Beyond the Boundaries of Health Care: Addressing Social Issues

During the past several decades, it has become increasingly apparent that a person’s “health” is influenced by many more factors than health care alone. These other determinants are defined by the conditions and environment in which people are born, grow, live, work, and age, reaching beyond just what the delivery of acute care services can influence. These “social determinants of health” result in billions of dollars of additional costs annually. By working to mitigate the negative impacts of these factors, significant benefits can be achieved that improve both access and outcomes for individuals and lower overall costs.

Addressing the social determinants of health has become a top priority for public and private institutions. State Medicaid programs and the Children’s Health Insurance Program (CHIP) have introduced care models to engage patients in improving their personal well-being. Private health plans also work to address environmental factors that impact a person’s health. For example, plans facilitate housing, transportation, and educational opportunities as complements to traditional health care services. Other approaches include offering early childhood support services; providing nutritional assistance for pregnant women, mothers, and children; and increasing access to case management services. While significant strides have been made to identify and address the social determinants of health, there is still much work to be done by public and private institutions to combat their influence.