The U.S. spends approximately $3.8 trillion annually on healthcare, about twice as much per person compared to other developed nations. However, the U.S. has a lower life expectancy and worse health outcomes than any other high-income nation. 

Why the gap between higher spending and lesser health outcomes? One key reason is the disparities in healthcare in this country, which are classified by the Agency for Healthcare Research and Quality (AHRQ) as differences in access to or availability of medical facilities and services and variation in rates of disease occurrence and disabilities between population groups. These groups are defined by socioeconomic characteristics, such as:

• Age
• Ethnicity
• Economic resources 
• Gender 
• Geographic location 

Although health disparities describe the differences in health outcomes among groups, they don’t provide an explanation for the origin of these differences. One such term that does is social determinants of health (SDOH), which are conditions in the places where people live, learn, work and play that affect a wide range of health and quality-of-life risks and outcomes. 

Examples of SDOH include safe housing, transportation and neighborhoods; racism, discrimination and violence; education, job opportunities and income; access to nutritious foods and physical activity opportunities; polluted air and water; and language and literacy skills. 

The Effect of COVID-19 on SDOH 

The COVID-19 pandemic exacerbated already existing health disparities for a broad range of populations, especially black and Latino adults and other people of color. It reinforced the fact that poor communities suffer more than their more affluent counterparts during a pandemic. 

Even before the COVID-19 outbreak, studies found that individual behavior, often spurred by SDOH, accounts for up to 40 percent of the risks for premature death. Rates of preventable, chronic diseases are rising in low-income communities, and the average life expectancy in low-income communities is 15-20 years shorter than those in higher-income communities. People who are homeless were at higher risk of viral transmission because of crowded living spaces and scarce access to COVID-19 screening and testing facilities. 

SDOH Strategies for Providers and Organizations

Research shows that SDOH can be more important than healthcare or lifestyle choices in influencing health. As evidenced by the COVID-19 pandemic, healthcare providers must strive to improve patient outcomes within the clinical setting. By focusing on social determinants of health, they have the capability to improve health outcomes, reduce emergency department and inpatient care visits and decrease downstream medical costs. 

More than 95 percent of hospitals report a commitment to fostering diversity and inclusion strategies within their organizations, and 45 percent state that they already have a comprehensive plan for doing so. Some hospitals along with physician practices utilize population health management, which uses SDOH to help ensure that information about the importance of timely medical care is directed at the most at-risk populations. 

Other providers deploy outreach strategies that allow them to promote preventive screening and care for patients experiencing healthcare disparities. Screening for SDOH doesn’t need to be administered by a physician; it can be performed upon check-in so as not to disrupt the flow of the visit while promoting more comprehensive care. 

Another method providers can use in their SDOH outreach strategies is remote patient monitoring (RPM). Healthcare providers of all sizes, from small physician practices to large health systems, can employ RPM to treat different populations, including individuals with chronic conditions. RPM programs can be utilized to provide educational content and remind patients to collect their vitals, thereby enabling physicians to leverage that data to provide patients with better feedback about their condition(s) and treatment.  

SDOH Technology Tips 

Any technology utilized for SDOH must promote effective communication between providers and patients, resulting in improved quality of care, enhanced patient experience, decreased clinician burnout, reduced cost of care and improved staff teamwork and collaboration. Using mobile technology to promote contactless care allows providers to share health information to low health literate audiences and addresses two of the five domains of SDOH: access to healthcare and education. 

The American Academy of Family Physicians (AAFP) recommends that physician practices develop a team approach to address SDOH by:

1.    Identifying opportunities to address SDOH

2.    Evaluating patients and workflows

3.    Defining a new system

4.    Identifying barriers and planning for change

5.    Measuring and celebrating success

6.    Finalizing a team-based implementation plan

At Epion Health, we’re dedicated to improving how healthcare works. Our powerful platform allows for custom configurations based on provider, specialty, appointment type, timing and patient demographics. For example, our patient check-in software results in a more uniform, efficient and accurate check-in that helps reduce costs while improving data capture for population health management initiatives and enables access to education and additional resources, such as prescription cost savings and health plan navigation. Contact us to learn more!