SDoH Survey Findings 2023

The delivery of healthcare in the United States is rife with inequities. Differences exist by income, race, ethnicity, disability, urbanicity, and other factors. Providing the best care for all Americans means reducing these differences. To this end, CMS implemented a number of changes in the 2024 Final Rule. While the replacement of the reward factor with the health equity index captures more attention, the proposed addition of a new measure, screening for social risk factors, suggests a move towards involving providers in the solution.

Social risk factors include a host of issues that both put people at risk for disease burden and make it more challenging to access care when needed. These usually include poverty, hunger, housing, transportation, personal safety and more. At Engagys, we conducted a consumer SDoH survey to delve into social risk factor issues and collected answers from 570 respondents through an online panel.

To qualify for the survey, adult respondents (age 18 and over) were required to have received healthcare services in the U.S. in the past 12 months. The survey was conducted in May and designed to mirror the U.S. population. By creating our own dataset, we are able to look for relationships that may be difficult to find in top line results published elsewhere. Here are key findings from the SDoH survey.

Consumers are delaying care

More than a third of respondents (43%) agreed or strongly agreed that they put off or didn't get medical care in the last 12 months. One implication from this finding is that healthcare organizations are going to struggle getting preventive care for their members. This, in turn, will make it harder to impact the HEDIS portion of the Medicare stars ratings. Combined with other changes, like the introduction of the Tukey Outlier Deletion Methodology, mean that plans will have to work harder to engage members to encourage them to get preventive care.

The group most likely to report delaying or not receiving medical care was the 30-44 segment at 51%. There are two likely explanations for this, which we cover in our SDoH survey results eBook.

Once care is provided, the outlook is brighter. When asked about their ability to get answers from their healthcare professionals and to manage their care among different providers and services, most respondents report positive experiences. A clear majority (69.1%) agree or strongly agree that they were able to ask all their health-related questions to healthcare professionals. A majority (67.7%) also agreed or strongly agreed that they were able to get the help they needed from their personal doctor’s office to manage their care among different providers and services, including specialists, labs, or pharmacists.

Social isolation is still a major factor

Our survey revealed that more than a third (37.7%) of Americans feel lonely or isolated. The results are worse for those with a disability - 46% of those with a disability reported that they also feel lonely. And, again, the most affected age demographic reporting the most feelings of loneliness was 30-44 at 42%.

Lack of transportation is a barrier for some experiencing SDoH issues

Our SDoH survey finds that just over 20% of respondents lack reliable transportation. Not surprisingly, those with household incomes under $25,000 are almost twice as likely to report struggles than those with incomes greater than $75,000.

In our experience, plans have been successful in improving preventive care and screening rates through interventions such as in-home assessments and transportation benefits. In fact, one plan sees that those who take advantage of non-emergency transportation benefits are 5% - 10% more likely to get an annual wellness visit than membership as a whole. The results for duals and non-duals is almost exactly the same, suggesting that reducing disparities is possible and reduces differences in quality.

Both ethnicity and education levels impact discrimination

Not surprisingly, survey respondents who are members of minority groups were twice as likely to agree they had faced discrimination whilst getting medical care than white respondents.

Yet discrimination amongst non-white respondents is not evenly felt. Almost a third (28%) of non-white respondents without any college education reported feelings of discrimination. Only 18% of non-white respondents with at least some college education had the same experience.

Closing

Interested in learning more about our SDoH survey findings and how Americans are faring with healthcare and SDoH barriers today? Want to find out why the 30-44 age group and Americans with annual household incomes between $25,000k-$50,000k are struggling within the healthcare system? Click here to find all that out and more in our Social Risk and SDoH Consumer Survey Findings 2023 eBook. 

Special thanks to co-author Bradyn Radford