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Employee Wellbeing

The Social Determinants of Health That Shape Well-Being and How They Affect Business

Karen H. Moseley

President, Health Enhancement Research Organization (HERO)

As employers increasingly embrace workplace well-being, they are realizing the importance of going beyond health insurance and fitness programs to consider the impact that economic and social conditions have on the well-being of employees.

Known in the public health sector as social determinants of health (SDOH), the conditions where an individual lives, learns, works, plays, and prays can influence health — or the lack thereof. A new report from the Health Enhancement Research Organization (HERO) examines the significant impact that the SDOH can have on well-being.  


  • Location: Where we live affects access to food and transportation, personal safety, and employment options. The impact is significant enough that it can influence the lifespan of people living in adjacent communities by as much as 20-30 years. To address this, one nonprofit collaboration in Silicon Valley is investing in affordable housing initiatives in the region.
  • Financial stability: How we live matters, too. Poverty has been linked to a higher incidence of diabetes, heart disease, stroke, obesity, depression, and premature death. What’s more, 29 percent of Americans skip medical care because of finances, and half of those say the treatment they’re missing is for a serious condition. Employers who understand the dynamics of their community can influence this by adjusting their pay scale accordingly. For example, the lowest wage earners at Tom’s of Maine are paid 25 percent above a living wage.
  • Food security: When people don’t have access to healthy food, whether due to availability or affordability, their health suffers. Unfortunately, more than 11.8 percent of homes that were food insecure in 2017 included adults who were employed full-time. Campbell Soup Company works to address this by convening government, nonprofits and businesses to improve food security.
  • Social connectedness:Social connections also affect our lifespan. Lonely people are more likely to catch a cold, have a stroke, develop heart disease, and even suffer from dementia. Loneliness can affect work productivity, creativity, and decision making. Humana’s Bold Goal initiative seeks to reduce loneliness and social isolation and other SDOH by creating partnerships between physicians, non-profits, businesses, and government.

SDOH impact

The impact of these factors for businesses is very real. About 86 percent of full-time employees are above normal weight or have at least one chronic condition, and these employees miss 450 more days of work than healthy employees, costing companies $153 billion in lost productivity.

Employers who want to influence employee health would do well to consider how factors outside of the workplace shape employee well-being and take steps to influence social determinants of health. Even small expenditures to address these priorities can lead to significant reductions in overall health costs and increased productivity.

What can employers do to make a difference?

  • Train managers to recognize employees who are struggling and address problems while they’re still manageable.
  • Create policies that support employees taking care of themselves and others.
  • Ask employees what they need and offer health and well-being benefits that are relevant to your workforce.
  • Review recruiting and hiring practices to incorporate new skills and perspectives.
  • Set up a confidential, safe place where employees can meet with appropriate onsite staff to help target local referrals.
  • Build a work environment that makes the healthy choice the easy choice.
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