Addressing Health Equity Through Data Solutions: Bridging the Gap in Healthcare

Health equity has continued to be a primary focus as the healthcare industry confronts long-standing systemic inequities that have long compromised the health and well-being of millions of Americans. While healthcare stakeholders, from providers and payers to life sciences companies, are committed to addressing these disparities, determining where and how to intervene remains a complex challenge.

A critical factor in achieving health equity is addressing social determinants of health (SDOH)—the conditions in which people live, work and play, along with broader economic and social systems that shape those conditions.¹ Medical care accounts for only 20% of patient outcomes; the remaining 80% is driven by behavioral, social, environmental and economic factors.² By identifying and addressing these SDOH barriers, healthcare organizations can take proactive steps to ensure equitable care and better health outcomes.

SDOH and Chronic Disease Management

Chronic diseases, such as diabetes, cardiovascular disease and chronic kidney disease (CKD), disproportionately affect marginalized populations, including people of color and those in low-income areas.⁵ These diseases account for 7 in 10 deaths in the U.S. and $3.8 trillion in healthcare spending annually.⁶ The burden of these diseases worsened in the wake of care disruptions caused by the COVID-19 pandemic.

Diabetes, in particular, poses an urgent challenge. It affects 1 in 10 Americans, and more than 1 in 3 Americans have prediabetes. Black and Hispanic/Latino adults are more impacted by type 2 diabetes, with increasing incidence rates across racial and ethnic minority groups.⁷ This growing challenge highlights the need for interventions that address the root causes of health inequities, including SDOH.

Barriers to Care: The SDOH Challenge

Despite growing awareness of the impact of SDOH barriers, stakeholders face significant challenges in addressing these factors. Payers often lack systematic ways to identify members facing social barriers to care, and providers may not have the tools or workflows to address these barriers effectively. Additionally, life sciences companies struggle to engage diverse patient populations in clinical trials, resulting in treatments not representative of all demographics.

The challenges are significant. Individual-level solutions take time to reach the right patients while planning large-scale interventions can be difficult. As a result, many patients face obstacles throughout their healthcare journey, from access to care to medication adherence. Issues such as food insecurity, housing instability and lack of transportation can further complicate disease management, especially for individuals with chronic conditions.¹¹

Data-Driven Solutions for Health Equity

The key to overcoming these challenges lies in data. According to the National Academies of Sciences, Engineering and Medicine, data enables stakeholders to identify individuals who benefit from targeted interventions.³ Comprehensive data sets—including socioeconomic information and social interactions—allow for a more complete understanding of patients' barriers to care, enabling more effective interventions.

One promising initiative is Healthy People 2030, led by the U.S. Department of Health and Human Services (HHS). This program aims to improve health outcomes by addressing SDOH and prioritizing chronic diseases like diabetes and cardiovascular disease.⁴ By uniting stakeholders around a common goal, Healthy People 2030 shifts the focus from reactive care to proactive, preventive measures that target SDOH.

Case Study: Diabetes and SDOH Interventions

Diabetes outcomes depend on regular interactions with the healthcare system, from routine screenings to medication access. However, individuals facing social barriers often struggle to access these resources, leading to poor disease management and a higher likelihood of complications.

For example, food insecurity—closely tied to income and geographic location—significantly impacts diabetes management. People with diabetes in food-insecure households are more likely to skip meals or consume high-sodium, calorie-dense foods, which worsen their condition.¹⁷ Programs like Geisinger Health System’s Fresh Food Farmacy, which provides patients with healthy food options and care team support, have demonstrated the potential of targeted interventions to empower patients.

The Path Forward: Scaling SDOH Solutions

To address health inequities, stakeholders must scale successful interventions to reach the populations most in need. Data-driven insights can help identify high-risk individuals and guide targeted interventions that improve health outcomes on a broader scale.

The journey toward health equity is complex, but with the right data, technology and strategic interventions, healthcare stakeholders can make meaningful progress in closing the health equity gap and improve outcomes.

 

Want to learn more? Download the full whitepaper from LexisNexis® Risk Solutions to explore in-depth strategies for addressing SDOH barriers and improving health equity across the patient journey.

**Refer to the white paper for the complete list of citations and sources.