One player alone cannot address the root causes of disease. But many players do not seem to be trying at all. More than one-third of respondents surveyed in PwC’s 2019 HRI global consumer survey indicated they had not engaged in conversation with any stakeholders about the social, economic, behavioral and environmental factors affecting their health.
Forty-three percent of consumers surveyed mentioned they had discussed those factors with physicians, but pharmacists, therapists, nurses and other health specialists are broaching the topic at a much lower level. This disparity highlights the huge opportunity to engage other health system workers in promoting conversation about social determinants of health.
It will take a coalition of partners who may need to stretch their roles, but leaders must find ways to show prospective partners how their goals meaningfully align. Constructing the right coalition also will require looking beyond the sector and traditional partners to consider the community groups, government agencies, universities, retailers, technology companies and new entrants that might contribute.
Articulating the overall costs to health systems and society can help motivate players. For example, faced with evidence that the estimated direct cost of medical care attributable to people being overweight and obese increased 61% from 2000 to 2008, Mexico in 2010 launched the National Agreement for Nutrition and Health campaign against obesity. This program gathered five business groups and 15 federal agencies, including the ministries of health and education, to work together with a focus on the school-age population.
In other cases, companies have stepped up as conveners. In the US, a digital health startup helps healthcare organizations find partners and coordinate to address social determinants of health. It recently announced a collaboration to help connect its complex, chronic patients with medical, behavioral, social and palliative care. Employers are recognizing that a different approach is needed, and some are taking a more activist role.
Though a social determinants of health focus can achieve tremendous savings for the overall system, the payoff may not be seen for years, and may stretch over two or even four election cycles. What can help build support?
Efforts to address social determinants of health often have not scaled beyond the pilot stage because of difficulties in quantifying the immediate and long-term value to risk bearing stakeholders. However, by developing common frameworks and harnessing the power of data analytics, organizations can build the infrastructure that will produce evidence for the business case.
For citations, implications and insights, please read our full report, Social determinants of health: Expanding the health ecosystem to encompass where people live, work and play.