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The current pandemic will likely have significant negative long-term consequences on health, with the economic downturn, job losses, social and emotional effects of social distancing and sheltering, and disruption to routine health care and education. These pressures exacerbate the existing shortfall of investment in social determinants of health (SDOH). Looking ahead, finding mechanisms to unleash and efficiently mobilize SDOH investment to address the country’s outsize social needs will be even more pressing.
The challenge of garnering sustainable investment in SDOH is long-standing. Len Nichols and Lauren Taylor outlined the reasons for that challenge in their Health Affairs article “Social Determinants as Public Goods: A New Approach to Financing Key Investments in Healthy Communities.” (See also a follow-up Health Affairs Blog post.) Because the benefits of such investments are diffuse, it is difficult for a single stakeholder, such as a health plan, to secure a return on investment (ROI) on SDOH outlays. Nichols and Taylor outlined an approach to overcome this difficulty by convening health care stakeholders in a given locality to make collaborative investments.
This post attempts to outline yet another approach to catalyze sustainable investment in SDOH. This approach harnesses the use of individual-level SDOH data and technology to identify precision SDOH investment opportunities and mitigate the need to formally convene stakeholders in a market. We refer to this concept as aggregated precision investment, or API.