Comparison of SDOH-related investments by Texas and California Medicaid health plans

Addressing nonclinical, social needs, or social determinants of health (SDOH), is a hot topic in health policy and practice discussions. Virtually every health conference has many sessions devoted to the subject. Many of the most-read pieces on Health Affairs Blog in 2019 concerned accurately defining terms and categorizing social interventions.

The topic takes on added urgency given the tsunami of social needs that is taking shape as a result of the COVID-19 pandemic and pre-existing system failures and gaps. Some of these issues have immediate, evident connections to health such as increases in domestic violence, food insecurity, depression and anxiety brought on by social isolation, and pre-existing and new barriers to mental health and substance use services. Other issues such as housing instability and economic insecurity will take an enormous toll on health over upcoming years. The social impacts of the pandemic are likely to follow the same racial and socioeconomic contours as the disparate medical effects and to be shaped by the same structural and historic factors.