Understand the social determinants of health to better manage provider networks

by April Stiles... 

​Health plans, providers, and workers’ compensation organizations have increasingly seen that supporting consumers, patients, and injured workers in a more holistic way can make a significant difference in the health and wellbeing of both the individual and the overall population. To be successful, it is important to find ways in which to reduce the burden caused by the social determinants of health (SDoH).
 
Addressing social determinants of health is a critical to achieving health equity. Although, it can’t address all the challenges related to SDoH, provider data management can play an important role by promoting network integrity and offering critical user insights to support decision-making.

According to the World Health Organization (WHO), “The social determinants of health (SDoH) are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life.” (1) Socioeconomic statuses such as age or housing, personal factors including finances and transportation, physical demands of employment, and access to appropriate healthcare are all factors that can affect a consumer’s or injured worker’s recovery and return to work and daily living.
 
Social determinants of health are defined as conditions in the environment that affect a wide range of health, functioning, and quality-of-life outcomes and risks.
A study from 2000 shed some light on the importance of identifying the need to address SDoH. It demonstrated that individuals with lower incomes, rural residents, those living or working in areas with poor environmental conditions, and people with risky lifestyles are most likely to experience adverse health outcomes.
 
>244,000 deaths were attributed to low education (less than some college education)
>133,000 deaths were attributed to individual poverty (household annual income of ≤$10,000)
>39,000 deaths were attributed to area poverty (live in a county where ≥20% of the population lives below the poverty line. (2)


1. Social determinants of health (WHO.int)
2. American Academy of Family Physicians. Social determinants of health policy. Accessed January 14, 2019.