Leveraging Social Determinants of Health to Improve Employee Wellness

Author: Natasha K.A. Wiebusch, XpertHR Legal Editor

December 22, 2022

Employee wellness has been around since at least the 1950's. Fortunately for everyone involved, we've come a long way from workplace smoking guidelines and lunchtime martini limits.

Even today, employee wellness is rapidly changing. What it is currently is not at all what it was just a few short years ago. Sure, we generally have the same goals, but the boundaries that define wellbeing are not the same. They're broader... and better.

Today, employers are leveraging Social Determinants of Health (SDoH), which go beyond the typical wellness indicators, to improve employee wellness for all employees.

Here's how:

Employee Wellness Redefined

Employee wellness is the global effort and investment employers make to maximize each employee's physical, economic, social, educational and community-focused well-being. A successful employee wellness initiative involves leadership advocacy, policy, programming, financial investment, upskilling, and much more.

Today, employee wellness may be viewed through the lens of Social Determinants of Health (SDoH), which include:

• Economic stability;
• Education access and quality;
• Health care access and quality;
• Neighborhood and built environment; and
• Social and community context.

According to the World Health Organization, SDoH are "the nonmedical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live and age, and the wider set of forces and systems shaping the conditions of daily life."

Viewing employee wellness through the lens of SDoH supports health equity and helps employers achieve better results overall.

So, how do we leverage SDoH to influence employee well-being?

Leveraging SDoH as an Employer

When done right, employers leverage SDoH to improve employee well-being through workplace interventions and employee benefits. The following table provides some examples:

Social Determinant of Health (SDoH)	Employer Role	Intervention Examples
Economic stability	Compensation and financial wellness	Consider cost-of-living discrepancies among employees in compensation strategy Fund financial wellness planning Identify employees taking hardship withdrawals Prioritize equity in compensation Increase childcare benefits, such as subsidies and onsite care.
Education access and quality	Career development	Assist employees with student loan repayment and tuition reimbursement Prioritize skills and experience over degrees Review the company's work architecture to maximize mobility Subsidize education, training, and relevant certifications.
Health care access and quality	Health care benefits	Identify highest out-of-pocket expenses for employees Understand employee demographics Limit cost-sharing for health plans Tier plans and fund pre-tax health accounts Consult a pharmacy benefit manager to manage prescription costs
Neighborhood and built environment	Workplace/flexibility	Identify which employees need transportation assistance Implement flexible work strategies Invest in on-site wellness and care services Provide on-site food options
Social and community context	Culture, Mission and Values	Align company values with employee values Take ownership and create accountability for DEI efforts Create opportunities for meaningful work based on employee goals Help employees support their community

The Future of Wellness: Influencing SDoH In New Ways

In 2023, employers will aim to influence SDoH in new ways to attract, retain and develop the best talent. The following are three employee wellness trends to keep in mind:

1. Enabling Technology

Steve Boese, HR Tech Conference Chair and President and co-founder, H3 HR Advisors, told HR Executive that in 2023, he would "look to adopt only those technologies that put employees first - in their accessibility, their ease of use, and their direct relevance to making employees' work and personal lives easier."

Other leaders echoed this opinion, signaling that in 2023, HR leaders should invest in technology that places employees at center stage.

As far as wellness is concerned, this means leveraging HR technology to enable SDoH interventions and optimize the employee's wellness experience.

2. Work Design for Meaningful Work

 McKinsey found that when employees find their work meaningful:

• Performance improves by 33%;
• Employees are 76% more committed to the organization; and
• They are 49% less likely to leave.

Promoting meaningful work supports key SDoH factors, including social and community context and education.

In 2023, employers will focus on meaningful work in new ways. According to Laci Loew, XpertHR's Senior Analyst HR Strategy and Insights, employers will look to "design well-being into meaningful work" by:

• Using systems to promote collaborative work; and
• Assigning high-priority work that aligns with employees' personal values.

3. Work Environment Interventions for Behavioral Well-Being

Over half of employees across 15 countries reported at least one mental health challenge this year. More importantly, employees reported toxic workplace behavior as "by far the greatest predictor of negative workplace outcomes," including burnout and intent to leave. It was 35 times more impactful on their mental health than "access to resources" like EAPs.

Instead of asking employees to focus inward by providing individual resources, in 2023, employers plan to implement cultural and environmental interventions to support behavioral well-being.

Two key interventions employers plan to drive forward on a global scale include growth mindset and psychological safety initiatives. The following are typical action items for these initiatives:

Creating a Growth Mindset	Fostering Psychological Safety
Address burnout directly and intervene Focus on upskilling employees in both hard- and soft-skills Promote and budget for career development opportunities Redesign performance reviews to focus on improvements and growth over output Reframe failure: create a culture that values learning and collaboration over outcomes	Advocate for inclusivity Be transparent and open to feedback Lead with empathy Require that leaders regularly promote psychological safety Reject perfectionism and treat mistakes as learning opportunities Train managers on how to give feedback

Key Action Items

Employers that want to improve employee wellness through SDoH should consider the following action items:

• Educate employees and managers about SDoH and how they influence employee wellness.
• Advocate for expanding the definition of employee wellness with key stakeholders.
• Innovate new approaches to employee wellness by considering less common SDoH.
• Invest in employee-centered technology to enable high-impact interventions.
• Assess the impact of interventions through employee surveys and analytics.