Michael Kersten, Director, Clinical Outreach and Engagement at Vynca

The U.S. Department of Health and Human Services defines social determinants of health (SDOH) as the conditions in the environments where people are born, live, learn, work, play and age. These conditions are separated into five distinct categories:

  • Economic stability
  • Education access and quality
  • Healthcare access and quality
  • Neighborhood and built environment
  • Social and community context

It has been widely reported that SDOH have an impact on a broad range of health, functioning and quality-of-life outcomes and risks. In fact, research shows that SDOH factors can drive as much as 80% of health outcomes.

The Connection Between SDOH and Serious Illness

According to the National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), 60% of adults in the U.S. have a chronic disease, and 40% have two or more. Chronic diseases are the leading causes of death and disability and is the leading contributor of America’s $3.8 trillion in annual healthcare costs.

Research shows that SDOH contribute to chronic disease disparities in the U.S. among racial, ethnic and socioeconomic groups, and respondents to the McKinsey 2019 Consumer Social Determinants of Health Survey who self-reported poor health or higher healthcare utilization were more likely to report multiple unmet social needs.

For example, a report from the Center for Health Analytics, Research and Transformation (CHART) at the New Jersey Hospital Association (NJHA) found New Jersey’s poorest zip codes have the highest rates of individuals with chronic diseases seeking care in emergency rooms. This research demonstrated a clear relationship between employment status, income and nutrition with poor health status and unmet needs in access to appropriate healthcare.

With serious illness impacting so many of us, it is time for equitable access to appropriate care and services.

How Our Serious Illness Management Platform Addresses SDOH

Vynca’s serious illness management platform helps care teams manage their most vulnerable populations – regardless of where the individual is located and other determinants of health. Coupling technology and analytics with our board-certified, physician-led palliative care team, we address the physical, mental, spiritual and social needs of every individual.

Through telehealth and community-based palliative care services, Vynca improves quality of life and reduces unnecessary, unwanted healthcare utilization and expenditure at the end-of-life. This is critical, as we are committed to improving the care experience for everyone – providing people facing serious illnesses with an avenue to have a voice and access to palliative care services.

The Impact of Advance Care Planning on Outcomes

Evidence shows that high-risk, high-cost populations are less likely to engage in advance care planning (ACP) conversations or document their end-of-life care wishes. Discussing and documenting care preferences is critical to ensuring people receive treatment that aligns with their goals and values. When people engage in ACP, care is less fragmented, and those who are most vulnerable do not fall through the cracks. Early and often ACP results in individuals receiving end-of-life care that is wanted and aligned with their values.

This increase in patient engagement has proven to improve clinical outcomes and highly engaged people living with chronic diseases experience better outcomes. Greater engagement is also connected with reduced spending.  

Addressing SDOH is Crucial to Personalized Care

An estimated 40 million people need palliative care each year globally; yet, just 14% of those individuals currently receive it. In the U.S., only 17% of rural hospitals with fifty or more beds report the availability of palliative care programs.

Palliative care is critical, as it focuses on providing relief from the symptoms and stress of the illness and is intended to improve the quality of life for both the individual and the family. Our providers take a holistic view – looking beyond clinical factors and including demographics, SDOH and individual history to deliver personalized care.

The benefits of palliative care include reduced emergency department utilization, reduced costly and unwanted utilization of acute care hospital services, and improvement of the overall healthcare experience of patients and families.

The shift to virtual palliative care also removes SDOH healthcare access barriers. Telemedicine allows palliative care to be efficiently delivered anytime, anywhere.  Our board-certified, physician-led interdisciplinary team works with the existing care team to deliver comprehensive, high-quality and standardized treatment resources, coordinate care, and enhance communication to meet the unique needs of each person. 

To truly meet the needs of everyone, the healthcare industry must recognize the role of SDOH in health outcomes and account for them when providing care. Especially when treating serious illnesses, advance care planning and palliative care are valuable tools to help overcome SDOH challenges.

About the Author

Michael Kersten

Michael Kersten is the Director of Partner Solutions at Vynca. Prior to Vynca, Michael worked at Hill Physicians Medical Group where he was the founding director of the complex and serious illness department.

Michael holds an MPH from UC Berkeley School of Public Health, an MDiv from Naropa University, and a BS in Biology from SUNY at Albany.