to check and report their own symptoms before going into the workplace, also may inform strategies for returning to work.

“Analytically speaking, it’s important to stay current with what the facts may be telling us, and in many cases, to examine data that is as recent, as local, as customized, and as population-driven as possible,” said Kurtzweil. “As communities and businesses start to open, our analytical tools show what sort of impact that may be having, preparing employers for what they might expect within their populations. This lets employers make more informed decisions that may be right for them.”

For more information, reach out to your consultant, broker or UnitedHealthcare representative.

Footnotes

  1. UnitedHealthcare data provided by Craig Kurtzweil, May 2020.
  2. UnitedHealthcare data provided by Craig Kurtzweil, May 2020.
  3. Axios/Ipsos Coronavirus Index, June 2, 2020.