Data from the Healthify platform shows early, alarming shifts in SDoH
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How has COVID-19 impacted the social determinants of health (SDoH) in the U.S.? To answer that, we examined trends in searches for resources on the Healthify platform, and our analysis shows us some early — and troubling — impacts of COVID-19 on SDoH.
In conducting our analysis, we divided the outbreak into two distinct periods, based on a timeline of official intervention and response:
- The "pre-COVID-19" period - the period starting from January 31st to March 12th, during which the name "COVID-19" was announced by the World Health Organization and official intervention in the U.S. was relatively limited.
- The "post-COVID-19" period - starting from March 13th to April 23rd, when nationwide response efforts significantly ramped up, with social distancing guidelines, stay-at-home directives, and restrictions on non-essential travel going into effect.
Pre-COVID-19 vs. Post-COVID-19 SDoH Data
Historically, the types of searches on the platform remain relatively stable throughout the year, with little variation from one month to the next. For example, transportation, food, and financial support — in that order — consistently rank as the three most-searched-for resources on the platform. This benchmark is a crucial consideration in how we view and interpret recent changes in social needs in the wake of COVID-19. And for population health leaders nationwide, it's the proper context to consider while developing rapid response and long-term SDoH strategies.
Overall, since COVID-19 response began in mid-March, searches for specific resources have decreased significantly on the Healthify platform.
In the pre-COVID-19 period of January 31st to March 12th, transportation searches made up about 28 percent of all searches on the platform nationwide. That number has decreased to 14.5 percent in the post-COVID-19 period of March 13th - April 23rd. This drop in transportation needs coincides with the stay-at-home directive issued by many states around that time.
Searches for medical transportation also dropped by 50 percent in the post-COVID-19 period - down from 15 percent of all searches in the pre-COVID-19 period to 7.5 percent of searches. Despite this drop, medical transportation is still the third most searched for resource on the platform since March 13th, indicating that it remains a critical need.
Comparatively, our analysis shows that searches relating to food have increased dramatically. Since the pandemic began, food-related searches have doubled, from 16 percent of all searches in the pre-COVID-19 period to 36 percent at its peak on March 27th. Food-related searches remain higher in the post-COVID-19 period than in the pre-COVID-19 period.
A more granular look at the data shows that within food-related searches, the most searched for resources over the last six weeks are food pantries and food and grocery delivery.
Searches for food pantries have increased from 7 percent of searches in the the pre-COVID-19 period to 12 percent of searches in the the post-COVID-19 period, peaking at 16 percent on March 20th. Food and grocery delivery searches have risen from 2 percent in the pre-COVID-19 period to 7 percent of all searches in the post-COVID-19 period, peaking at 9 percent on March 20th as well.
There was also a notable increase in searches for Meals on Wheels and emergency food. Meals on Wheels searches peaked at 9 percent in the post-COVID-19 period on March 20th and while searches are trending back down, they still remain up at 5 percent. Emergency food searches have increased from 2 percent in the pre-COVID-19 period to 5 percent of searches in the post-COVID-19 period, peaking at 8 percent on March 27th and again on April 10th.
All other categories have remained within a few percentage points of their typical levels - indicating that those needs remain a pressing issue despite the evolving crisis.
SDoH Trends in the Context of an Evolving Pandemic
The data from our platform and the recent headlines about the state of SDoH post-COVID-19 unveils a sobering reality: These emerging SDoH trends aren't seasonal or isolated. These needs were already present and they aren't going away anytime soon on their own.
For example, take the most searched for resource on the platform - food.
While food-related searches have surged on the platform, an estimated 11.1 percent of U.S. households were already experiencing food insecurity at least some of the time before COVID-19, according to the latest available data. And as the pandemic crisis continues to evolve, that figure is quickly changing. Our analysis of searches for food-related resources on the platform already shows that food insecurity is steadily on the rise.
Experts nationwide also estimate that food banks and pantries are contending with a 40 percent increase in demand right now. Meanwhile, some food banks report critical donations from food manufacturers are at roughly half their previous levels. In Pennsylvania, food banks are reportedly going over budget by as much as $1 million each week in some cases, while in Alabama, one major food pantry anticipates that it will be over budget by more than $3.6 million by as early as August.
Finally, there's next quarter's unemployment rate forecast: 32.1 percent, or nearly one in three Americans out of work. As unemployment rates continue to skyrocket, we can expect to see a rise in the number of individuals and families experiencing food insecurity and other social needs.
Cumulatively, these factors make it clear that social needs in the post-COVID era aren't seasonal or isolated - the needs were always there and exacerbated by the pandemic, it’s safe to say that this reality is our "new normal." Without strategic, targeted interventions the situation will only continue to deteriorate.
Moving Toward Solutions for SDoH Post-COVID-19
Our analysis indicates that social needs have intensified since the beginning of the pandemic, revealing the sheer magnitude of the challenges we face in the post-COVID-19 world. Still, it's important to consider that all other searches for resources have remained within a few percentage points of their typical levels, which indicate that existing needs pre-COVID-19 have not suddenly gone away.
While the nationwide trends we've identified offer valuable insights about the big picture ahead, the real-time situation on the ground looks markedly different from state to state. Given that historically, we've seen different needs more prevalent in some areas of the country than in others, and that COVID-19 response varies from state to state, the impact of COVID-19 expectantly varies.
New York, for example, already has more than 20,000 deaths from COVID-19 — and more confirmed cases than any country on earth — while states like Hawaii, Montana, and Wyoming have experienced only a handful of cases (so far). And their response efforts have looked very different.
In the next post in our data series, we'll take a closer look at city-specific SDoH trends pre- and post-COVID-19. Subscribe to our blog to receive the next post in your inbox.
All of these factors and more will have to be taken into account by population health leaders to develop solutions that effectively address SDoH in the post-COVID-19 era.
The disproportionate impact of COVID-19 on lower-income populations reflects that SDoH and overall health outcomes are inextricably linked. For population health leaders, the goal should be not only to curtail the spread of the virus but to do it in a way that takes into account its long-term impact on SDoH. If not, we risk bringing to life the worst of both worlds: undermining the efficacy of our response efforts while compounding existing health inequities.
For other decision-makers, particularly those actively involved in coordinating COVID-19 response efforts, our analysis surfaces key areas that could help inform priorities and interventions going forward.
Organizations like Blue Cross and Blue Shield of Kansas City (Blue KC) are already mobilizing to mediate the effects of the virus. In Kansas City, Blue KC is spearheading SDoH initiatives to offset some of the early and long-term impacts of COVID-19. The initiatives include developing a COVID-19 community fund and partnering with hotel chains to develop a COVID-19 safe discharge and housing strategy.
To learn more about Blue KC's efforts and other innovative approaches to SDoH, check out our latest webinar.