A first-of-its-kind study reveals that community health and non-clinical social barriers have a much more profound impact on workforce health than previously recognized. “Surprisingly, only about 20% of our health is determined by the medical care we receive,” says Heather Kane, chief executive officer of UnitedHealthcare, Arizona & New Mexico, citing the findings from the Health Action Council/UnitedHealthcare White Paper. “The other 80% comes from what we call social determinants of health — like where we live, our access to healthy food and even our social life. These things play a big role in our overall health and wellness. Until now, no one had studied how everyday life factors, seen through insurance claims, affect our health and, in turn, how they drive up costs for employers. That makes this study a game changer.”
The report, which focused on Health Action Council members’ claims across more than 217,000 covered lives, marks the first study to examine social factors within any claims data. It unveils some of the most comprehensive findings on social determinants of health (SDoH) — the conditions in which people live, learn, work, play, and worship – ever released at the member level.
Titled “Community insights: Key factors that influence employee health,” the seventh annual white paper by HAC and UnitedHealth Group highlights crucial insights for HR and benefits managers to utilize when customizing their plans, ultimately helping to improve the health and productivity of their workforce.
Important Stats We Learned
One of the white paper’s most striking takeaways is the connection between where employees live, its effect on their life expectancy, and costs for both employers and their employees.
There is an extreme disparity in mortality rates among employees who work for the same company, across various states. And employees who live in less healthy states cost employers more. Approximately 66% of HAC members live within the 20 least healthy states, according to America’s Health Rankings data. If those members lived in the 20 healthiest states, the total covered per member per month (PMPM) amount would be reduced by $61 million — 7% of spend.
“We learned that factors like being lonely, having unstable housing or financial insecurities, are affecting more than half of the employed workforce around the country whose claims were studied. Even more concerning, 41% of children have a parent battling at least one of these high-risk issues, leading to higher rates of suicidal ideation, depression and ER visits among those kids,” Kane says. “We also learned that employees who face these social challenges and live in states in which the overall population is less healthy end up costing employers about 7% more in coverage costs.”
What Employees Can Do
This study marks a turning point in benefits strategy, transitioning from the traditional focus on retrospective claims data, company culture, and budgets, to a more comprehensive approach. It emphasizes a need for employers to consider both the geographic locations of their employees and the associated community health and SDoH data to help advance employee health, boost productivity and optimize costs.
Kane addresses steps benefits managers can take to help lead this change for their employees and their dependents: “Employers can make a big difference by first understanding the specific challenges their employees are facing and drilling down to understand how they differ between employee groups, since it’s not a one-size-fits-all situation. By getting to know the unique needs of their workforce, employers can offer health plans and programs that meet employees where they are. It’s also crucial to educate a workforce about the importance of regular checkups and building a strong relationship with their primary care physician to monitor, prevent health issues before they start or early in the onset of an illness.”
By embracing these strategies, benefits managers can spearhead transformative health management initiatives within their organizations. This approach helps ensure that interventions are grounded in comprehensive data analysis, tailored to meet individual needs, and enhanced by educational efforts to foster a proactive and informed culture of health.
Patty Starr is president and CEO of Health Action Council, and Craig Kurtzweil is chief data & analytics officer at UnitedHealthcare Employer & Individual. Health Action Council is a not-for-profit organization representing large employers to enhance human and economic health through thought leadership, innovative services, and collaboration.
