UHG Reviews Senior Social Determinants of Health Pre-Pandemic

May 20, 2021 - While some social determinants of health factors such as food security and high-speed internet access have improved in recent years, seniors experienced an increase in factors such as poverty and housing insecurity before the coronavirus pandemic, a United Health Foundation report revealed.

“The America’s Health Rankings Senior Report, now in its ninth year, provides a portrait of the health and well-being of older adults in the U.S., capturing key trends, successes and challenges in order to spark meaningful dialogue and action to improve senior health across the nation and on a state-by-state basis,” the report began.

The senior community’s share of the US population is climbing past 16 percent, meaning that unsolved gaps in senior care will have an even broader impact.

“It is essential that policymakers, community leaders and public health officials consider how to best safeguard and improve the health of older Americans,” the report emphasized.

The report examined social and economic factors, clinical care, behaviors, and physical environment to assess their impacts on seniors’ clinical outcomes. For America’s Health Rankings analyses, the researchers may draw from a number of public data sources such as the American Community Survey (ACS) and the National Immunization Survey.

All data was from before the coronavirus pandemic struck the US.

While social and economic factors saw a surprising improvement over the timeframe of 2014 through 2019, poverty became a more significant challenge to seniors.

From 2014 to 2018, food insecurity dropped 16 percent according to United Health Foundation’s assessment. By the end of that timeframe, 13.3 percent of Americans that were 60 years old or older faced food insecurity.

High-speed internet access also improved from 2016 to 2019. Prevalence rose approximately 10 percent in three years. By 2019, nearly eight out of every ten Americans in the Medicare-eligible age range (78 percent) had access to high-speed internet. This would be an increasingly critical metric as seniors relied more heavily upon virtual care during the pandemic.

Clinical metrics saw a significant improvement as well. The number of geriatric providers increased from 2018 to 2020 by 13 percent. In 2018 there were almost 27 geriatric providers per 100,000 seniors, whereas two years later there were slightly over 30 geriatric providers per 100,000 seniors.

Flu vaccinations also jumped six percent between 2017 and 2019 and preventable hospitalizations dropped by six percent from 2017 to 2018.

Exercise among seniors increased 31 percent from 2017 to 2019. By the end of that timeframe, less than a quarter of all seniors (23.1 percent) were adhering to the federal physical activity standards.

However, this was attended by an increase in physical inactivity among individuals with fair health or better. From 2018 to 2019, five percent more seniors who described their health status as “fair” or better did no more physical activity than their job required in a month’s timeframe.

Despite these successes, the racial disparities in poverty grew. Poverty increased 2.7 times higher for seniors who did not identify as non-Hispanic White, compared to those who did identify as non-Hispanic White.

Housing was also an issue from 2013 to 2017 with around one in three senior households having trouble securing stable housing.

All of these social determinants of health factors combined contributed to a one percent drop in early deaths among Americans between the ages of 65 and 74. But drug deaths escalated by almost 40 percent, suicides rose by three percent, and mental distress was 11 percent more common.

Medicare Advantage health plans are strategically positioned to address these social determinants of health needs.

Humana, for instance, found that its Bold Goal communities, in which Medicare Advantage plans focused on solving particular social determinants of health needs for seniors, were more successful at diminishing seniors’ unhealthy days. The payer concentrated on food insecurity, transportation, and isolation during 2020.

Payers responded in a variety of ways to the pressing seniors’ social determinants health needs that the coronavirus pandemic caused, such as WellCare’s food delivery partnership and Cigna and SCAN Health Plans’ social isolation programs.

However, the United Health Foundation report serves as a reminder that none of these social determinants of health barriers are new for seniors and that payers will need to enter the “new normal” with strong social determinants of health strategies for their senior member population.