Dive Brief:

• Though employers have invested increasingly in a variety of healthcare and healthcare-adjacent benefits, few of these efforts effectively address social determinants of health that can negatively affect patient outcomes, according to a report published this month by the Northeast Business Group on Health.
• Social determinants of health include factors such as education access and quality; healthcare access and quality; economic stability; neighborhood and built environment; and social and community factors. Differences in these areas lead to disparities not only in terms of health outcomes, but also in cost management and general employee health and well-being, NEBGH said.
• Employers can start addressing social determinants by collecting survey data on employees' needs and risk factors, per the report. From there, NEBGH recommended that benefits design focus on equitable benefits access, such as evaluating what percentage of pay their health plans comprise at different pay levels. Other strategies cited include improving health literacy, taking advantage of partnerships and improving organizational culture around health and well-being, among others.

Dive Insight:

Far from an undiscussed topic in the employee benefits space, social determinants of health have long been recognized by consultants and employer advocates as potential contributors to workers' health and well-being struggles despite increased investment in benefits.

In addition to the categories highlighted in NEBGH's report, social determinants may include aspects such as income and ethnicity. Sometimes these broad issues directly impact health; one source previously told HR Dive that racism and gender discrimination rates contribute to higher rates of stress-induced chronic illnessess in Black women, for example.

Employers may be able to see health and well-being disparities exacerbated by social determinants play out between employees with the same health condition. NBEGH gave the example of two employees with Type 2 diabetes, one of whom lives in a food desert with limited access to fresh fruits and vegetables, and another of whom lives in an affluent suburb with easy access to grocery stores and farmers' markets. The latter worker "is more likely to have good glucose control, avoid severe complications and live a longer life," NEBGH said.

The report outlines several potential solutions. In the above scenario, employers might offer healthy, affordable meals at an on-site cafeteria or a subsidy for in-person or online markets and food delivery services. In a 2020 guide, NEBGH recommended that employers consider providing transportation services or reimbursement for public transit that diabetic, low-income workers use to attend care appointments.

A focus on health equity can be one aspect of an employer's larger diversity, equity and inclusion efforts, but part of the problem has been access to diverse groups of care providers. That has led to a push from both employers and vendors to seek culturally competent care, or providers who are able to treat diverse populations and their particular needs.