Today, the healthcare ecosystem centers the social determinants of health (SDOH) conversation around socioeconomic factors, such as an individual’s education, income, and occupation – factors that are often aligned with where someone lives. Because of this, some argue a person’s zip code is a better predictor of health than their genomics, biometric screen or medical history since much of an individual’s ability to access and receive quality care is primarily determined by their home address.
While geographic location is important, what if we looked beyond an individual’s zip code to create a more comprehensive map of their health conditions and opportunities? Let’s call this their “health code” – a holistic evaluation that incorporates an individual’s life choices and stressors, in addition to their traditional SDOH factors.
By taking a holistic view, there is an opportunity for organizations within the healthcare ecosystem to partner with the people and organizations on the fringes to assess and incorporate care strategies that support an individual’s (and even a community’s) broader “health code.”
Changing the conversation
Addressing SDOH is frequently included in a healthcare provider’s and health plan’s strategy to improve care and drive better financial results, yet these strategies fall short by missing some key attributes outside the SDOH scope.
The strategy is more often than not centered around comparisons of whether an individual is poor vs. wealthy, isolated vs. centralized, educated vs. non-educated, etc. is a good start. But, what if the conversation went deeper? What if we broadened our SDOH model to incorporate situations that challenge someone’s ability to live a healthy life? A few examples include:
- Moral decisions. Regardless of where a woman lives or her level of education, when looking into an intrauterine device or other contraception methods, she is faced with moral, as well as economic and physical, implications influencing her decisions.
- Time and cost constraints. These can prohibit people from getting necessary care. A busy work life combined with poor health insurance benefits can lead a person to forego care altogether.
- Accountability. Without a dependable, caring circle of support, an individual is less likely to be surrounded by others that will influence positive healthy behaviors.
- The sense of belonging. Emotional isolation can leave people feeling left out, causing them to negatively act out to gain the attention of their community.
- Caring for others takes a toll. With an aging population, more people are taking on caregiving roles for family members, friends, co-workings, and neighbors at the expense of spending time caring for themselves.
As our understanding of the impacts of SDOH on a person’s health evolves to incorporate lifestyle factors and extenuating circumstances, the lens widens to include the ripple effects that neither the scope a genetic or a zip code can contain.
Organizations leading the charge
There are individuals and organizations stepping up and taking an initiative to ensure better health for their communities. By implementing strategies that incorporate a fuller spectrum of health challenges, these organizations are embracing a more complete set of needs that may not show up in a genetic or zip code but will be exposed in a broader health code.
- Alexandra Drane (Cashier, Walmart; Co-Founder, ARCHANGELS and Eliza Corporation): Co-founder of ARCHANGELS, an organization dedicated to supporting caregivers, Drane has made it her personal mission to expand the definition of health to include life. ARCHANGELS provide caregivers access to underutilized resources, such as meal planning ideas and tips for managing household chores, to alleviate the mental, physical and emotional burdens of caregiving.
- Esther Dyson: Executive Founder of Wellville, a nonprofit evidence-generating project devoted to implementing and refining models for investing in community health, Dyson is passionate about applying approaches known to work on a larger scale in small communities. She works with communities to set goals around health conditions and issues, and Wellville finds partners and funders to manage accountability.
- Healthify: A software suite, Healthify gives providers and others resources to connect patients with community organizations that can help address social needs, such as food insecurity and affordable housing.
- Medicines360: A nonprofit, mission-driven women’s health pharmaceutical company, Medicines360 addresses gaps in women’s health. When women face limited choices, the company develops medicines that expand options and make them available to help close access gaps.
- Dignity and Sutter Health: These two health systems, along with other systems across the country, are investing in housing programs for homeless patients to help curb emergency department overutilization and reduce healthcare costs. The purpose of these programs is to not only provide housing but also ensure that these individuals have access to and receive follow-up healthcare services after they are discharged from the hospital.
- Someone With: Supporting those battling and recovering from cancer, Someone With gathers physician-approved resources – both medical and personal – in one place for a patient to easily access, purchase and use. For example, the company distributes metal free deodorant for patients to use while undergoing radiation.
Moving forward to crack the (zip) code of health
Changing the current approach and creating a system that values and supports a more comprehensive picture of health seems daunting. The healthcare system is complex, has many moving parts and involves a number of stakeholders that will need to come together to shift from addressing the tangibles defined by a genetic or zip code to include the intangibles of a broader “health code.”
The issue today is not a lack of technology or innovation. The issue is an overall market definition of what impacts and determines how people make healthy decisions – and live healthy lives.
At HLTH, we are changing the conversation. By bringing together stakeholders from within and on the fringes of the healthcare system, we can engage in a more meaningful dialogue on how we frame and address health. Unlocking an individual’s unique “health code” is a mutual win for all stakeholders of health: providers, payers, employers, policy-makers, the government, solution providers, and – most importantly – each and every one of us.
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