Know Your Members: Identifying and Addressing Social Determinants of Health in Low-Income Populations

Forster J
Publication Year: 2018
Patient Need Addressed: Chronic Conditions
Population Focus: Low income
Type of Literature: Grey

Those who work in healthcare tend to assume that healthcare consumers care about the same things we do—getting and staying healthy by participating in annual well visits, managing chronic conditions, taking medications as prescribed, and being a well-educated patient. However, we need to acknowledge that these things are not often on the minds of the typical healthcare consumer, especially those experiencing socioeconomic barriers to care. healthcare may be one of many competing priorities that goes on the back burner when compared with a much longer list of more important things like paying the rent, finding a job, or simply getting to an appointment.

Insights Results

Overview of article

  • Through surveys with health plan members, Managed Health Connect found that social determinants of health affect members in a variety of ways: 1) people who reported concerns about life necessities (food, shelter, safety) were five times more likely to report having poor health, two-and-a-half times more likely to report their health negatively affecting their work, and eight times more likely to report high emotional stress; and 2) among low-income populations, those who are dual-eligible for Medicaid and Medicare, have shown to have the most concerns about life necessities, followed by Medicaid enrollees and then Marketplace members, of which, about 85% are below 400% of the federal poverty level
  • Healthcare organizations need to go beyond claims data and have conversations with consumers to identify life circumstances beyond the models by: 1) Developing strategies to assess and address social determinants of health, and have a direct and open dialogue with members; 2) Asking members about access to life necessities such as food, shelter, and housing as well as access to transportation to get to doctor’s appointments; 3) Assessing members’ mental and physical health changes and housing stability over time, as well as financial worries, caretaker stress, and their perceived ability to overcome problems and seek help when needed; and 4) Listening to their responses, and connect them with plan and community resources that can help them overcome barriers to care (this can be achieved through care managers, Meals on Wheels, or a ride to an appointment)
  • Moving forward, it is important to use multiple opportunities to collect social determinants of health responses from members throughout their tenure with a plan and monitor any changes over time. Offer immediate assistance to people who report issues for which resources are available to address barriers to care. Then analyze health behaviors in light of responses and interventions to glean lessons learned and evaluate programs

Key takeaways/implications

  • This article suggests that early screening and identification of social determinants of health through interactive conversations with members is one way to ensure low-income populations are connected with effective interventions to address the underlying factors influencing health