Social determinants of health are the conditions by which people live, work, and play, according to the American Academy of Family Physicians. These environmental factors outside of the doctor’s office all play a significant role in an individual’s health and wellness, regardless of age, gender, ethnicity or race.

In fact, up to 55% of health outcomes are impacted by elements outside of the control of the doctor’s office, including:

  • Socioeconomic status
  • Education
  • Physical environments
  • Employment
  • Social support networks
  • And more

Payers and providers see the impact of social determinants of health on their patients every day. While healthcare organizations conduct a range of preventative care patient outreach such as annual wellness exams, chronic care management, and health education, many patients who experience environmental challenges are likely focusing their attention elsewhere.

In order to improve patient outcomes within the clinical setting, payers and providers must deploy alternative patient outreach strategies that allow them to care for patients experiencing healthcare disparities in their communities, homes, and jobs.

Read on to learn about three types of social determinants of health that can be addressed using patient outreach.


1. Life Necessities

Individuals who experience challenges meeting basic needs like nutrition, shelter, and safety are more likely to report having poor health. Consider the following annual statistics from the American Hospital Association:

  • 40 million Americans face hunger
  • 11.8 percent of U.S. households are food insecure
  • 1.5 million individuals in the U.S. are homeless

Without access to some of life’s essentials, it’s no wonder that responding to patient outreach for doctor visits aren’t top of my mind for these patients. Instead, they’re focused on caring for their family’s immediate needs, including what they’ll put on the table for dinner or where they’ll sleep at night.

In order to improve the health and wellness of these patients, healthcare payers and providers need to first understand the individual needs of their patients and then conduct patient outreach by directing them to the most relevant resources that can meet those needs.

For example, patients identified as food insecure are considered to be at an increased risk of developing chronic diseases, including obesity and diabetes. In order to combat this, payers and providers can tailor patient outreach programs for these patients that offer supplementary food assistance, dietary education, and nutrition programs.


2. Transportation

In addition to life necessities, access to reliable and convenient transportation is important for helping patients receive the medical care they need. However, 3.6 million individuals experience transportation barriers that prevent them from accessing medical care, according to the American Hospital Association, and one-third of missed medical appointments for senior citizens are the result of transportation challenges.

Transportation barriers may be a result of a variety of factors, including:

  • Living geographically distant from healthcare services
  • Not possessing a driver’s license
  • Not having access to a working vehicle
  • Being unable to drive due to a physical, cognitive, or mental limitation
  • Costs associated with transportation options

To combat these limitations, many healthcare organizations are establishing relationships with popular rideshare transportation services such as Uber and Lyft. Leveraging two-way text messaging, these service offerings conduct patient outreach to identify patients who are in need of a ride to scheduled appointments. If patients respond ‘yes’, these solutions automatically generate a ride offer via text, letting the patient know when their ride will arrive so they can be on time for their healthcare appointment. After the appointment, returning home can be just as easy with automated communications systematically scheduling patients a ride based on when is convenient for them.

Proactively offering transportation options via patient outreach eliminates the need for patients to worry about their ride so they can focus on making healthy choices that are within their control.

Read about other questions to consider when anticipating the potential barriers your patients face.


3. Financial Stress

Finally, according to The Commonwealth Fund, U.S. adults are more likely to report financial barriers to health care compared to other countries. Financial stress is a major barrier to good health and can be impacted by a patient’s:

  • Employment
  • Income
  • Expenses
  • Debt
  • Medical bills
  • Support

Patients experiencing financial stress may be less likely to show up for scheduled appointments and procedures out of fear they won’t be able to pay for the services. As a result, they may experience poorer health outcomes for diseases that could have been avoided.

As a remedy, healthcare payers and providers can conduct patient outreach targeting populations identified as low-income to offer cost-effective alternatives for otherwise costly services. For example, being able to identify patients who may not be able to afford rising medication prices can help providers and payers think through budget-friendly alternatives, including how and where they can buy generic alternatives.

Other patient outreach ideas could consist of workforce development and training for underserved populations.

LCH, a Federally Qualified Health Center located in Pennsylvania, offers GED and ESL courses for a primarily Spanish-speaking population. In addition, job placement services help them to address their patients’ personal and professional goals through employment matching. Offering referrals to job skills training programs and connections with local employers allows them to fully support their community as they work to support and care for their families.



By using patient outreach to address social determinants of health, healthcare payers and providers can work to mitigate health disparities, ultimately resulting in healthier populations and lower healthcare costs.

To see how Providertech can help you reach more underserved patients, contact us today.