John Selig, senior vice president at the Lewin Group and former director of the Arkansas Department of Human Services, was interviewed recently at the Health IT Summit hosted in Baltimore (April 5–6). He discussed the impact of social determinants of health (SDOH) on overall health outcomes. SDOH is still a relatively new area of focus in health care, but as stakeholders, we cannot deny their importance.
SDOH contribute to an individual’s well-being and can often impact overall health more than standard health care services themselves. Education level, access to nutritious food and medical services, physical safety, living environment, employment and housing are types of social determinants. But SDOH do not stop at the individual level — they impact entire communities. As a result, we may see changes in how we spend traditional health care dollars on social programs in the near future.
There is no standard approach to capturing or integrating SDOH data into existing health care data sources, such as claims and electronic health records (EHR). However, the opportunity to implement IT support of SDOH data exists. Incorporating SDOH into reporting tools or predictive models can help expand patient health insights and lead to more impactful care plans. And when providers have access to SDOH data, they can refer patients to beneficial resources in their community.
Selig believes that Medicaid can help address SDOH for better outcomes, as it is a primary integrator in connecting the health system with social programs. Medicaid programs can be tailored to local populations and connect them to the appropriate social resources. Targeted use of Medicaid funds on social programs could even help reduce overall Medicaid costs.
Technology is another connector between social programs and improved health outcomes. To develop an effective “culture of health,” states must be willing to invest in technology solutions that identify links between those programs and allow seamless access to the right support at the right time.
Individuals and families can use web-based, consumer-facing integrated eligibility systems to simultaneously apply for Medicaid and other public health benefits, along with food and cash assistance programs, child care assistance and other support services. States with strong data systems and analytics can then track and measure program success or address needed improvements.
According to Selig, health care alone can only go so far to improve health. How and where people live may be more important in determining overall health and longevity. In other words, your ZIP code may play a bigger role in your overall health than access to health care services.
The American Healthcare Paradox: Why Spending is Getting Us Less (2013), from Yale University researchers, directly connects investments in social services with a country’s overall health. Using comparative data, the researchers found that the U.S. ranks near the bottom in many health outcomes, despite leading the world in per capita spending on traditional health care. One reason for this is that we spend comparatively little on social services. The same also seems true for individual states. Those with higher social-to-health care spending ratios generally have better health outcomes than states allocating less to social programs.
Health care and social services systems need each other — to serve their communities as fully as possible, to contain costs and to improve care. Investing in social programs is essential to moving the needle on improving health outcomes across the board and across the country.
For more on the conversation with John Selig, which dives deeper into all of these topics, please download the full interview brief.
About the author:
Steve Griffiths, PhD, MS
Senior Vice President, Chief Operating Officer
Optum Enterprise Analytics
Steve Griffiths has more than 20 years’ experience in health analytics management, and currently heads up the Optum Enterprise Analytics organization. His main focus is driving growth and innovation through Optum products and services. Steve has a master’s degree in biostatistics from the University of Washington and a PhD in health services research, policy and administration from the University of Minnesota.