Recently, the Aetna Foundation became the latest in a long-line of health stakeholders to make a statement regarding the need for solutions to address the “social determinants of health” (SDOH). They awarded nearly $2.4 million in grants to address SDOH challenges. A collaboration between the University of Wisconsin Health Institute and the Robert Wood Johnson Foundation asserted that health behaviors and clinical care represent only half of what determines an individual’s health — social and economic factors together with physical environment constitute the other half. The emerging consensus is clear; there are factors that drive an individual’s health which extend far beyond traditional healthcare.
One of those important factors that health plans are starting to address is United States Veteran’s status. An individual who served in the US military will have a unique health profile (with higher lifetime likelihood of certain conditions often linked to period and location of deployment). And, as is too often overlooked, Veterans have unique resources available to them – including a wide range of Veterans benefits programs. Too often, these excellent programs are underutilized by the people they are set up to serve.
To help members live their healthiest lives, health plans need to understand all the drivers of member health. Without knowing which members served, health plans may be unaware that (as cited in a 2016 study published by Advance in Medical Education and Practice the “(v)eterans experience mental health disorders, substance use disorders, post-traumatic stress, and traumatic brain injury at disproportionate rates compared to their civilian counterparts.” Beyond understanding who these members are, the challenge is linking them with appropriate services. A frequently overlooked component is the prevalence of programs designed to help senior Veterans decades after their discharge from the military. The Department of Veterans Affairs has issued guidance presumptively linking conditions to service decades after the fact. Knowing this, and what benefits it might make available to a Veteran, is crucial to ensuring Veterans access the right benefits to meet their particular challenges.
Looking at Social Determinants of Health has limited value to the extent that we consider it as a fixed and immoveable determinant. Fortunately, the reality is that knowing the determining factors (i.e. Veterans status) is only half the challenge. Once we understand who the Veteran population is, there are a wide range of governmental and non-governmental benefit programs available to help. In recent years the Department of Veterans Affairs has broadened its program offerings and developed its infrastructure to provide meaningful services to Veterans. And there are a wide range of not-for-profit entities offering a nationwide patchwork of services for Veterans. The services are there, but the challenge is often sifting through the range of options and requirements to link Veterans with the services they need.The increasing focus on treating health by understanding the whole person, represents an exciting step forward. It is important that focus be further refined to emphasize determinants that can be impacted. Fortunately for the nation’s 21.8 million Veterans their unique needs can often be met by a wide range of SDOH impacting programs.