The correlation between environment and health is perhaps best encompassed in the population health mantra, your ZIP code is more important to your health than your genetic code.

Roughly 3.6 million Americans miss or delay medical care each year because of transportation issues. Social determinants, such as access to transportation and unstable housing, can significantly impact health outcomes and increase risk behavior – leading to higher medical costs. The need to understand social determinants of health has become an increased priority, especially when building programs to alter unhealthy behavior. A deeper understanding of social determinants can help health plans develop programs that lead to better health outcomes for members while also reducing costs.

Social determinants of health

The World Health Organization defines the social determinants of health as “the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life.” Broadly, these determinants include a person’s social, economic, and physical environment. Extensive research has shown that these factors are major drivers of health outcomes and medical costs. The correlation between environment and health is perhaps best compassed in the population health mantra, your ZIP code is more important to your health than your genetic code.

social determinants
Source: Kaiser Family Foundation

Translating social determinants to reduce costs

For health plans, addressing social determinants of health can reduce downstream costs and utilization. As a result, health plans like Molina, Humana, and Kaiser Permanente are investing in programs and partnerships to address social determinants for their members. At NextHealth, we work with plans to incorporate social determinants and behavioral science to enhance analytics and consumer engagement. Below are three examples of social determinants that we use to better understand behavior, segment at-risk populations, and help consumers achieve better health outcomes.

Income data

Income level is a major determinant of health. According to the World Health Organization, “higher income and social status are linked to better health. The greater the gap between the richest and poorest people, the greater the differences in health.” Additionally, data from the Kaiser Family Foundation shows that Americans with lower incomes are much less likely to report being in good health than those with high incomes.

NextHealth can enhance health plan data with information on members’ income level and educational attainment. This data allows our prescriptive analytics engine to generate insights and tailor member outreach based on socioeconomic factors.

Vehicle ownership

Members without access to a car may have difficulty accessing care or showing up to a doctor’s appointment. The NextHealth platform can identify these members and nudge them with messages about transportation options. For example, some health plans have partnered with ride-sharing companies like Lyft to provide free rides to the doctor.

English language proficiency

For patients who are not fluent in English, language barriers can have a negative impact on health outcomes. NextHealth accounts for language differences by conducting outreach in the member’s preferred language. Additionally, members that speak uncommon languages may be interested in using a telehealth or mHealth service to connect with a provider that speaks their native language.

At NextHealth, we recognize that socioeconomic factors are major drivers of health and medical costs. These are just a few examples of how we partner with health plans to help members make the best healthcare decisions. Successful programs will rely on the understanding how social determinants of health impact individuals – and providing holistic and personalized support.

Contributed by Zach Capshaw, Product Analyst, NextHealth Technologies


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WHO Social Determinants of Health

Zip code better predictor of health than genetic code

Payer Collaboration Can Address Social Determinants of Health


Download a whitepaper to learn more about how NextHealth clients achieve causal outcomes and use behavioral nudges to change member behavior.

The NextHealth platform scales to address multiple use cases.