The State of U.S. Healthcare Data & How BDOH & SDOH data Make an Impact
For decades, the U.S. healthcare system has leaned heavily on clinical and claims data to explain outcomes and design interventions. Yet evidence shows that clinical care explains only 20–30% of health results, while the rest is shaped by social, behavioral, and environmental factors. Despite this, most organizations lack access to non-clinical data that can truly predict risk.
This imbalance has fueled widespread investment in Social Determinants of Health (SDOH) data, which includes factors like income, housing stability, food access, and transportation that explain why two patients with similar clinical profiles may experience very different outcomes.
But SDOH is only a portion of the story, shedding light on the external factors and conditions that influence people’s lives and health. To understand individual differences within the same environment, healthcare organizations must also consider Behavioral Determinants of Health (BDOH)—the daily choices, actions, and engagement patterns that ultimately drive outcomes.
Together, SDOH and BDOH offer a whole-person perspective that can transform how the industry predicts risk, personalizes care, and addresses inequities.
What Exactly Are Behavioral Determinants of Health?
Behavioral Determinants of Health focus on individual-level actions and choices people make regarding their lifestyle that include their health—not just the conditions around a person. They answer questions such as:
- Does the patient refill prescriptions on time?
- Do they seek preventive screenings or delay care until emergencies?
- Are they purchasing health-related foods, supplements, or fitness services?
- Do they engage with digital health apps, wearables, or online health communities?
- Do they consume alcohol or tobacco regularly?
In short:
- SDOH tells us where and how someone lives.
- BDOH reveals how they choose to live within that context.
This distinction matters because two patients in the same zip code may have the same social risks but completely different outcomes depending on how they respond behaviorally.
BDOH in Action: Lessons from Multiple Myeloma Research
The potential of combining SDOH and BDOH is evident in a first of its kind study powered by HealthWise Data and conducted in partnership with GSK and IQVIA, recently published in Future Oncology.
Analyzing over 4,700 patients with multiple myeloma, researchers found:
- Food insecurity was associated with significantly shorter survival rates—even when adjusting for clinical and demographic variables.
- Non-clinical factors, both social (SDOH) and behavioral (BDOH), proved as predictive of survival as the treatment regimen itself.
This demonstrates the profound value of integrating non-clinical data alongside traditional clinical records. By illuminating the interplay between environment and behavior, healthcare organizations can better identify at-risk populations and design more equitable care pathways.
Inside the BDOH Data Landscape
At HealthWise Data, we categorize BDOH into several domains, each reflecting daily choices that affect health outcomes:
Health Engagement
- Fitness and wellness activities (exercise equipment purchases, gym memberships)
- Preventive screenings and wellness program participation
- Adherence to recommended care protocols
Lifestyle & Consumer Behaviors
- Nutritional patterns (health-focused food and supplement purchases)
- Insurance engagement and financial planning for medical costs
- Commitment to wellness products and services
Healthcare Utilization
- Preventive care versus ER usage
- Prescription refill behavior and follow-up compliance
- Provider communication and care coordination patterns
- Predictive interest in specific treatments like GLP-1 medication
Digital Health Engagement
- Wearable devices and mobile health app usage
- Participation in health forums and digital communities
- Adoption of telemedicine and virtual care services
These elements, available through our HealthWise 360 data offering, are validated, privacy-safe, and designed to integrate seamlessly with other systems and analytics platforms.
Why BDOH Matters for Different Stakeholders
Payers: Predictive Risk & Smarter Resource Allocation
Health plans can use BDOH data to refine actuarial models and identify risk earlier. Instead of waiting for costly events, they can anticipate which members are likely to miss medications, delay screenings, or disengage from care—and design personalized interventions that reduce costs.
Providers: More Precise and Equitable Care
For providers, BDOH transforms population health management. Knowing which patients are less likely to adhere to treatment, or which respond best to digital nudges, allows care teams to direct resources where they will have the most impact. This not only improves outcomes but also reduces strain on overextended clinical teams.
Life Sciences: Optimizing Trials and Real-World Evidence
Pharma and biotech companies can optimize clinical trial recruitment and retention using BDOH insights. Participants who demonstrate high digital engagement or preventive care behaviors may be more likely to complete studies. Post-market, BDOH data strengthens real-world evidence by clarifying how patient behaviors shape drug effectiveness.
Consultants & Actuarial Firms: Better Strategy Development
Advisory firms can incorporate behavioral insights into risk models, market analyses, and care design strategies. Instead of recommending one-size-fits-all solutions, they can advise clients on targeted, behaviorally informed approaches at both the geographic and individual level.
Marketers: Precision Targeting That Drives Action
Healthcare marketers can build audience segments not just by age, gender, or diagnosis, but by behavioral health engagement patterns. Campaigns can then be measured not by clicks, but by health outcomes—whether members enrolled in a wellness program or patients followed through on care.
Implementation Considerations
Adopting BDOH data requires thoughtful execution:
- Data quality – Behavioral indicators must be verified, validated, and updated regularly.
- Privacy and compliance – Tokenized IDs and HIPAA-compliant delivery are essential to safeguard sensitive data.
- Integration – BDOH data should flow easily into existing EHRs, claims databases, and analytics platforms.
- Organizational readiness – Teams need training to interpret behavioral signals and build them into workflows.
When these foundations are in place, organizations can act on behavioral insights with confidence.
The Road Ahead: BDOH as the Next Frontier
Healthcare is moving rapidly toward personalization. BDOH is at the center of this shift, enabling:
- Real-time behavioral monitoring through wearables and digital biomarkers.
- Predictive modeling that anticipates adherence challenges or health risks before they occur.
- Personalized interventions that align with an individual’s lifestyle and decision-making patterns.
- Cross-industry applications in wellness, nutrition, fitness, and chronic disease management.
The future of healthcare will not only measure what treatment patients receive, but also how they live, engage, and behave.
Conclusion: The Future Is Behaviorally Informed Healthcare
The bottom line is simple: to deliver equitable, cost-effective, and personalized care, the industry must move beyond clinical and simple demographic data.
- SDOH explains the environment.
- BDOH explains the individual.
- Together, they unlock predictive power clinical data alone cannot match.
At HealthWise Data, we’re proud to pioneer this movement with a robust dataset that truly delivers a 360-degree view of patients, ultimately supporting our vision of empowering healthcare organizations to see the person behind the patient. Or as we like to say, it’s data with a heartbeat.
Interested in learning how BDOH can reshape your strategies? Contact HealthWise Data today.
Frequently Asked Questions About BDOH
- What is the difference between BDOH and SDOH?
SDOH focuses on the broader societal and environmental context—income, housing stability, transportation, food access. BDOH focuses on the individual behaviors and daily choices shaped by those conditions—exercise, diet, adherence to medications, insurance and financial planning, use of certain products and services. Together, they explain outcomes more powerfully than either alone. - How is BDOH data collected?
BDOH data is compiled from verified consumer behaviors, lifestyle patterns, health engagement activities, and digital interactions. HealthWise Data validates and refreshes this data regularly to ensure accuracy, while also applying tokenization and privacy-safe processes to protect patient confidentiality. - Why is BDOH important for healthcare organizations today?
Traditional clinical and claims data only provide a partial picture of health. BDOH data allows payers, providers, and life sciences companies to anticipate risks, personalize interventions, and measure outcomes at the individual level. This leads to earlier interventions, reduced costs, and better patient engagement. - Is BDOH data HIPAA-compliant?
Yes. HealthWise Data delivers BDOH insights using persistent tokenized IDs that de-identify individuals while still enabling longitudinal analysis. All data integrations meet HIPAA and evolving state and federal privacy standards, especially since this data is predictive consumer information built for analytics and targeting purposes. - What are examples of BDOH indicators?
Examples include: participation in wellness programs, preventive screenings, prescription refill behavior, supplement and fitness-related purchases, wearable device usage, preferred media channels, and engagement with digital health communities. These indicators reveal how people live and manage their health, beyond their clinical record. - Can BDOH really predict outcomes as well as clinical factors?
Yes. In fact, the recent multiple myeloma study conducted with GSK and IQVIA showed that social and behavioral determinants together were as predictive of survival as the treatment regimen itself. That level of predictive power underscores why BDOH is gaining such momentum across healthcare.
