SDoH and COVID-19

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Original story posted on: May 20, 2020

The new face of the SDoH: The healthcare workforce

The end of 2019 saw healthcare jobs become the hottest career around, with over 1.9 million jobs added and eager anticipation about job opportunities to come. However, the healthcare industry is incredibly fluid, with its own workforce now the latest face of new populations dealing with the social determinants of health (SDoH).

Some numbers to chew on, courtesy of the U.S. Bureau of Labor Statistics and American Hospital Association’s May Issue Brief:

  • Healthcare spending fell 18 percent for the first quarter of 2020.
  • As of this writing, 260 hospitals and healthcare organizations have furloughed or laid off employees since the start of the pandemic, with 78 percent of the 18 million reporting unemployment in April being temporary furloughs.
  • Ten percent of the 1.4 million members of the workforce who lost jobs in April were hospital staff alone.
  • There are expectations that some 47 million people will wind up filing for unemployment, leaving potentially as many as 40 million without health insurance.
  • Monthly hospital and health system losses are averaging $50.7 billion, totaling $202.6 billion for the past four months.
  • One of the most profound figures aligned with the dollars spent by hospitals and health systems for their patient populations impacted by the SDoH, a figure often discussed this broadcast, is this: from 2017 to the end of 2019, hospitals spent $2.5 billion on SDoH-related programming and initiatives:
    • $1.6 billion for housing
    • $1.1 billion for employment
    • $476 million for education
    • $294 million for food security
    • $253 million for social and community programs
    • $32 million for transportation


Estimates by the American Hospital Association tally almost $2.2 billion that is expected to be spent by facilities for the non-clinical needs of their frontline workforce, roughly $550 million per month, through June: these are costs to provide child care, housing, transportation, medical screening, and treatment of COVID-19. Hospitals and healthcare systems could barely afford increased health system utilization costs related to the SDoH, due in part to increased and recurrent emergency department and primary care visits, hospitalizations with elevated lengths of stay, increased readmissions, and poor outcomes for populations. What happens when the employees of these systems who have been laid off become as vulnerable and needy as the populations they long served?

This week’s Monitor Mondays Listeners’ Survey, sponsored by the American College of Physician Advisors, looked further at the immense impact of COVID-19 and the SDoH on the healthcare workforce. The record results of the survey can be viewed here. As we see more hospitals proceed with furloughs and layoffs, the ripple effect to state and federal budgets and benefits will continue.

Programming Note: Ellen Fink-Samnick is a permanent panelist on Monitor Mondays. Listen to her live reporting every Monday at 10 a.m. EST.

Ellen Fink-Samnick MSW, ACSW, LCSW, CCM, CRP

Ellen Fink-Samnick is an award-winning healthcare industry expert. She is the esteemed author of books, articles, white papers, and knowledge products. A subject matter expert on the Social Determinants of Health, her latest books, The Essential Guide to Interprofessional Ethics for Healthcare Case Management and Social Determinants of Health: Case Management’s Next Frontier (with foreword by Dr. Ronald Hirsch), are published through HCPro. She is a panelist on Monitor Mondays, frequent contributor to Talk Ten Tuesdays, and member of the RACmonitor Editorial Board.

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