Revising Employee Benefits for the Sake of Health

An individual's health is affected not only by access to health care but also by a number of determinants such as income and education. Individuals with low incomes are not as healthy as those with higher incomes. Thus it seems important to explore possible avenues for improving the health of low income individuals with an eye toward ameliorating the complicated determinants of health status, aside from health insurance. Many countries in the Organization for Economic Cooperation and Development (OECD) are currently developing public policy to address this issue. In the U.S., however with its market based economy, the likelihood of adopting this public policy approach is small. Given that reality, is it possible to explore other avenues such as designing employee benefit packages with the aim of ameliorating the socio-economic determinants of health? Objective: The goal of this project is to explore the feasibility of designing employee benefits in a manner that may improve their health, by ascertaining the perspectives and preferences of low income employees regarding employee benefits designed to ameliorate the social determinants of health. Four hundred male and female low-income individuals recruited from clinical, community, and employment settings will participate in small group exercises in which a facilitated discussion will take place using a previously tested group decision tool (CHAT: Choosing Health plans All Together) that has been modified for this project. Data will be anonymously collected regarding socio-demographic characteristics, attitudes toward health, preferences for possible employee benefits and assessment of the exercise. Group discussions will be audio-taped. Data will be analyzed quantitatively to determine preferences of employee benefits and socio-demographic factors associated with these preferences. Discussions will undergo qualitative analysis go explore the underlying reasons for participant preferences. Participants will receive $75 dollars as compensation for their participation unless they participate during working hours. Risks and Benefits: Given the anonymous nature of the data collection we anticipate no risks other than those entailed in discussion of poor health outcomes associated with lack of insurance and low income. Participants may benefit from learning about factors that improves health status. Outcome and Meaning to the Field: Study results will yield information about what employee benefits would be of utmost priority to low income employees. This is unique information that may contribute to efforts to find affordable strategies for ameliorating the socio-economic determinants of health for the low-income working population in the US.