October 31, 2023

Addressing social determinants of health (SDOH)—the circumstances in which people are born and live—offers an opportunity for organizations and the communities in which they operate to improve the health and well-being of people. These complex and interconnected factors impact physical and mental health, the ability to be productive at work and overall quality of life. They include early childhood experiences and educational opportunities; employment status and livable wages; housing, food, water, transportation, public safety, gender and racial equality; and of course, health care. Leading employers look beyond individual behavior modification and consider ways that benefits and well-being initiatives can be expanded to address the underlying conditions that impact the health of employees and their families.

Business Group on Health’s Social Determinants: Acting to Achieve Well-being for All resource is for benefits and well-being leaders who are passionate about making a meaningful change in their organization and beyond. It is a companion piece to the Employer Guide to Health Equity that outlines how employers can influence health equity through health care access, equitable engagement, inclusive experience and social determinants of health.

1 | Identify employees’ social needs.

• Social needs assessments: Add questions about social needs to existing health or well-being assessments. Validated questionnaires exist that you may be able to draw questions from, including The Accountable Health Communities Health-Related Social Needs Screening Tool and the Protocol for Responding to and Assessing Patient Assets, Risks, and Experiences questionnaire. Assessing social needs through questionnaires may be particularly relevant for global employers, who may not have a line of sight to the social challenges of their workforce.
• SDOH analytics: Partner with organizations that provide SDOH analytics. These organizations include health plans, health services organizations and consulting firms, as well as organizations specifically focused on social determinants of health. They may be able to integrate multiple sources of data to paint a complete picture of the risks and opportunities that your population faces.
• Public health partnerships: Work with local public health departments. They may be poised to help you identify the greatest social, economic and environmental factors impacting local community health, available community resources, and importantly, insights on gaps in programs and services.
• Public data: Use publicly available data on social determinants. Helpful data sources may include those compiled by the Centers for Disease Control and Prevention or Data for Health Equity which provides more than 70 datasets of SDOH in multiple countries.^{36, 37} Health plans may also have publicly available data on social determinants of health or the conditions affecting the health and well-being of individuals.
• Employee feedback: Hear directly from employees on their social needs and potential gaps in benefits or programs. Focus groups or discussions with employees (such as through employee resource groups) may enable you to obtain deeper insights into employee needs and desires than through surveys or data analytics alone.

2 | Connect employees with community resources that address unmet life needs.

Leveraging internal HR staff, well-being champions and vendor programs, such as advocacy/concierge services, engagement platforms, EAPs and/or on-site clinics, to refer employees to community resources provides pathways to needed services. To create effective referrals, consider the following:

• How will the program or benefit sensitively identify the social barriers employees are facing? It may be necessary to implement training among those interacting with employees on ways to recognize social needs and how to respond.
• How will the program or benefit know what programs or services might be available to employees? There are publicly available, up-to-date lists of social services (e.g., findhelp for the U.S. and Puerto Rico) that aggregate free or low-cost programs and services and make them searchable by zip code and topic. There are also many companies that address social needs by coordinating referrals and care between health care and community-based organizations.
• What mechanism will be in place to track referrals to community programs or services? Tracking referrals can help you better understand employee social needs and potential gaps in employer-sponsored programs or benefits.

3 | Filling gaps through benefits, programs and policies.

While numerous social factors impact health, Business Group on Health selected seven areas of focus—income, access to health care services, transportation, food access and insecurity, childcare, housing insecurity and racism—that employers can influence through health and well-being benefits, programs and policies. Click on the icons below to deepen your understanding of these social determinants and actionable solutions for employer implementation.

4 | Advocate for and partner strategically to improve community health and sustainability.

• Partnerships: Engage in partnerships with public entities and community health organizations to address social determinants. In these partnerships, businesses can offer expertise, resources (e.g., funding, services or products), strategy/leadership support and political influence.
• Trust: Support public health efforts and use messaging internally and externally to build trust in public health institutions and initiatives.
• Advocacy: Advocate for evidence-based public health policies, programs and funding that align with workforce and community health needs.
• Volunteer: Support local health departments and community health organizations by allowing employees to volunteer and/or offer pro bono services, particularly with skills-based work (e.g., IT, legal/contracting, communications, logistics) that large companies have sophisticated expertise in executing.

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