As oft-cited as social determinant of health investments may be in healthcare discussions and strategy, their causal relationship to health outcomes remains blurry with savings that are often overestimated, according to a brief published in July by The Manhattan Institute.
The Manhattan Institute is an American conservative think tank focused on domestic policy and urban affairs. Its brief, "Is Everything Health Care? The Overblown Social Determinants of Health," is authored by senior fellow Chris Pope, who argues for healthcare providers to stick with a narrower definition of healthcare and challenges the thinking behind the Biden White House's policy guide, "The U.S. Playbook to Address Social Determinants of Health."
"Social services are best provided by social work agencies, not doctors or hospitals," Mr. Pope writes. "Hospitals interact with most patients only sporadically and are unlikely to have a good understanding of their specific nonmedical needs."
The report contends that most scholarship on SDOH fails to disentangle causation from correlation, with research that is entwined with advocacy, subject to financial conflicts of interest and often politically motivated. Mr. Pope also argues that "shoehorning social work into medical practice burdens clinicians with extraneous tasks for which they are poorly suited and leaves less time for them to treat patients."
In addition to the nearly 6,500-word brief, Mr. Pope and The Manhattan Institute also ran an op-ed in The Wall Street Journal, challenging the value of investments made by health insurers like UnitedHealthcare, Centene and Humana toward affordable housing.
"Social theories of health have become so popular because they allow states, nonprofit groups and other policy advocates to tap into the much larger pool of federal funding that is allocated to healthcare," Mr. Pope wrote in the op-ed. "For instance, citing social theories, states have successfully reclassified social policy expenditures under Medicaid and thereby secured generous matching federal funds."
The brief published by The Manhattan Institute calls for policymakers to oppose efforts to make insurers, hospitals or other medical providers responsible for addressing SDOH with tax or payment incentives, along with calls for greater constraints on Medicare and Medicaid funding beyond the programs' core covered benefits.
Find the complete issue brief from The Manhattan Institute here.