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COVID-19 may be inflection point for investment in social determinants


The COVID-19 crisis underscores the importance of strategic, well-targeted programs to address social determinants of health.

Food insecurity has skyrocketed. Housing instability is likely to grow as unemployment persists and eviction moratoriums expire. Social distancing may exacerbate social isolation. These and other social determinants of health, or SDOH, are well-known to impair management of chronic conditions, like asthma and heart disease, and to increase unnecessary utilization of emergency rooms and inpatient care. As a result, a secondary effect of the coronavirus crisis may be preventable declines in health, particularly among lower-income populations.

At the same time, the capacity to provide social services is strained. Community-based organizations, primary-care practices and emergency rooms are on the front lines of identifying people facing health-related social needs and referring them to or providing services. They face revenue shortfalls, staff shortages and massive uncertainty about their futures.

Driven by this crisis, the healthcare system is embracing collaboration and innovation at an unprecedented rate.

Health plans, accountable care organizations and other payer-provider systems are well-positioned to rise to these challenges and embrace these innovation opportunities. My research interviews with dozens of SDOH leaders in healthcare organizations and community-based organizations outline a comprehensive set of initiatives with some impressive results. Many healthcare organizations have already built programs to address SDOH, often in partnership with community-based organizations.

SDOH programs are still relatively new to healthcare. The COVID-19 crisis may be an inflection point that will spur additional investments and initiatives. While certainly not the only path forward, these programs have the potential to quickly address mounting social needs and prevent the associated health complications.

Alexandra Schweitzer
Senior fellow
Mossavar-Rahmani Center for Business and Government
Harvard Kennedy School





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