Time for Employers to Consider Social Determinants of Health

Social Factors Affect Workers' Health, Employer Costs, Business Performance

A wide range of social factors have a major influence on employees' health — and thus on employers' bottom line, reports a "fast-track" paper in the August 2018 issue of the Journal of Occupational and Environmental Medicine.

"Social determinants of health [SDH] appear to have a significant impact on employee health status, and consequently on employer healthcare costs as well as business performance," according to the article by Bruce W. Sherman, MD, of Case Western Reserve University, Cleveland, and Emily Stiehl, PhD, of University of Illinois at Chicago. They introduce the concept of SDH and the growing appreciation of its role in health management of commercially insured workers.

Social determinants of health include individual-level factors such as education, income, and stress level; and work-related factors such as job type, wages and hours, and the physical and social work environment. Estimates suggest that social factors may contribute up to 40 percent of an individual's health status.

But so far, SDH in the workplace has received little attention as part of employer insurance and other workplace wellness efforts. Increased attention to SDH in employee benefits and workplace culture "will improve the employer's ability to more comprehensively and effectively address diverse population health and well-being needs — and ultimately, the value of their workforce's human capital," Drs. Sherman and Stiehl write.

How can employers get started in addressing social factors affecting employee health? Because of the health disparities among income groups, wages are a "reasonable initial proxy" for evaluating SDH, the authors believe. Their article includes a representative listing of SDH measures, including data sources and examples of practical applications.

"We believe that employers can have a favorable impact on employee health status, by thoughtfully implementing strategies to address SDH concerns," Drs. Sherman and Stiehl conclude. "By so doing, we expect that employers will appreciate more meaningful and lasting healthcare cost containment."
About the Author — Dr. Sherman may be contacted for interviews at bruce.sherman@case.edu.

About ACOEM — The American College of Occupational and Environmental Medicine (www.acoem.org), an international society of 4,500 occupational physicians and other health care professionals, provides leadership to promote optimal health and safety of workers, workplaces, and environments.

About JOEM — The Journal of Occupational and Environmental Medicine (www.joem.org) is the official journal of the American College of Occupational and Environmental Medicine. Edited to serve as a guide for physicians, nurses, and researchers, the clinically oriented research articles are an excellent source for new ideas, concepts, techniques, and procedures that can be readily applied in the industrial or commercial employment setting.


Sherman BW, Stiehl E. Health management in commercially insured populations: it is time to include social determinants of health. J Occup Environ Med. 2018;60(8);688-92.