Highlights

• RISE and Aligning for Health held the inaugural SDOH Policy Forum Nov. 28 – 30!
• CDC report analyzes percentage of adults who lived in food insecure families in 2021
• HHS officials publish blog post on improving health and well-being through community care hubs
• AHRQ blog outlines the National Healthcare Quality and Disparities Report findings
• USDA proposes science-driven updates to foods provided through WIC in proposed rule
• HHS ASPE publishes maternal health vignettes on enhancing data infrastructure to improve outcomes
• CMS report outlines rural-urban disparities in health care in Medicare

Member News

Aligning for Health is pleased to announce our newest member, Socially Determined! Socially Determined’s mission is to deliver an unparalleled Social Risk Intelligence™ platform and scalable solutions to unlock improved business performance, clinical outcomes, and health equity.

Times Union: Local organizations take to the ground to connect communities with aid (11/20) - Care deserts, areas with limited access to health and social care resources, exist throughout the Capital Region of New York. Community resource organizations are working to connect such communities, particularly those in hard-to-reach regions, with much needed help and on-the-ground outreach. Healthy Alliance is focused on supporting groups who are in their community addressing the social care needs of individuals who need support.

Health Payer Intelligence: CareSource Addresses LGBTQA+ Housing SDOH Barriers (11/17) – CareSource announced it will provide $1 million in funds to United Church Homes, a large nonprofit senior living organization in Ohio, to create a residential community specifically designed for LGBTQA+ individuals and allies in an effort to reduce social determinants of health barriers and discrimination.

PR Newswire: Cureatr and Unite Us Collaborate to Launch Program to Advance Health Equity for Patients (11/17) – Cureatr, Inc. and Unite Us have partnered to launch a new program that will advance health equity and support patients experiencing transitions of care. The partnership has empowered Cureatr to more holistically care for patients and evolve the role of Cureatr's certified community health workers (CHWs). The new health equity program allows CHWs to screen patients for SDOH insecurities related to food, transportation, housing, and health literacy and connect them to community resources in their area.

Health Payer Intelligence: 2022 RI Life Index Finds SDOH Barriers in RI (11/16) – Blue Cross Blue Shield of Rhode Island, a health plan of the Blue Cross Blue Shield Association, released its 2022 RI Life Index for the fourth year in a row in order to assess social determinants of health barriers and the impact on residents’ perceived health and wellbeing. The RI Life Index score overall was a 59 out of 100, and the highest-ranked categories were perceptions of community for children (72), racial equity (73), and food security (80).

Signify Health: National Rural Health Day – How One Signify NP is Bridging Health Equity Gaps in West Virginia (11/16) – Rural communities often struggle with many of the same health care challenges as those who live in suburban and urban communities, yet geography and other factors can pose challenges in accessing care and social services in these areas. This blog by a Signify Health nurse practitioner outlines the benefits of being in a patient’s home for in-home health evaluations for observing the clinical, social, financial and environmental factors that impact a person’s health and to connect members directly to community and clinical resources to meet their needs.

Legislative Updates

Build Housing with Care Act (12/1) - Rep. Bonamici (D-OR) and 12 cosponsors introduced the Build Housing with Care Act (H.R. 9375), which would establish a grant program to address the crises in accessing affordable housing and child care through the co-location of housing and child care. Fact Sheet

AHEAD Act (12/1) – Sens. Cardin (D-MD), Booker (D-NJ), Bennet (D-CO), and Brown (D-OH) introduced the Assessing Health Evaluations to Advance Decision-making (AHEAD) Act (S. 5162), which would require HHS to provide for a study by the National Academies of Sciences, Engineering, and Medicine on the potential benefits on population health outcomes of incorporating into the Federal legislative process tools that measure the impacts of proposed legislation (including in areas outside of health care) on health and health disparities. Rep. Trone (D-MD) introduced companion legislation in the House (H.R. 9400).

Mental and Physical Health Care Comorbidities Act: (11/17) - Sen. Bennet (D-CO) introduced the Mental and Physical Health Care Comorbidities Act (S. 8), which would establish a demonstration program to promote collaborative treatment of mental and physical health comorbidities under the Medicare program. The bill would work through the CMS Innovation Center to help hospitals and health systems improve care and outcomes for people who face mental and physical health challenges from low-income backgrounds and those dually eligible for Medicare and Medicaid, and would address social determinants of health by encouraging innovation of best practices and effective models that promote holistic care and treatment.

Helping HANDS for Families Act: (11/17) - Sens. Rubio (R-FL) and Casey (D-PA) introduced the Helping Households and Neighbors Distribute Services (HANDS) for Families Act (S. 5115), which would allow community supports to meet specific welfare needs of families and children through an electronic care portal under the MaryLee Allen Promoting Safe and Stable Families program that would connect child welfare cases with civil institutions ready and willing to help.

Lifting American Children from Poverty Act (11/16) - Reps. Velazquez (D-NY), Evans (D-PA), Chu (D-CA), Jackson Lee (D-TX), Garcia (D-IL), and Watson Coleman (D-NJ) introduced the Lifting American Children from Poverty Act (H.R. 9323), which would establish an interagency task force on child and family economic security and stability for economic growth.

House Committee on Rules (11/14) – The House Committee on Rules marked up and held a committee vote on a draft report on the Ending Hunger in America initiative, which included testimony and documents to offers solutions to hunger and ways to improve the nation’s health. The Committee voted to release the report to the full House for consideration.

To view a full list of the legislation we are tracking around social determinants of health, health equity/disparities, and maternal health, click here.

Administration Updates

CDC: QuickStats Report on Percentage of Adults Living in Families that were Food-Insecure (12/2) – The CDC released a report on the percentage of adults living in food insecure families in the past 30 days by family income and rural/urban status. The report revealed that in 2021, 5.9 percent of adults aged 18 or older lived in families that were food insecure in the past 30 days.

Health Affairs: Improving Health and Well-Being Through Community Care Hubs (11/29) – As part of its strategic approach to addressing social determinants of health, HHS envisions a future in which all individuals, regardless of their social circumstances, have access to aligned health and social care systems that achieve equitable outcomes through high-quality, affordable, person-centered care. In this article, officials from across HHS departments discuss the role and functions of hubs, provide examples of these organizations, and explore policy opportunities to maximize their roles.

HHS: HHS OCR Works with AZ State Court to Ensure Meaningful Access for People with Limited English Proficiency (11/22) - HHS Office of Civil Rights (OCR) announced a county in Arizona has taken a number of action steps to ensure that individuals with limited English proficiency are provided meaningful access to justice in its court proceedings and operations, programs and activities.

AHRQ: The 2022 National Healthcare Quality and Disparities Report: We Still Have Work to Do (11/22) – The Agency for Healthcare Research and Quality (AHRQ) posted a blog on the 2022 National Healthcare Quality and Disparities Report, which highlights areas in which the health care system has made advances in improving quality of health care and addressing disparities, and where shortcomings remain.

USDA: USDA Proposes Science-Driven Updates to Foods Provided Through WIC (11/17) – The US Department of Agriculture (USDA) issued a proposed rule, outlining proposed changes to the foods prescribed to participants in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC). The proposed changes will align the food packages with the latest nutrition science and support equitable access to nutritious foods during critical life stages.

SAMHSA: Special Conditions for Awards for Behavioral Health Disparity Impact Statement (11/16) – The Substance Abuse and Mental Health Services Administration (SAMHSA) launched the new disparity impact statement (DIS) for discretionary grantees. The new DIS aids both the grantee and the agency in gaining a greater understanding of how SAMHSA funding is being used to reduce behavioral health disparities across the nation.

HHS ASPE: Domestic Violence Housing First Demonstration Evaluation (11/16) - The HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE) released a report finding that unstably housed domestic violence survivors who received Domestic Violence Housing First (DVHF) model services – including housing-related advocacy and/or flexible financial assistance – reported a number of positive changes within 24-months after seeking services.

HHS ASPE: Enhancing Data Infrastructure to Improve Women’s Health Outcomes: Maternal Health Vignettes (11/16) – HHS ASPE released the 2022 Maternal Health Vignette, detailing how the Office of the Secretary’s Patient Centered Outcomes Research Trust Fund (OS-PCORTF) cross-agency projects are working to improve maternal health by enhancing women’s health data for research, adding electronic health records to the suite of maternal health data for research, and linking maternal survey data with other health data.

CDC: Death Rates for Leading Causes of Death Among the Three Largest Race and Ethnicity Groups (11/15) – The CDC released a data brief on death rates for leading causes of death by race and ethnicity, which found that death rates for non-Hispanic White, non-Hispanic Black, and Hispanic people increased from 2013 through 2020.

CMS: Rural-Urban Disparities in Health Care in Medicare (11/15) - CMS released a report on rural-urban disparities in health care among Medicare beneficiaries, which identified noteworthy variation in patterns of rural-urban differences by race and ethnicity. CMS also released the Advancing Rural Health Equity Year in Review, which details CMS efforts to serve people in rural, tribal, and geographically isolated communities in FY 2022.

SDoH & Health Equity in the News

NEJM Perspective: The White House Conference on Hunger, Nutrition, and Health – A New National Strategy (12/1) – This NEJM Perspective piece outlines key takeaways and goals of the recent White House Conference on Hunger, Nutrition, and Health and corresponding National Strategy. The author writes that although the new strategy is expansive, it remains to be seen how quickly and broadly its components will be adopted and how it might address the major underlying drivers of food insecurities and health disparities. The author presents several additional meaningful actions that could be considered, such as other actions to advance nutrition security through SNAP.

Health Payer Intelligence: NCQA Confers Health Equity Accreditation on Elevance Health Medicaid Plans (11/29) - Elevance Health announced that 21 Medicaid plans have achieved health equity accreditation from NCQA. The membership of the 21 health plans that received the NCQA health equity accreditation equaled more than nine in ten Medicaid beneficiaries who were enrolled in Elevance Health plans (93 percent).

National Association of Community Health Centers: A Health Center that Prescribes Food as Medicine (11/23) - Community Health Centers are all too aware that food insecurity is a social driver of health, and many are finding innovative ways to address it beyond the walls of the exam room. As an example, HOPE Clinic in Houston, TX runs an initiative called Bite of HOPE, which integrates culinary into clinical care and is designed to reverse chronic disorders and reframe the way communities connect to food by making a healthy diet accessible to everyone.

The Commonwealth Fund: Health Care’s Increasing Focus on the Drivers of Health (11/18) – Federal policymakers are beginning to look to measure and screen for what are known as the drivers of health. On this episode of The Dose, Shanoor Seervai talks with Alice Chen, M.D., chief medical officer at Covered California, the state’s health insurance marketplace, about gathering momentum in the health sector to acknowledge and address nonmedical risk factors for health.

 Spotlight on Maternal Health

American Journal of Preventive Medicine: Social Support and Breastfeeding Outcomes Among a Racially and Ethnically Diverse Population (11/29) - Social support is a modifiable social determinant of health that shapes breastfeeding outcomes and may contribute to racial and ethnic breastfeeding disparities. This study characterizes the relationship between social support and early breastfeeding. In this sample of racially and ethnically diverse mothers, social support was associated with longer planned breastfeeding duration but not with early breastfeeding or breastfeeding confidence.

PR Newswire: Kettering Health Partners with Nest Collaborative to Provide Virtual Breastfeeding Support for New Parents (11/29) – Nest Collaborative and Kettering Health have partnered to provide telehealth breastfeeding support to families giving birth at the health system's maternity centers in Ohio. Nest Collaborative's International Board Certified Lactation Consultants (IBCLCs) will augment Kettering Health's own lactation program by providing virtual prenatal and postpartum support for new parents seven days a week.

Detroit News: Michigan Medicaid to reimburse for doula services starting in 2023 (11/27) – Beginning in 2023, Michigan Medicaid will begin reimbursing for doula services and create a division to support doula workers. Leaders hope this will positively affect social determinants of health, and decrease health and racial disparities in the state.

 Data & Innovation

National Quality Forum: NQF Seeks Comments on 52 Quality Measures Being Considered for 17 Federal Healthcare Programs (12/1) – The National Quality Forum (NQF) announced it is accepting comments on 52 health care quality measures under consideration for use in federal health care programs. The review is part of the Measure Applications Partnership (MAP). Several measures under consideration address social drivers of health and health equity, including: Screen positive rate for social drivers of health; Screening for social drivers of health; Facility commitment to health equity; Hospital Disparity Index; and Resolution of at least one health-related social need.

HL7: HL7 Gravity Project – An Ongoing Evolution (11/28) – The Gravity Project, an HL7 FHIR Accelerator, is evolving the way it advances social care integration as a strategy to promote health equity and maintain continuity with the mission and consensus-based processes at the core of the project. This blog outlines what’s on the horizon this year and next for the Gravity Project, as well as recent Gravity Project accomplishments, including recent examples of Gravity standards integration.

Healthcare Exec Intelligence: Addressing Data Sharing Barriers for Care Coordination from Jail to Community (11/21) - Jails can provide opportunities to diagnose and treat individuals for HIV. However, supporting care coordination for formerly incarcerated individuals upon reentry into the community can be difficult due to data sharing challenges. Following CDC guidelines for HIV care post-release is challenging for jail providers because they cannot always predict when someone will be released, especially if the individual is pretrial. Further, patient health data is siloed between carceral record systems and EHRs, so sharing patient records presents interoperability challenges.

 New Research and Reports

Becker’s Hospital Review: Insurers spend less than 1% of net income on SDOH efforts, study finds (11/30) – A new study in the Journal of General Internal Medicine found that the top 20 private health insurers spent $1.87 billion on SDOH between 2017 and 2021, which equates to 0.11 percent on SDOH in 2017, 1.6 percent in 2020 and 0.67 percent in 2021 as a percent of their net income. General SDOH funding accounted for $247 million in spending, with the most funds going to housing ($1.2 billion) and food security ($238 million).

JAMA Network Open: Association Between Housing Affordability and Severe Maternal Mortality (11/22) – This study looked at whether area-level rental housing costs are associated with severe maternal morbidity (SMM) and whether the availability of publicly supported affordable housing attenuates the associations. The study found that higher municipal rental housing costs were significantly associated with greater odds of SMM, and the availability of publicly supported affordable housing appeared to attenuate the associations.

Newswise: Homelessness, hospitals and mental health: Study shows impacts and costs (11/17) – A new study by the University of Michigan Institute for Healthcare Policy and Innovation looked at housing instability and homelessness Z codes to understand the most common reasons for hospitalization among patients with coded housing instability. The study found vast differences in diagnoses between patients with and without housing issues who are admitted to hospitals, including a sharp divide in care for mental, behavioral, and neurodevelopmental conditions.

Health Affairs: Grocery Purchase Changes Were Associated With a North Carolina COVID-19 Food Assistance Incentive Program (November 2022) - Many low-income Americans experience food insecurity, which may have been exacerbated by economic instability during the early stages of the COVID-19 pandemic in 2020. This study assessed the impact of Healthy Helping, a short-term fruit and vegetable incentive program aimed at alleviating food insecurity and improving diet quality for SNAP participants, on grocery purchases, using transaction data from a large supermarket chain in North Carolina.

Health Affairs: Easing Cash Assistance Rules During COVID-19 Was Associated with Reduced Days of Poor Physical and Mental Health (November 2022) - Temporary Assistance for Needy Families (TANF) is the primary cash assistance program for low-income families in the US, with benefits conditional on work activities and subject to suspension. However, many states loosened requirements during the pandemic. Using TANF policy data and data from the Behavioral Risk Factor Surveillance System from the period January 2017–December 2020 with a triple-difference design, this study found a general protective effect of supportive changes to TANF on poor physical and mental health days and binge drinking during the COVID-19 pandemic for likely TANF participants.

Upcoming Events

December

• December 6 – Center for Health Care Strategies, “Population-Based Payments in Medicaid: Strengthening Provider Incentives to Transform Care.” Virtual.

• December 6 – AARP International Team, “LGBTQ+/SGL – Affirming Housing for Older People.” Virtual.

• December 6-8 – Unidos US, “Latinx Health Equity Summit 2022.” Phoenix, AZ.

• December 7 – Blue Shield of California, “Addressing Social Drivers of Health Through Payment Innovation and Collaboration.” Virtual.

• December 7 – Systems for Action, “Addressing the Health and Social Needs of Justice-Involved Young Adults.” Virtual.

• December 8 – American Medical Association, “Communicating Social Determinants of Health: A Role for Coding.” Virtual.

• December 8 – Big Cities Health Coalition, “The Future of Health Series: An Introduction to the Urban Health Agenda and Discussion on Interagency Collaboration with Anneta Arno, DC Health.” Virtual.

• December 8 – Health Affairs, “EITC, TANF, and More: The Health and Policy Implications of Building Income Supports for Low-Income Families with Young Children.” Virtual.

• December 9 – Alliance for Health Policy, “Examining the Social Determinants of Health: Measures, Evidence and Policy Solutions.” Virtual.

• December 13 – National Academies of Science, Engineering, and Medicine, “The Role of Business in Improving Health and Health Equity: A Workshop.” Washington, DC.

• December 15 – Trust for America’s Health, “Age Friendly Public Health System Training.” Virtual.

• December 28 – White House, “White House Conference on Hunger, Nutrition, and Health Monthly Update.” Virtual.

2023

• January 11, 2023 – Systems for Action, “Can Subsidized Transportation Options Slow Diabetes Progression?” Virtual.

• January 12, 2023 – Big Cities Health Coalition, “The Future of Health Series: An Overview of the Urban Health Agenda and Discussion on Collaborating with Community-Based Organizations with Charlene McGee of Multnomah County.” Virtual.

• February 7, 2023 - Big Cities Health Coalition, “The Future of Health Series: An Overview of the Urban Health Agenda and Discussion on Social Determinants of Health.” Virtual.

• March 29 – 30, 2023 – HRSA, “2023 PCMH Health Equity Technical Assistance Symposium.” Virtual.

• April 2-4, 2023 – RISE, “The Rise Summit on Social Determinants of Health.” Chicago, IL.

SDoH Opportunities

December

• Deadline: December 2 – Healthy People 2030, Request for Comments: Proposed New Objective on Social Determinants of Health

• Deadline: December 4 – AHRQ, Request for Comments: Draft Comparative Effectiveness Review – Social and Structural Determinants of Health Risk Factors for Maternal Morbidity and Mortality: An Evidence Map

• Deadline: December 5 – HHS, Funding Opportunity: Maternal Health Research Centers of Excellence Data Innovation and Coordinating Hub/Resource Center

• Deadline: December 5 – HHS, Funding Opportunity: Maternal Health Research Centers of Excellence Implementation Science Hub/Resource Center

• Deadline: December 5 – HHS, Funding Opportunity: Maternal Health Research Centers of Excellence

• Deadline: December 5 – HRSA, Grant Opportunity: Fiscal Year 2023 Quality Improvement Fund – Maternal Health

• Deadline: December 5 – HRSA, Request for Comments on Two Draft Recommendations to Update the HRSA-Supported Women’s Preventive Services Guidelines Relating to Screening for Diabetes in Pregnancy and Screening for Type 2 Diabetes After Pregnancy

• Deadline: December 7 – Center for Health Care Strategies, Request for Applications: Equity Changemakers Institute

• Deadline: December 7 – National Quality Forum, Request for Comments: 52 Quality Measures for Consideration in 17 Federal Healthcare Programs

• Deadline: December 8 – AHRQ, Request for Supplemental Evidence and Data Submissions on Respectful Maternity Care: Dissemination and Implementation of Perinatal Safety Culture to Improve Equitable Maternal Healthcare Delivery and Outcomes

• Deadline: December 20 – CMS, Notice of Funding Opportunity: Connecting Kids to Coverage HEALTHY KIDS American Indian/Alaska Native 2023 Outreach and Enrollment Cooperative Agreements

• Deadline: December 27 – NIH, Notice of Funding Opportunity: Community Partnerships to Advance Science for Society (ComPASS): Coordination Center

• Deadline: December 30 – Department of Veterans Affairs, Notice of Funding Opportunity: Funding Opportunity Under Legal Services for Homeless Veterans and Veterans At-Risk for Homelessness Grant Program

• Deadline: December 31 – AHRQ, Supplemental Solicitation for Nominations of Members from Populations Underrepresented in Medicine (URIM) to Serve on Scientific Peer Review Committee

2023

• Deadline: January 6, 2023 – HRSA, Grant Opportunity: Rural Health Network Development Planning Program
• Deadline: January 17, 2023 – NIH, Funding Opportunity: John Lewis NIMHD Research Endowment Program
• Deadline: January 23, 2023 – National Institutes of Health, Research Opportunity Announcement: Community Partnerships to Advance Science for Society (ComPASS) Program: Community-Led, Health Equity Structural Intervention Initiative
• Deadline: January 23, 2023 – HRSA, Request for Nominations: Advisory Committee on Infant and Maternal Mortality
• Deadline: February 1, 2023– CDC, Notice of Funding Opportunity: Advancing Policy as a Public Health Intervention to Reduce Morbidity, Mortality and Disparities in HIV, Viral Hepatitis, STDs, and Tuberculosis
• Deadline: February 6, 2023 – National Institutes of Health, Notice of Special Interest: Implementation Science to Advance Maternal Health and Maternal Health Equity for the IMPROVE Initiative
• Deadline: February 21, 2023 – USDA, Request for Comments: Revisions in the WIC Food Packages proposed rule
• Deadline: June 1, 2023 – HHS Administration for Community Living, Grants Notice: No Wrong Door Community Infrastructure Grants – Scaling Community Care Hubs through Lead Entities

Rolling Basis

• Deadline: Open - Aligning for Health, Endorse the Social Determinants Accelerator Act

• Deadline: Open - Aligning for Health, Endorse the LINC to Address Social Needs Act

• Deadline: Open - Trust For America’s Health, Endorse the Protecting the Health of America’s Older Adults Act

• Deadline: Open - U.S. Breastfeeding Committee, Sign-On Opportunity: Urge Senate Passage of the PUMP for Nursing Mothers Act

• Deadline: Open – U.S. Breastfeeding Committee, Sign-On Letter: Ask Congress to Support FY2023 Funding for CDC Breastfeeding Programs

• Deadline: Open - House Committee on Rules, Request for Stories: Experiences, Research, and Solutions to Guide Committee Work in Addressing Hunger

• Deadline: Open - Robert Wood Johnson Foundation, Open Call for Proposals - Evidence for Action: Innovative Research to Advance Racial Equity

• Deadline: Open - Sepsis Alliance, Pledge for Equity, Diversity, and Inclusion In the Fight Against Antimicrobial Resistance, Sepsis and its Underlying Causes

• Deadline: Open - Arnold Ventures Advancing Medicare & Medicaid Integration initiative, Funding Opportunity: Technical Assistance to Advance Medicare and Medicaid Integration for Dual-Eligible Individuals.

• Deadline: Open - Robert Wood Johnson Foundation, Evidence for Action: Investigator-Initiated Research to Build a Culture of Health.

• Deadline: Open - TFAH, Endorsement of the Improving Social Determinants of Health Act.

• Deadline: Open - American Hospital Association, Hospital Community Collaborative National Cohort Application.

• Deadline: Open - The de Beaumont Foundation and Johns Hopkins University, Stories of Alignment: Share a reflection related to the “Seven Ways Business Can Align with Public Health for Bold Action and Innovation” report