Blue Cross Blue Shield Association Report Links Social Determinants to the Adverse Health Impact of Specific Diseases

Moody’s Analytics uses the Blue Cross Blue Shield Health IndexSM to identify select diseases that are not as impacted by social determinants

Chicago – A Moody’s Analytics report, prepared for the Blue Cross Blue Shield Association (BCBSA), was released today linking social determinants of health to differences in health across communities.

Moody’s Analytics utilized the Blue Cross Blue Shield Health IndexSM (BCBS Health Index) – a first-of-its-kind measurement of health for nearly every county in America. The BCBS Health Index identifies the health conditions with the greatest impact on the commercially insured and – paired with an analysis by Moody’s Analytics – how the level of health impact of these conditions is influenced by social determinants of health such as socioeconomic conditions, level of education, community health behaviors and local health system characteristics.

The report, “Understanding Health Conditions Across the U.S.,” shows that social determinants of health drive larger differences in the impacts for common chronic conditions such as hypertension, diabetes and coronary artery disease. In addition, the analysis shows these determinants drive smaller differences in the impact of other conditions such as cancer, substance use disorder and mental health, which are influenced more by individual factors such as family health history and personal lifestyle choices. The analysis also shows that relative to broader social determinants, differences in local health care system characteristics have a more modest association with the health impact of disease on a community’s commercially insured population.

“Blue Cross and Blue Shield companies are dedicated to addressing social determinants of health at the local level by identifying geographic areas of opportunity and targeting services to improve health in communities,” said Maureen Sullivan, chief strategy and innovation officer for BCBSA. “This analysis also shows the need for continued improvements in the economic opportunities and social influences that drive healthy behaviors within a community.”

“This analysis demonstrates the value of the BCBS Health Index for developing a deeper understanding of how and why community health varies across the country,” said Mark Zandi, chief economist of Moody's Analytics. “The results make clear that to understand how demographic, behavioral and structural factors impact health requires the kind of detailed look at individual conditions that the BCBS Health Index makes possible.”

The BCBS Health Index, powered by de-identified data from more than 40 million commercially insured members of Blue Cross and Blue Shield (BCBS) companies, finds that five conditions nationally are responsible for 30 percent of the adverse health of this population. Those conditions are: depression, anxiety and other mood disorders; hypertension; diabetes; high cholesterol; and substance use disorders.

As a comprehensive measurement of actual health care experiences, the BCBS Health Index was designed to support national and local discussions about how to improve American health policy and practice. It quantifies how more than 200 common diseases and condition categories affect overall health and wellness by assigning each county a health impact measure between 0 and 1, designating the proportion of optimal health reached by the county’s population.

This is the sixteenth study of the Blue Cross Blue Shield, The Health of America Report® series, a collaboration between the Blue Cross Blue Shield Association and Blue Health Intelligence, which uses a market-leading claims database to uncover key trends and insights into health care affordability and access to care.

About Blue Health Intelligence
Blue Health Intelligence (BHI)® is an independent Licensee of the Blue Cross Blue Shield Association.  BHI is a trade name of Health Intelligence Company, LLC.  Further information is available at

About Moody’s Analytics
Moody’s Analytics helps capital markets and risk management professionals worldwide respond to an evolving marketplace with confidence. The company offers unique tools and best practices for measuring and managing risk through expertise and experience in credit analysis, economic research and financial risk management. By providing leading-edge software, advisory services, and research, including the proprietary analysis of Moody’s Investors Service, Moody’s Analytics integrates and customizes its offerings to address specific business challenges. Moody's Analytics is a subsidiary of Moody's Corporation (NYSE: MCO), which reported revenue of $3.6 billion in 2016, employs approximately 11,700 people worldwide and maintains a presence in 41 countries. Further information is available at


The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies.