Article

What are the social determinants of health?

Understanding SDoH and Its Effects on Your Population

Diabetes, hypertension, and other cardiometabolic diseases are chronic conditions that affect Americans in great numbers. However, chronic care management—which helps mitigate the health risks of recurrent conditions—can be impacted by access to care.

Many communities struggle to get access to healthcare; some more than others. In fact, it’s possible to even draw connections between a person’s social determinants of health (SDOH) and their health long-term.

SDOH are the conditions that people experience in their environment as they go about their day-to-day lives. This includes safe housing, discrimination, income, language, and access to nutritious foods. The US government breaks down the social determinants of health into five main influences:

1. Economic stability

In the United States, 1 in 10 people live in poverty. This makes it difficult for many people to afford things like healthcare, healthy food options, and housing. Economic instability makes it disproportionately harder for these groups to receive reliable care, because it’s less likely for those with steady income to face these challenges. Additionally, disabilities and chronic conditions can make finding and keeping steady work even more difficult. Plus, employment doesn’t mean enough income to prioritize personal health.

2. Education access and quality

A high-quality education can also influence a person’s social determinants of health. Education can impact future employment and one’s ability to create a stable economic future. Yet children coming from low-income families, those with disabilities, or ones who face social discrimination are more likely to struggle in school. This decreases their chances of graduating from high school and college, making it harder for them to get high-paying jobs. But even more critical, they are also more likely to have health problems like diabetes and depression.

3. Healthcare access and quality

Insurance coverage is a major player in healthcare access in the United States. Most insurance is employer-provided, covering 54.4% of the population, followed by Medicare, Medicaid, and then direct purchase. Even so, 28 million Americans weren’t covered by health insurance in 2020, at any point in the year. For those un- or under-employed, they are less likely to have coverage; by extension, it also limits access to a primary care provider or affordable health services, medications, and preventive treatment for chronic illnesses.

4. Neighborhood and built environment

Safety risks like violence, unsafe water, or bad air conditions can all affect a population’s health. Racial minorities and low-income households are more likely to live in places with these risks. Legislation can also impact these neighborhood landscapes, as walkable and bike-friendly neighborhoods are also more likely to improve health and encourage active lifestyle choices.

5. Social and community context

Family, co-workers, and friends can all influence a person’s health journey. Relationships and interactions with the community can impact someone’s choices and wellbeing. Therefore, positive and safe relationships can have a positive impact on one’s overall health. Fractured or unsafe home life and relationships can negatively influence a person’s physical and mental health, as well as their ability and mindset around receiving care.

How does SDOH affect healthcare delivery?

Peer-reviewed studies show that SDOH acutely impacts healthcare outcomes.1, 2, 3 Vida Health recognizes that every person deserves high-quality healthcare. That’s why health equity is a guiding principle for how we design our core product and deliver our care.
Social determinants of health impact all forms of care, so it’s important for care providers to be focused on solutions for their populations.

How diversity, equity, and inclusion initiatives can have an impact

Due to language barriers, 25 million Spanish speakers receive about a third less health care than English-preferred speakers. Healthcare providers have to be intentional about meeting the needs of these populations. Because right now, Spanish-preferred speakers are up to 42% less likely to receive healthcare than native English speakers.

At Vida, Spanish-speaking members select healthcare providers they can relate to and who speak their preferred language.

Culturally-adaptive care plans have to do more than think about language barriers. They also have to consider the impact of different backgrounds, dietary preferences, faiths, traditions, and levels of education.

Other factors can play a part in accessible care across populations. When it comes to virtual care, how often members are engaging with an app is a great way to measure its effectiveness. Not everyone interacts with an application the same way, but it’s a key to behavior change and outcomes. Therefore, care solutions have to get a hold of members with different outreach methods: whether that’s by phone, in a clinic, by mail, or even on social media.

Vida lets members chat with their coaches how they’re most comfortable—by phone, computer, video, or text—and in the setting that works best with them, one-on-one or in a group.

SDOH puts populations at greater risk for chronic disease

Factors like economic stability, food access, neighborhood and work environment, health literacy, and education create barriers to care and health inequalities.4 Over 200 million Americans are impacted by SDOH factors like food deserts, high-crime neighborhoods, or rural regions with minimal access to healthcare.

SDOH tell us that access to technology and health literacy are big players in a person’s access to care. Since research shows that these circumstances affect outcomes, these populations are at greater risk for chronic diseases in the long term.

Conscious leaders understand that a care solution can’t only cater to tech-savvy populations. You need one that can serve a broad population, including people with severe cardiometabolic conditions who can hardly afford their medications, have minimal access to healthy food, and live in rural areas without 5G access.

Member story: Life with diabetes begins with education

Just like obesity, type 2 diabetes is a disease that creeps up on many people — often because they lack sufficient nutrition education. But once a person has diabetes, it’s incredibly important that they understand its effects on their lives.

In Robert’s case, his registered dietician focused on helping him decrease his alcohol intake and replacing those calories with more nutritious foods that were diabetes-friendly and low in sodium. By incorporating more fresh foods into his diet, Robert lost over 15 pounds and lowered his A1C by 1.3 points — putting his diabetes into remission.

Just as importantly, Robert now knows how to keep both the weight off and his A1C in check by eating healthy, drinking more moderately, and exercising regularly — habits he learned under Vida’s care.

Tackling all of the health inequities in our country is a massive effort that goes beyond what benefits and health plan leaders can accomplish on their own. But deploying an SDOH-attuned virtual care solution is a strong step in the right direction. You can make a real difference for the hundreds — and even thousands — of people just like Robert in your care.

Their health depends on informed and careful food consumption. This is why Vida focuses much of its educational content on teaching those nutritional skills. Our members learn how to count carbs and read nutritional labels through engaging lessons on the app.

We teach members how to use glucometers and continuous glucose monitors (CGMs) to see how different foods directly affect their blood sugar levels.

Meeting your people where they are

In America, 68% of people screen positive for at least one social determinant of health. Providing adequate care means understanding a person’s needs, which is why Vida offers health guides and care navigators to support our members.5

  • Vida’s approach to social determinants of health sets members up for success. Our SDOH-attuned virtual care solution focuses on four categories:
  • Accessible care through multiple communication channels and a national provider network
  • Personalized eating plans to improve health outcomes
  • CBT-based coaching and therapy to understand member habits and motivation
  • Health literacy skills to improve care navigation now and in the future

Human connection matters when it comes to understanding and addressing social determinants of health among patients and communities. And your people deserve quality care regardless of zip code, technology access, cultural background, or comorbid conditions. That’s why choosing a virtual care solution with a human-led, personalized approach can make such a meaningful difference in your population.

Learn more about how Vida Health can make a positive influence for your communities today.

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  1. Graham, H., & White, P. C. L. (2016). Social determinants and lifestyles: integrating environmental and public health perspectives. Public Health, 141, 270-278.
  2. Sederer, L. I. (2016). The Social Determinants of Mental Health. Psychiatric Services, 67(2), 234-235.
  3. Hood, C. M., Gennuso, K. P., Swain, G. R.; & Catlin, 8.B. (2016). County Health Rankings. American Journal of Preventive Medicine, 50(2), 129-135.
  4. Pera, M. F., Cain, M. M., Emerick, A., Katz, S., Hirsch, N. A., Sherman, B. W., & Bravata, D. M. (2021). Social Determinants of Health Challenges Are Prevalent Among Commercially Insured Populations. Journal of Primary Care & Community Health, 12, 1-10.
  5. Vida’s Book of Business, June 2022