7 Steps for Employer Social Determinants of Health Strategies

Despite the many challenges that can hinder progress on social determinants of health, employer social determinants of health strategies can profoundly impact employees’ families and communities, according to a report from the Northeast Business Group on Health.

There are several steps that the Northeast Business Group on Health identified as crucial for employers looking to engage in employees’ social risks and social determinants of health.

First, employers need to gather data. The step comes at the top of the list, but it is one of the biggest barriers employers face when considering getting involved in employees’ social determinants of health.

Some employers do not have to look too far to access relevant employee social risk data. Specific employee data points that employers may already collect can shed some light on potential social determinants of health barriers. These include demographic data such as race, ethnicity, and zip code.

However, this data should be supplemented with data from public health organizations, community-based organizations, and even employer-driven, targeted efforts at gathering relevant data by working with a third-party vendor.

With the help of a strong vendor partner, employers can create and distribute social determinants of health surveys. These can be anonymous, and the sensitive data results should be highly private and secure. 

Such a survey could include questions like “are you worried that in the next two months you may not have a safe or stable place to live?” or “do you need help getting child care or care for an elderly or sick adult?”

Employers should also discuss with their payer and vendor partners about the data they already collect, to see if any of it might be relevant for social risk identification efforts. The report urged employers to advocate for their health plans to use Z codes.

Second, employers should analyze their existing health plan benefits to see whether their offerings advance health equity.

The report encouraged employers to calculate what percentage of employees’ salaries go toward health-related needs and compare these percentages across different salary levels, including deductibles and out-of-pocket healthcare spending maximums. Employers should look for any noticeable imbalance in what managers spend compared to lower-level workers.

High deductible health plans can also give employers more control over existing benefits to promote health equity. Employers that already offer rich benefits such as tuition assistance or childcare may want to assess whether all employee populations who need this benefit are given equal access to these benefits.

Third, after assessing their existing benefits, employers should consider whether they are missing any benefits that could help diminish employees’ social risks and social determinants of health barriers. For example, the report named caregiving benefits, tuition assistance or reimbursement, career training, reimbursement for medical transportation, and nutrition benefits.

Fourth, employers can look at their employee paid time-off information to see whether these align with their vision for health equity and social risks improvement. Having enough sick leave, mental health leave, and other types of time off can be crucial to employees’ overall wellbeing.

Fifth, employers and payers could help members gain better healthcare literacy and financial wellness. The report shared some simple, cost-effective ways to ensure that employees can understand their benefits and own finances. 

Employers can offer health benefits counseling and resources and organize the resources that they already have so that they are easily accessible and transparent. Health literacy is particularly a priority for employers offering consumer-driven health plans and high deductible health plans.

Additionally, employers can provide classes with investment advisors and financial partners to help employees navigate personal finances.

Sixth, the report emphasized that employers cannot achieve improvements in social determinants of health on their own. Instead, they must forge partnerships that will support these efforts. Partnering with health plans, hospitals, and national advocacy organizations is a great way to start.

Finally, employers will need to reduce stigma around and improve company support for employees’ health-related social needs. Management and senior leadership have to be aligned on the business case for addressing employees’ social determinants of health needs, which may require employers to educate managers about the impact of social risks.

Employers can also integrate their efforts to reduce social risks with other related endeavors, including improving mental healthcare support and prioritizing health equity through diversity, equity, and inclusion.

“Employees need to believe their organization cares about their health and well-being and that of their families and colleagues,” the report explained. “Creating a culture that is sensitive to SDOH and embraces equity is important.”