Social determinants of health: Why such a hot topic?

Sept. 25, 2017 / By Gretchen Mills

I’ve been following many recent articles about the increased interest in social determinants of health. This topic caught my attention a few years ago when I came across the pioneering research by Yale researcher Elizabeth Bradley.  She has just been named President at Vassar

Dr. Bradley compared total healthcare spending in the U.S. to the spending in other countries. What she found is that the U.S. spends much more on medical care  while spending much less on social services (housing, child care, food assistance for those in need).  Despite its higher spending levels, the U.S. fared worse in health outcomes. This Commonwealth Fund issue brief  summarizes her findings. (Exhibit 8).

Okay, you say, this is all very interesting, but so what?  As we grapple with the challenges of reducing the costs for health care in this country, can we learn from these other countries and spend our public funding more wisely?  A recent post from the National Association for State Health Policy said that states are looking at funding housing as a way to reduce healthcare expenses.

Health plans, particularly Medicaid managed care firms are incorporating funding for social determinants into the care management programs. These firms know that their so-called frequent fliers with high rates of E.R. visits and hospital admissions often lack adequate social support including a high correlation with homelessness. Dear reader, I will admit to you that I am less interested in philosophical debates about whether or not we should spend public dollars on social services than I am in seeing payers use these findings as a practical way to improve outcomes and reduce total spend for those in need.

Gretchen Mills is manager of market strategy for populations and payment solutions at 3M Health Information Systems.

Learn more in these articles on health plan use of social determinants.