Social Determinants of Health By Miriam Lucero With Joseph Gaudio CEO of United Healthcare Community Plan of Arizona


Joseph Gaudio you are the CEO of United Healthcare Com- munity Plan of Arizona, the Medicaid division of UnitedHealth Group. Would you explain or define Social Determinants of Health? How it can affect a Member physically, behaviorally, and socially?


40% of our health costs are driven by social deter- minants, what that means is do we have enough to eat, do we have a stable roof over our heads. Do we have reliable transportation? Those are the items that impact 40% of our health outcomes or health- care costs, as we struggle to meet those social needs it creates toxic stressors. Which has the negative im- pact on our health outcomes. The other factors in- volved here are 10% environmental, 30% are health choices, 20% are actually driven by your engage- ment in the healthcare system. So really the bulk of your healthcare is really driven to meet these so- cial determinants. An example I like to use to put this in perspective, think about a young mother on      continue to reach out to her, and encouraging this young mother to take her child in for Well Child visits, Well Women visits, but in reality this young mother is not thinking about those types of items, nor preventative medicine, what she is worried about is whether she has food to feed her kid tonight, or a stable roof over her head, her day to day is about survival. And that puts it into perspective of social determinants of health. That daily struggle for survival, creates toxic stressors.


United Healthcare appears to be a forefront leader in So- cial Determinants of Health. Would you share some of the programs or community involvement? How these programs can benefit the Members, and or other health plan members, Medicare, and commercial health employer plans? We have several initiatives here locally, we have partnered with St. Mary’s Food Bank in Phoenix, to help address food insecurities, which means you don’t know where your food is coming from. 1 in


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4 children in Arizona will go to bed tonight without food, so we’re partnering with St. Mary’s Food Bank to sponsor a mobile food bank, this is the next evolution in mobile food pantry. Food pantry will actually be a semi-trailer that can be left at a site, refrigerated. For instance you can take it to a church, or a community center, and have it open to pass out food, fresh produce.  housing is probably the key, your housing and your health outcomes are linked. Your health outcomes are more driven by your zip code than your genetic code. What we have done here in - cano Por Las Casa, which is a community base or- ganization here in Phoenix and we provided CPLC a real estate loan and with that loan they purchased two apartment complexes in Maryvale, West Phoe- nix. They remodeled those complexes, they put          below market interest rate, 100% loan value, which means they don’t have to put anything down, with   aside 100 to house our homeless members. So the rent on the other 400 units subsidizes 100 units. So we bring our homeless members in, they have no      which is designed to house individuals as they are. You don’t have to be in treatment, many of them


come to us still addicted and require a treatment program. That’s               roughly a year they will be at zero percent subsidy and they will be  We have been operating this program in Maryvale for two years, and we have housed 156 of our homeless individuals and 56 have graduated to date. Meaning they went from 100% subsidy to 0% sub- sidy. We have seen quality of life and health outcomes improved, over 50% reduction in health care costs; it has been an incredible pro- gram and a testament to this notion that we call Housing First. The most cutting edge solution that you can provide to reduce homeless- ness is actually provide a home to someone.


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