How health apps are changing Social Determinants of Health

Social Determinants of Health (SDOH) are aspects of a patient’s environment and lifestyle—such as housing, food, finances, education, employment, and transportation—that can directly affect health. Studies have found that individual behavior, driven by social determinants, accounts for up to 40 percent of the risk of premature death. SDOH also include the presence or lack of personal support networks, with research revealing that social isolation is as much a threat to longevity as obesity.

As gaps in health equity continue, new technology platforms are helping to narrow the distance between patient and healthcare access. With wide-spread use of smartphones and wi-fi connectivity, digital health appears to offer new avenues to create engaging and effective patient-centered delivery models that move beyond SDOH. 

Patient Awareness 

One critical aspect to reduce SDOH is through patient awareness and education. It’s been said that “when people know better, they do better.” This extends to healthy behaviors and the use of digital health channels to create informed patients. In communities of under-served populations and/or those with a lack to critical healthcare infrastructure, patients may be unaware of options that support better health actions. For example, patients may be unaware of a local organization that offers needed assistance, such as with transportation. Other examples are behavioral approaches that can help them address chronic conditions.

Digital health is helping to reduce some of those barriers by capturing more patient data, beyond the typical EHR system to create a more complete and comprehensive view of patients. New digital health platforms analyze elements such as the patient’s medical needs, their social needs, community standards, access to care, demographic and patient history, financial challenges, and even historical data. By bringing together these components, practitioners can get a better understanding of some of the more abstract elements that influence patient health and start to address those through digital health platforms. 

Reducing health disparities

Reducing health disparities is a core component to solving SDOH, and digital health has helped to make significant progress toward this goal.  Digital health platforms help to close the gap for patients that may need ongoing care or specialized treatment in rural or underserved areas. For rural Americans, health is often affected by greater geographic isolation, lower socioeconomic status, higher rates of risky behaviors, and fewer job opportunities. Research indicates that rural residents are older, poorer, have a smaller cadre of physicians to care for them, and face more transportation challenges in accessing healthcare providers. Digital health solutions help to bridge the gaps created by geography with smartphone solutions, such as Vivify’s Pathways +Go that engage patients on a large scale and expand access for the most medically underserved populations. 

At the start of the COVID-19 pandemic, CMS leadership moved swiftly to approve telemedicine solutions to help enable treatment of patients in remote and underserved areas. This effort led to a dramatic increase in utilization, wider patient adoption, and potentially life-saving care delivered to those who otherwise might not have access to care. As such, leaders in Washington are now eyeing more ways to further expand tech capabilities to solve the health disparity gap and bring more advanced care into harder-to-reach areas, ensuring that SDOH may someday no longer be affected by geographic locations. 

Digital Determinants of Health

Digital technology has been a great equalizer for many, and cuts across numerous socio-economic boundaries. As the use of technology has expanded into healthcare, digital health is playing an important role in reducing disparities and expand access to underserved areas and populations.  Digital health apps have put health engagement and awareness in patients’ hands. Popular apps such as SleepScore, Apple Health, and FollowMyHealth allow patients real-time access to their health information, track heart rate and sleep cycles, and measure improvements or serious changes in health measures. These apps, along with thousands of others, are free to use and provide essential information for users to stay connected to their health. 

But breaking down barriers in SDOH requires more than just building an app. Platforms must understand the variances and nuance of its users, and how elements such as geography, salary, race, ethnicity, support systems, and other stressors can impact a patient’s health and offer support in a holistic approach. Medisafe is a digital health platform that helps patients manage their medications and provides personalized patient support unique to each user throughout their individual patient journey. Failure to maintain medications can be the result of environmental factors or social issues. Medisafe aims to solve for those by integrating specific interventions, group support, financial assistance, and the ability to connect care givers to help patients stay on track. It’s a no-cost way to approach patient health, understand the factors impacting their complete health, and deliver solutions in a preferred channel. 

Changing the Future SDOH

In order to change SDOH, a new approach is needed on how patients access care and understanding the components that impact patient health. There is growing support for value-based models of healthcare, focusing on positive outcomes instead of individual procedures or treatments. This model places great emphasis on prevention for improving population health.

Blue Cross Blue Shield is adopting SDOH as part of its’ strategy to address food insecurity, poor transport links and boosting social care among vulnerable populations. This approach becomes really exciting when the proven effectiveness of preventative medicine is paired with the power of technologies such as big data, enabling greater depth, breadth and specificity in delivery of services. Other companies such as AT&T and T-Mobile are working to further expand broadband and wi-fi access to the 21M people who currently lack access. And companies like CityBlock are partnering with local healthcare providers to use data to deliver targeted health and social care services focused on prevention.

With more companies, communities, and tech entities using digital means to better understand the upstream determinants of our health, there is the opportunity to provide policy makers and healthcare organizations with improved capabilities. Using digital health tools to tackle SDOH could create more efficient and equitable public health programs. The challenge will be to deliver these improvements to a number of populations in times of rapid social, economic and technological change.