Engagys Survey Explores Social Determinants of Health

  • July 25, 2023
  • Press Release
  • Kathleen Ellmore
Healthcare SDoH survey data

BURLINGTON, Mass. – July 25, 2023 – Health plans’ consumer health engagement capabilities are facing a critical test, as plans work to persuade people who defer care or who encounter health barriers related to Social Determinants of Health (SDoH) to get routine and needed care.

Research by Engagys LLC, the leading healthcare consumer engagement consulting and research firm, found that an alarmingly high proportion (43%) of adults from age 18 to 60-plus had put off getting needed care in the 12-month period preceding the May survey.

Interestingly, the Engagys survey uncovered an inverse relationship between age and delayed care. As age increases, fewer respondents reported that they had delayed seeking care. More than half (51%) of younger adults between the ages of 30 and 44 said they had delayed seeking care, while a far lower proportion (35%) of those 60 and above did so.

“Older adults are doing far better than younger adults,” observes Kathleen Ellmore, Cofounder and Managing Partner at Engagys. “Young people don’t have as much experience as health care consumers, and because they often lack health care knowledge, they may also lack confidence in navigating the healthcare system.”

Though Ellmore says young people need more help, she also acknowledges that health plans have historically struggled to connect with a younger age cohort. “Young people are straining under the weight of work plus family obligations, and health plans are asking them to allocate scarce resources – time and potentially money – to get care that feels optional to young and healthy consumers. It can be a hard sell, but health care organizations can play an essential role in helping younger people and families understand the importance of preventive care, how to manage health costs, resolve concerns about time constraints, and gain knowledge of the healthcare system.”

The Engagys survey also looked at how several SDoHs and Social Risk Factors affect patients accessing care.

  • Lack of Transportation

Slightly more than one in five survey participants indicated that they did not have access to reliable transportation. Young people 18 to 29 years old, Hispanics, and those with an annual income of $25,000 or less were most likely to lack transportation.

  • Isolation and Loneliness

More than one in three (38%) respondents said they had felt isolated and lonely, with young adults 30 to 44 years old reporting at the highest rate (42%) and one in three (32%) in the 60-plus age group did. Those with an annual household income below $50,000 (36%) and those with a disability (46%) were substantially more likely to have felt lonely or isolated.

  • Discrimination and Racism

Minority group members were twice as likely to say they had encountered discriminatory practices in health care, as compared to white respondents. Asian (21%) and Black or African American (21%) participants were most likely to report discrimination in a health setting. Only one in 10 whites (11%) had encountered discrimination or racism in health care. Non-whites with a high school education or less were much more likely (28%) than those with at least some college (18%) to have felt discrimination.

  • Confidence

A clear majority (69%) of respondents reported that they were able to ask healthcare professionals all their health-related questions. Older adults, those over the age of 45, were 29% more likely to do so.

These results demonstrate the challenges health plans may encounter as they implement programs to engage members and beneficiaries whose social risk factors act as barriers to good health.

Leveraging direct marketing techniques, behavioral economics, evidence-based communication insights and best practices, Engagys works with health plans to dramatically increase the success of engagement programs. It has defined and designed preventive care programs to reach the hard-to-reach and vulnerable populations, optimized programs that proved ways to overcome the barriers of SDoH, crafted condition management enrollment campaigns, evaluated effectiveness of existing engagement approaches to determine SSI eligibility, established channel strategies to address the disengaged, and more.

For more on the survey, access the eBook on the Engagys website.

About Engagys

Engagys is the leading healthcare consumer engagement consulting and research firm. With decades of experience in healthcare, including having deployed hundreds of marketing and engagement projects, Engagys has driven significant improvement in consumer behavior change, to driven lower costs, greater satisfaction, higher revenue and improved health outcomes.

Kathleen Ellmore



Ms. Ellmore is one of the earliest pioneers in bringing the best of consumer marketing and data driven methodologies to healthcare. Instead of getting you to eat when you are not hungry and buy things you don’t need, we can finally use the same strategies to instead change the health equation in America. Kathleen previously led the Consumer Engagement consulting practice for Welltok (formerly Silverlink) for 12 years, leveraging its data repository of over a billion consumer health interactions, the best of behavioral economics, and the latest in clinical research, to create evidenced-based communications on what works to drive consumer healthcare behavior yielding better outcomes and lower costs. She is often quoted in the trade and national press and is a regular speaker on the national stage, having spent the first twenty years of her career in brand marketing at leading consumer marketing organizations, including General Mills and P&G. Additionally, she was a Vice President at Digitas, a leading direct marketing firm. Recently she was selected as Consultant Member of the first ever FDA’s Patient Engagement Advisory Committee.