Social Determinants of Health
Our mission to build strong, healthy communities goes beyond clinical care. More than 80 percent of a person's health is tied to factors other than clinical care.1 These factors, known as the social determinants of health, include access to nutritious food, proper care, safe housing, reliable transportation, and community supports.
These underlying drivers of health impact every part of our physical, mental, and social well-being. When they work against someone or are left unaddressed, they create health inequalities — which lead to worse outcomes and more expensive care.
The human impact of social determinants
According to the Centers for Disease Control and Prevention (CDC), 60 percent of premature deaths are associated with social, environmental, and behavioral circumstances. Only 10 percent are the result of inadequate clinical care, and 20 to 30 percent stem from genetics.2
Additionally, the Kaiser Family Foundation found that more than one-third of total deaths in the United States every year are attributed to social factors such as low education, racial segregation, lack of social supports, and poverty.3
We are responding by delivering an unprecedented, relationship-based, whole-person model of care that goes beyond the doctor's office — a strategy that fully integrates the social and clinical programs that produce a positive difference in our members’ health outcomes.
By ensuring that our members have the critical support and services they need, we can help them make important lifestyle changes and lead healthier, more productive lives.
Our areas of focus
We focus our efforts on:
Education, including early childhood development, high school graduation or GED® completion, higher education, and enhancement of language and literacy skills.
Health literacy, including improvement through self-management goals and supports and access to integrated primary care.
Housing, including securing accessible, affordable, and safe housing and making modifications to members’ homes to achieve better health.
Transportation for both medical and nonmedical needs.
Material security, including food, utilities, child care, clothing, phones, and household needs.
Our work with social determinants
No managed care company can expect to influence every single social determinant. Many areas of concern involve larger societal factors that are out of our control. But by focusing on person-centered member outreach and connecting members to resources to promote their knowledge and skills for a healthier lifestyle, we can still make a lasting difference in their lives.
Our approach of universal screening for social determinants of health allows us to quickly identify a member’s status as either in crisis, vulnerable, or stable. We can then take appropriate action, such as:
- Referring to a Care Manager.
- Connecting with a local food bank.
- Using social platforms such as Aunt Bertha to help find shelter.
- Working with members via our Community Care Management teams (CCMTs), frontline allies in addressing the negative factors in our members’ lives. Each comprised of a licensed nurse, a licensed social worker, and Community Health Navigators, CCMTs reach out to the highest risk population to help with complex care needs.
Programs and partnerships
- Transportation: We offer transportation to members needing rides to and from appointments with primary care providers through partnerships with local transportation services, such as Lyft in Washington, D.C.
- Housing stabilization: We assist members in navigating the housing system with the goal of securing accessible, affordable housing through federal, state, and local programs. We also can arrange modifications to existing housing to meet members' health needs.
- Peer supports: We offer peer-support programs and community resources, such as our wellness centers, to motivate members to participate in preventive health care and to change unhealthy behaviors.
- Emergency food and clothing: Through partnerships with programs such as the Metropolitan Area Neighborhood Nutrition Alliance (MANNA) in Philadelphia and Mom’s Meals nationwide, we help members with special needs access nutritious meals.
- Employment: We help members find a pathway to self-sufficiency through programs such as Mission GED and Pathways to Work, which prepare them for jobs and career opportunities.
- Sanne Magnan, "Social Determinants of Health 101 for Health Care: Five Plus Five," NAM Perspectives, Discussion Paper, National Academy of Medicine, Washington, DC, 2017, doi.org/10.31478/201710c.
- Nancy E. Adler and Aric A. Prather, "Population Health: Behavioral and Social Science Insights: Determinants of Health and Longevity," U.S. Department of Health and Humans Services, Agency for Healthcare Research and Quality, September 2015, www.ahrq.gov/professionals/education/curriculum-tools/population-health/adler.html#ref4.
- Harry J. Heiman and Samantha Artiga, "Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity", Kaiser Family Foundation, November 2015.