Last week, Icario Medicaid Advisory Council Member, Sara Ratner presented a webinar called “COVID-19 Butterfly Effect: The New Era of SDoH” for Medicaid Health Plans of America (MHPA) about the good, the gaps, and what’s next for Medicaid in light of COVID-19. 

This post is an abbreviated version of a full webinar presented by Sara Ratner. For the full conversation, a deeper dive, and more insights, view the complete webinar “COVID-19 Butterfly Effect: The New Era of SDoH”.

This complete webinar served as a comprehensive overview of the COVID-19 impact on social determinants of health and while there are numerous critical areas to focus on, there are 3 key areas to highlight—the underserved, including essential workers and the digital divide, the mental health impact, and care avoidance.

The Underserved Magnified

Before the COVID-19 pandemic, we had a strong grasp on the underserved population, the social determinants associated, and the health implications of barriers. However, things have changed. 

Yesterday’s underserved population has expanded to include a new population of over 62 million Americans that didn’t exist pre-COVID—a population that is situationally at odds with the “Shelter in Place” mandate. This includes categories of essential workers, including those working on the front lines in the healthcare industry and low wage essential workers at high risk interacting with the public, such as grocery store workers, public transit drivers, mail carriers, etc. These jobs have always been essential, but their criticality has been amplified during the pandemic, but not without great health risk associated given the increased chance of interacting with an infected individual. 

As a result of the pandemic, a secondary underserved population emerged as “Stay at Home” orders spread throughout the country—those without access to broadband. This becomes an issue as workers are asked to conduct their work duties from home, kids are going to school remotely, and people are losing their jobs. 

Our current situation has brought to light the fact that most people in 62% of counties across the US did not have the government’s minimum download speed for broadband internet. Without access to the internet or a device that can connect the internet, it becomes extremely difficult and in many cases, impossible, for people to work, go to school, or seek employment. Access to the internet has become an essential utility that all should have access to live.

Mental Health Impact

The mental health impact of the COVID-19 pandemic cannot be understated. Before the spread of COVID-19, the United States was already suffering from a shortage of mental health workers and resources. As the outbreak spread and people were asked to self-isolate, stay at home, and as many lost their jobs, mental health symptoms skyrocketed. 

In fact, 53% of people state they are more emotionally exhausted and 53% reported increased sadness in day-to-day life. The effects aren’t only felt by those sheltering in place, healthcare workers are experiencing significant mental health strain as well. 

As more people are suffering and less resources are available, we’re on the brink of the next health crisis before the pandemic ends—the mental health crisis.

Care Avoidance

A recent Harris Poll conducted by Icario shows that the effects of COVID-19 are far reaching and will likely overwhelm the healthcare system for months to come. According to the poll, 66% of people have postponed care due to COVID-19 closures and 96% plan to reschedule within 6 months after the restrictions are lifted.

The implications of this will be severe—delaying care will push a large amount of demand into a system that is not staffed to support the volume, leading to a tidal wave for treating more severe conditions, creating a significant cost burden. And, as a result, preventive care will be sacrificed.

While there is a lot of heaviness brought to light during this time of rapid change and uncertainty, there are silver linings that we need to recognize and use as motivators to drive us forward. For complete context, view the full webinar

It’s important for leaders in the healthcare industry to continue pushing forward and drive change because periods of tremendous turmoil and challenge can absolutely drive innovation. As Sara mentioned during the webinar, Winston Churchill said it best, “never let a good crisis go to waste.”