Social determinants of health (SDOH) are the conditions that shape and influence employee experiences where they are born, grow, play, learn, work, and pray.1 They are the conditions that have a major impact on people’s health, well-being, and quality of life, which in turn influence productivity and performance in the workplace.2 SDOH include a variety of factors including safe and affordable housing, health care services, access to nutritional food and clean drinking water, public safety, a high-quality education. Unmet social needs contribute to wide health disparities and inequities.1,2
Work is a key SDOH, as many aspects of the workplace such as the work environment, compensation, job security, and demands may affect the health of employees. It is important for employers to understand how these factors may be impacting their employees and implement strategies and solutions to meet their employees’ needs and promote equity in the workplace.1,2
The HERO Health and Well-being Best Practices Scorecard in Collaboration with Mercer© (HERO Scorecard) is a free online survey that was designed as an educational and benchmarking tool to help employers identify and assess their use of practices that support more effective health and well-being initiatives. Recently, the HERO Scorecard released new Best Practice Scores in 3 key areas to help organizations assess their health and well-being initiatives in three important areas: Mental Health and Well-being; SDOH; and Diversity, Equity and Inclusion. This commentary will focus on the practices in the SDOH Best Practice Score and assess the differences in SDOH Score by organization size, industry type, and geographic location.
HERO Scorecard data were explored from 210 organizations that completed the HERO Scorecard Version 5 through September 30, 2022. Organizations were categorized by size into small (<500; n=69), medium (500 to <5,000; n=83), and large (5,000+; n=54) organizations. Differences by industry type were assessed between financial (n=25), Hospitals/Healthcare clinics (n=21), Technical/professional services (n=27), Government (n=29), and High Tech (n=44) organizations. Finally, a comparison of SDOH Score by geographic location was assessed by categorizing organizations into West (n=72), Midwest (n=52), Northeast (n=38), and South (n=46) regions.
The SDOH Best Practice Score was compiled from the workforce health and well-being practices listed throughout the Scorecard relating to each area. The range of scores is 1-100 points. A list of all the practices included in the SDOH Best Practice Score can be found in the HERO Scorecard user’s guide, but in brief includes practices from all six sections of the Scorecard (strategic planning, organizational and cultural support, programs, program integration, participation strategies, and measurement and evaluation). Examples of practices included in the SDOH Best Practice Score include providing or facilitating access to child care, providing or facilitating transportation to work, and addressing food insecurity. Table 1 provides a breakdown of the number of practices and points by section for the SDOH Best Practice Score.
Table 1. Number of practices and points by Scorecard section
| Number of practices | Points Contributed to SDOH Best Practice Score | |
| Strategic planning | 5 | 18 |
| Organizational & Cultural Support | 16 | 41 |
| Programs | 11 | 19 |
| Program Integration | 4 | 8 |
| Participation Strategies | 3 | 5 |
| Measurement & Evaluation | 4 | 9 |
| Total | 43 | 100 |
The mean SDOH Best Practice Score for all respondents was 37 points. When comparing the SDOH Best Practice Score by organization size (Table 2), small organizations scored lower (24 points) than medium (37 points) and large (53 points) organizations.
Table 2. A comparison of SDOH Best Practice Score by Organization Size
| n | Mean | |
| All respondents | 210 | 37 |
| Small (<500 employees) | 69 | 24 |
| Mid-size (500 to <5000 employees) | 83 | 37 |
| Large (5000 + employees) | 54 | 53 |
Discrepancies were found when comparing the SDOH Best Practice Score by industry type. Table 3 provides a comparison of SDOH Best Practice Score by industry type. Of the industry types that with benchmarking data available, financial services had the highest SDOH Score, followed by hospitals/healthcare clinics and high-tech businesses. Government had the lowest SDOH Score. Benchmarks will become available for additional industry types when there are at least 20 unique Scorecard completers in a specific industry.
Table 3. A comparison of SDOH Best Practice Score by Industry Type
| n | Mean | |
| Financial Services | 25 | 52 |
| Hospitals/Healthcare clinics | 21 | 46 |
| Technical/professional services | 27 | 35 |
| Government | 29 | 25 |
| High Tech | 44 | 44 |
The comparison by U.S. geographic regions only showed slight differences by region. On average, organizations in the Northeast region scored the highest with 41 points, followed by organizations in the South region with an average of 38 points for the SDOH Score. Organizations from the Mid-West region that completed the Scorecard had an average of 36 points and organizations in the West region of the US averaged 34 points.
The results from this commentary show there is opportunity for employers to improve their HWB initiatives to address SDOH. By addressing SDOH in the workplace, employers will help to improve the HWB of their employees, while also positively impacting business performance and profitability (SDOH resource). In 2019, HERO published a report entitled Social Determinants of Health— an Employer Priority, which provides employer and business implications of SDOH and offers specific action steps employers can take to address SDOH within their workforces1. The goal of the Scorecard’s new Best Practice Scores, including the SDOH Best Practice Score, is for organizations to take the information gained to create a strategic plan using resources such as the Social Determinants of Health— an Employer Priority report, that has actionable steps to address the social determinants impacting their employee population.
- Social Determinants of Health— an Employer Priority Report. https://hero-health.org/wp-content/uploads/2019/09/HERO_HWHC_SDOH_Report_FINAL_090419.pdf
- What Employers Need To Know About Social Determinants Of Health. Forbes. https://www.forbes.com/sites/onemind/2021/08/24/what-employers-need-to-know-about-social-determinants-of-health/?sh=33b3a2951681
