Does it matter how close you live to a grocery store? Can it affect how long you’ll live? What if you don’t have a way to get there? Sometimes it’s more than illness or injury that takes a toll on your health.

Imagine this: It’s dinnertime. You’d like to make a healthy meal for you and your family. Grilled chicken, some greens and your mom’s famous mashed potatoes sounds good. Sadly, the only place nearby is a quick store stocked with instant noodles, chips, sugary drinks and processed food. 

Maybe you live in a rural community. The closest supermarket is 10 miles away and you don’t own a car. So you stock up on frozen TV dinners rather than fresh foods.

This is something many people in the U.S. face every day. 

An area with limited access to healthy foods is called a food desert. Living in a food desert can lower a person’s chance for living a long and healthy life.

The Big Five

There are five issues that make up the social determinants of health.  They are conditions in the places “where people are born, live, learn, work, play, worship, and age.” And they shape a wide range of health and quality-of-life outcomes. 

1. Health care access and quality considers health care, primary care and insurance coverage.
2. Education access and quality factors in years of schooling, languages spoken, reading literacy, plus early childhood development and education.
3. Social community and context covers sense of community, civic participation, discrimination, workplace conditions and incarceration.
4. Economic stability addresses poverty, employment, food security and housing.
5. Neighborhood and build environment focus on access to quality housing, transportation, healthy foods, clean air and water, plus neighborhood crime and violence.

The Impact on Health

When one or more of these five issues affect a person, it can lead to health disparities. 

Disparities may be based on:

• racial or ethnic group
• religion
• socioeconomic status
• gender
• age
• mental health
• cognitive, sensory, or physical disability
• sexual orientation or gender identity
• geographic location

Living in a food desert is just one social determinate of health. Neighborhoods with high crime rates can affect a person’s mental health or their ability to safely go outside for some exercise. 

What about people who live in rural parts of the state? If they live far from care providers, they may not be able to keep up with their health visits, screenings and immunizations.

Experts say that if we eliminate these health disparities, it will save the U.S. billions of dollars a year in direct health care costs — and over a trillion in indirect costs.

For example, data shows that reducing disparities just 10% in asthma treatment for Black workers would save more than $1,600 each year per patient in medical and missed work costs.

Closing the Gaps

Health equity means everyone has an equal shot at living their healthiest life, regardless of their background, education or where they live. When people are touched by health disparities, it creates gaps in health equity. 

The U.S. still has a long way to go to close these gaps. The effort calls for broad collaboration between health care and community partners.

As one of those partners, Blue Cross and Blue Shield of Montana is doing our part to close gaps in the communities we serve. 

• Our chief medical officers and their teams work with other medical and community experts to better understand the different health outcomes of affected groups.
• Our Business Resource Group is made up of BCBSMT employees with diverse backgrounds. Together, they provide valuable insights about cultural norms and issues that affect different social groups, including minorities, people who live with physical or mental conditions and the LGBTQ community.
• BCBSMT provides grants and resources to local charity and community groups to address affordable housing, domestic abuse, food insecurities and access to health care.
• Our Care Van® program offers access vaccines and health screenings in rural and underserved communities in Montana.
• Each year, BCBSMT distributes a total of $1 million to support community action and health care across the state.

You can learn more about all the ways BCBSMT helps local communities in our Corporate Social Responsibility report.

Have you faced challenges that have made it hard to take care of your health?

Sources:  About Social Determinants of Health,  Centers for Disease Control and Prevention, 2022; Health Equity,  CDC, 2022; Social Determinants of Health,  Health.gov; Access to Healthy Food: A Key Focus for Research on Domestic Food Insecurity,  U.S. National Library of Medicine; The Cost of Racial Disparities in Health Care,  Harvard Business Review, 2015; Estimating the Economic Burden of Racial Health Inequalities in the United States,  U.S. National Library of Medicine, 2011; Healthy People 2030,  Health.gov

Originally published 4/1/2022; Revised 2024