By Carli Friedman, CQL Director of Research
Social determinants of health are “conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks” (United States Office of Disease Prevention and Health Promotion, n.d., n.p.). Recently, more attention has been drawn to social determinants because they can not only promote the health and quality of life of people with disabilities, but also because they represent an opportunity for cost savings, such as in managed care and with value-based payment models (VBP).
Although less is known about the social determinants of health of people with intellectual and developmental disabilities (IDD), research suggests that social determinants can reduce the emergency department use of people with other disabilities and nondisabled people. For this reason, the aim of this study by CQL | The Council on Quality and Leadership was to examine the impact social determinants of health can have on the emergency department utilization of people with IDD. To do so, we analyzed Personal Outcome Measures® Social Determinant of Health Index data, and emergency department utilization data from a random sample of 251 people with IDD.
The findings from our study revealed the more social determinant outcomes people with IDD had present, the less often they visited the emergency department, regardless of their demographics. In fact, there was an 8.0% decrease in emergency department visits for every single social determinants outcome people had present (see figure). For example, compared to a person with IDD with no social determinant outcomes present, a person with 5 out of the 11 possible social determinant outcomes present had a 39.9% decrease in emergency department visits.
The Relationship Between Social Determinants Outcomes and Emergency Department Visits
“Although health and safety are critical for people with IDD, particularly given the health disparities people with IDD face and the high rates of abuse, neglect, mistreatment and exploitation for people with IDD, health and safety alone are insufficient to demonstrate quality services. Instead, social determinants are critical to promote the health equity and quality of life of people with IDD… Our findings suggest that by paying attention to social determinants – facilitating community integration, choice, engagement and relationships, rights, and respect outcomes, among others – we can reduce emergency department utilization” (Friedman, 2020, pp. 14-15).
- United States Office of Disease Prevention and Health Promotion. (n.d.). Social determinants of health. Author. https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health