Healthcare organizations have increasingly focused on addressing social determinants of health (SDOH) to improve patient outcomes and reduce healthcare costs. SDOH refers to non-medical factors like income, education, environment, employment, and social networks that heavily influence a person’s health. These elements can often impact health more than direct medical care.
Studies reveal that SDOH may account for up to 80% of health outcomes, making them a crucial area for healthcare entities aiming to improve public health and lower costs. In response, leading health insurers and providers are investing in SDOH initiatives like social service referrals, affordable housing projects, and food security programs. While these efforts address core issues of health inequality, they are only part of the solution.
The Impact of Policy on SDOH
Beyond direct investments, long-term improvements in SDOH depend largely on government policies at all levels. Policy decisions on housing, education, employment, and social safety nets significantly influence health outcomes. Therefore, healthcare stakeholders must also push for policy reform to create more lasting changes in these areas.
Lobbying offers a powerful way for healthcare organizations to influence these policies and address the root causes of poor health. However, many healthcare organizations have yet to fully leverage lobbying to drive improvements in SDOH.
A Missed Opportunity for Healthcare Lobbying on SDOH
An analysis of federal lobbying disclosures from top healthcare organizations between 2015 and 2019 highlights an underutilization of lobbying efforts to address SDOH. The study focused on issues like housing, food security, transportation, and financial strain, as outlined by the Accountable Health Communities Model (AHCM).
The results showed that while some organizations lobbied on certain SDOH topics, others left key issues untouched. For example, five out of ten organizations lobbied on SDOH, with priorities including financial strain, employment, and interpersonal safety. However, housing, transportation, and education were notably absent from many lobbying efforts, despite their well-known impact on health outcomes.
Given that these organizations spent over $507 million on lobbying from 2015 to 2019, there is substantial potential to expand their lobbying efforts and advocate for a broader range of SDOH-related policy reforms.
Corporate Lobbying Incentives and SDOH
To understand why healthcare organizations are not fully engaged in lobbying for SDOH, it’s important to consider the motivations behind corporate lobbying. Lobbying typically advances financial interests, improves reputation, or aligns with shareholder values.
For healthcare organizations, lobbying on SDOH may not seem to provide immediate financial returns compared to issues like reimbursement rates or regulatory changes. Additionally, healthcare organizations might feel more comfortable advocating for healthcare-specific policies rather than social issues like housing or transportation, especially in profit-driven settings where shareholder value is the priority.
Furthermore, SDOH issues may be siloed within specific departments, such as community health or corporate responsibility, which might limit their integration into broader lobbying strategies.
Despite these challenges, there is a strong argument for expanding lobbying efforts on SDOH. Policy changes on housing, education, and transportation could significantly improve public health, reduce disparities, and lower healthcare costs over time. Furthermore, organizations that take a leadership role in advocating for SDOH policies can boost their reputation and better align with the values of modern consumers, employees, and policymakers.
Recommendations for Enhancing SDOH Lobbying
To improve lobbying efforts on SDOH, healthcare organizations should consider the following:
Integrate SDOH into Lobbying Agendas: Ensure that SDOH issues are part of broader lobbying strategies, breaking down silos between departments to align advocacy efforts.
Collaborate with Advocacy Groups: Partner with existing coalitions focused on SDOH issues to amplify lobbying efforts and leverage political connections.
Use Contract Lobbyists: Healthcare organizations can expand their influence by directing contract lobbyists to focus on SDOH alongside traditional healthcare topics.
Increase Public Awareness: By raising awareness of SDOH issues through media and public forums, healthcare organizations can build momentum for policy change.
Align Financial Incentives with SDOH: Advocate for payment models that reward addressing SDOH, such as value-based care, to create stronger financial incentives for healthcare providers.
Looking Ahead
As the healthcare industry moves towards value-based care, addressing SDOH will be key to improving health outcomes and reducing costs. Expanding lobbying efforts in this area represents both a moral imperative and a strategic opportunity for healthcare organizations. Those that take a leading role in advocating for SDOH policy reforms will be well-positioned to drive change, enhance their reputations, and promote health equity in the communities they serve.
