Whether employees can show up to work in good health goes far beyond just walking through the company's front door. Today, employers are not only beginning to recognize this, but are also taking action.

In the medical field, doctors have long advocated for attention to what are known as the "social determinants of health": factors such as safe housing, reliable transportation, healthy food, clean water and air, and freedom from racism and discrimination, which impact an individual's health and well-being. In recent years, some employers have begun adopting a similar mindset when treating their employees, assessing the "social determinants of work"—the various factors that affect employees' ability to show up to work in a healthy state.

Discovering both social and financial returns

"Employers have both financial and social returns in helping employees overcome social determinants of work. It's not only the right thing to do, but it can also positively impact profits," Aflac Chief Human Resources Officer Jeri Hawthorne told HR Dive.

The 2023-2024 Aflac Workforces Reportfound that 66% of employees are less likely to seek a new job if they feel their company cares about their well-being. Hawthorne said Aflac focuses on five dimensions of employee health: physical, emotional, financial, spiritual, and social.

In practice, this includes on-site care centers offering preventive care, virtual primary care physician services, therapy benefits for employees and their families, flexible spending accounts and deferred tax savings options (including 401(k) contributions), non-denominational corporate chaplains (for weddings, end-of-life ceremonies, and funerals), volunteer opportunities, scholarships for employees and their families, career development, and car safety seats for new parents.

"When considering the social determinants of work for Aflac employees, we strive to see employees as whole people. We think about our products, services, and support considering the many facets of their identities beyond logging into their computers," Hawthorne said.

Listening to employee voices

At Northwell Health, a New York healthcare system, ensuring employees can fully engage in their work is directly tied to patient care, said Gregg Nevola, vice president and head of total well-being.

"In healthcare, it's crucial that our team members are actively engaged and providing care to our communities and patients," Nevola said.

Programs that help reduce stress or alleviate employee distress can lead to better patient experiences because employees are more engaged in their work, Nevola said. "This improves health outcomes and truly drives the mission of the health system," he said.

But the key to effectively engaging employees lies in communicating with them, Nevola said. Employers often find a program and decide to try it without first checking with employees to see if it's actually useful, he said.

For example, Northwell Health has an on-site Employee Assistance Program (EAP), but found that employees were coming with serious issues such as domestic violence and suicidal thoughts. Instead of launching another EAP, the system hired a social worker to help employees connect with resources to bring safety and stability, Nevola said.

"What we really need to do is understand what resources are available externally and creatively build those connections," Nevola said.

Another example is that members of Northwell's caregiver employee resource group shared concerns about finding resources to care for aging parents. The system gathered information on internal resources, such as home health and physical therapy services, and then established a partnership with the virtual home care app eFamilyCare, which connects caregivers with care advisors.

"Most importantly, how can we truly impact employees' lives by thinking a little differently and challenge ourselves as employers to do better," Nevola said.

Community collaboration efforts

United Way of Greater Cleveland has embraced the concept of social determinants of work and is creating a toolkit for community employers to address employee needs, said Renée Timberlake, the organization's director of economic mobility.

The organization urges companies to survey employees to identify barriers they face at work, then calculate the money the company loses from being unable to fill open positions. Using this information, companies can decide how much they're willing to invest to address these barriers and adopt solutions ranging from cheap and simple to expensive and complex, Timberlake said.

According to Edie Goldberg, president of the SHRM Foundation,the cost of recruiting a new employeecan be three to four times that employee's salary.

"Now is the best time to do this. The demand for workers is so high," Timberlake said.

A program calledBridges@Workhelps United Way assist employees at partner companies in Geauga County, Ohio, with challenges affecting work productivity. Over the past year, the program's resource coordinators helped 855 employees with financial emergencies, childcare, housing, transportation, and elder care issues, while another 146 employees received $1,000 emergency loans to cover unexpected expenses. The program is free for employees and relies on partnerships with local charities and growth organizations.

Timberlake emphasized that employers should not assume what employees need. "You need to understand what solutions truly work for employees," she said. "People know what they need."

Taking direct measures

"During COVID-19, we invested heavily in resources, solutions, and well-being initiatives with good intentions, but participation and usage rates didn't meet expectations," said Dr. Bipin Mistry, chief medical officer at Alight, who has a background in internal medicine. "So we started thinking, 'How can we do this in a better, more meaningful way?'"

In September, Alight, a cloud-based human capital services provider, launched anew partnershipwith Socially Determined, a social risk analytics company, aimed at helping employers identify employees at risk from social determinants of health and connect those employees with available resources.

For many chief human resources officers, deciding which strategy to adopt to meet needs can feel "broad and daunting," Mistry said. But after identifying community resources, employers can focus on gaps that need to be filled, he said.

To help the most vulnerable employees better access healthcare, companies could, for example, lower copays or health plan contributions for lower-income workers, Mistry said.

"If people invest in employee health and well-being as well as financial well-being, it truly leads to more productive employees and less absenteeism. It's a win-win for employers," Mistry said.

In some cases, employers set up food banks at large distribution centers or manufacturing plants to provide healthy food to employees, said Dr. Trenor Williams, CEO and co-founder of Socially Determined. Or they offer meal delivery options or literacy programs to help address nutrition-related conditions like diabetes, he said.

"I think if we in the medical community tried to do this without employer engagement, first, I don't think it would be as successful; second, I don't think we could have as much impact. We'd miss the opportunity to integrate and collaborate with one of America's largest industries," said Williams, who has a background in family medicine.

Finding partners

Dilip Rao, CEO and co-founder of Sharebite, wants to address food insecurity. Through its corporate meal benefits program, for every meal purchased, Sharebite donates to organizations addressing child hunger.

"We started this company to truly explore how to leverage the private sector. It's really about aligning the incentives of the private sector to take on social good and public welfare," Rao said.

Through Sharebite, companies purchase meals or meal vouchers for employees, who can get food from local restaurants delivered to the office or home.

"The average employee in your company might be barely getting by, or might be food insecure but won't tell you. We're determined to change that," Rao said.

Rao started this business to address a need he experienced firsthand. Early in his career, he worked in investment banking in the financial industry, and for two years, he could only get by on working late every night. That way, the company gave him a $20 meal allowance, which he used to order dinner and then saved half for the next day. In every way, he "looked the part and sounded the part," but was silently struggling inside, he said.

The Urban Institute estimates thatone in five adults experienced household food insecurity in summer 2022due to food inflation and rising costs of other basic necessities.

"In hindsight, if someone relatively well-paid and quite successful today remembers going through something like that, what about the average American worker?" Rao said.