The effort to label housing policy and education as ‘social determinants of health’ is pure advocacy.
Health insurers like UnitedHealthcare, Centene and Humana have devoted billions of dollars in the past decade to building new “affordable housing.” They’re also spending heavily on nutrition programs and local community resources. No, the insurance industry hasn’t suddenly begun emphasizing philanthropy over profit. Rather, it is responding to a recent, concerted shift in public policy toward fostering investment in what are commonly called social determinants of health.
In November 2023, the Biden White House published a 53-page policy guide, “The U.S. Playbook to Address Social Determinants of Health,” which contends that improving Americans’ health requires a greater focus on underlying “social circumstances and related environmental hazards.” It notes that poorer Americans suffer from higher rates of disability, heart disease, stroke, diabetes and other chronic conditions and that they are more subject to obesity, physical strain and environmental pollutants.
The guide argues that good housing improves health by providing safety from hazardous waste, that poor nutrition aggravates chronic medical conditions and that early childhood education can improve health and health behaviors. Relying on a number of scholarly studies, the guide contends that increased public spending on social-policy interventions can ultimately reduce healthcare costs. Several studies have, for instance, claimed that providing housing and support services to homeless people with serious mental illnesses may pay for itself by averting costly hospitalizations.
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Chris Pope is a senior fellow at the Manhattan Institute. Follow him on Twitter here. This piece is adapted in part from a forthcoming report.
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