New study confirms that social determinants of health challenges are prevalent among commercially-insured populations
Jun 16, 2021
Analysis of a large commercially-insured population shows that more than a quarter of the workforce is vulnerable to SDoH barriers to care
SAN FRANCISCO – June 16, 2021 – Castlight Health, Inc. (NYSE: CSLT), a leading health navigation platform, today announced the results of a new study on the impact of social determinants of health (SDoH) factors on workforce health. Published in the Journal of Primary Care and Community Health, the new study found that 27 percent of more than five million commercially-insured people live in a zip code where the median income is at or below 200 percent of the Federal Poverty Level (FPL). This population was significantly more likely than those living in wealthier zip codes to use ER services (34% vs 9%), miss preventive care (27% vs 14%), have a behavioral health condition (29% vs 11%), diabetes (34% vs 8%), overweight/obesity (30% vs 10%), or a high-risk pregnancy (24% vs 15%).
One of the most important barriers to health for those people with food-sensitive health conditions such as diabetes, hypertension, overweight/obesity, and high-risk pregnancy is lack of access to healthy foods. Fifteen percent of the commercially-insured population live in a low access food area or food desert as defined by the USDA.
Among employees reporting barriers to getting healthcare or medications:
- 56% identified cost or insurance
- 26% identified family, school, or work responsibilities
- 4% identified travel or transportation
Additionally, the study found considerable variability in access to employer-sponsored resources to address these needs—while 70 percent of employers provide behavioral health services through Employee Assistance Programs (EAP) and other supplemental programs, and 63 percent now provide tele-health programs as an alternative to over-utilization of ER services, only one percent offer healthy food programs, only seven percent offer financial programs beyond EAP, and less than 0.5 percent offer either child care or transportation support programs.
“Without access to the resources employees and their families need to stay healthy, many people with SDoH-related barriers to care are forced to make healthcare decisions with limited resource options,” said Dr. Bruce Sherman, study co-author and assistant clinical professor of medicine at Case Western Reserve University.
“Individuals may delay or forgo care, or choose easier-to-access but costlier providers for basic care like the emergency department, resulting in higher costs. More importantly, without regular primary care follow-up, they are at substantially greater risk for development of disease-specific complications.”
With the disparities in care exposed by the COVID-19 pandemic and a recent Robert Wood Johnson Foundation report confirming that up to 80 percent of health outcomes are driven by factors such as one’s living and working conditions, income, and access to education, nutritious food, and healthcare resources, large employers are recognizing that SDoH care barriers are resulting in worse outcomes for their members.
This Castlight study is the first study to explore the prevalence of SDoH barriers with associated clinical risk factors for common medical conditions within a large and diverse commercially-insured population. In helping to identify the SDoH barriers to care among an employer’s vulnerable workforce, the study findings present a unique opportunity for employers to help bridge gaps in care.
“With this new data showing that a large proportion of a commercially-insured workforce is vulnerable to SDoH barriers to care, our findings highlight the need for employers to consider implementing key additional programs that address common social and economic barriers to care,” said Dr. Dena Bravata, study author and chief medical officer at Castlight Health. “Technologies and services that connect these populations to no- and low-cost services can make a real impact in ensuring an employer’s health programs are reaching and fully benefitting all employees.”
About the Study
This study is based on a national sample of five million people eligible for Castlight Health’s navigation platform between 2019 and 2021. Castlight aggregates medical and pharmaceutical claims from self-insured employers and health plans that purchase access to Caslight’s transparency tools and benefits platform. Approximately 200 employers with employees in all 50 U.S. states contributed data, representing several industries and varying from 1,000 to 500,000 employees.
Other authors of the study include Nicole A. Hirsch, PhD at the University of California at Berkeley, and Dr. Bruce W. Sherman of Case Western Reserve University and the National Alliance of Healthcare Purchaser Coalitions, and Megan Pera, Mary Cain, Ashleigh Emerick, and Stephanie Katz of Castlight Health.
About Castlight Health
Castlight is on a mission to make it as easy as humanly possible for people to navigate the healthcare system and live happier, healthier, more productive lives. As a leader in healthcare navigation, we provide a world-class digital platform with a team of clinical and benefits experts to help members easily connect and engage with the right programs and care, at the right time. Castlight partners with Fortune 500 companies and health plans to transform employee and member benefits into one comprehensive health and wellbeing experience to deliver better health outcomes and maximize returns on healthcare investments.
Director, Corporate Marketing