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Getting To Know Patients With Social Needs

posted by Rashi Venkataraman, AHIP Executive Director, Prevention & Population Health

on June 26, 2019

Efforts to address social determinants of health include better understanding patient perceptions, support systems

After caring for her husband for 12 years before he passed away, 86-year-old Joyce Bigelow became homeless and moved into her truck. Her Kaiser Permanente care team connected her with housing and community resources. Her story shows why it’s so important to address patients’ social needs, such as the ability to have a safe and reliable place to live.

Research shows that conditions such as safe, affordable housing and access to healthy foods are closely linked to health outcomes. In fact, some researchers say clinical care may only account for 10% of overall health. The real drivers of overall health are individual behaviors, social circumstances, and environmental factors.

Health insurance providers continue to create innovative programs that address non-medical issues. They’re also investing in research to better understand how their members think about these needs, so they can design interventions and resources to reach the right patient at the right time and in the right way.

One such study from Kaiser Permanente found that social needs are a significant source of stress for American families, regardless of their income. And patients recognize that health isn’t narrowly defined by the clinical care they receive – respondents said stable housing (89%), balanced meals (84%), reliable transportation (80%), and supportive social relationships (72%) are important to overall health.

The value of supportive social networks was also underscored in 2018 research from global health service company Cigna. It found that nearly half of Americans report sometimes or always feeling alone (46%) and that Generation Z (adults aged 18-22) have the highest loneliness scores. Further analysis from Cigna also looked at what individual factors such as daily behaviors and demographics like gender, race, and income are most related to loneliness. To help address loneliness, Cigna is working to connect the dots across health and well-being services with a new program, Health Accelerated: Life Connected®. It addresses whole health needs and explores 5 dimensions of well-being:

  1. Physical
  2. Emotional
  3. Environmental
  4. Financial
  5. Social factors

Through this work, Cigna aims to deliver a more streamlined, proactive, and coordinated support system to improve health, productivity, and peace of mind.

How patients view their social needs often differs from how researchers and journalists cover these issues. For example, individuals emphasize influences that impact them daily – finding the right doctor for their condition, whether they have the support of their family, according to a study from Anthem’s Public Policy Institute. Researchers and journalists, on the other hand, often focus on structural factors – education, income level – in part because these factors are easier to measure.

And not surprisingly, a patient’s diagnosis affects their perception of social needs.  The availability of social and family support was much more important for people with cancer or mental health conditions, compared to those patients with diabetes. And concerns about access to healthy food and diet were more prominent in patients with diabetes.

With all this mind, it’s essential that people with social needs have support and tools they can rely on. However, according to the Kaiser Permanente study, 35% of people lack confidence they could identify the best resource for transportation, food, housing, or social isolation. This is where the role of health care providers may come in: 42% would turn to their medical services provider when looking for help with their social needs and 30% would turn to their health insurance provider for this information. The majority of survey respondents say their medical provider should ask them about these needs during visits.

Health insurance providers have long-recognized the role that social factors play when it comes to accessing clinical care. Moreover, they’re committed to investing in sustainable interventions that match up with what their members need to live happy, healthy lives.

To learn more about how AHIP and its health insurance provider members are addressing social barriers to good health, visit Project Link.