The biggest challenge in supporting health plan members on their health journeys often has little to do with medical care. Increasingly, proper care depends far more on an individual’s station in life and their willingness and ability to prioritize their health.
We call this collection of barriers non-medical drivers of health (NMDOH) or social determinants of health (SDOH), which can influence health disparities and drive up to 80 percent of health outcomes.
Give members what they truly need while reducing your costs. Explore the root causes of non-medical barriers to health and how they impact member behavior—we’ll show you how to activate them to achieve better outcomes.
What are the most common non-medical barriers to health?
Non-medical barriers are the collective structural and social conditions in which people are born, grow, live, work and age. NMDOH needs generally fall into five categories:
- Economic stability: Access to employment, livable wages, food security and stable housing.
- Education: Language and literacy skills, access to quality education, and early childhood development.
- Healthcare access and quality: Access to primary care, adequate insurance coverage, and health literacy.
- Neighborhood and built environment: Housing quality, access to transportation, availability of healthy foods, air and water quality, and neighborhood safety.
- Social and community context: Opportunities for civic and community participation, fair workplace conditions, and freedom from discrimination or incarceration.
When someone is struggling to fulfill their housing, transportation, food, income or safety needs, it can significantly impact their health and wellbeing. That’s because unmet NMDOH needs often prevent these members from accessing care, understanding and following treatment plans, and managing chronic diseases.
ICD-10 coding makes tracking NMDOH easier.
Documenting non-medical drivers of health with codes from the International Classification of Diseases (ICD-10) helps plans and providers better understand individuals by pulling in holistic medical, social, and behavioral health data. Use the ICD-10’s Z codes to identify non-medical barriers. Several Z codes can be used to indicate NMDOH problems:
- Z55 education and literacy
- Z56 employment and unemployment
- Z57 Occupational exposure to risk factors
- Z58 physical environment
- Z59 housing and economic circumstances
- Z60 social environment
- Z62 upbringing
- Z63 primary support/family circumstances
- Z64 certain psychosocial circumstances
- Z65 other psychosocial circumstances
The Centers for Disease Control (CDC) strives to understand non-medical determinants of health and provide programs to help. Its Healthy People 2030 initiative is just one example, targeting access to safe housing, transportation, clean air and water and nutritious foods.
What actions can you take to help members overcome non-medical barriers to health?
To overcome NMDOH challenges for better health, members have to be open and willing. Because these challenges are deeply personal, go slowly. Start by screening members to identify non-medical barriers to care. Once you do, you can begin to share helpful resources and build trust to activate them toward managing their health.
Offer access to food boxes.
Food insecurity is one of the most common non-medical barriers to health, so make strides to resolve it by establishing a dedicated program. Food boxes literally get your foot in the door to connect with members and uncover other challenges. Just by delivering nutritious foods, your team can drop off educational materials or mention resources in passing to guide members to them.
Provide community resources.
Part of the problem of battling non-medical needs is not knowing where or how to start. Point members in the right direction by sharing information about community resources such as homeless shelters and social services organizations. Even if your plan doesn’t directly cover or offer programs for specific NMDOH needs, connecting members with solutions in your broader network can give them the push they need.
Activate members.
Those with severe NMDOH needs—including loneliness and isolation—often disconnect from their plan, impacting both their health and costs. Whether it's not taking medications properly, overutilizing emergency department services due to seeking care at the last minute, or not managing diabetes and other chronic conditions properly, the consequences add up.
Make activation your ultimate goal. Combining tangible resources like food boxes with empathy-driven technology and real human connection does far more than a text reminder or robocall ever could. Resolving an urgent need gives members immediate relief and the mental space to focus on their broader well-being. More importantly, delivering that hands-on support builds the trust members need to open up, accept further assistance, and make lasting, positive changes to their health.
Rise Above NMDOH with Pyx Health
Personal circumstances certainly impact quality of life and happiness, but when those spill into broader well-being, health plans have an important role to play. Give your members the tools to overcome the non-medical drivers of health that interfere with their wellness.
Pyx Health is your all-in-one solution to lift the weight of members’ NMDOH burdens. Starting with empathetic care coordinators and tangible support like food box delivery—which serves as a powerful engagement tool to build rapport—our program connects with members right where they are. Try the My Pyx app to help members close care gaps, address loneliness, and ensure consistent access to nutritious meals. Partner with Pyx Health to give them more.
Curious how it works? Get in touch to discuss your goals.
