If we are looking to impact the health and health care issues ofthose enrolled in our company's health and welfare programs, wemust consider social determinants of health. (Photo:Shutterstock)

Health care continues to evolve with a greater emphasis on value through new payment modelsand new partnerships. If we are truly going to impact the healthcare system, there is one key area that requires a revolutionrather than evolution. That is the issue of social determinants of health (SDOH). Accordingto the World Health Organization, SDOH are defined as social andeconomic influencers that can impact one's health and healthstatus. This includes income and social status, employment andworking conditions, education and literacy, safe and consistentliving conditions, food and nutrition, and adequatetransportation.

Related: Should housing, food and transportation be coveredhealth costs?

While many of these areas are outside of the traditional healthcare environment, SDOH are conditions in which people are born,live, learn, work, play and worship. And many people all over theworld have vulnerabilities in one or more of these areas.

Why should employers care?

One misconception that must be addressed is the populationimpacted by SDOH. When most people think about those strugglingwith various issues, they most commonly think about the unemployedand socio- economically challenged. And while it's true that manypeople impacted by SDOH have these attributes, what's oftenoverlooked is the impact to employees and their family members. Infact, many struggle with one or more of these issues.

At a recent client meeting an employer shared the demographic,financial and educational profile of their employee base. It was areal eye-opener, as 82 percent of their employees looked more likean individual on Medicaid than what we would consider thetraditional profile of an employed individual. What this means isthat SDOH are not someone else's problem. It is our problem if weare looking to impact the health and health care issues of thoseenrolled in our company's health and welfare programs.

What can employers do?

Most employers want to improve the health and health care oftheir employees and family members. They invest in their workforcefor a variety of reasons—to attract and retain high qualityemployees, provide cost-effective benefits, and remain competitivein a global market. Regardless of the reason, it's important toremember that it's not that employees don't want to take care oftheir health, but they may not know how or what to do.

Consider the employee asked to follow a heart healthy diet thatmay have little or no food for themselves or their family. Or anemployer with a plan design that requires an employee to travelacross town to get their care when they must rely on publictransportation. And the worker that needs to exercise, but theneighborhood where they live isn't safe to walk.

Here are several recommendations that employers should considerwhen embarking on the journey of addressing social determinants ofhealth:

• Know who your audience is when targeting action andinterventions to ensure resources are offered to thosemost impacted by negative social determinants of health as thiswill vary based on the employee population. Needs across theworkforce will differ from that of an employee facing a temporaryor situational need such as cancer or transitioning out of thehospital or skilled facility, to those identified through riskassessments. Additional factors that should be considered includethe needs and obstacles of low wage employees, employees in fooddeserts and dual income families without time to plan theirmeals.
• Determine the goals of what you are looking toachieve by addressing social determinants of health. Thegoals that you are trying to achieve will depend on the populationthat you are targeting. Goals can be concrete such as financialsavings due to reduced hospital and emergency department use ormore clinically focused such as reduction in risk for chronicdisease. Objectives can be even more general such as reduction instress, employee satisfaction or retention of employees.
• Thoughtfully consider the what types of programs andinitiatives to launch and potential partners such asnon-profit community organizations, employee assistance program andother vendors.

Focusing on social determinants of health is not easy or a"check the box" type of initiative. One needs to be realistic as towhat can be achieved and within what timeframe. As an employer youdo not have to attempt this on your own. There are severalorganizations that can help employers in this revolution includingprivate, public and community organizations.

The good news is that you can make a difference for both you andyour employees. When you're focusing on lifestyle, chronic diseasesand other health-related factors, don't forget to also focus onsocial determinants of health—it matters and makes real sense foremployers.

Jan Berger, MD, MJ, is medical director forthe MidwestBusiness Group on Health.

Read more: 

• How do social factors affecthealth?
• How social determinants of health affect youremployee benefit program
• Insurers to work together on social barriers tohealth