Stress, social isolation, and physical inactivity can affect high status, high-income individuals as well as lower income people. Research shows that where a person lives, their education level, their access to nutritious food, their access to health care, and their personal support system greatly impacts their health outcomes. Addressing these issues is key to improving health and to lowering health care costs. Using this research, federal and state regulators/payers (Medicare and Medicaid), community groups, doctors, hospitals, and health insurance companies have joined together to address the social and environmental factors that lead to poor health outcomes and high health care costs.

Employers that want to offer credible, research-driven wellness benefits should follow the lead of public payers and incorporate socioeconomic screenings and benefits into their wellness programs.

Workplace Wellness Programs—Entrenched and Evolving

According to the Kaiser Family Foundation, 49% (157,381,500) of Americans were covered by employer-sponsored health plans in 2016. In addition to their health insurance coverage, many of these individuals have access to an employer-sponsored wellness program. Despite the growing cynicism about the efficacy of workplace wellness programs, they don’t seem to be going away.

Wellness programs have expanded and evolved from weight loss clubs, health screenings, fitness challenges, and annual flu shots to onsite health clinics, fitness trackers, and financial counseling. So-called innovative wellness programs at top companies like Google, Motley Fool, and Zappos, provide nap rooms, Ping-Pong tables, massages, weekly recess, and other unique perks. But what started as common-sense promotion of healthy behaviors has turned into an unconnected, mix of wellness benefits without thought or impact. However, there may be a way for workplace wellness programs to redeem their legitimacy.

Getting Serious About Workplace Wellness Programs

If workplace wellness wants to return to its serious origins, it should look to the important work taking place in the public health care sector—screening for and addressing social determinants of health (SDOH). The Healthypeople.gov website defines social determinants of health as, “conditions in the environments in which people are born, live, work, learn, play, worship, and age that affect a wide range of health outcomes.” Specifically, SDOH includes factors such as income, education, food, environment, transportation, housing, and race and ethnicity.

Employers may think that confronting socioeconomic issues is an invasion of their employees' privacy, and that this work is best left to public policy experts. This is a legitimate concern; however, as the second largest payer of health care in the country, employers should not wait until government or some other group does the work for them. At a minimum, employers should become familiar with SDOH research, and incorporate socioeconomic screenings and benefits in their health plans and wellness programs.

Private health insurers can serve as a resource for employers that want to address socioeconomic issues through their benefits plans. Insurers (BCBS, UnitedHealthcare, Cigna, and Aetna) have experience creating tools and designing SDOH benefits for their Medicare and Medicaid enrollees. Some SDOH benefits employers should consider including in their health plan or wellness program include:

• • A database of community resources (to help with utility bills, rent support, home repairs, etc.)
• • Free transportation to and from medical appointments (free Uber or Lyft rides)
• • Healthy grocery vouchers to purchase fruits, vegetables, canned fish, and peanut butter
• • Free, no-internet mobile phones
• • Paid sabbaticals
• • Free or subsidized cultural and social engagement and volunteer opportunities (theatre and museum tickets, community center/YMCA memberships
• • Enhanced dental and vision benefits (based on health status and financial need)
• • Living wage

Tags: workplace wellness, Social determinants of health