What has the biggest impact on our health?

Nov. 29, 2017 / By Rebecca Caux-Harry

Last month, I wrote about my experience with The Texas Medical Center and the loss of my mother. One reader questioned whether the healthcare system is working (as I maintained in my blog) when many people can’t afford their insurance premiums. Although I took care to indicate I was only writing about the practice of medicine and not the insurance industry, I know there are a variety of pains we’re all familiar with (insurance premiums, deductibles and copays, in-network verses out-of-network pricing, as well as denials). These “pains” are very real and impactful, but in my mind are related to insurance, not health care. These two industries will always be closely linked, as very few of us can afford to pay out-of-pocket for health care. But they are different industries. 

I will not add my voice to those working to uphold, change or replace policy with regard to health insurance, as I believe the arguments are loud enough as it is. I certainly can’t change the trajectory of those debates, nor would I consider myself well-enough informed to do so. But, what I can do is learn as much as I can about how to positively impact my health, therefore reducing my need to access either industry. In a recent article published by America’s Health Insurance Plan (AHIP), the major forces impacting health were reviewed. The article, detailed a new acronym for me: SDOH, Social Determinants of Health. AHIP is an association of health insurance sellers, so their research might contain some bias, although I didn’t detect any.

This article listed the most impactful determinants of health and the percentages attributed to each. Most impactful: Individual Behavior at 40 percent. That’s really good news for many of us because this is something we can exert some control over. While insurance doesn’t always reimburse a gym membership or exercise equipment, using either can have a powerful impact on health. Some insurers will reimburse smoking cessation support. An active lifestyle and not smoking always top any list of changes we can make to improve overall health.  While smoking and exercise weren’t the only two activities mentioned in the article, we can do a lot to reduce our healthcare costs by being proactive. 

There are some things we can’t control: Genetics at 30 percent is the second most impactful determinant of health. Ah, if only we could choose our ancestors, but we can’t. We must be aware of the genetic gifts given to us at birth and be mindful of those potential health weaknesses as we age. Proactive screening for our inherited conditions should be on everyone’s radar.  Environmental Factors (15 percent) and Social Circumstances (5 percent) are additional elements where our control is variable.  If I live in a violent or polluted area and don’t have the means to change that, these two factors will negatively impact my health. So I’ll exert control where I’m able.

But where is health care on the list? Health care comes in at a 10 percent impact, second from the bottom. This low percentage doesn’t diminish the financial impact of insurance and healthcare costs. But the article and the list of SDOH percentages reminds me that while I don’t have much, if any, impact on the cost of my insurance premiums, I can do everything in my power to make sure I maximize a positive impact on my health by modifying these factors where ever possible. 

Rebecca Caux-Harry, CPC, is the CodeRyte product specialist for cardiology with 3M Health Information Systems.