Any healthcare provider could tell you that if that person does not have a place to live, a reliable source of food, or cannot afford their medication, the could get the best healthcare in the world and it would not matter. These social factors in a person’s life have such a major impact on health that a new term was coined in the last several years to describe the effect: Social Determinants of Health.

What are Social Determinants of Health?

Healthy People 2020 describes Social Determinants of Health as: “conditions in the environments in which people are born, live, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.”

Healthy People 2020 focuses on five key areas:

• Economic Stability
• Education
• Social and Community Context
• Health and Health Care
• Neighborhood and Built Environment

We all know that eating healthy food, staying active, not smoking, and annual screening by a provider helps us stay healthy. However, the communities we live in play a large part in how easy it is for us to do those things. Having access to resources like safe and affordable housing, healthy foods, and environments without toxins like smoke or car pollution is a major barrier for many people.

The pandemic further highlighted these problems. People in public housing and rural areas far from providers felt the brunt of the impact. As healthcare organizations figure out how to recover financially from the pandemic, many are rethinking their approach to Social Determinants of Health.

This is leading to innovations both in technology and business models to address these issues. Here are some of the most interesting innovations announced this year.

Using Big Data to Identify Social Determinants of Health

Big Data is the buzzword applied to large sets of data that can be used for analytics. While there are a lot of pie-in-the-sky ideas about what Big Data can do for healthcare, there are also some very practical things health systems are trying to address Social Determinants of Health.

Researchers at the University of California San Francisco (UCSF) connected public data sets with electronic health records to tie information about a person’s community to their healthcare. The idea is for providers to use this information to screen patients for social needs and refer them to community resources.

Their website, HealthAtlas, allows users to explore a map of California by different factors. These factors include things like food insecurity, access to an automobile, extremely low income, seniors living alone, and overcrowded housing. They also track the spread of COVID-19, so you can also see how these factors impact who contracts the virus.

HealthAtlas was built around the areas outlined by Healthy People 2020. The researchers hope it can help the state plan vaccine rollout. The map creates a visual display of data. This can help organizations consider different factors in how they approach different areas. For example, the researchers partnered with the San Francisco Department of Public Health in a program called Partnership for Healthy Cities to address chronic diseases.

Unlikely Investors in Affordable Housing

CVS Health, along with Aetna, announced their plans to address Social Determinants of Health in mid-2019 in their Destination Health platform. Recognizing that 60% of a person’s life expectancy is determined by factors outside of the healthcare setting, they launched a series of business programs.

One program, called Building Healthier Communities, involves a five-year, $100-million commitment. This money goes to programs focused on improving local access to affordable quality care. The company wants to impact public health challenges like chronic disease and opioid abuse, and partner with local communities.

Another program is their partnership with Unite Us – a care coordination platform and hands-on community engagement process. CVS and Aetna planned to offer this program to Aetna Medicaid and dual Medicaid-Medicare members in Kentucky, Florida, and Louisiana.

However, the program that is most surprising is their investment in affordable housing. CVS invested $114 million in affordable housing in 2020. The money will go to building or renovating over 2,800 affordable housing units in 30 cities and 12 states. That includes 460 units for people who are homeless, and 560 unites for seniors.

Social Determinants of Health in Clinical Platforms

The most useful place to have information about potential Social Determinants of Health for a person is in a clinical platform. The idea is to have that data available at the point of contact with a person.

Humana recently announced they are piloting a chronic care management platform. The platform will integrate social determinants of health data in its approach. It will use data analytics and a multidisciplinary care team – including nurses, pharmacists, and social workers – to address individual needs.

The focus will be people with chronic illnesses. The company plans to start with members of the Medicare Advantage plan in Pennsylvania, West Virginia, and Kentucky. Plans for the platform started before the pandemic, but that health crisis provided the fuel to move it forward.

Providing Equitable Access to Telehealth

While record numbers of people adopted telehealth in 2020, many were still left out. Seniors, people with a low-income, and people in rural communities are among them. As healthcare organizations take more ‘virtual first’ approaches, many are concerned about the folks who cannot take advantage of it.

One of the biggest barriers to using telehealth is lack of broadband and technology skills. Even with 5G and other ultra-high-speed networks coming out, there are many communities that will not have access to them.

The recently formed Telehealth Equity Coalition (TEC), hopes to change that. Guided by values like equity, inclusion, collaboration, and innovation, they are a coalition of organizations. Their members include the American Telehealth Association, Grapevine Health, Howard University Department of Community and Medicine, and personal wellness telehealth company Hims & Hers.

The coalition plans to use data to advocate for better telehealth policy. They also plan to create an open-source telehealth data dashboard and map. Their goal is to address the gap in quality and affordability of healthcare for vulnerable communities.

Key Takeaways:

Recognition that someone’s environment impacts their health is long overdue. Now that Social Determinants of Health is an area of focus, healthcare organizations must think about the whole person.

There are areas where innovative solutions offer hope:

• Leveraging Big Data to identify Social Determinants of Health.
• National pharmacy chains and insurance companies investing in affordable housing.
• Integrating Social Determinants of Health data in clinical platforms.
• Attacking telehealth disparities head on.

While there is no one easy solution to address these issues, focusing on them will generate more innovative ideas. This is an area where technology can make a difference.