Unmet SDoH needs impact hospital utilization, says survey

A new survey from McKinsey found that 53% of consumers report being adversely affected by one or more of the social determinants of health (SDoH), and having these needs unmet leads to more emergency room (ER) visits and hospital stays.

The survey looked at SDoH in the following five categories: food environment, community safety, housing, social support, and transportation. The results came from 2010 respondents between the ages of 18–84, with the following insurance coverage: Medicare, Medicaid, dual coverage, individually insured, and uninsured. Survey participants were asked questions about income, family size, employment, education, food security, community safety, housing, transportation, social support, and use of social services. Those with unmet needs were considered adversely affected by the SDoH.

The most common unmet need was food security, with 35% of respondents reporting an unmet need. In the other categories, 25% reported an unmet need for community safety, 21% for housing, 17% for social support, and 15% for transportation.

Respondents who self-reported poor health, poor mental health, or high healthcare utilization were more likely to report multiple unmet social needs compared to those reporting no unmet social needs. See the breakdown of these findings below:

• Self-reported high healthcare utilization: 45% multiple unmet social needs vs. 21% no unmet social needs
• Self-reported poor physical health: 45% multiple unmet social needs vs. 17% no unmet social needs
• Self-reported poor mental health: 41% multiple unmet social needs vs. 7% no unmet social needs

In addition, those survey respondents who reported higher inpatient or ER utilization were more likely to report unmet social needs. Of respondents with at least one inpatient stay over a 12-month period, 52% reported unmet food security needs; of those with at least two ER visits over a 12-month period, 57% reported unmet food security needs. Compared to those whose food security needs are met, those reporting food insecurity are 2.4 times more likely to report multiple ER visits and 2.0 times more likely to report an inpatient stay over a 12-month period.

Food insecurity is not the only indicator of increased ER visits and hospital stays. Those reporting unmet transportation needs are 2.6 times more likely to report multiple ER visits and 2.2 times more likely to report an inpatient stay over a 12-month period. Respondents reporting unmet community safety needs are 3.2 times more likely to report multiple ER visits over a 12-month period than those reporting no unmet community safety needs.