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Social Determinants Updates

June 26 through July 10, 2020

Welcome to Aligning for Health's Social Determinants Updates newsletter.

In this newsletter you will find updates on how the health care system is helping to meet health and social needs during the current public health emergency, notable links to research, data, and news related to health disparities and social determinants, and upcoming virtual events and opportunities.

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Member News

Health Payer Intelligence: (7/2) – Payers are finding new ways to meet the social needs during COVID-19, including Blue Cross Blue Shield Association, which has been working to meet the transportation, housing, and employment needs of their communities in Massachusetts, New Jersey, and Oklahoma, and CareSource’s JobConnect program.

CareSource: (7/1) – The CareSource Foundation has contributed $1 million to local economies during COVID-19 to help local communities survive the health and economic crisis and support small businesses in its local markets.

HIMSS: (6/29) – Alliance for Better Health CEO Dr. Jacob Reider argues that in order to promote health equity during COVID-19, the health system needs to go beyond education tactics and implement a listen and learn model of response.

Social Determinants Accelerator Act

Rep. Bustos: (6/30) – The Social Determinants Accelerator Act was included as a key next step in the House Select Committee on the Climate Crisis Report as a way to help Illinois mitigate risk, increase resilience, and address climate-related health disparities in America.  

SDoH in the News

NASEM: (7/9) – The National Academies held a workshop examining the drivers of racial disparities and what can be done to remedy them, highlighting the fact that Black Americans have been experiencing higher rates of infection and death from COVID-19 than white Americans. The full recording of the workshop can be found here.

AZ Central: (7/9) – The Home Matters Arizona Fund is a $100 million fund to solve Arizona’s growing housing affordability problem and address racial inequities in housing and is supported by major health care companies like United Healthcare, CVS Health, Mercy Care and other health care companies and insurers.

Health Affairs: (7/9) – Public health has been chronically underfunded in the United States, but COVID-19 has led many advocates to propose more funding and different approaches to catching public health problems “upstream” before they reach and negatively impact a population.

EHR Intelligence: (7/8) – The Regenstrief Institute has added new COVID-19 related codes to the Logical Observation Identifiers Names and Codes (LOINC) dataset, including terms for laboratory and clinical results, surveys related to social needs and food security.

Stat: (7/7) – The measures, incentives and risk models in our health care delivery system focus almost entirely on clinical care, despite the fact that social determinants drive over 70% of health factors. The health care system cannot return to “normal,” and instead health care reform has to go beyond clinical care.

Health Affairs: (7/6) – Contact tracing efforts need to account for the roots of the health inequities that are endemic to COVID-19 mortality and morbidity rates and be informed about or come from the communities they are tracing to lessen the growing divide in health inequities among racial and ethnic minorities.

Politico: (7/7) – According to the Household Pulse Survey from Northwestern University based on Census Bureau data, nearly 39% of black families and 37% of Hispanic families are struggling with food insecurity during COVID-19.

Civil Eats: (7/7) – During the coronavirus pandemic, black organizers around the country, like Tony Hillery of Harlem Grown, are working to bridge the food access gap by getting fresh, healthy food and groceries to their communities.

The Philadelphia Inquirer: (7/7) – The internet is a “super” determinant of health, as the coronavirus pandemic has exposed the digital divide within patient populations as access to telemedicine and broadband internet is unaffordable or inaccessible for many Americans.

Patient Engagement HIT: (7/6) – At Illinois Practice Alliance, an integrated behavioral health network, practicing managed care and addressing the social determinants of health requires a sustainable, three-pronged support system: screening, intervening and connecting patients with community health workers to address social needs.

NEJM Catalyst: (7/6) – Racism, cultural mistrust, miscommunication, chronic illness connected to limited food and living choices, and lived experience are striking parallels between communities of color like the Navajo Nation and those living in Chelsea, Massachusetts. Dr. Thomas Sequist discusses steps to help health care providers on the front lines tackle the root causes of suffering during COVID, including by addressing social needs.

Daily Free Press: (7/4) – Massachusetts Governor Charlie Baker announced a $20 million fund on Tuesday to support individuals and households experiencing difficulties paying for housing during the COVID-19 pandemic.

U.S. News: (7/2) – COVID-19 has underscored the urgent need for federal investment in public housing; this article highlights the challenges that individuals relying on the New York City Housing Authority face in accessing safe housing and how it affects their health outcomes.

Health Affairs: (7/2) – With states increasingly releasing data on COVID-19 infections and death that reveal profound racial disparities, this article highlights five ways to address racial inequities and lessen health disparities.

Health Affairs: (7/2) – Addressing health disparities requires focusing on racial justice, as many social determinants of health are entrenched in racial segregation and stratification across access to housing, environmental protection, transportation, and healthy sources of food.

ROI-NJ: (7/1) – Right before coronavirus started, Horizon Blue Cross Blue Shield of New Jersey launched Horizon Neighbors in Health, a $25 million program in which Horizon works with community partners to improve health care among the state’s most vulnerable populations. COVID-19 strengthened its determination to address the social needs.

KXNT: (7/1) – The city of Las Vegas is offering a new, temporary grant program to provide short-term assistance to city residents experiencing housing insecurity due to COVID-19 related loss of income.

MedCityNews: (6/30) – COVID-19 has exposed the challenges and threats that rural communities and minorities face when accessing care and addressing chronic conditions. This article calls for HHS, CMS and Congress to permanently remove restrictions that prevent the full utilization of currently available technology in rural areas to combat health disparities.

Health Leaders Media: (6/29) – A survey from the Pacific Business Group on Health found that nearly two-thirds of employers say they will focus more on social determinants of health due to recent social unrest.

Health Affairs: (6/29) – The COVID-19 pandemic creates an opportunity for  Medicaid Managed Care Plans to test flexibilities for how to use health resources to address social factors sustainably, while also becoming an integrated part of local recovery.

Patient Engagement HIT: (6/29) – According to Dr. Patrice Harris, health disparities that have emerged during the coronavirus pandemic can be boiled down to three root causes: structural racism affecting patient access to care, high occurrence of chronic disease, and economic inequalities leading marginalized populations to work high-risk jobs.

KPBS: (6/27) – While the coronavirus pandemic has revealed enduring racial inequity and COVID-19 fatalities in cities like Washington, D.C., black doctors argue that medicine alone cannot fix the health disparities without addressing the social determinants of health.

SHVS: (6/26) – This 50-State Databook displays the projected changes in federal and state Medicaid and CHIP expenditures during calendar years 2020 and 2021 for the COVID-19 pandemic and plausible policy responses of how enrollment and spending will change during the duration of the public health emergency.

SHVS: (6/23) – GMMB spoke with state health agencies and health insurance marketplaces that have actively identified opportunities to conduct outreach in communities that have been disproportionately impacted by COVID-19 to get a better understanding of the community-centered outreach they do.

Health Affairs: (July 2020) – In an interview with Sir Michael Marmot, Health Affairs Editor in Chief Alan Weil explores how a global health equity movement relies on research showing how social factors affect health.

NIEHS: (July 2020) – The National Academies held a workshop to collect information on how aging and disease processes affect the body at multiple levels, asking experts to explore the way that the body responds to different chemicals in the environment and how these exposures affect aging.

CHCS: (June 2020) – CHCS released a technical assistance tool on addressing health-related social needs among Medicaid beneficiaries, including how cross-sector partnerships may be able to do more by mapping out complementary activities.

New Research and Reports

American Journal of Preventive Medicine: (7/9) – A new article published in the American Journal of Preventive Medicine argues that while access to nature is an established social determinant of health with clear benefits to physical, mental and social health, it does not receive as much attention by health care providers or health systems as other social concerns, but should be used as a community health tool.

BMJ: (7/3) – Governments need to create a sustained commitment to reducing social, economic, and environmental inequalities in order to create a truly positive effect from COVID-19 responses.

Hypertension Journal: (7/2) – New data published in the American Heart Association’s Hypertension Journal revealed that black patients in Mississippi who experienced moderate discrimination through their lifetimes were more likely to develop hypertension than black patients who reported low levels of discrimination.

Patient Engagement HIT: (6/29) –According to a new report from the United Hospital Fund, a community health, grassroots approach is integral to creating a health through housing population health strategy, providing a framework for how community organizations and healthcare providers can partner to address housing security.

Health Affairs: (July 2020) – This month’s issue of Health Affairs contains articles examining the programs and initiatives outside of the health care system that affect people’s health, including food, income, and work.

Health Affairs: (July 2020) – This study examined the health effects of the New York City Paycheck Plus, finding that the intervention had a modest positive effect on employment, particularly among women, but earnings but no effect on health-related quality of life.

Health Affairs: (July 2020) – Health systems are investing in community workers who come from the communities they serve as part of their COVID-19 response to meet patient needs that extend beyond clinic walls.

Health Affairs: (July 2020) – This study suggests that the Health Hunger-Free Kids Act’s science-based nutritional standards should be maintained to support health growth, especially among children living in poverty.

ASPE: (2020) – ASPE released a report on social risk factors and Medicare’s value-based purchasing programs, which includes recommendations for HHS to develop a comprehensive approach to move towards programs that incentivize providers and plans to improve health outcomes by rewarding and supporting better outcomes for beneficiaries with social risk factors.

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