Health equity and social determinants of health: an interview with Tammie Jackson

September 22, 2021

People living on the Upper East Side of New York City live an average of 90 years — but a few blocks away in East Harlem, the average life expectancy drops to 71 years. 

A person’s state of health takes so much more into account than what happens in the doctor’s office. Differences in access to healthcare, healthy food, quality education and other social conditions lead to health disparities. 

While health disparities have long been present across U.S. communities, the COVID-19 pandemic brought the issue to the forefront. 

“The pandemic has revealed these huge disparities in disease prevalence and mortality rates and outcomes — it didn’t create them, it revealed them — but it’s not simply access to testing and vaccinations,” said Tammie Jackson, vice president of go-to-market strategy and sales at TransUnion and chair of the Healthcare Financial Management Association. “You can’t ‘make believe’ we don’t know how social determinants of health manifest themselves and not try to solve for it.” 

There’s now an increased recognition of the need to strive for health equity — when all members of society can enjoy a fair and just opportunity to be as healthy as possible. 

What are social determinants of health (SDOH)? 

Social determinants of health are the conditions in which people are born, grow, live, work and age that shape health. The Office of Disease Prevention and Health Promotion (ODPHP), part of the Department of Health and Human Services, breaks SDOH into five categories. 

1. Economic stability 

People in poverty often can’t afford things like healthy food, healthcare or safe housing. And in a negative cycle, people with disabilities, injuries or conditions like arthritis may have limited work abilities — leading to worse economic outcomes and worsening health. 

2. Healthcare access and quality 

Healthcare access and quality manifests in many ways, from lack of reliable transportation in rural communities to lack of health insurance and access to providers. With these barriers to quality care, there are many people who routinely skip annual checkups, follow-up visits and/or recommended screenings. 

3. Social and community context 

Positive relationships at home, school, work and in the community have a major impact on health and well-being. Supporting and encouraging these relationships and community ties will improve health outcomes. 

4. Education access and quality 

Higher levels of education correlate with improved health and longevity. Students who do well in school more frequently see positive, long-term health benefits. 

5. Neighborhood and built environment 

Some neighborhoods may have unsafe air and water, high rates of violence or other safety risks. Some jobs and workplaces expose employees to secondhand smoke, dangerous noise levels or other physical harm without adequate protection. Many governments, community organizations and healthcare organizations work to address the many social determinants of health with the goal of achieving health equity. “There’s an opportunity for each one of us to do this kind of work from exactly where we’re sitting,” said Jackson. 

The goal of health equity is driving healthcare technology adoption 

The drive to achieve health equity has become a leading factor in the implementation and improvement of healthcare technologies. Technology solutions have the potential to increase and improve access to care, as well as provide more personalized care for patients. As technology companies work more closely with healthcare organizations, health tech has come to realize the important role their solutions play in providing equitable care. 

One example is the increased adoption of telehealth. Telehealth exploded in popularity during the pandemic, and leaders quickly saw it as a phenomenal way to engage underserved populations who’ve traditionally had trouble accessing care.  Telehealth eliminates the barriers like transportation, childcare, scheduling and even paid time off that have too often prevented people from visiting their doctor. With telehealth, all patients gain easier access to the care they need.Digital front door strategies have also emerged as another key example. The digital front door encompasses a range of technologies connecting patients and providers beyond the physical care locations, supporting patients at various points in their health journey. Things like online self-scheduling and automated follow-up reminders bring the convenience consumers need and expect to a previously outdated healthcare journey.

In the larger vision, automation in general should lower the cost of care and break down barriers, making healthcare more accessible to everyone. Rural patients should have access to the best and most accurate radiology readings. Patients without access to reliable transportation shouldn’t miss follow-up appointments. And minority patients shouldn’t have worse health outcomes because of biases. 

Tammie Jackson on health equity, SDOH and workplace culture 

Health equity is near and dear to Jackson, who sat down with Mike Biselli, a health tech entrepreneur and Olive’s Evangelist, to speak about her experiences at TransUnion, what she hopes to accomplish as chair of HFMA and more. 

Watch the whole interview to learn how Jackson sees the future of healthcare and how we can work together to address social determinants of health.