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Social Determinants Updates

July 10 to July 24, 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, as well as other notable links to research, data, and news related to social determinants, and upcoming virtual events and opportunities.

Do you have an event or opportunity coming up that you'd like to highlight?  Email info@aligningforhealth.org to be included in the next newsletter. 

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Member News

Westside Seattle: (7/23) – Community Health Plan of Washington has launched a partnership with Unite Us to connect members with local social service to address social and mental health needs.

Dayton Daily News: (7/23) – CareSource has donated $50,000 to the YWCA Dayton to support programming for women and children in its domestic violence shelter during COVID-19.

Unite Us: (7/22) – Unite Us published an article on data lessons learned from New York’s COVID-19 surge, highlighting the social care crisis, community entry points of care that are key to testing and contact tracing, and the increased need for housing and utilities assistance.

RAC Monitor: (7/15) – Centene is highlighted in this article for partnering with community-based organizations to provide access to food and other essential supplies across the country. Blue Cross Blue Shield Association is also noted for bringing care delivery to at-risk communities and sending out vans to do mobile coronavirus testing throughout Oklahoma.

Cumberland Times-News: (7/15) – UPMC Western Maryland committed $61 million in community assistance during fiscal year 2019, showing the health system’s longstanding commitment to meet the needs of the communities it serves.

Patient Engagement HIT: (7/16) – CDPHP and the Healthy Alliance IPA, which is part of the Alliance for Better Health have unveiled a food security program that would connect high-risk CDPHP Medicaid members with the Food Pantries for the Capital District and offer options for meal delivery or traditional food pantry pick-up. The press release notes that more than 80,000 people (10% of the population) are considered food insecure in Albany, Rensselaer, Saratoga and Schenectady counties.

DotMed: (7/8) – Dr. James Schuster, associate chief medical officer and senior vice president of medical and behavioral services for UPMC notes that improving community care through value-based healthcare delivery requires identifying social determinants of health among certain populations.

Social Determinants Accelerator Act

MobiHealthNews: (7/17) – In this article, health executives note that COVID-19 has made health disparities worse, but legislation like the Social Determinants Accelerator Act and technology tools can help make progress moving forward.

NAM: (7/13) – The Social Determinants Accelerator Act was cited in this National Academies of Medicine discussion paper on patient and family engaged care as an essential element of health equity.

House Appropriations Committee: (7/12) The House Appropriations Committee released a report that includes language incorporating parts of the Social Determinants Accelerator Act, providing $10M to CDC to award grants to states to develop Social Determinants Accelerator Plans. It would also instruct the Secretary of HHS to convene a council to oversee the grants and to draft and release a report on federal cross-agency opportunities to address social determinants.

Rep. Cheri Bustos: (7/13) – Representative Cheri Bustos (D-IL) issued a press release after helping pass the Labor-HHS-Education FY 2021 appropriations package our of the House Appropriations Committee. The package included language from the Social Determinants Accelerator Act. Watch Rep. Bustos’s comments on the Social Determinants Accelerator Act during the markup.

American Hospital Association: (July 2020) – The AHA included the Social Determinants Accelerator Act in a list of federal public policy and legislative solutions that would improve maternal health.

Endorse the Social Determinants Accelerator Act

Please consider filling out the form below to add your organization to the list of organizations in support of the Social Determinants Accelerator Act. Please sign as organizations only. Click here to see the list of organizations that have already endorsed SDAA: 

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SDoH in the News

Health Affairs: (7/23) – COVID-19 has given the United States the opportunity to make its healthcare system better, with the authors of this article laying out ten actions for better post-pandemic health care in the United States, including ensuring safe housing.

Patient Engagement HIT: (7/22) – Nurse practitioners are pivotal in health equity work; they can help discuss social needs with patients who otherwise wouldn’t disclose these needs to providers. However, without regulatory support to expand their scope of practice, it is difficult for nurse practitioners to fulfill their potential while treating patients.

Patient Engagement HIT: (7/22) – The Office for Civil Rights within HHS issued guidance reminding organizations in federal programs that they cannot limit care access on the basis of race, color or national origin to assure racial health equity.

Harvard Business Review: (7/21) – The lack of standardized approaches to health equity data and the failure of state and federal agencies to collect and report data sorted by demographic factors is a reminder of the urgent need to track and address inequities in health care.

Healthcare Finance: (7/20) – UnitedHealthcare donated $12.3 million to help community-based organizations across 21 states recover from the pandemic as part of its Empowering Health commitment that increases access to care in underserved areas as a means to address the social determinants of health.

Health Affairs: (7/20) – COVID-19 has exposed the impact of COVID-19 on communities of color; h this post presents a framework for understanding health disparities during the COVID-19 pandemic as well as short and long-term solutions to reduce these disparities.

The Blaze: (7/18) – Two U.S. cities, Minneapolis, MN and Burlington, VT, have declared racism a public health emergency, passing resolutions that named systemic racism as a principle social determinant of individual and public health.

Kera News: (7/17) – The Parkland Center for Clinical Innovation in Dallas, Texas developed the Vulnerability Index, to uncover racial disparities by highlighting zip codes in North Texas that are most at risk for COVID-19 infections.

Essex News Daily: (7/17) – RWJ Barnabas Health has received $2 million in a grant from the Walmart Foundation to pilot a universal social needs screening tool for patients in select locations across the system.

Med City News: (7/16) – The United States spends the least amount of money on social care and the most on medical care, compared to other developed countries, but has worse overall health outcomes. This article argues that we must intentionally and strategically reallocate some healthcare dollars to invest in communities.

Healio: (7/15) – The American Heart Association released a scientific statement detailing the many correlations between homelessness, low-quality housing and neighborhood environment with the prevalence of COVID and its risk factors.

Medium: (7/14) – Intermountain Healthcare is one of the companies that is taking steps forward with public-private partnerships before and during the COVID-19 pandemic, investing in affordable housing to address social needs and structural racism.

Drug Topics: (7/14) – As nonmedical issues require pharmacists’ attention in increasingly urgent ways, enhanced pharmacy services such as home delivery, curbside services, and expanded personal patient outreach create opportunities for pharmacist and pharmacy services to address social needs during the pandemic.

State of Reform: (7/14) – A survey found that a majority of Texans say lawmakers should prioritize social determinants of health as they expand access to healthcare.

Healio: (7/14) – The United States Preventative Services Task Force has developed a plan for creating primary care-based recommendations regarding social determinants of health in recognition of the impact social determinants have on well-being.

KSDK: (7/14) – Th St. Louis Area Foodbank has distributed 16.7 million meals since March 16 as part of their coronavirus relief efforts, bringing on 70 new food distribution sires since March.

DNYUZ: (7/10) – The Los Angeles County Health Department reported this week that Black residents were dying at twice the rate its white residents were, suggesting that residential segregation could be one of the primary drivers of racial health disparities.

Health Affairs: (7/10) – Moving forward, health services researchers, innovators and public health advocates should employ approaches to rigorous study design when thinking about how to transform care delivery to address the needs of complex populations and strengthen evidence around the most promising models of care.

NPR: (7/10) – Around the country, volunteers, firefighters and nurses are knocking on doors in minority neighborhoods to stop the spread of coronavirus and address the social determinants of health by distributing personal protective equipment, hand sanitizer and helping citizens connect to health care services.

NACHC: (June) --- The National Association of Community Health Centers released an infographic about the impact of COVID-19 on the Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences (PRAPARE) social determinants of health domains.


New Research and Reports

NEJM: (7/22) – Beyond revealing the need to integrate public health efforts with broader public policy, COVID-19 has demonstrated the need to implement policies that address structural racism and social determinants of health.

Nemours: (7/21) – Nemours Children’s Health System and the Duke Margolis Center for Health Policy released a joint issue brief providing recommendations to accelerate pediatric value-based payment and integrated care models to address social drivers and health equity. 

Health Affairs: (7/21) – Released in conjunction with an issue brief, Nemours Children’s Health System and the Duke Margolis Center for Health Policy wrote an article highlighting that the economic, racial and health disparities that existed at baseline in our health and social service systems for children have been intensified by COVID-19 as both systems are stretched to their capacity, necessitating integrated care models to address social drivers and health equity.

Alzheimer’s Disease and Dementia: (7/21) – A new study found that black women who frequently experienced daily racism had 2.7 times the risk of poor subjective cognitive functioning than women who experienced lower levels of daily racism. Those who experienced the greatest degrees of institutional racism in regard to work, housing, or police, were 2.66 times more likely to report poor cognitive functioning than women who experienced institutional racism less often.

AHA Journals: (7/16) – This study examined the individual and cumulative effects of the social determinants of health on incident stroke, finding that the risk of stroke increased with an increasing number of social determinants in fully adjusted models compared to those without any social determinants.

NEJM: (7/15) – Health disparities in nutrition and obesity correlate closely with the racial and ethnic disparities related to COVID-19, creating a need for public health policies and legislative initiatives that reduce food insecurity and food deserts in vulnerable communities to address the upstream determinants of health.

Health Affairs: (7/14) – Using data from the Medical Expenditure Panel Survey to explore potential explanations for racial and ethnic disparities in COVID, researchers found that among Hispanic adults at high risk, 64.5 percent lived in households with at least one worker who was unable to work from home, versus 56.5 percent among African Americans and only 46.6 among whites.

AJPH: (7/14) – This study reviewed the use of universal screening of social determinants of health at a large US academic medical center in 2018, finding that the screening helped identify a previously undetected population of rising risk patients who are socially but not yet medically complex.

Annals of Family Medicine: (7/14) – The authors of this study developed a single risk score derived from multiple social needs that predicts county-level cardiovascular disease mortality, which can identify counties with high COVID risk and has the potential to improve risk predictions and interventions for vulnerable populations at the county level.

Urban Milwaukee: (7/13) – Researchers at the Medical College of Wisconsin found that the financial hardship factors, such as difficulty paying bills, were more consistently associated with worsening blood sugar control over time than psychosocial and neighborhood factors. The research highlights the need for targeted health related interventions that address social concerns.

SIREN: (July 2020) – This study examined a comprehensive range of clinical, behavioral, social risk, and social determinants of health factors in order to develop decision models capable of identifying patients in need of various wraparound social services. The study found that decision models for each wraparound service demonstrated performance measures ranging between 59.2% and 99.3%.

NEJM: (July 2020) – This research article examines the history of Black Americans through marginalization and discrimination, structural racism, social risk factors and the convergence of these issues with COVID-19.


Legislative Roundup

S. 4248/ H.R. 7618: (7/21) – Senator Kamala Harris (D-CA) and Rep. Alma Adams (D-NC) introduced a bill that would establish a grant program to provide funds for health care entities to establish or improve bias and anti-racism training to help reduce racial and ethnic disparities in COVID-19 testing, treatment, health outcomes, and vaccine access.

H.R. 7510: (7/17) – A new legislative proposal, the Assimilating Health and Equity Assessments into Decision Making (AHEAD) Act (H.R. 7510), introduced by Rep. TJ Cox (D-CA) would call on HHS to study the use of health impact assessments and how lawmakers can integrate these and related assessments into federal policymaking

Ways And Means Democrats: (7/14) –The Ways and Means Democratic staff released a report highlighting health disparities in rural and urban underserved areas, highlighting the need to implement public financing to address social and structural determinants of health and the bleak picture that stakeholders described about the issues these areas face. Here is the summary and state and territory health equity maps.

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Aligning for Health

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Washington 20008 United States

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