How Does Chronic Illness Affect SDOH Perceptions?

June 19, 2019

New study shows that the public thinks about SDOH differently than academics.

Connecting members with chronic conditions to social support service is critical to improving their well-being, according to a new white paper from Anthem’s Public Policy Institute.

There’s been a lot of discussion in recent years of social determinants of health, particularly in the media and academic research, but no one had ever looked at how individuals who have chronic or acute conditions perceive social determinants and compared it to the public dialogue until now, according to Jennifer Kowalski, vice president of Anthem’s Public Policy Institute.

“Individuals who are living with chronic or acute conditions perceive and discuss social determinants of health differently than researchers and the media, creating missed opportunities for payers and care providers to address gaps and engage more effectively with members and patients,” says Kowalski.

Anthem’s Public Policy Institute partnered with Quid, a research platform designed to analyze text-based data, to compare academic papers, news articles, and individuals’ posts on patient forums focused on cancer, diabetes, and mental health conditions.

Individuals appear to focus on factors that may be more easily modifiable, (e.g., increased social support, better access to healthy food), while the academic literature is focused on structural factors (e.g., education) that may take more time and greater resources to address, according to Kowalski.

“The gap between these differing perspectives highlights opportunities to improve the health and wellbeing of individuals-in particular by addressing social connectedness and community support,” she says.

By better understanding how individuals view and talk about social determinants, payers and care providers alike can identify new and improved ways to engage with them to more effectively improve their health and well-being and the delivery of healthcare, according to Kowalski.

Related: Five Ways To Treat Chronically Ill Patients

“One of the more interesting findings was that individuals were concerned with factors like social supports and food that might be easier to modify, while academic and news reports focused on factors like education and economic stability that take more time and resources to address,” she says.

Across the patient forums differences were observed in social support needs. “Individuals with diabetes and cancer, for instance, reported having positive support from family members and their community,” Kowalski says. “In contrast, those living with mental health conditions were less likely to be receiving needed social support. Individuals with mental health conditions disclosed that their inability to communicate their experiences to others triggered feelings of insecurity and self-doubt. They frequently worried about pushing away or ‘ruining’ important relationships because of their conditions.”

Another interesting finding was that all groups expressed concern about maintaining a proper diet but tended to have different perspectives. “Individuals with mental health conditions frequently mentioned healthy food access, while those with diabetes worried more about hunger and people with cancer focused on nutrition,” she says.

“The report suggests that payers, care providers and other engaged stakeholders can take steps including investing in and expanding community capacity to improve access to food, transportation, and social capital, among other resources; and supporting policy and funding mechanisms that expand available solutions and enhance the impact of resources aimed at reducing barriers,” Kowalski says.