PwC Health Research Institute report shows social determinants of health undermining progress of modern medicine


Fifty-seven percent of consumers surveyed said their doctor had never discussed the important social factors affecting their health.

Without renewed urgency, PwC healthcare leaders say medical advances will be rendered ineffective.

September 24, 2019— The rise in illnesses caused by our behaviours and the social determinants of health threatens to suffocate budgets in both wealthy and poor countries, while suppressing the power of modern medicine to improve lives. PwC’s new report “Action required: The urgency of addressing social determinants of health” outlines why healthcare stakeholders need to act now.

Social determinants of health—or the social, economic and environmental factors of where we live and work such as social isolation, economic inequality, pollution and food deserts—are preventing too many people across the globe from making healthy choices. And the impact cannot be ignored: PwC projects that by 2025, many countries will see obesity/overweight rates exceeding 68 percent of the population. By investing earlier in social determinants strategies that help people with housing, exercise, mental health support and ability to afford medications, governments and health systems stand to save money in the long term and improve health outcomes.

“Innovative medical treatments are rendered ineffective if people don’t have social support and access to resources readily available to help keep them well,” said Kelly Barnes, PwC’s Global and US Health Industries Leader. “This is not optional; healthcare and government organizations that don’t act on social determinants will spend more and more money, only to watch health status decline.”

The report’s results suggest opportunity for healthcare systems and governments to target social determinants of health by intervening earlier to prevent or stall the progress of chronic disease, especially when it comes to obesity and diabetes.

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Helen Harris

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How to lead in social determinants of health: Five steps for bold action

PwC has identified five steps to help stakeholders develop social determinants of health strategies:

  1. Build the collective will. Too many healthcare stakeholders aren’t talking about social determinants, as only 43 percent of respondents to a PwC Health Research Institute June 2019 global consumer survey said their doctor has even raised the subject with them. Other health workers, such as nurses, pharmacists and dietitians, are talking about it at a much lower level, highlighting the opportunity to involve healthcare workers more broadly. A convener can help bring partners together across the system by demonstrating the long-term benefits to each stakeholder of preventing more illness.
  2. Develop a framework that enables partners to work toward common goals. Once they have done the hard work of building coalitions, partners must overcome the everyday challenges of merging disparate workplaces with different missions, incentives and perspectives. Consumers expect that care should be better integrated to create a seamless experience; roughly one-third of consumers asked in a 2019 HRI global consumer survey indicated that there was an opportunity to better connect healthcare and social services.
  3. Generate data insights to inform decision making. Predictive analytics can also be used to consider both individual behaviour and the behaviour of populations. Many consumers do feel some individual responsibility to make a change, but 47% of respondents to PwC’s 2019 HRI global consumer survey indicated healthcare providers are not sharing predictions about what healthcare services these patients may need in the future considering their medical history. Even if people find the motivation, they often lack the information or tools to prevent chronic conditions.
  4. Engage and reflect the community. Social determinants of health strategies must be grounded in the way people live and work. While 56 percent of HRI consumer survey respondents indicated they use or plan to use their smartphone to support their heath, technology can only work if it is embraced and trusted by the community members expected to use it. Retailers, technology providers, home health workers and educators could provide new pathways to engage with consumers.
  5. Measure and redeploy. In Western Sydney, a coalition dedicated to diabetes prevention in its area population set measurable goals such as reducing population weight and HbA1C levels, then started developing a diabetes dashboard to help measure which interventions worked and track trends in costs. An annual year-end review report and plan for the year ahead helped further refine its strategy and investments.

“Leaders in social determinants of health have built coalitions, harnessed the potential of data and predictive analytics, and identified where early investments in an intervention can have tremendous impact on people’s health and lives,” said PwC’s Kelly Barnes. “We can’t underestimate the transformative effect this action can have not only on health systems and governments, but the healthy life years we can give to more people across the globe.”

For more on PwC’s new report “Action required: The urgency of addressing social determinants of health,” download the report at

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