How accurately capturing social determinants of health can positively impact health outcomes

June 14, 2024 / By Michelle Badore

Social determinants, or drivers, of health (SDoH) are the non-medical factors that influence our health outcomes and play a vital role in shaping the well-being and quality of life for individuals and communities. SDoH data covers various dimensions including economic stability, education access and quality, health care access and quality, neighborhood environment, and social and community context. These drivers have an important influence on health inequities, the unfair and avoidable differences in health status seen within and between countries. In countries with all income levels, health and illness outcomes follow a social gradient: the lower the socioeconomic position, the worse the health.

In the United States, SDoH has increased pressure on policymakers, hospitals, providers and communities to improve population health and promote equitable health outcomes. We have made good strides in the acute settings, with the coding, clinical documentation integrity (CDI), provider triumvirate. One example is the Hospital Inpatient Quality Reporting Program, whereby hospitals are now mandated to report how many patients 18 years or older were screened for SDoH and the percentage of patients who screened positive for one of the drivers of health needs.

This is a screening for the five drivers of health – food security, housing stability, transportation access, utility access and interpersonal safety. Another example is the recent Centers for Medicare & Medicaid Services (CMS) change in the severity of three ICD-10-CM diagnosis codes describing homelessness from a non-complication/comorbidity (CC) to a CC designation. This will reflect the higher average resource costs of cases with these diagnosis codes compared to similar cases without these codes and will affect reimbursement. There are expanded code sets with each release by CMS. The White House has published the first ever SDoH Playbook, a policy guide on working towards integrating social services, public health and the health care system to improve health outcomes in local communities by breaking down federal agency and local system silos.

To learn more about efforts using SDoH to improve population and promote equitable health outcomes, continue reading here.

Michelle Badore is a global clinical and nosology content manager at Solventum.

James Donaher is a clinical development analyst with the clinical and economic research group at Solventum.