Social Determinants Updates


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April 29 to May 13, 2022

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

To add news or events to this newsletter, email info@aligningforhealth.org.

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Highlights

Member News

Healthcare Business Today: (5/9) - Community-based organizations (CBOs) have the capacity to help formerly incarcerated individuals break the cycle of recidivism, but without the right tools to coordinate care and track success, their impact is limited. Technology could help mitigate these challenges by providing a seamless workflow to ensure newly released individuals get the help they need, and CBOs can measure their impact. This op-ed, written by Unite Us’ Eric Beane, outlines how coordinated social care platforms can reduce uncertainty in the reentry process and help reduce rates of recidivism.

Post Gazette: (5/8) - As the United States grapples with higher death rates among Black mothers and babies, doulas have emerged as a way to help Black women advocate for better care. UPMC’s Birth Circle doulas program has doulas that speak several languages to help immigrants and refugees, who are also at higher risk of worse birth outcomes than white women. UPMC is gathering data on whether its program can help decrease rates of cesarean sections, increase breastfeeding rates and improve patient satisfaction.

Tennessean: (5/7) - As diaper need has become a troubling issue, Nashville Diaper Connection and findhelp partnered to distribute millions of free diapers to mothers without access. As Nashville’s sole diaper bank, Nashville Diaper Connection serves approximately 10 percent of low-income families with young children in the Nashville area.

mHealth Intelligence: (5/6) - Blue Shield of California, a health plan of the Blue Cross and Blue Shield Association, has entered into a partnership with Maven Clinic to give eligible members access to Maven’s virtual family care platform to provide virtual pregnancy and postpartum care. The goal of the collaboration is to enable Blue Shield of California members to take a comprehensive approach to maternal health and postpartum care.

American Hospital Association: (5/4) - The American Hospital Association wrote a letter to the leaders of the Senate HELP Committee regarding funding for health care programs for fiscal year 2023, asking the Committee to give favorable consideration to funding for health care programs that have proven successful in improving access to care. This includes supporting a $153 million request to support the CDC Social Determinants of Health Program to continue efforts to fund another round of Social Determinants Accelerator Plans to states, tribes, territories, and/or localities, among other areas.

Health Leaders: (5/2) - Blue Cross and Blue Shield Association has released a data-focused health equity action plan, which challenges health care stakeholders to adopt the plan to reduce health disparities while aligning to national standards. This article outlines the three recommendations made in the following areas: growing health equity data collection; following national standards; and making data collection ethical and transparent.

Medpage Today: (4/29) - The pandemic shed light on the importance of addressing health equity in a variety of ways. Researchers at Vizient used inpatient data to identify racial and economic disparities in patients’ risk for COVID-19 diagnosis and admission. The researchers found that SDOH data can be leveraged to improve health outcomes. The study also found that most organizations have only recently prioritized health equity in their strategic planning and achieved buy-in from leadership, and that the most common challenges were collecting, analyzing, and validating data and demonstrating impact.

Modern Healthcare: (4/28) - University Hospital has partnered with Unite Us, specifically Unite Ohio, to provide services to patients outside of clinical needs. The Clinic, MetroHealth, and University Hospital social workers now collaborate on the Unite Us platform to track patients and communications between the social workers, allowing patients to benefit from a secure, central point of contact where health care providers, social service organizations and individuals can access and refer people to services while monitoring progress and outcomes.

Vizient: (4/27) - Vizient is working to develop the Vizient Vulnerability Index to bridge data gaps that impact health care organizations’ ability to understand patients’ specific obstacles to care and provide the right resources for the right people to improve health equity. The index integrates data from multiple sources to provide deeper insights regarding community needs, and identifies eight social determinants of health domains that become even more insightful when combined with patient outcomes data.

ASK E&C LEADERS TO ADVANCE IMPORTANT SDOH LEGISLATION

We invite your organization to sign on to a letter urging House Energy & Commerce Committee leaders to build upon the important progress made by the Subcommittee on Health last summer by moving forward and passing into law legislation to advance equity and to address the social determinants of health.

The letter encourages the Committee to advance important SDOH legislation that will empower organizations and communities to work across sectors to foster partnerships, coordinate care and services, share data, and leverage available resources to drive improved and equitable outcomes, and that would catalyze federal cross-sector opportunities to address SDOH.

Apologies for the short turnaround - the deadline to sign on to this letter is COB TUESDAY MAY 17.

Read letter

Sign-on

Legislative Updates

Rep. Cheri Bustos: (5/4) - Rep. Bustos (D-IL) announced that HomeStart, a local Illinois non-profit working to develop and preserve affordable housing options, will receive $176,000 in funding from NeighborWorks America to revitalize and sustain neighborhoods. Addressing social determinants of health, like housing insecurity, is a top priority for Rep. Bustos, who also is co-founder of the Congressional Social Determinants of Health Caucus and co-sponsor of the Social Determinants Accelerator Act.

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

HHS: (5/11) - HHS announced the availability of $5 million for community health centers, funded by HRSA, to increase equitable access to life-saving cancer screenings. This funding supports President Biden’s call to action on cancer screening and early detection as part of the Administration’s Cancer Moonshot initiative.

White House: (5/9) - The Biden-Harris Administration secured commitments from 20 internet providers to cut prices and increase internet speeds for millions of American families. The Administration also launched a comprehensive effort to make sure as many Affordable Connectivity Program (ACP)-eligible households as possible can take advantage of this program by launching GetInternet.gov, reaching out to eligible households through federal agencies, partnering with states and cities, and collaborating with public interest organizations.

CMS: (5/6) - CMS approved Tennessee and South Carolina’s state plan amendments to expand Medicaid and CHIP coverage to 12 months postpartum to an estimated 22,000 and 16,000 parents, respectively. CMS is also working with another nine states and D.C. to extend postpartum coverage for 12 months after pregnancy. HHS press release

HHS: (5/6) - HHS announced the launch of the Maternal Mental Health Hotline, a new, confidential, toll-free hotline for expecting and new moms experiencing mental health challenges.The initial investment of $3 million will help to launch the hotline with counselors available to provide mental health support.

HHS: (5/6) - HHS is seeking input from individuals and organizations regarding supportive, nutrition, evidence-based disease prevention and health promotion, caregiver, legal, long-term care ombudsman, and other services provided via states, tribes and tribal organizations, area agencies on aging, and local service providers. Comments are due June 6, 2022.

White House: (5/4) - President Biden announced that the White House will host a Conference on Hunger, Nutrition and Health this September. The Conference, and the preparatory work leading up to it, will accelerate progress and drive significant change to end hunger, improve nutrition and physical activity, reduce diet-related disease, and close the disparities around them. It will also launch a national plan around combating hunger in the U.S. For additional information, visit the website dedicated to this conference here. Statement by HHS and USDA

HHS: (5/2) - HHS Secretary Becerra and Ambassador Tai released a joint statement in celebration of Asian American, Native Hawaiian, and Pacific Islander Heritage Month. The statement outlines the steps HHS has taken to provide relief and care to the AA and NHPI communities. Fact sheet

SDoH & Health Equity in the News

MaineHealth: (5/11) - MaineHealth announced it is opening a food pantry in partnership with the Good Shepherd Food Bank. This new community service will support MaineHealth’s vision of improving the health of its community by promoting consistent access to food that supports health.

Health Affairs: (5/9) - A key way to reduce disparities in outcomes for dual enrollees is by improving their access to high-quality medical care and innovative payment and care delivery models within Medicare. This article argues that CMS should take action within its quality measurement and incentive programs to remedy such inequities by updating current incentive structures within Medicare that disincentivize care of duals and reward clinicians and health systems for providing high-quality care to this population.

State of Reform: (5/6) - Equality Health announced their participation in the ACO REACH value-based payment model and plans to use this model to advance its mission of addressing social determinants of health and driving down costs while keeping the quality of care high. Equality Health is also participating in the model as part of a larger effort to create a more culturally competent and accountable health care delivery system centered around whole-person care.

Health Affairs: (5/5) - The National School Lunch Program and School Breakfast Program are together the second-largest food safety net in the United States, providing 30 million healthy and nutritious meals to children and adolescents each day. During the pandemic, the US Department of Agriculture (USDA) implemented the Universal Free Meals program to allow schools to offer meals to students for free, among other actions. Waivers to expand access to school meals are set to expire at the end of the current school year, causing concern about access to this vital safety net and discussions around making this a permanent part of the toolkit to fight hunger.

Modern Healthcare: (5/4) - Foster children and young people transitioning out of the child welfare system frequently encounter obstacles to adequate housing, which some health care providers and health insurance companies are trying to address with novel programs. By tackling housing problems head on and helping youth leaving the foster care system to stay healthy, health care companies can also save money.

Health Affairs: (5/4) - In this episode of The Earth Disease podcast, journalist Jared Downing discusses how social determinants of health programs intersect with climate and health policy with guests from the Harvard T.H. Chan School of Public Health, Boston Medical Center, and Good Food Markets.

Health Affairs: (5/3) - Since Medicare Advantage (MA) plans are paid on a capitation basis, insurers have financial incentive to control health care costs, and much attention has been focused on addressing social needs to yield health benefits, and ultimately save MA plans money. In this episode of the Health Podyssey podcast, Brian Powers discussed understanding the unmet social needs of Medicare enrollees.

Wisconsin Department of Health Services: (5/2) - The Wisconsin Governor’s Health Equity Council voted on final recommendations to achieve long-lasting and equitable health outcomes for all Wisconsinites. The Council released an executive summary and will later release the full report in summer 2022. The Council has been focused on targeting social determinants of health and put forward proposals to combat pervasive health disparities across race, economic status, education, geographic location, and history of incarceration.

STAT: (4/29) - Physicians would like to improve the health of their patients exhibiting poor health outcomes due to social factors by addressing their social drivers of health, but are often limited in their ability to do that. CMS could change this by enacting the first-ever measures in a federal quality or payment program that offers incentives to physician practices and hospitals to engage their patients around these issues. This article makes the case for why this is a necessary step for CMS to take.

State of Reform: (4/29) - At the 2022 Utah State of Reform Health Policy Conference, experts discussed the importance of community health workers (CHWs) as a way to engage underserved individuals to help address their social needs, outlining initiatives underway in Utah to address SDOH. CHWs were essential to expanding access to care throughout the pandemic and could help screen for social needs.

Spotlight on Maternal Health

Medpage Today: (5/11) - Patients who had a C-section birth during the COVID-19 pandemic were more likely to be discharged early versus those who delivered before the pandemic, with socially vulnerable patients more commonly discharged sooner. These findings suggest that increased early discharges fall disproportionately on socially vulnerable patients.

State of Reform: (5/10) - CMS recently approved Michigan’s Medicaid and CHIP coverage for 12 months postpartum, which the Michigan Health and Hospital Association said would provide needed coverage to 35,000 pregnant and postpartum women who have many medical needs after 60 days postpartum. It will also improve health equity and access to behavioral health treatment in the state.

Patient Engagement HIT: (5/10) - Through two programs, Geisinger Health System is helping to address holistic maternal health care. The Free2BMom Program is tailored for pregnant people with substance use disorders that offers SDOH screening and referrals. Geiseinger also provides wraparound maternity care by prioritizing the use of midwives.

News Medical: (5/10) - Scientists from the University of Massachusetts found that breastfeeding is associated with improved maternal mental health overall, however difficulties experienced during breastfeeding can negatively impact the mental health outcomes of mothers.

Patient Engagement HIT: (5/10) - A report in Obstetrics and Gynecology found that neighborhood disadvantages were linked to higher rates of COVID-19 among minority pregnant people. Nearly one in ten of all patients within the cohort tested positive for COVID-19 antibodies, yet Hispanic and Black people saw higher rates of positive than Asian and White patients. Neighborhood characteristics such as deviation and crowding were associated with a higher rate of COVID-19, but racial segregation was not a driving factor in the disparities.

Rocky Mountain PBS: (5/8) - After working as a doula for several years in Colorado, Birdie Johnson saw the health care disparities for people of color and began networking with any person of color that worked in maternal health. She opened Mama Bird Maternity Wellness Spa, which offers a variety of services to provide health, wellness, and self-care resources to empower pregnant people of color. The maternity wellness spa also works with one of the only Black midwives in the Denver areas.

Patient Engagement HIT: (5/3) - A study by researchers at Mount Sinai Health System found that structural racism and pandemic stress are prominent contributors to racial disparities in birthing outcomes, leading to a greater risk for preterm birth. Researchers found that women in predominantly Black, low-income neighborhoods were nearly three times more likely to contract COVID-19 infection than those in predominantly White, higher-income areas. People in neighborhoods with greater unemployment rates in the first wave of the pandemic had a 60 percent greater risk for preterm birth.

Patient Engagement HIT: (5/3) - According to recent figuresfrom the CDC, hypertension during pregnancy is a growing problem in the United States, with Black and American Indian/Alaska Native pregnant people being the most at-risk for hypertension. Hypertensive disorders during pregnancy (HDPs) are critical conditions that can lead to adverse maternal health outcomes, like heart attack and stroke, and are a leading cause of pregnancy-related death in the US. Between 2017 and 2019, the rate of HDP in pregnancy hospitalizations increased from 13.3 percent to 15.9 percent.

New Research and Reports

Duke Margolis Center for Health Policy: (5/10) - The COVID-19 pandemic has magnified how structural racism and other structural determinants of health affect the lived experience of the public health emergency on marginalized and minoritized communities. This paper proposes a policy framework to identify common barriers to equitable COVID-19 testing and facilitate the scaling-up of the solutions that emerged to address them. The paper also identifies five key policy levers and three foundational components that are necessary to lead to measurable improvements in health equity.

American Heart Association: (5/10) - The American Heart Association published new policy solutions to promote equity in access to nutritious foods throughout the lifespan. The policy statement sets a new agenda to help make healthy foods within reach for all, including through working through many programs already in place to provide more nutritious foods to underserved populations.

Health Affairs: (5/5) - A comprehensive public and private sector response to economic hardship during the pandemic likely helped mitigate an increase in food insecurity and its associated health consequences. This brief reviews the literature measuring the health impact of federal nutrition assistance and summarizes the innovation, expansion, and modification of federal, state, local, and tribal nutrition assistance in response to COVID-19. It also discusses the synergies of this assistance with broader safety net policies and highlights the need to maintain nutrition standards in the face of programmatic changes.

Northwestern Institute for Policy Research: (5/4) - This brief examines the LINC to Address Social Needs Act, legislation currently before Congress to address the lack of coordination between the health and social services sectors. The proposed networks included in the legislation offer a chance to establish crucial connections between health care and social service providers to address essential needs, especially in underserved communities. The brief proposes three additional evaluative measures that could be included in the bill to further this work.

Brookings: (5/3) - Cross-sector partnerships can be impactful in addressing social determinants and improving health, with one of the most untapped of such beneficial partnerships being between the health and housing sectors. Partnerships need “connective tissue” - an infrastructure supporting frequent and systemic level collaborations - to help form the partnership and hold it together over time. This report outlines why housing-health partnerships are important, more on this approach and cross-sector planning to build connective tissue, and highlights examples of initiatives that could lead to this including passing the bipartisan LINC to Address Social Needs Act or Social Determinants Accelerator Act.

Disaster Medicine and Public Health Preparedness: (5/2) - Co-occurring social determinants of health disparities and other underlying determinants have exacerbated the COVID-19 pandemic, particularly for vulnerable communities. This literature review examined the literature focused on SDOH and COVID-19 outcomes and identified SDOH disparities associated with COVID-19 outcomes. COVID-19 outcomes were associated with SDOH indicators, such as race and ethnicity, poverty, housing density and insecurity, and more. The review called for action to integrate SDOH indicators along with relevant health data when implementing solutions and intervention strategies in pandemic response.

Health Affairs: (May 2022) - Telemedicine use exploded during the pandemic, but it has done so without sufficient attention to disparities by payer, age, race and ethnicity, income, English language proficiency, and geography. This report examines telehealth policies that ensure equity that will require a more comprehensive, cautious approach that acknowledges the unknowns about how to implement telemedicine to improve health, address multilevel barriers to equity, and reconsiders the purpose and value of telemedicine.

Center for Health Care Strategies: (May 2022) - Integrated, cross-organizational care teams can offer high-quality care for people with complex health and social needs. This brief outlines lessons from the MassHealth Care Planning Learning Collaborative, where Massachusetts Accountable Care Organizations and Community Partners integrated care planning across their organizations to improve care for Medicaid members with complex needs.