The purpose of this study was 3-fold: to evaluate the prevalence of: (1) common SDoH factors in a large commercially insured population, (2) common conditions such as diabetes, behavioral health issues, overweight/obesity, and high-risk pregnancy among those at risk of SDoH, and (3) addressable health services utilization concerns such as overutilization of emergency services, lack of preventive care, and non-adherence to hypertension medications among those at risk of SDoH.Ĭastlight collects health assessment data, which include a question that asks members, “Was there any time in the last 12 months when you needed to get health care or medications but could not?” People who respond “yes” are further asked to select the reasons from the following: “family, school, or work responsibilities ” “cost of care or insurance coverage ” “travel or transportation ” or “other.” 10 To date, none have explored the prevalence of social determinants of health with associated clinical risk factors for common medical conditions within a large commercially insured population. Recent studies of individuals with employer-sponsored insurance have described utilization patterns for preventive services, 7 delays in care, 8 as well as hospital admissions and emergency department visits, 9 but few have considered this information in light of social determinants of health, such as worker wage level 1 or place of residence. They justify the need to more comprehensively identify social barriers that adversely affect employee health and address them with relevant programs and interventions. 1 These trends suggest worse outcomes for low-wage workers and higher costs for employers. 6 A recent study of the relationship between wages and health care utilization among commercially insured populations found that low-wage workers used emergency room services 3 times more than their high-wage counterparts, used preventive care services 50% less, and had 4-fold more avoidable admissions. 5Įmployers are increasingly recognizing the need to understand and address SDoH issues to enable employees to utilize health benefits and control health care spending. Among commercially insured populations, individuals negatively impacted by SDoH are more likely to ration or delay care, engage in unhealthy behaviors, and experience diminished physical health and behavioral health, including higher rates of chronic disease. 4 Left unaddressed, SDoH create barriers to care that lead to poor health and high costs. has done little to improve outcomes related to social determinants. As a result, the $3.8 trillion spent annually on health care in the U.S. 3 Addressing the socioeconomic factors that negatively impact vulnerable populations has not been a key focus of health care spending, however. Remarkably, they drive as much as 80% of health outcomes. 1, 2 SDoH include factors such as economic stability, neighborhood and physical environment, education, health literacy, food access, and community and social contexts. Challenges related to the social determinants of health (SDoH), the economic and social conditions that influence individual and group differences in health care status, are key to driving health outcomes.
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