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Life After COVID: Short- and Long-term Effects of the COVID-19 Pandemic on the Social Determinants of Health

May 04, 2021  |  Article

 

Yogin Shroff, Senior Partner and Chief Operating Officer

What effect has COVID-19 had on the social determinants of health, and what can healthcare organizations do to address evolving limitations among their members?



Effectively managing social determinants of health (SDoH) is arguably the greatest challenge the healthcare sector faces today. As food and housing insecurity complications continue to climb sharply due to the pandemic, overarching issues like health disparities and health inequities are similarly escalating at an uncontrollable rate. Unfortunately, the COVID-19 pandemic has intensified the worsening conditions faced by far too many individuals. Most recently, those suffering from economic instability are facing difficulty meeting the demands of their rental properties. Studies have shown that 22 percent of Black renters, 20 percent of Latino renters, and 19 percent of Asian renters were not caught up on rent, compared to 9 percent of White renters during the COVID pandemic.1 The truth gets uglier as you look at other statistics spanning across ethnicities and SDoH risk factors.

It is important to note that social determinants continue to play a critical role even as COVID-19 vaccinations are slowly normalizing. Data through the pandemic has shown that the oft-marginalized races and ethnicities are far less likely to obtain vaccines than their Caucasian (and in some cases, Asian) counterparts. A highly telling statistic comes from a study conducted by Kaiser Family Foundations where they found a consistent pattern across states of Black and Hispanic people receiving smaller shares of vaccinations compared to their shares of cases and deaths and compared to their shares of the total population.4

How should healthcare professionals address health disparities during the COVID-19 pandemic?

The likely root causes of these population health concerns are low access to care and transportation. Many of the individuals suffering from social determinants are not only disengaged with their health plans and care providers, but also distant from vaccine sites, further debilitating their ability to receive vaccinations. These facts, again, point towards a growing need to address overall health disparities with more structure and efficacy; one that is driven by purposeful execution and lasting results.

The ability to integrate zip-code-level demographics with SDoH risk factors is a critical foundation behind understanding the unique needs of a given population. In accordance with the pandemic impacts, organizations must now also be agile in recognizing COVID-19 infection and vaccination rates for its membership base. Next, once the data analytics are established, healthcare players must commit to long-term investment towards resolving health inequity and health disparity concerns. And it is ever more imperative that these programs and initiatives are tailored to each social circumstance given the state of the COVID-19 virus. No singular solution is inclusive of all SDoH risk factors, so healthcare organizations must be highly intentional about the approach.

How do we determine if the interventions and strategies are succeeding in both member care and health equity? In our research and study of SDoH interventions, this is the question that is most left unanswered. Obtaining data and proper SDoH investment prior to the implementation of key initiatives is absolutely a necessity. But where we see health plans and institutions mightily struggling, in the fight against social barriers, is in capturing metrics around the progress of deployed interventions. It is essential to be able to track key performance indicators such as 'member cost of care' and 'intervention enrollees' to visibly analyze progress. This largely helps trend reduction in health disparities over time, but also supports sound financial decisions. We would be remiss for not mentioning that as the pandemic rages during the simultaneous rollout of COVID vaccinations, vaccine deserts are rapidly becoming a new type of SDoH risk factor that must be addressed.

The challenging journey ahead

COVID-19 has unmasked the need for all to be more vigilant across the many populations suffering from health disparities and health inequities. Addressing economic security issues like access to food, proper housing, and overall unmet needs is indeed a challenging road. Organizations striving for positive health outcomes are often stymied not only by the current COVID-19 climate, but also because of the consummation of finite resources, time, and funds. Consequently, in many cases, key stakeholders are unsure of which intervention deployments will yield the maximal return and positive impact on health disparities.

Nonetheless, advancing health equity has never been more critical. This growing concern expedites the need for payers, providers, and public health entities to unify in the fight against social determinants of health and focus on the root cause of member conditions, rather than just the condition itself. As COVID-19 runs rampant, further decreasing quality of life and increasing overall healthcare costs, we must make more meaningful and purposeful efforts to mitigate social barriers to care.

REFERENCES

1 CBPP (2021, April 8) Tracking the COVID-19 Recession's Effects on Food, Housing, and Employment Hardships. Retrieved from https://www.cbpp.org/research/poverty-and-inequality/tracking-the-covid-19-recessions-effects-on-food-housing-and

2 Heath, S (2020, December 10) COVID-19 Health Disparities May Stem from Care Access Inequity. Retrieved from https://patientengagementhit.com/news/covid-19-health-disparities-may-stem-from-care-access-inequity

3 Orgera, K, Garfield, R, Rudowitz, R (2021, March 16) One Year into the Pandemic: Implications of COVID-19 for Social Determinants of Health. Retrieved from https://www.kff.org/coronavirus-covid-19/issue-brief/one-year-into-the-pandemic-implications-of-covid-19-for-social-determinants-of-health/

4 Ndugga, N, Pham, O, Hill, L, Artiga, S, Alam, R, Parker, N (2021, April 7) Latest Data on COVID-19 Vaccinations Race/Ethnicity. Retrieved from https://www.kff.org/coronavirus-covid-19/issue-brief/latest-data-on-covid-19-vaccinations-race-ethnicity/

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