The who, what, where of your health
When you think about the kinds of things that impact your health, some are obvious, and some are hidden. Let’s use Marisol as an example. Marisol is a 30-something woman who eats a healthy diet but is rarely physically active.* Those choices can have a positive and negative effect on her health. To an outside observer, Marisol looks healthy. But her latest biometric results would paint a different picture. Her LDL cholesterol is on the higher end of normal and her HDL cholesterol is low. Those can indicate a rising risk for heart disease. What else might affect Marisol’s health?
Aside from risk for heart disease, Marisol has to be mindful of other things that impact her health that aren’t directly linked to her medical care. Marisol works from home, and she’s chosen to live in a small town in the country that’s about an hour from the nearest large city. She sees a doctor in the only family practice in her town, but if she needs specialist care, she’ll need to travel to get it. Her town has a history of coming together to provide meals and do small errands for people in need. Transportation to receive care could be an issue should she become seriously ill, though.
The impact of where we live, work and play
Social determinants of health (SDOH), conditions that exist in the environments that surround us, are easy to discount when we think of what affects our health. They may be less obvious, but they can be more impactful than you might think. On a county-by-county basis, the availability and quality of clinical care may result in a 20% differential in health outcomes. In contrast, SDOH can create a 50% differential in outcomes, with poverty, education and employment having the largest impacts.1
What can we learn from SDOH?
SDOH aren’t inherently negative; they simply are. They also reflect our ability to understand our health, access health care, afford the care we need and the safety and support systems present in our communities. However, it’s important to understand the social and, to the degree that we can, the cultural context of the people we work with every day.
Understanding the conditions that surround our members can give us insight into trends around economic stability, education and family structures where they live. We can add this information to other established factors related to health – like age, biological sex and underlying medical and behavioral health conditions. Then, accounting for modifiable factors like adherence to prescriptions and lifestyle behaviors, we can assign a metric to a person’s health as it is today and identify opportunities for improvement. Taking it further, we can assess what the person’s best possible health could be if they act on those opportunities.
Looking to the future with respect for today
People will continue to make the unhealthy choice that feels comfortable over healthier choices that feel unfamiliar or irrelevant. We can use what we know about who our members are and where they live to guide our work together. Our goal is to deliver highly personal, relevant experiences that both respect our members’ values and traditions and address relevant SDOH factors.
1Department of Health and Human Services Office of Health Policy. Whitman A, De Lew N, et al. Addressing Social Determinants of Health: Examples of Successful Evidence-Based Strategies and Current Federal Efforts. April 1, 2022. Available here. Accessed August 16, 2022.
*This is a fictitious example.