How Employee Surveys and Health Risk Assessments Address Social Needs

Employers are adapting their employee surveys to include questions pertaining to health equity and social determinants of health.

From reviewing restaurants to rating apps and everything in between, we’ve all grown accustomed to completing surveys and giving feedback. And for many workers today, these surveys include employer-driven health risk assessments to inquire about medical history, lifestyle habits and potential risks.

Employers aren’t trying to be intrusive or spy on their employees; confidential self-assessments reveal valuable insights to help them understand the most pressing health risks impacting their workforce. For employees, the results provide a starting point to address their needs, often before they become more serious problems.

Increasingly, employers are adapting their employee surveys and risk assessments to include questions pertaining to health equity and social determinants of health — income, community, transportation, literacy, housing, among others — so they can provide more equitable access to healthcare and social services.

Employees typically complete a health risk assessment digitally at the start of employment, and then on an annual basis. Employers provide the assessments in tandem with biometric screenings and offer incentives — typically cash payments, a reduction in insurance premiums or HSA contributions — upon completion of the assessment.

Employers receive the results in aggregate (or as a whole) to protect privacy and adhere to HIPAA. For example, if the assessment reveals a high number of diabetic employees, it may signal the need for a dedicated diabetes educator and support group.

According to a 2020 study by the Kaiser Family Foundation, 60% of large employers provide health risk assessments, while 52% offer employee incentives upon completion of the assessment.

“To screen for the social determinants of health, these surveys typically include questions related to access,” says Alisa Allicock, Nurse Practitioner and Regional Clinical Leader at Marathon Health. “Do you have access to transportation? Are you worried about running out of food before you can go to the grocery store? Do you have access to fresh produce and vegetables? Do you have electricity? Do you have running water? What about a place to live?”

Allicock adds these questions might seem basic, but stresses employers should not take them for granted. “There’s an assumption that if someone is employed, they automatically have a home to go back to. I can assure you we found that wasn’t always the case. We’ve had patients who were in fact homeless, or live in non-traditional housing where they didn’t have an oven or stove.”

Frank Alexander, Manager of Health & Welfare Benefits for ConocoPhillips, says the organization uses its annual employee engagement survey to gather feedback on topics relevant to the health and long-term success of the company, such as culture, company strategy, career development, leadership and well-being. He notes a recent survey received over 10,700 written comments.

“We read every single comment,” he says. “And we review the data for comments about benefits … and then use it to derive trends in our employees’ perspectives about their benefits. We’ve received a wide range of feedback about which benefits work well and which benefits employees have challenges taking advantage of.” 

In addition to their company-wide survey, Alexander says ConocoPhillips drills deeper and solicits feedback from various employee resource groups composed of traditionally underrepresented populations, such as their Black, Hispanic, and LGBTQ+ employees.

“During our most recent annual benefits review cycle, we solicited feedback and dialogue with each of these employee resource groups,” he says. “We did this to understand which benefits were working well and which benefits weren’t and where there may be potential gaps. We wanted to hear from our employees who may face challenges in accessing healthcare.”

Situations can change at a moment’s notice. Employee surveys provide an effective tool to gauge social needs in real-time. For example, many employer surveys found an increased need for mental services due to pandemic stress.

“We sent out a childcare survey because many of the childcare centers closed and a lot of employees with school-age children were having a hard time,” says Carolyn Smalls, Human Resources Director for Chatham County, Georgia. “We asked: Do they need a stipend, do they need money to help pay for childcare, do they need flexibility in their work schedule to take care of their children?”

To her surprise, Smalls says most employees asked for more flexibility in their work schedules, not additional money. Based on the survey results, Chatham County is currently working on plans to address remote work and give employees more flexibility in their work schedules.

At the end of the day, employers need to understand their workers come from diverse backgrounds and experience a wide range of environmental and social needs. Surveys give every employee a voice.

“Across the board, there’s a real opportunity to make a difference by addressing health disparity and socio-economic factors,” Allicock says. “Even moving the needle a little bit is going to make a big difference in an employee’s life.”

This article is the second in a four-part series on how employers can deliver an equitable healthcare experience for all employees. Explore the other articles to learn more about the value of health equity in employee healthcare, overcoming healthcare stigmas in the workplace and how to make employee healthcare more equitable and accessible for all.