What Are the Long-Term Effects of COVID-19 on SDoH?



Since the beginning of 2020, we’ve seen COVID-19 wreak havoc on our communities. As of December 2021, more than 800,000 Americans have died from the virus and across the country, millions of people have felt the impact. And even though we’re nearly two years into this, the devastation isn’t slowing down. 

Right now, the healthcare system is overburdened. Healthcare workers and social services providers are buried in responsibilities and exhausted, if not already burnt out. So, too, is the public.  

While we’d like to believe the end is near, COVID-19 is still rampant in many parts of the country and around the world. Facing yet another surge, we’re all wondering: what are the long-term effects of COVID-19 on social determinants of health (SDoH)? And how can payers, providers, and community-based organizations (CBOs) work together to meet the needs of so many? 

COVID-19 is fueling long-term financial insecurity  

As Congress remains deadlocked on President Biden’s $1.75 trillion social spending legislation, federal pandemic aid programs—including monthly child tax credit payments and a pause on student loan payments—are set to expire. Ending these programs would cause additional hardship to millions of households experiencing financial losses.  

According to the most recent data from the U.S. Census Bureau's Household Pulse Survey, covering the period between Sept 29 and Oct 11, 2021:  

  • More than 52 percent of adults “had difficulty paying for usual household expenses” in the previous week 
  • Seven percent did not think they’d be able to make next month’s rent or mortgage payment  
  • More than 9 percent reported not having enough food 

And for many Americans, the long-term financial picture looks bleak. A recent survey from the Pew Research Center found that:  

  • Approximately half of non-retired adults say that COVID-19-related financial fall-out “will make it harder for them to achieve their long-term financial goals.”  
  • 44 percent of those who reported worsening finances due to the pandemic say that “it will take them three years or more to get back to where they were a year ago.” Of those, one in ten do not think their finances will ever recover.   

The economic fallout has impacted almost everyone, but the hardest hit are low-income people and people of color, as they were most likely to have lost jobs, had their wages cut, or taken on debt to cover bills during the pandemic. As we consider the best path forward, it is critical that stakeholders work together to provide free or discounted services and find ways to support people, so as not to further exacerbate these wealth disparities.  

SDoH concerns are rising 

Not only has the pandemic illustrated our global interconnectivity as the virus has hopscotched between continents, but it has proven that physical, social, and economic factors are deeply intertwined.  

In an April 2021 editorial that marked one year of the pandemic, National Institute of Mental Health (NIMH) director Joshua Gordan emphasized the connection between mental health issues and access to basic needs, such as social supports, income, and food or housing.  

“We [know] that addressing people’s basic needs can help alleviate their psychiatric symptoms,” he wrote. “For example, one study showed that food insufficiency was independently associated with all symptoms of poor mental health, but that association was mitigated for those who received free groceries or meals.” 

Not only has the pandemic impacted people’s health and well-being, but it has also had an enormous effect on mental health. A CDC report published in June 2020 found that 31 percent of surveyed adults had symptoms of anxiety or depression, and 11 percent reported serious thoughts of suicide—nearly double the pre-pandemic rates. Now more than ever, we must screen individuals for stress and mental health issues and refer them to appropriate resources, such as helplines, low-cost therapists, and CBO partners who can provide free or low-cost services.  

Cross-sector partnerships ensure community needs are met 

Nearly all sectors have had to make radical changes to adapt to the “new normal” of the pandemic—from inventing drive-through COVID-19 testing to curbside grocery pickup. Many providers have adapted to digital platforms and now social services providers will conduct intakes by phone or online, just as medical providers will continue to offer telehealth appointments to their patients.  

While COVID-19 has exacerbated many issues, it has also led to many meaningful and necessary changes. Since the start of the pandemic, we've seen countless cross-sector stakeholders work together to provide additional services. In many cases, partners who have historically not worked together have joined forces to provide COVID-19 relief, leveraging staff and resource capacity to reach more individuals in need.  

In an interview with Health Leaders Media, Dr. Creshelle Nash, Medical Director for Health Equity and Public Programs at Arkansas Blue Cross and Blue Shield, described how COVID-19 shone a light on infrastructure and social gaps in her state.  

“The digital divide came out loud and clear as we were rolling out the vaccine,” said Dr. Nash. “Initially, people would sign up to get a vaccine online. Well, if you don't have access to broadband, the internet, or have experience with digital platforms, you couldn't get an appointment.”  

Additionally, transportation barriers were “loud and clear in rural areas in Arkansas and across the nation,” as people needed to access their vaccine appointments, said Dr. Nash. “The disparities won't disappear with the end of the pandemic. We have to continue to ensure that those who are in the most need can get access to resources and receive care.”  

To improve health equity, Dr. Nash places a strong emphasis on cross-sector health education and access programs, and partnerships between payers, providers, and community leaders.  

“It's important to use this crisis to look beyond the pandemic and to build health equity solutions into the healthcare system in the long term,” said Dr. Nash. “No one system or one sector can address health inequities; it'll take partnership across sectors [and] multi-level interventions with the political will and commitment over time.” 

About us 

Our mission at Healthify, powered by WellSky is to ensure that no one’s health is hindered by their need. We provide end-to-end solutions to address social drivers of health. We work with payers, providers, and CBO partners to ensure that social services are available to those who need them most.  

You can learn more about our solutions here. 

Topics: Healthify social determinants of health health disparities COVID-19 SDoH interventions transportation sdoh health equity

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