This study titled, “Association Between Self-reported Health-Related Social Needs and Acute Care Utilization Among Older Adults Enrolled in Medicare Advantage” found that certain social determinants of health were associated with statistically significantly higher rates of acute care utilization, which included >50% increases in avoidable hospital stays and emergency department visits.

In the population of over 56,000 Medicare Advantage beneficiaries, almost 50% reported one or more health-related social needs (HSRN). The exposures evaluated included food insecurity, financial strain, loneliness, unreliable transportation, utility insecurity, housing insecurity, and poor housing quality.

While these risk factors do not stand alone the study identifies the significant role of specific social exposures in determining the increased incidence of avoidable hospitalizations, ED visits and 30-day readmission rates. These results negatively affect the Triple Aim of value-based care by increasing cost of care without improving quality or outcomes.

Understanding how different HRSNs relate to different health outcomes can inform targeted, evidence-based policies, investments, and innovations to address specific social determinants of health without “medicalizing” them.

A study titled, “Association of Social and Behavioral Risk Factors With Earlier Onset of Adult Hypertension and Diabetes” found cumulative social and behavioral risk was significantly associated with earlier onset of hypertension and diabetes.

1) Controlling for age, sex, race/ethnicity, body mass index, and survey year, people with 3 or more risk factors were 41% more likely to develop hypertension compared with those with 0 risk factors.
2) Controlling for age, sex, race/ethnicity, body mass index, and survey year, people with 3 or more risk factors were 53% more likely to develop hypertension compared with those with 0 risk factors.

Based on the individual determinants of hypertension and diabetes in rank order of increased hazard ratio, this study demonstrates that education level is a far more prevalent determinant to both hypertension and diabetes than unhealthy behaviors such as smoking and infrequent exercise.

While these risk factors do not stand alone, and other, seemingly important factors such as dietary habits and access to healthy food were not considered, the study identifies the significant role of social exposures in determining the onset of hypertension and diabetes.