How to Align Your Well-Being Strategy With the Social Determinants of Health

Social determinants of health (SDoH)—the circumstances in which people are born and live—are a set of interconnected factors that influence our physical and emotional well-being, our ability to be productive in work and school, and our quality of life. Society expects employers to invest in comprehensive benefit strategies and external community partnerships that provide access to social resources aiding in overall health and well-being. They include our opportunities to learn, work, earn a livable wage, and have access to housing, transportation, public safety, nutritious food, clean water, and healthcare. Investment in coalitions and policy advocacy to address SDoH, as well as programs to screen for addressing social risk factors/needs, is both a responsibility of good corporate citizenship and a key element of an enterprise talent strategy.

Organizations can support the social determinants of health of their workforce by building a workplace environment and culture that addresses the conditions in which employee populations live and work that affect their well-being, not merely focusing on individual lifestyle modifications alone (e.g., diet, physical activity, and stress). Use the prompts below to identify the why, what, and how of your strategy that can support your organization’s business priorities.

Behavioral change programs that aim to promote well-being and medical benefits alone will not be as effective if social determinants are not addressed.
 

Potential strategy drivers

• Over 44% of working Americans are identified as low-wage workers.
  
  
• Low-wage workers use the emergency room twice as often, have a higher incidence of preventable chronic illness, suffer later-stage recognition and treatment of disease, and visit a primary care provider less often.
  
  
• ”…Employees with one or more unmet basic needs (i.e., housing, transportation, food, etc.) were around 2.4 times more likely to have not received needed physical healthcare and to have missed six or more days of work in the past 12 months.”
  
  
• Chronic conditions impact employee performance and productivity with an underlying increase in absenteeism, presenteeism, turnover, healthcare costs, workers’ compensation, and disability. 
  
  
• Non-medical modifiable factors, such as the social determinants of health, account for at least 80% of people’s health outcomes, including their social and physical environment and lifestyle choices. 
  
  
• People experiencing food insecurity—the inability to afford enough food for a healthy, active life—are at greater risk for chronic diseases such as obesity, hypertension, and diabetes, all of which are cardiovascular disease risk factors.
  
  
• Wage increases for low-wage workers affect many measures of public health, including low birthweights, reductions in smoking prevalence, and absence from work due to illness.
  
  
• Health inequities (or the difference in health status or distribution of health resources between groups of people) are expensive. They account for $93 billion in excess medical costs.
  
  
• Society increasingly expects organizations to play a role in addressing the social determinants of health and 64% of millennials report they would not take a job at a company that wasn’t socially responsible. 

Potential opportunities

• The organization’s overall culture supports all employees’ social, physical, and economic well-being.
  
  
• Company policies and benefits are in place (FMLA, sabbatical, use of PTO, flexible scheduling, parental leave, workers’ comp, etc.).
  
  
• Managers and supervisors receive professional development to identify employee challenges tied to social determinants.
  
  
• Leadership considers employee social needs and persona data in decision-making.
  
  
• Leadership considers social determinant risks and income when designing benefits packages, contributions, and well-being strategies.
  
  
• Employees are aware of how to seek help if they need food, emergency financial assistance, or transportation, all of which are downstream results of social inequities. 
  
  
• The organization has partnerships with community entities that can support employees with gaps in access. These could include public health departments, universities, food shelves, and more. 

Potential tactics to improve social well-being

• Work with vendor partners to view existing data with a social determinant of health lens (employee surveys, employee assistance program, 401k, health claims, etc.).
  
  
• Identify employee social needs through validated tools and/or employee focus groups. 
  
  
• Create a supportive, caring, and inclusive workplace culture that meets the needs of a diverse workforce. Approach decision-making with a health equity and inclusion lens by asking tough questions and examining the distribution of power, money, and resources as well as who is left out of decision-making within the workplace.
  
  
• Focus on whole person well-being by taking a health in all policies approach that ensures everyone has an equitable opportunity for optimal well-being and protection against safety and health hazards.
  
  
• Support economic security by offering living wages that allow employees to live a modest yet adequate standard of living.
  
  
• Enhance employee quality of life by providing resources, benefits, and management training to mitigate workplace psychological stress and provide mental well-being supports,. Also consider offering healthy food choices and caregiver support. You can also create social cohesion through resource groups, on-the-job training opportunities, and financial security.
  
  
• Provide access to affordable healthcare coverage to all members of the workforce, including features such as telehealth, plan choice, and use of a value-based benefit design (alignment of employee cost-sharing with high-value services) to close the health equity gap. 
  
  
• Put in place robust environmental, social, and governance criteria (ESG) as well as diversity, equity, and inclusion (DE&I), and anti-racism strategies. 

• Jill Verchota-Luce
• Megan Patterson
• Heidi Orstad

Please contact Heidi Orstad with questions about the social determinants of health playbook.