How Priority Health is Working to Address Social Determinants of Health in Michigan Communities

The primary goal of health care is to help people stay healthy — historically, this has been executed through medical intervention. However, health systems, and health plans like Priority Health, are recognizing the important role that social determinants of health, defined by the World Health Organization as “the conditions in which people are born, grow, live, work, and age,” play in health outcomes. Priority Health is committed to being part of the effort to address these factors to significantly improve care outcomes for all our members and reduce health disparities in our state.

The Six Categories of Social Determinants of Health

Social determinants of health are organized into six categories. Each of these factors can directly and indirectly impact physical and mental health outcomes.

1. Economic stability: Poverty and lack of access to steady employment impact a person’s ability to access the necessary services to stay healthy, such as regular screenings and support for managing chronic conditions. These factors can also impact an individual’s ability to access timely, quality care when they need it.
2. Neighborhood and environment: The physical and digital environments within our communities can encourage healthy behavior. Playgrounds and after-school programs, for example, can significantly improve the health of children. People also need adequate housing and access to reliable transportation and the Internet to maintain a healthy lifestyle.
3. Education: An individual’s level of education and literacy can impact their ability to control and manage their health. Limited literacy can make it harder to take medications properly, navigate complex health conditions or care for multiple dependents with varying health needs.
4. Food: A nutritional diet and access to healthy food options is key to maintaining good health, especially for those living with chronic conditions such as diabetes or heart disease.
5. Community and social context: Good health is also a matter of being closely connected with the surrounding community and the support systems it offers. The availability of support systems impacts both mental and physical health. This category also factors in acceptance within a community, civic involvement, discrimination and more.
6. Health care system: Local health care providers must be accessible and understanding of the needs of the surrounding community. Fluency in languages spoken locally and understanding of cultural factors is essential to ensure everyone feels comfortable with their providers and is supported by the local health care community.

How SDoH Impacts Our Communities

According to Priority Health’s Health Equity and Social Determinants of Health report, researchers have estimated that social determinants of health are responsible for up to 50% of health outcomes. To illustrate by the numbers: someone who is unemployed has a 30% higher death rate than someone who is employed. Living as a black man in poverty has a 2.6x higher death rate; living as a woman in poverty has a 1.8x higher death rate.

Communities of color are most affected by these disparities; they have less access to healthy food, green outdoor spaces, and secure housing. These factors contribute to underlying health conditions like diabetes and heart disease and can increase an individual’s risk of serious illness. This has been illustrated throughout the COVID-19 pandemic, when we saw Black and Hispanic Americans hospitalized for coronavirus-related illnesses at higher rates than any other racial or ethnic group.

Bringing this issue closer to home, the state of Michigan has made some great progress when it comes to making sure our residents have health coverage. According to Census data, about 5.4% Michigan residents — or 535,000 people — lacked health insurance in 2018. That compares to 12.4%, or 1.2 million, in 2010 and 10.9%, or 1,071521, in 2013, the year before the Affordable Care Act (ACA) was fully implemented. However, during the 2020 COVID-19 pandemic, as many as 1 million Michiganders lost insurance. Michigan, similar to other states throughout the U.S., experienced a 46% increase in the number of uninsured adults from February to May 2020. The Biden administration recently extended a 2021 Special Enrollment Period to help states like ours address this issue, giving Michigan residents additional time to enroll or re-evaluate their coverage needs with increased tax credits available to reduce premiums.

But just having health coverage doesn’t address all concerns. According to the Michigan Department of Labor and Economic Opportunity’s Poverty Task Force, 1.4 million Michiganders fall below the poverty level. And the United Way’s ALICE Report shows that 43% or 4.3 million of working Michigan households struggle to afford the necessities like housing, childcare, food, technology, health care and transportation. To afford the basics, single adults need a salary of just above $21,000 and a family of four needs more than $61,000. At Priority Health, we recognize the significant impact this issue is having on our state and our members. We’re taking several steps to address them in our communities. We also make sure our own team members are compensated fairly by benchmarking nationally and locally for all positions to remain competitive.

Priority Health’s Innovative Approach

Priority Health is committed to driving high-value care through effective and innovative programs that seek to address the social determinants of health most critical to our members. We also have a unique opportunity that most other health plans do not have: we are an integrated health system with 14 hospitals and 4,600 doctors. We can harness the power of this network to support our members at every stage of their care journey.

Our approach has two parts: developing results-oriented programs to address the health of our members and building a strong foundation of data on our members’ needs so we can create programs to serve them. In the last few years, Priority Health has made great strides to develop programs that fit these requirements.

• SDoH Provider Incentives: Last year, Priority Health became the first insurer in Michigan to offer incentives to providers who screen patients who may be facing food or housing insecurity, transportation or financial challenges — or have other SDoH needs. Partnering with providers to collect this data allows us to better understand what programs will be most beneficial to improve health outcomes of our members.
• CenteringPregnancy?: In 2020, we began to provide financial incentives to providers who adopted the CenteringPregnancy? care model. Launched in 2015, this program was designed to address Michigan’s 10% preterm birth rate, which is a result of factors such as lack of access to care, poor nutrition and limited community support networks. The program offers essential prenatal care in a supportive environment. Over 435 women have participated in the program with a 91% full-term birth rate. With over 50% program participants identifying as Black, the program has also made strides in addressing racial health disparities in our community.
• Papa Companion Care: Feelings of loneliness and isolation can have a significant impact on health, and this need became even more urgent during COVID-19. In fact, a new report from the National Academies of Sciences, Engineering, and Medicine (NASEM) points out that more than one-third of adults aged 45 and older feel lonely, and nearly one-fourth of adults aged 65 and older are considered to be socially isolated. To help combat these feelings for our most vulnerable senior populations, Priority Health developed a partnership with Papa, a program that connects caregivers with older adults. Called “Papa Pals,” these individuals provide companionship and help with everyday tasks such as grocery shopping and picking up medications.
• Medicaid Transportation: Accessing quality medical care is one of greatest barriers to health equity. Priority Health is working to address this need through our Medicaid transportation program. Though providing transportation to medical appointments for Medicaid members is required by the state, we consider our program a leader or “gold standard.” Instead of fulfilling this requirement through an outside vendor, Priority Health runs our program completely in house with our own team members. In 2019, we were able to provide 56,000 rides to help members access care.
• National Fitness Campaign – Priority Health Fitness Courts: We believe all people deserve the opportunity to live a healthy life, and that includes having access to safe and effective exercise equipment. Through our partnership with the National Fitness Campaign, we are working to build up to 20 outdoor fitness courts in our state through 2022. These courts provide communities with free access to simple, high quality workouts. We launched this partnership with a pilot fitness court in 2019 at Oakland University, and will be announcing more Michigan locations soon.

• Total Health Care Foundation: The Total Health Care Foundation, funded by Priority Health, was created to help address health disparities in Southeast Michigan communities. The foundation recently announced the first round of grants, which total more than $1.8 million. These grants are going to organizations in the greater Detroit area that are committed to improving the health and well-being of the individuals they serve — from providing access to preventive health care to creating sustainable housing options.
• Priority Health Connect: This recently expanded tool is an online platform designed to connect individuals in the community with free and reduced-cost programs and critical social services such as transportation, childcare and affordable housing. Previously only available to Medicaid members, expansion has now made the program accessible to all of Priority Health’s over one million members in the state of Michigan. Users can input their zip code and be connected to a database that helps them find resources near where they live.
• Priority Health for Good: Addressing health disparities is one of the key focuses of our corporate responsibility work. Throughout 2020, we partnered with 79 local organizations. Priority Health distributed 226,858 diapers and over 80,000 meals to families in need. We also worked on initiatives supporting COVID-19 relief, mental health care, environmental health and more. Through Priority Health for Good we will continue to mobilize our resources throughout 2021. For example, just this month we announced partnering with the Rocket Mortgage Classic for a $50,000 matching gift to the Connect 313 Fund, which addresses the digital divide in Detroit. Access to broadband is being dubbed a “superdeterminant of health” due to the ongoing necessity of reliable internet access.

These are just some of the ways our teams and partners are working together to create health equity in our state. At Priority Health, our mission is to improve health, inspire hope and save lives. We strive to deliver personalized care made simple, affordable and exceptional. To achieve this goal, taking steps and partnering with our communities to address social determinants of health is crucial. I am excited for Priority Health to continue to form partnerships and develop innovative plans to address health inequity in 2021 — and well into the future.