Social Determinants of Health: Addressing Employee Needs to Attract & Retain Talent

May 20, 2021

Employee Benefits, Senior Living & Social Services, War For Talent

Many industries are facing employment crises, and employers must go beyond traditional compensation and benefit offerings in order to solve them. This is particularly prevalent in a service industry like senior living and social services.

This industry’s employee demographic operates with unique characteristics that influences their needs and desires from an employer. Employers must consider their employees’ social determinants of health in order to build a customized incentive, compensation, and benefit plan that fits their needs.

For example, increasing an employee’s wages or making changes to the organization’s health insurance plan may be among strategies a traditional employer would deploy. However, in senior living, some employers are increasing their starting wages from $12-$14 per hour to $15-$25 per hour for starting caregivers and still not getting applicants for open roles. Others are making significant changes to their health plan and still getting only 40% of their employees to enroll in health insurance. This implies many of the employees don’t value that investment in itself, or that changes to health insurance aren’t enough.

M3’s senior living and social services practice has been highlighting the need to address social determinants of health for years, encouraging our clients to dig into the data surrounding their employee population and bringing innovative solutions to the table that have improved absenteeism, increased productivity, and improved employee engagement.

Today, creativity is necessary to get people in the door to apply for open roles. In a societal moment where employers in many industries are struggling to find employees who can (or are willing to) work a productive number of hours, addressing employees’ social determinants of health can help employers meet workers where they are.

What are social determinants of health?

Social determinants of health is the concept that says the conditions in the place where people live, learn, work, and play affect a wide range of health risks and outcomes. (Source: CDC) The concept is important for employers to understand, as it highlights the areas in which they need to adjust benefits (beyond wages and health insurance) to positively impact their specific employee population, encourage tenure, and promote a healthier work environment.

There are generally four modifiable factors impacting the health of employees:

Social and economic factors (local cost of living and wage adequacy, societal norms)
Health behaviors (likelihood of chronic disease, local diet)
Clinical care (quality of care available)
Environment (pollution, ergonomics, etc.)

About 40% of the social determinants of health of the general population are weighted to social and economic factors, however, in the senior living employee population, this number can be as high as 80%. Unfortunately, the weight of these factors is underrated – most employers are addressing less than 50% of the contributable cost through wellness and healthcare.

How does an insurance advisor help?

When an employer is able to identify the underlying factors affecting their desired employee population in each category listed above, they can take steps to address these factors through their benefits program offerings and position their organization as a preferred workplace in their industry.

Our framework for addressing social determinants of health with our clients looks like this:

Purpose – Achieve health equity by addressing health disparities of employees
Process – Compile and analyze data/trends to determine a baseline and develop strategies to address the social determinants of health within the employee population
Payoff – A healthier, engaged and fulfilled employee population carrying out the employer’s mission

This framework is supported by a solid communication strategy. At M3, we help clients by addressing different components of the social determinants of health throughout the year, not just once a year. We work with our clients to create a communication plan that meets employees where they are at, using multimedia channels and proven communication techniques. Example: Generation Z Employees (those under the age of 24), need short, visual modes of communication, whereas employees who may have English as their second language may need further accommodation.

How do employers address social determinants of health with benefits and compensation?

Employees are an employers’ most valued resource. Addressing social determinants of health through two different lenses lets employers identify solutions that resonate with their employee demographic and increase employee wellbeing. This impacts employee engagement and productivity, and boosts talent attraction and retention.

Lens #1: Holistic Wellbeing

It’s important to see your employees’ wellbeing as a holistic concept. At M3, we analyze wellness through four factors: physical health, emotional health, financial health, and social/spiritual health.

The solutions we bring to our clients impact each of these areas in order to generate a holistic result that actually improves the lives of employees, addresses their social determinants of health, and strengthens their alignment with the employers’ mission and values.

Lens #2: Subsidies and Caps

Employers also need to understand how government subsidies and caps can influence the number of hours an employee works, the benefits that are important to them, and what changes employers need to make to their benefit and compensation plan to meet employees where they are. Perhaps more importantly, employers need to understand what changes they need to make to support their employees’ career development. What is specifically getting in the way of an employee accepting a promotion or additional hours?

The Benefit Cliff

The benefit cliff is a term used to describe when a low-income family receiving public benefits gets a slight increase in their pay, which results in a sudden loss of program eligibility. Employers should be aware of how their employees may be affected by this phenomenon due to changes in their benefit and compensation packages.

Benefit Cliff Graphic

M3 assists our clients in finding out-of-the-box solutions that can assist in addressing their employees’ social determinants of health and encouraging tenured employment.

How our clients are addressing social determinants of health

As I’ve mentioned, social determinants of health do not have a one-size-fits-all solution. In fact, it’s right there in the name of the concept. The solutions are determined by the different social factors employee populations are experiencing.

My recommendation is to work with an insurance consultant who understands your industry, how it’s changing, and your unique culture – one who can also analyze your population health data and bring forth opportunities for improvement. At M3, we have found many clients in this space are dealing with a growing percentage of part time employees who aren’t benefit eligible. Moreover, the majority of benefit eligible employees aren’t taking the health insurance, therefore employers are looking at reallocating the traditional spend for the benefits and compensation package.

Below are a few examples of how M3 clients are supplementing, based on the social determinants of health of their employee population:

Emotional Health

Employee assistance programs (EAP) that are coordinated with health, wellness, and workers’ compensation (safety) programs
Mental health benefit via telehealth
Mindfulness or meditation education and support

Financial Health

Tuition assistance
Earned wage access
Offering a stipend and/or group rates for cell phone, auto insurance, etc.
Budget and financial planning assitance

Physical Health

No deductible health coverage
Integrating workers’ compensation, disability, and FMLA
Encouragement or rewards for annual physician visits, wellness programs, and virtual visit promotion (a low cost alternative)

Social/Spiritual Health

Matching mission with culture
Team building & resilience training
Establishing mentorship programs
Diversity, equity and inclusion plan
Engaging/employing persons with disabilities, youth or international workers
Training/education on trauma informed care principles for residents and employees

Key Takeaway

Employers in every industry, but particularly the senior living and social services industries, must be aware of the social determinants of health that can impact their employees’ willingness or ability to work at a high-level and for consistent periods of time.

Employers seeking to increase talent attraction and retention during current employment crises must re-evaluate their benefit and compensation programs to ensure they assist their employee population with issues that matter to them.

Reach out to your M3 account executive to discuss how your benefits programs could be adjusted to better serve your employees, impact their social determinants of health, and position your organization as a preferred employer in your industry.