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Social determinants of health and your patients


The conditions in which people live, learn, work, and play that can affect a wide range of health risks and outcomes.

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The topic of social determinants of health is receiving much attention lately, particularly in academic papers and consumer media. The question for doctors, however, is how do social determinants apply to the everyday practice of medicine?

According to the Centers for Disease Control and Prevention, social determinants of health are the conditions in which people live, learn, work, and play that can affect a wide range of health risks and outcomes. Everything from access to healthy food and housing to safe neighborhoods and education are considered social determinants and, in theory, can serve as predictors of-and factor into-population health.

In practice, however, social determinants take on a more real-world meaning. In a medical setting, they mean asking our patients some nontraditional-and sometimes difficult-questions.

Are you getting enough to eat? Do you feel safe at home? Do you feel lonely or isolated? These are just a few examples of the queries we should be posing to get a complete understanding of our patients’ medical history.

The good news is according to a survey from Leavitt Partners, more than 50 percent of physicians believe assisting patients with social determinants of health matters for wellbeing. The bad news is this research found the majority of physicians do not feel well-positioned to help address social determinants.

In addition, the majority of those surveyed do not believe doctors or insurance plans are responsible for providing that assistance, even though nearly half thought their patients would benefit from this type of assistance.

We physicians have a lot on our plates. But what if there were resources available to help patients without adding more to an already overworked schedule? By incorporating actions to help our patients who need it, we can make strides and enhance patient care and reduce traditional healthcare needs. For example, there are resources such as WellCare Health Plans’ free CommUnity Assistance Line (CAL) available to everyone in all 50 states, whether they have WellCare insurance or not. The call center fields more than 100,000 calls per year, connecting callers to local social services and programs that meet their needs.

And research shows programs such as these – ones that strengthen the social safety net – actually save money and improve outcomes, benefitting the health system and our patients. A recent study from the University of South Florida revealed a 10 percent reduction in healthcare costs for those who were connected to social services through WellCare’s CAL, which equates to nearly $2,500 per person annual savings. The findings provide additional evidence that social service programs can improve community health outcomes and reduce healthcare spending.

Taking on social determinants of health can feel daunting. But if we don’t address these issues, our patients can’t get to our offices, eat healthy foods, live in safe housing or meet their basic needs, which leads to, and magnifies, medical and behavioral health issues.

Tackling this issue isn’t solely a physician responsibility. It’s a collective one. But as a first step, we can help identify issues and refer patients to appropriate and available resources for support.

Mark Leenay, MD, is the chief medical officer and senior vice president of WellCare Health Plans, Inc. He is board certified in family medicine, geriatrics and hospice and palliative care.

If you know of patients in your practice who are struggling with social determinants of health, please refer them to WellCare’s toll-free Community Assistance Line at 866-775-2192.

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