Blue Cross Blue Shield Association: (4/27) - Without the right data, it’s hard to quantify the extent of health disparities impacting the health and well-being of communities across race and ethnicity, sexual orientation, gender identity and socioeconomic status. As part of its National Health Equity Strategy, Blue Cross and Blue Shield Association companies have a clear plan for getting the data needed to accelerate meaningful change. This blog outlines highlights from its thought leadership paper, The Ethical and Transparent Use of Data to Reduce Health Disparities, calling for more robust data, common industry standards for collecting data, and ethical and transparent use of data.
Business Wire: (4/27) - findhelp announced a new research collaboration with Nashville’s Meharry Medical College’s Center for the Study of Social Determinants of Health, as part of a consortium of top research centers to transform chronic health disparities that disproportionately overburden ethnic and racial minority communities. The research collaboration hopes to set the standard for assessing the impact of addressing social needs on smoking cessation and pave the way for policymakers to include SDOH resources to support people seeking smoking addiction support in their communities.
3M: (4/25) - 3M Health Information Systems published a study finding that Medicare beneficiaries in low socioeconomic status (SES) areas have fewer physicians and care management visits and are less likely to be admitted from the emergency department for low severity medical care or admitted to a skilled nursing or rehabilitation facility following hospital discharge. The report also found that beneficiaries in low SES areas have more per capita inpatient complications, admissions and emergency department visits, and readmission and post-discharge returns to the emergency department, as well as higher surgical mortality rates.
Dayton 247 Now: (4/24) - CareSource recently asked the Governor of Ohio to expand the Healthy Beginnings at Home research program, which has found access to affordable housing decreases infant mortality outcomes. The study resulting from this pilot research program, which surveyed 100 pregnant CareSource patients experiencing housing instability or homelessness in the past, proves the affordable housing crisis has far-reaching effects on health disparities.
American Hospital Association: (4/19) - The need to improve maternal and child health equity in the United States while reducing access disparities has become a national focus, however gaps in maternal health persist. This blog by the American Hospital Association outlines key ways hospitals and health systems are stepping up with innovative efforts to address maternal health innovation, including examples from Northwell Health, Banner Health, and the University of Nebraska Medical Center.
American Hospital Association: (4/19) - The American Hospital Association (AHA) launched the Health Equity Roadmap on March 29, an innovative framework from its Institute for Diversity and Health Equity to support hospitals and health systems in their efforts to become more equitable organizations. This blog highlights a conversation with Leon D. Caldwell, AHA’s senior director for health equity strategies and innovation and one of the Roadmap’s architects, about its importance to hospitals and health systems.
Pittsburgh’s Action News 4: (4/14) - Data shows Black mothers are more likely to die while giving birth compared to white mothers. UPMC is trying to spread awareness and stop the maternal health crisis by providing facts and support during its Black Maternal Health Week, which took place April 11-17. UPMC formed a health equity committee to focus on decreasing maternal mortality in vulnerable populations, specifically pregnant people of color, and has taken part in activities like walks where doulas and midwives visit patients.
Upwardly Global: (4/14) - Upwardly Global has partnered with Unite Us to provide equitable access to resources, and focus on offering immigrants and their families employment opportunities through a secure, coordinated care network. The partnership will expand Upwardly Global’s reach through a referral program that connects its clients’ community resources, with referral categories including employment, housing, health and wellness, and mental health.
WIC Healthy Beginnings Act: (4/27) - Reps. McBath (D-GA), McClain (R-MI), Levin (D-MI), and Miller-Meeks (R-IA) introduced the WIC Healthy Beginnings Act of 2022 (H.R. 7603), which would require the Secretary of Agriculture to establish a publicly available database of big solicitations for infant formula under the special supplemental nutrition program for women, infants, and children (WIC). The bill would improve the WIC public-private partnership to ensure transparency and access to high-quality, safe products.
Mamas First Act: (4/27) - Sen. Warren (D-MA) and six cosponsors introduced the Mamas First Act (S. 4100), which would provide coverage under the Medicaid program for services provided by doulas and midwives. The bill would significantly expand access to doulas and midwife services, increase the focus on culturally competent and patient-centered care, and improve health outcomes for mothers and babies in underserved and under-resourced communities.
Health Equity and Accountability Act: (4/26) - Rep. Kelly (D-IL) and the Congressional Black Caucus Health Braintrust introduced the Health Equity and Accountability Act of 2022 (H.R. 7585), which would address social determinants of health, reduce racial and ethnic health inequities, improve access for underserved communities, address maternal health, and more. The package also included provisions included in the Social Determinants Accelerator Act to establish an interagency council on SDOH and award grants to eligible entities for the development of social determinants accelerator plans. Fact sheet Section-by-section
Rep. Underwood: (4/21) - Reps. Underwood (D-IL), Adams (D-NC) and Kelly (D-IL) led 81 Members of Congress in a letter urging Senate Majority Leader Schumer to prioritize investments to address the U.S. maternal health crisis in the next reconciliation package. The Members are pushing for the inclusion of permanent yearlong postpartum Medicaid coverage in every state and for the Black Maternal Health Momnibus Act to eliminate preventable maternal mortality and end racial and ethnic maternal health disparities.
NIH IMPROVE Act: (4/21) - Reps. Underwood (D-IL) and Herrera Beutler (R-WA) introduced the NIH Implementing a Maternal Health and Pregnancy Outcomes Vision for Everyone (IMPROVE) Act (H.R. 7565), which would continue to fund the NIH IMPROVE Initiative through the Eunice Kennedy Shriver National Institute of Child Health and Human Development to better understand factors that lead to adverse maternal health outcomes and inequities. The bill would authorize $30 million per year for this program over the next five years so the NIH can continue to carry out life-saving maternal health research.
To view a full list of the legislation we are tracking around social determinants of health, health equity/disparities, and maternal health, click here.
CMS: (4/28) - The CMS Office of Minority Health released the 2022 Racial, Ethnic & Gender Disparities in Health Care in Medicare Advantage (MA) report to further understand health disparities. The report details the racial, ethnic, and sex differences in health care experiences and clinical care received by MA enrollees in 2021. The report can be used to raise awareness of health disparities, develop health care interventions for racially and ethnically diverse populations, and implement quality improvement efforts that improve health equity.
CMS Office of Minority Health: (4/22) - The CMS Office of Minority Health released the CMS Framework for Health Equity 2022–2032. Using five priority areas, CMS will use this framework to design, implement, and operationalize policies and programs to support health for all people served by its programs, eliminating avoidable differences in health outcomes experienced by people who are disadvantaged or underserved, and providing the care and support enrollees need to thrive.
Centers for Disease Control and Prevention: (4/22) - The CDC released two reports that show that differences in death rates still remain between certain racial and ethnic minority groups. The first report provides an overview of provisional U.S. mortality data for 2021, including a comparison of death rates for all causes of death and for deaths involving COVID-19. The second report shows that from 2020 to 2021, differences in COVID-19 death rates decreased among most racial and ethnic groups.
HHS: (4/21) - HHS, through the Health Resources and Services Administration (HRSA), announced the availability of nearly $90 million in American Rescue Plan funding to support new data-driven efforts for HRSA Health Center Program-supported health centers and look-alikes (HRSA-designated health centers) to identify and reduce health disparities.HRSA’s modernized data collection and reporting initiative is designed to collect more and better data on social determinants of health, while also streamlining and improving data quality reporting for health centers. This effort will enable health centers to tailor their efforts to improve health outcomes and advance health equity.
JAMA Network: (4/21) - Dr. Meena Seshamani, Director of the Center for Medicare, and Dr. Doug Jacobs, Chief Transformation Officer at the Center for Medicare, penned an op-ed on leveraging the Medicare program to advance health equity. Consistent with CMS’ updated health equity strategy, the vision for health equity in Medicare is 2-fold: improving operations and implementing policies that advance health equity.
Healthcare Innovation: (4/21) - The Centers for Disease Control and Prevention (CDC) is establishing a cross-sector Social Determinants of Health Public Health Use Case Workgroup to engage public- and private-sector partners to advance SDOH data exchange for chronic disease prevention and health promotion. The project will follow the framework of the Gravity Project, which has made strides in establishing a foundation for representation and exchange of SDOH data across and between health and community-based systems.
CMS: (4/20) - CMS released a health equity action plan that details steps all CMS Centers and Offices are taking to advance health equity and build health equity into their core work, aimed to better identify and respond to inequities in health outcomes, barriers to coverage, and access to care. The action plan outlines CMS’ health equity goals and calls on private sector partners to engage with this strategy to sustain long-term action.
CMS: (4/18) - CMS released the fiscal year (FY) 2023 Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System (PPS) proposed rule. The rule includes three health equity-focused measures in hospital quality programs, seeks stakeholder input related to documenting social determinants of health in inpatient claims data, and proposes a “Birthing-Friendly” hospital designation. Comments are due by June 17, 2022. Fact sheetHealth equity fact sheet
SDoH & Health Equity in the News
Health Affairs: (4/28) - The Robert Wood Johnson Foundation launched the National Commission to Transform Public Health Data Systems, with a purpose of challenging the way we think about data with equity at the core. The commission reached a unified vision for an equity-centered public health data infrastructure. This blog offers the commission’s three “North Star” guidelines for a series of recommendations, including suggested implementation strategies.
Business Wire: (4/28) - Socially Determined and the Institute of Public Health Innovation (IPHI) announced a partnership to enhance health care access and address disparities across Virginia. Socially Determined will provide SDOH data, risk analytics, and expertise as part of IPHI’s “Community Health Workers for a Healthy Virginia'' project, and this effort will build on IPHI’s history of developing partnerships and solutions to improve the health and wellbeing of people in Virginia, Maryland, and D.C.
Mathematica: (4/27) - Current equity work often overlooks and excludes the one in four Americans with disability from efforts to center health equity and confront preventable health disparities. This article examines and argues why it is critical that people with disability are included in advocacy for health equity, and recommends several concrete actions that organizations working to advance health equity can take to ensure people with disability are included in the research and policymaking process.
Health Affairs: (4/22) - Access to preventive dental care remains an issue for minoritized children, as well as working-age adults and older adults. Medicare and many state Medicaid programs also lack comprehensive dental benefits for beneficiaries, contributing to existing racial oral health inequities. This article calls for better policies to move the US from its current status quo: oral health equity requires attention to racial equity.
NACCHO: (4/22) - The National Association of County and City Health Officials (NACCHO), with support from the CDC, developed the Health Equity and Overdose Prevention and Response Mentorship Program to continue supporting local health departments in their efforts to address drug overdoses in communities. Participants supported under the program will receive individualized peer-to-peer assistance and technical support in order to increase their capacity to integrate health equity into their drug overdose prevention and response efforts.
Becker’s Hospital Review: (4/21) - Bon Secours Mercy Health released the results of a two-year housing stability program, which showed it was successful in stabilizing tenants and may have contributed to health equity and outcomes. The program connected eligible residents to CARES Act funding and brought in additional financial assistance and support services to prevent foreclosures and eviction for more than 200 at-risk households. Just over two-thirds of the recipients of the support said someone in their household lived with a chronic disease or mental illness and that the support may have prevented negative health outcomes or instability.
Health Payer Intelligence: (4/21) - An issue brief from the Commonwealth Fund found that California, Connecticut, DC and Massachusetts pursued different Affordable Care Act marketplace strategies to improve health equity for underserved populations. While the states’ health equity goals were similar, they took various approaches to achieving those goals and these approaches required some adjustments. Even though the marketplaces based their strategies on race, ethnicity, and gender, their methods of using this information and addressing disparities varied.
Second Wave Michigan: (4/21) - Michigan Governor Gretchen Whitmer launched the Food Security Council in August 2020 to focus on food insecurity in the state. The council recently issued its final report, with 11 recommendations that seek to ensure Michigan families have access to affordable, nutritious food. The recommendations cite the need for funding more fresh food through local and regional programs, getting feedback from Michiganders using community food programs, and helping Medicaid beneficiaries access foods that address food-related illnesses, like diabetes.
Fierce Healthcare: (4/20) - The Health Equity Coalition on Chronic Disease (HECCD) was recently formed to advance health equity among communities of color living with chronic diseases. This nationwide effort will focus on obesity, which disproportionately impacts communities of color, with plans to focus advocacy less on the health care system itself and more on education and preventive care.
The Commonwealth Fund: (4/19) - Social drivers of health lie outside of traditional medical costs but contribute to health outcomes. CMS recently approved a proposal by California to use “in lieu of services”(ILOS) to offer a robust menu of health-related services through Medicaid managed care, allowing health plans to pay for nonmedical services instead of standard Medicaid benefits when it is medically appropriate and cost effective to do so. The ILOS in California include providing asthma remediation in the home and nutritious foods for people struggling with food insecurity and chronic health care conditions, among others.
Healthcare Dive: (4/19) - Icario announced the launch of Digital Bridge, a new program that Medicaid and Medicare plans can use to improve broadband access and education to members. Digital Bridge provides plans with the resources they need to inform their members on the availability of free or low-cost devices, broadband internet service, hotspot, and education and technical support to use these tools to take health actions.
Fierce Healthcare:(4/15) - Kaiser Permanente has doubled its social impact investment fund to $400 million to help build affordable housing and invest in other value-based initiatives. Kaiser’s Thriving Communities Fund has invested heavily in affordable housing opportunities and is on track to create or preserve 15,000 units of housing by 2025.
Spotlight on Maternal Health
PR Newswire: (4/20) - Brave Health, a virtual-first behavioral health provider focused on serving Medicaid populations, announced a new partnership with The Doula Network, a Medicaid provider committed to improving access to doula care and expanding reimbursement for doula services. This collaboration seeks to address the maternal and mental health disparities that disproportionately affect women in underserved communities.
Kaiser Family Foundation: (4/15) - Kaiser Family Foundation published a graphic showing key maternal and infant health disparities among Black people in the United States. A recent analysis by KFF found that Black people fared worse than other racial and ethnic groups in all maternal health indicators measured, and were more likely to have preterm births and have low birthweight babies compared to other racial and ethnic groups.
Data and Innovation
EHR Intelligence: (4/21) - Data standards and community stewardship are critical elements for social determinants of health data exchange. The Gravity Project worked with health care stakeholders to develop a foundational elements framework for SDOH information exchange, providing a set of conceptual guidelines that can help shape the planning, design, implementation, and evaluation of initiatives to facilitate social information exchange.
Health IT Analytics: (4/18) - Providers and payers are turning to data analytics to help combat social determinants of health like social isolation. Several companies have emerged that help health care stakeholders assess and measure SDOH data to guide their health equity efforts. Socially Determined, for example, offers social risk intelligence to providers and payers through their SocialScape platform to help health care stakeholders decide how and when to deploy targeted interventions to enhance population health.
New Research and Reports
Center for American Progress: (4/28) - To improve health and well-being, policymakers must act to address inequities, infrastructure, and social determinants of health that contribute to poor health. Doing so can help improve health, reduce racial disparities, and contribute to economic mobility. This fact sheet and accompanying report outline 10 priorities for improving the nation’s health.
JAMA Psychiatry: (4/27) - This study looked at to what extent individual and structural social determinants of health and vaccinations were associated with child mental health during the COVID-19 pandemic. Pandemic-related food insecurity, parental unemployment, disrupted mental health treatment, living in neighborhoods with higher shares of adults working full-time, and living in states lagging in vaccination rates were associated with increased trajectories of perceived stress, sadness, and COVID-19–related worry. Associations between SDOH and these mental health outcomes were more common among Asian, Black, and Hispanic children, more than White children.
Health Payer Intelligence: (4/25) - Humana released an issue brief outlining how payers, providers and policymakers have taken a variety of approaches to social determinants of health data collection and interventions. The brief provided an overview of the policymaking landscape surrounding SDOH data collection, and assessed state Medicaid policies around health-related social needs.
Medical Xpress: (4/25) - In a peer-reviewed article published in Population Health Management, researchers found that continuing telehealth care delivery beyond the COVID-19 pandemic would benefit publicly insured children if they are ensured equitable access to telehealth services. Researchers examined disparities in telehealth utilization in a population of publicly insured children, finding evidence of disparities in telehealth use by race, ethnicity, rurality, and family income.
Patient Engagement HIT: (4/21) - Researchers at Johns Hopkins Bloomberg School of Public Health found that patients in food-insecure households were two times more likely to cancel or delay care during the first year of the pandemic, widening health disparities for minorities who are disproportionately impacted by food insecurity. The study found that nearly one in five adults reported experiencing food insecurity at some point in the previous 30 days, and nearly three in 10 of those experiencing food insecurity had delayed or foregone medical care in the previous month.
BMC Public Health: (4/21) - This systematic review looked at the associations of health and health care utilization of interventions aimed at reducing barriers to non-emergency transportation and non-medical transportation to further examine transportation as an important social determinant of health. Interventions aimed at non-emergency transportation barriers to access health care are associated with fewer missed appointments, however the association with costs, utilization or health outcomes is insufficiently studied to reach conclusions.
Patient Engagement HIT: (4/21) - A new report from the Commonwealth Fund found that patients are still reporting a health care experience characterized by racial discrimination despite recent efforts by the medical industry to address racial biases in health care. The report found that one in four Black and Hispanic adults over age 60 said they’ve experienced racial discrimination in health care, and that their clinicians treated them unfairly or did not take their symptoms seriously because of their race.
Manatt: (4/20) - In a new issue brief for the Robert Wood Johnson Foundation’s State Health and Value Strategies program, Manatt Health examines Medicaid’s role in promoting health equity and describes ways states can center and advance health equity and address structural racism through each Section 1115 demonstration’s life cycle stage. This article summarizes this issue brief and provides insights and recommendations for states to center health equity in Medicaid.
Patient Engagement HIT: (4/20) - A report by the Autism Intervention Research Network on Physical Health found that race and income are key social determinants of health that affect the outcomes for kids with autism and carve out steep health disparities for this population. Over half of children with autism lived in a low-income household, and around a fourth were living in poverty. Kids with autism living in low-income households were also more likely to be non-White relative to the general population.
Population Health Management: (4/19) - Pediatric primary care practices in New York City universally screen for social determinants of health and mental health needs, providing an opportunity to assess changes in the population's needs during COVID-19. This study assessed changes in SDOH and mental health needs of pediatric families before and during COVID-19, finding that SDOH needs around food, public benefits, and housing increased significantly during COVID and that patients with such needs had a significantly higher likelihood of having emotional or behavioral difficulties.
Avalere: (4/18) - Quality regulators are implementing new requirements and performance measures to expand health equity expectations for health plans. Health plans need to respond to these changes and coordinate across business units to meet the expectations of regulators and consumers around health equity. This report describes common approaches and identifies data-driven strategies to respond.
Health Affairs: (April 2022) - Housing quality is a primary determinant of asthma disparities by race and social class in the US. This study assessed how housing code enforcement systems in Boston, Massachusetts address tenants’ reports of asthma triggers. After adjustment for income and other neighborhood characteristics, racial demographics were significantly associated with asthma trigger incidence.
Journal of Managed Care and Specialty Pharmacy: (April 2022) - A growing body of evidence supports the need for health systems to shift towards addressing social determinants of health as part of routine care. However, little is known about the state of the industry in terms of procurement and use of SDOH data. This study assessed stakeholders’ perceptions and experiences in collecting and utilizing SDOH data, finding that stakeholders consider patient SDOH indicators important but report significant challenges in collecting such data.