Who are you excluding from your health benefits?

Impacting Social Determinants of Health and Benefits Equity through Whole-Person Wellbeing

Healthcare and employee benefits have primarily focused on clinical care as the primary driver of a person’s health status. However, there is growing recognition and understanding that health status is driven mainly by other factors such as lifestyle and environment, so tackling the non-medical factors to influence your people’s health and wellbeing is critical.

Understanding the influences of health and wellbeing

When it comes to healthcare spend, the most dollars are spent on episodic care, not on the areas that can improve population health, such as preventive care and whole-person wellbeing.

During the pandemic, delayed care was attributed to accessibility and fear of contracting COVID-19; now, inflation is the problem. Even more alarming is that delayed care is at its highest point yet – 38% at the end of 2022. Even scarier is that 27% of people reported the delayed treatment was for a “very” or “somewhat” serious condition or illness, according to a recent Gallup poll. “Very” and “somewhat” serious conditions and illnesses rarely improve when left untreated. The truth is, they get worse, which almost always means higher medical bills and costs for everyone.

With health, preventative care is cheaper and more effective than reactive care. Skipped care leads to higher costs and worse outcomes at every stage, which is painful for the employee and impacts your bottom line.

Commercially insured high-cost claimants represent nearly a third of all healthcare spending, even though they are only 1.2% of commercial health insurance enrollees. According to the American Health Policy Institute, their costs average $122,382 annually – 29.3 times as much as other members.

If “health” is a state of physical, mental, emotional, social, and financial wellbeing, then what contributes to whole-person health?

As little as 20% comes from medical care. The other 80% of contributors are often broadly called social determinants of health (SDOH): behaviors, social and environmental factors, and genetics.

What are the social determinants of health?

SDOH are nonmedical factors that influence health outcomes. They are conditions in which people are born, grow, work, live, and age, and the broader set of forces and systems shaping the needs of daily life.

Five forces of social determinants of health:

Healthcare Access and Quality: Health insurance, availability and quality of healthcare services, and health literacy and support level.
Social and Community: Workplace conditions and connections, discrimination, community cohesion, and civic participation.
Economic Stability: Financial resources available to an individual, income, cost of living, poverty, food security, and housing stability.
Education Access and Quality: Education level achieved, literacy, childhood development and education.

Neighborhood and Built Environment: Housing quality, transportation access, availability of nutritious foods, pollution levels, and neighborhood crime.

As a benefits leader, understanding the five factors of SDOH is critical, as is understanding the difference between equity and equality when designing employer-sponsored benefits.

Ensuring equity, not just equality, in employee benefits

Equality aims to ensure everyone gets the same things to enjoy whole, healthy lives. We can think of this as a baseline, the things you provide to everyone.

Equity, in contrast, involves trying to understand and give people what they need to enjoy whole, healthy lives. Think of this as personalized, individualized support, such as:

Not just offering the same plan design to everyone, but making plan designs that are affordable and do not deter care
Not just offering access to carrier programs and resources, but delivering tactical access, provider diversity, health and wellbeing resources, literacy, and support
Not just offering voluntary benefits, but offering incremental benefits that meet the needs of a diverse workforce, such as caregiving, parental, financial wellness, and others supporting the whole-person
Not just offering paid and unpaid leave, but flexible work policies
Not just offering other perks and resources, but meaningful resources to address SDOH, social connection with peers, climate, etc.

“Equality is at its best when everyone starts on equal footing, and if their needs are the same or at least similar,” says Jeff Jacques, MD, Chief Medical Officer at Personify Health. “Whole-person wellbeing supports equity by matching support with people’s individual needs, deliver the care they need when and where they need it, and empower them to lead healthier and happier lives.”

Impact of unintentional inequity in employee benefits

Consider this.

A top performer visits the ER as a result of an untreated chronic condition not being managed. A singular healthcare-only view concludes that the person needs another medication to control the now-advanced condition. Only when we zoom out and see the context of the individual’s life do we see that lack of childcare to attend medical appointments and that the medication was unaffordable is what landed them in the ER. Social support, accessibility, and affordability are the problem.

In this typical example, we can see the outsized role that SDOH plays in health and wellbeing and the need for employee benefit equity.

What happens at work influences life; what happens in life shows up at work. For organizations, this presents as absenteeism and presenteeism, impacting productivity, satisfaction, and wellbeing. Hundreds of billions of dollars in productivity are lost each year due to health-related work absences. This does not even account for medical and pharmaceutical costs.

Only when benefits leaders are empowered to deliver meaningful programs to engage people with programs, services, and resources that meet the individual where they are in their moment of need will they make demonstrable impacts for their people and their organization.

Ways organizations can tackle SDOH and deliver equitable employee benefits

Health and wellbeing

A health and wellbeing program built on the science of behavior change and a 360-degree view of people, including a wide array of SDOH data points plus your claims and employee data, ensures a personalized experience delivered every time, making the right choice easy. By giving employees content and programming specific to their wellbeing, habits, health, conditions, and needs, Personify Health drives the right time and place engagement for an experience that is inclusive, relevant, and beneficial for each individual.

Access to healthcare

Fifty percent of people feel lost when they are trying to navigate the healthcare system. Personify Health’s Benefits Navigation with Advocacy solution takes it further by providing digital and human support when needed to ensure access to high-quality, affordable care. Providing a single digital front door for your equitable benefits supports in-the-moment needs, effectively delivers the care they need when and where they need it, and empowers them to live healthier and happier lives.

Building a culture of belonging 

Research shows strong social connection leads to a 50% increase in longevity. Partnering with Personify Health, clients support their entire population through workplace challenges, social groups, recognition, and free friends and family invites to build connections at work and in life.

Equitable benefits

Our 70+ partners accelerate your ability to offer equitable benefits across your entire population in one orchestrated experience. Organizations can choose from the most sought-after needs, like mental health, nutrition, family health, caregiving, and more, to support a wide range of needs while not incurring and cost of identifying, implementing, and communicating benefits to the right person at the right time, our platform makes this seamless for all.

Want to see how Personify Health can help you deliver a personalized employee experience, cultivate a culture of wellbeing, and manage rising costs? Watch a recorded demo.

Additional resources:

Healthcare Benefits Navigation with Advocacy – New insights on how personalized healthcare benefits navigation can help retain employees, manage rising costs, and deliver better health outcomes