Social Determinants of Health & Employers
Over the past decade, the focus on improving employee health has morphed from a single spotlight on physical wellness to an overarching view of well-being, including mental, physical, and social health. Even with that shift, however, the focus has remained on the individual employee’s health risks and behaviors.
As healthcare technology advances, research indicates that an individual’s health is comprised of more than just his or her actions and genetics. Social determinants of health (including the economic, political, and environmental conditions in which people are born, age, live, and work), have a significant impact on development and the future health of individuals.2 Public health organizations and healthcare providers have been leveraging this concept to empower better health in communities, but there’s a key player in healthcare that needs to shift its focus: employers.
On average, full-time employees spend more than one third of each day, five days a week, at their workplace.3 With employees spending a large amount of time spent on in one location, leaving work out of considerations of population health “create a blind spot” in looking at the full scope of social determinants of health.4 Many aspects of a career, including the social environment, income, prestige, and stress, all play a factor in one’s health.4
The effects of social determinants of health: at a glance
- Economic stability:8% of Americans fail to obtain medical care due to cost barriers.5
- Education: By age 25, adults without a high school diploma are expected to die 9 years earlier than those with a diploma.6
- Physical environment: Transportation and distance to healthy food options impact the health of low-income and rural communities.7
- Social support: The stress of social isolation can lead to premature cognitive decline, chronic disease, and premature death.6
- Access to healthcare: The rate of physicians per 100,000 people ranges from 54.0 to 115.9 per state, meaning that the state someone lives in can have a significant impact to the availability of care.6
What should employers do to address social determinants of health?
By focusing on creating a culture of health, employers can positively affect workplace-related social determinants of health, as well as impact those outside of the workplace. Examples include 8:
- Ensuring all workers are paid a living wage for their geographic location to address economic stability
- Improving access to healthcare by offering yearly preventive screenings and connection to in-network primary care
- Focusing on clinically based services that help reduce healthcare spending for both employees and employers alike
- Partnering with vendors who can help connect the right employees into the right care—it’s not everyone having access to every service, it’s about getting those who need the service most to engage
- Creating policies that allow employees to take time away from work for health-related issues without fear of losing their job
- Subsidizing healthy food options in the cafeteria and addressing food security through a workplace food bank
- Selecting health plan providers that focus on the well-being of the community where employees live
- Educating people managers on social determinants of health and how they can affect workplace performance
- Health IT Analytics. What are the social determinants of health? https://healthitanalytics.com/features/what-are-the-social-determinants-of-population-health. August 18, 2017. Accessed Oct. 25, 2019.
- World Health Organization. Social determinants of health. https://www.who.int/social_determinants/en/. 2019. Accessed Dec. 16, 2019.
- Centers for Disease Control and Prevention. Workplace health promotion. https://www.cdc.gov/chronicdisease/resources/publications/factsheets/workplace-health.htm. March 12, 2019. Accessed Dec. 16, 2019.
- Ahonen EQ, Fujishiro K, Cunningham T, Flynn, M. Work as an Inclusive Part of Population Health Inequities Research and Prevention. American Journal of Public Health. 2018;108(3):306-311. https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2017.304214. Accessed Dec. 16, 2019.
- Centers for Disease Control and Prevention. Access to Health Care. https://www.cdc.gov/nchs/fastats/access-to-health-care.htm. 2017. Accessed Oct. 25, 2019.
- Centers for Disease Control and Prevention. Social Determinants of Health Recommended Queries. https://www.cdc.gov/nchhstp/atlas/slides/sdh-slideset.html. 2017. Accessed Oct. 25, 2019.
- Office of Disease Prevention and Health Promotion. Access to foods that support healthy eating patterns. https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-health/interventions-resources/access-to-foods-that. 2019. Accessed Oct. 25, 2019.
- Health Enhancement Research Organization. Social Determinants of Health – an Employer Priority. https://hero-health.org/wp-content/uploads/2019/09/HERO_HWHC_SDOH_Report_FINAL_090419.pdf. 2019. Accessed Dec. 16, 2019.