Highlights

• COVID-19 Health Equity Task Force releases final report with recommendations and implementation plan

• HHS announces 200 hospitals participating in new maternal and infant care collaborative

• GAO releases report on youth homelessness and how HUD and HHS could enhance coordination to support communities

• HHS ACF awards more than $3.3B in relief funds through LIHEAP to support families with heat costs

• Op-ed calls for Congress to pass the Social Determinants Accelerator Act of 2021

Member News

CareSource: (11/10) - The CareSource Foundation announced a grant to the Little Timmy Project in support of the Black, Indigenous, People of Color (BIPOC) Doula Scholarship Program, which supports the training and recruitment of Black and Brown birth workers in Indiana. The goal of the program is to promote positive pregnancy outcomes while addressing the maternal and infant health crisis in the state.

Healthcare Innovation: (11/9) - In a recent interview with Healthcare Innovation, Dan Brillman, CEO and co-founder of Unite Us, described the company’s evolution and vision for improving health. Brillman pointed to ground-breaking work happening in North Carolina, which is putting $650 million into non-clinical services through a payments mechanism run by Unite Us, among other efforts to connect health and social care providers to serve the health and social needs within communities.

Forbes: (11/5) - This article outlines the steps that should be taken to achieve health equity and to turn health equity into a lasting movement. The first is through deepening community collaboration, citing partners like Unite Us and community-based organizations to identify what needs to be done and how to best work together to advance health equity. The second step is attending to the “causes of the causes,” the underlying issues and SDOH that drive inequities. The author advocates for funding upstream solutions and policy changes that address long-standing system issues.

Columbia Star: (11/4) - The South Carolina Department of Health and Human Services partnered with the Children’s Trust of South Carolina to launch Community Connections, a free database of resources that connects South Carolinians in need with available social and health care services across the state. This platform is supported by findhelp, and can be used as a referral system in addition to connecting individuals to needed resources.

American Hospital Association: (11/3) - In the latest American Hospital Association Members in Action podcast, Northwell Health’s Viktor Klein, M.D., system director of quality and patient safety for OB/GYN, and Adriann Combs, clinical director of OB/GYN services, share how launching the Maternal Outcomes and Morbidity Collaborative (MOMS) has increased awareness of maternal health complexities, and reduced disparities in maternal care.

CareSource: (11/1) - CareSource has invested $2.5 million toward a new partnership as part of its ongoing efforts to invest in affordable housing projects in Indiana and across the US. The organization is investing with Indianapolis Neighborhood Housing Partnerships (INHP) to bolster efforts to create homeownership opportunities for individuals and families experiencing disproportionate wealth and racial disparities in Marion County.

The Hill: (10/28) - Kim Keck, President and CEO of the Blue Cross Blue Shield Association, wrote an op-ed on maternal health disparities and how Congress needs to act now to advance solutions to change the trajectory and create a more equitable health care system. She calls for Congress to pass the Black Maternal Health Momnibus in its entirety to drive transformative change, particularly for women of color, in improving maternal health care, saving lives, and addressing racial health disparities head-on.

Vizient, Inc.: (10/19) - In October, Vizient kicked off its new five-part Health Equity Leadership Series to explore how Vizient members can work to achieve and maintain health equity. The first session highlighted why advancing health equity matters with several steps that organizations can take to address it, and future sessions will include insights from members about how they are identifying disparities, addressing community needs and improving the lives of individuals in the communities they serve.

Legislative Roundup

Rural Health Equity Act: (11/3) - Reps. McEachin (D-VA), Sewell (D-AL), and Bishop (D-GA) introduced the Rural Health Equity Act (H.R. 5848), which would direct the Secretary of Health and Human Services to establish within the Office of the Director of the Centers for Disease Control and Prevention the Office of Rural Health. Sens. Merkley (D-OR) and Smith (D-MN) introduced companion legislation in the Senate (S. 3149).

Black Maternal Health Caucus: (11/3) - The Black Maternal Health Caucus published a document with quotes from organizations in support of the historic Momnibus and postpartum Medicaid investments included in the text of the Build Back Better Act (BBB). Aligning for Health is among the list of supporting organizations. “Aligning for Health strongly supports the investments made in the Build Back Better Act to address social determinants of maternal health, to promote maternal health equity, to expand access to maternal health equity digital tools, and to strengthen maternal health programs. As a coalition dedicated to addressing the barriers and challenges that limit our ability to improve health outcomes and wellbeing for all, we commend the inclusion of these vital provisions,” said Melissa Quick, Co-Chair of Aligning for Health. To view the provisions of the Momnibus included in BBB, see here.

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

Support Legislation Endorsed by Aligning for Health!

Aligning for Health is proud to support the Social Determinants Accelerator Act (H.R. 2503/S. 3039) and the LINC to Address Social Needs Act (S. 509). To learn more about these important pieces of legislation, visit our website or read on below for news coverage.

The Hill: (11/10) - Trenor Williams, founder and CEO of Socially Determined, wrote an op-ed in support of the Social Determinants Accelerator Act of 2021, calling for Congress to pass the bill. Williams notes the challenges he has seen related to SDOH firsthand as a physician, and how this bill is a way to address the gaps between health care and social services by providing grants and targeted technical assistance for communities to create innovative, evidence-based approaches that coordinate health and social services.

Administration Updates

COVID-19 Health Equity Task Force: (11/10) - The White House COVID-19 Health Equity Task Force released its final report with recommendations on mitigating inequities caused or exacerbated by the COVID-19 pandemic and for preventing such inequities in the future. The report contains four overarching suggested outcomes as the Task Force’s vision for change, five proposed priority actions to spur this change, and 55 final recommendations. The report was also accompanied by an implementation plan and accountability framework, with guidance on how to implement the 55 prioritized recommendations with action steps, an evaluation framework and key performance indicators for this work. Additional coverage on the Task Force’s work can be found here.

HHS: (11/10) - HHS, through HRSA, announced $143.5 million in American Rescue Plan funding to expand community-based efforts to conduct tailored local outreach about vaccines, build vaccine confidence and address barriers to vaccination in their communities. The funding will support two programs in which award recipients will develop regional and local partnerships to reach unvaccinated individuals who are pregnant, live in underserved and high-risk communities, and to ensure equitable access to the vaccine in such communities.

HHS: (11/8) - The HHS Office of Women’s Health announced the over 200 hospitals that are participating in the HHS Perinatal Improvement Collaborative. This new network is focused on improving maternal and infant health outcomes by reducing disparities. The collaborative is also the first to evaluate how pregnancy affects overall population health by linking inpatient data of newborns to their mothers.

GAO: (11/2) - GAO issued a report finding several challenges in serving youth experiencing homelessness, including both young adults and minors. GAO recommended the Departments of Housing and Urban Development (HUD) and HHS take steps to improve coordination and the delivery of services to both young adults and minors at the local level.

HHS: (11/1) - HHS, through the Office of Community Services (OCS) at the Administration for Children and Families (ACF), announced awarding $3.37 billion in relief funds through the Low-Income Home Energy Assistance Program (LIHEAP) to help low-income individuals and families afford home heating costs this winter and cover unpaid utility bills.

EMI Advisors: (11/1) - EMI Advisors LLC is partnering with the CDC National Center for Chronic Disease Prevention and Health Promotion Office of Informatics and Information Resource Management to inform and develop a public health SDOH data sharing and interoperability Business Case and Use Case. This initiative will help accelerate the CDC’s ability to scale the use of SDOH data for prevention and control of chronic disease and reduction of health disparities, as well as to use integrated SDOH data for more meaningful outcome analyses and improve care delivery.

SDoH & Health Equity in the News

AP News: (11/10) - Food banks in the US are struggling to adapt to increased demand from families impacted by the pandemic, while food prices and supply chain issues continue to surge across the country. Higher food prices means food insecurity will worsen for those already experiencing it, and this coupled with limited availability of foods means families may get smaller servings or substitutions for staples such as peanut butter, as costs for some goods are two to three times higher than normal.

Milbank Memorial Fund: (11/10) - The US has recently seen a sharp decline in birth rates, a demographic trend that is an important indicator of population health. Many of the social determinants of morbidity and mortality in populations are also the social determinants of fertility and birth, meaning this decline is a warning sign regarding the social and economic factors that serve as fundamental drivers of population dynamics like population health.

The Philadelphia Inquirer: (11/9) - In this op-ed, Yale-trained molecular oncologist Sophia Ononye-Onyia discusses how focusing on social determinants of health can help advance health equity in Philadelphia. She notes how socioeconomic status is a consistent and reliable predictor of a vast array of outcomes across a person’s life span, including physical and psychological health, and highlights plans that have potential to address this such as the Philadelphia City Council’s poverty action plan that was announced in March 2020.

Business Wire: (11/9) - United Health Foundation awarded a three-year grant of $3.4 million to Children’s National Hospital in Washington, DC to improve access to health care for school-aged children in the most under-resourced communities. The grant will enable a unique program that brings together a team of school nurses, community health workers, and mobile medical services to address issues like child poverty, asthma, and obesity and to connect children and families to mobile health services to advance health equity.

First Report Managed Care: (11/4) - In a recent conversation with Icario, Lynette Hansen of Molina Healthcare shared Molina’s success in enhancing member connections, as well as strategies to address SDOH and improve health plan ratings. Hansen highlighted how Molina is working with Icario to identify individuals who need help the most through using zip codes as a key predictor of overall health and using community connectors to work closely with case management teams to ensure each member receives appropriate clinical care.

Politico: (11/4) - California is home to 28 percent of the nation’s homeless population and 51 percent of the unsheltered population, which made COVID planning for this population particularly challenging at the start of the pandemic. The state turned to unoccupied hotels as a way to get thousands of people off the streets and to turn around the state’s homelessness crisis, with many other states following suit. Project Roomkey ultimately provided temporary shelter to over 48,000 people in hotel rooms leased by the state.

Washington Post: (11/3) - Voters in Maine approved an amendment to enshrine the “right to food” in the state, the first of its kind in the US. The amendment declares that all people have a “natural, inherent and unalienable right” to grow, raise, produce, and consume food of their choosing as long as they do so within legal parameters. The amendment aims to fight hunger in the state and address corporate control of the food supply.

Becker’s Hospital Review: (11/3) - A recent survey by Anthem on drivers of health found that 60 percent of Americans said their communities face issues tied to social determinants of health. About 50 percent of survey respondents said that access to healthy, affordable food was limited, and 91 percent said that providers should lead the charge in addressing SDOH, among other findings.

Milbank Memorial Fund: (11/3) - This article explores the role of collective action in addressing social determinants of health, and its potential to integrate greater resilience into an interconnected system of care. Research shows, however, that not all public discussions of collective action are equivalent in their ability to move sticky problems of social, cultural, and political power, like the social determinants of health.

Office of AG Maura Healey: (11/2) - In FY2020, hospitals and health maintenance organizations (HMOs) in Massachusetts contributed almost $1 billion in Community Benefits for residents of the state, which included significant investments in health equity and social determinants of health. About half of the funding was allocated to one of four statewide health priorities - including $8 million toward housing stability and homelessness - while the other half was used to address other health needs identified by the community.

Medpage Today: (11/1) - This article highlights Chicago’s Rush University Medical Center (RUMC) as a hospital that has made achieving health equity a central strategic goal early on. David Ansell MD, MPH in particular has been a motivating force behind this, as he has challenged academic medical centers to confront issues of structural racism, economic deprivation and neighborhood conditions as a first step in identifying ways to address health inequities. Earlier this year, RUMC undertook a multi-year, culture changing, enterprise-wide strategy and adopted a 5-pillar framework to achieve health equity.

Milbank Memorial Fund: (11/1) - In this article, Aligning for Health Advisory Board Member Marcella Maguire of the Corporation for Supportive Housing offers guidance for government officials on bridging the bureaucratic silos for health and housing based on the supportive housing sector’s experience. She explains how systems of health coverage, long-term services and supports, and housing supports are misaligned and discusses innovative approaches that blend funding from different sectors. She also provides lessons, such as the allocation of flexible funding, for achieving success with cross-sector initiatives that can help all Americans thrive as they age.

Health Leaders Media: (11/1) - Nemours Children’s Health has led an effort to develop a five-part toolkit to help community organizations advance health equity. Nine communities have received the toolkit, which contains resources, coaching, and technical assistance from experts to test best methods to promote wellness and equity.

New Research and Reports

Business Wire: (11/9) - athenahealth, Inc. unveiled data reinforcing the notion that addressing SDOH is a crucial part of care delivery, finding that patients in low-income zip codes were less likely than patients in high-income zip codes to have scheduled an annual wellness visit within 90 days of eligibility. High-risk patients living in low-income zip codes were less likely to close care gaps than those living in high-income zip codes, despite these patients being the ones that most needed preventive care services.

Healthcare IT News: (11/9) - A paper in the Journal of American Medical Informatics Association outlined barriers to health equity research serving deaf and hard-of-hearing patients, and how EHRs may be making such barriers worse. The study noted that while EHR systems can be useful in identifying health inequities, they can also interfere with efforts to improve health outcomes among this population including by misclassifying ASL as an “other” language, for example.

Duke Margolis Center for Health Policy: (11/8) - In June 2021, the National Governors Association Center for Best Practices, the Duke-Margolis Center for Health Policy, and the National Academy for State Health Policy co-hosted a virtual summit on data and health equity. The summit convened state leaders from 20 states to discuss challenges and strategies for collecting, reporting and using race and ethnicity data to improve health equity during and beyond the COVID-19 pandemic. This issue brief summarizes state strategies and experiences shared during the convening, as well as lessons learned during the COVID-19 pandemic.

Patient Engagement HIT: (11/4) - According to a study by researchers from NYU Langone Health, an individual’s proximity to a fast-food outlet leads to a higher risk of Type 2 diabetes, emphasizing geographic health disparities within different communities. The study, which focused on veterans without diabetes at the start, found that throughout the study 13 percent of all participants were diagnosed with Type 2 Diabetes and that those who lived in high-density urban areas lived on average within one mile of a fast food restaurant.

Patient Engagement HIT: (11/3) - A survey from United Hospital Fund (UHF) found that although patients and caregivers agree patient education at the point of facility discharge from a skilled nursing facility (SNF) is generally good, few said they completed SDOH screening or had follow-up care scheduled for them. Fewer than half of respondents said they completed an SDOH screening during discharge, with patients and caregivers citing particular gaps in screening for housing instability or lifestyle and health care unaffordability.

ASCO Post: (11/2) - Survivorship care plans are an important tool to help cancer survivors transition from active treatment to follow-up care, however a recent study found that a number of vulnerable groups had a lower likelihood of receiving such plans. This study looked at data to determine the role that social determinants of health play in the reception of survivorship care plans and recommended several steps to reduce barriers to plan delivery and encourage physician participation in survivorship care.

PubMed: (11/1) - Social determinants contribute to racial disparities in asthma outcomes, and community health worker (CHW) programs can play a role in screening for SDOH to connect patients to resources. This study evaluated a CHW program for children hospitalized with asthma in a predominantly Hispanic community by examining rates of SDOH and social resource navigation. CHWs identified a high burden of unmet social needs and provided associated social resource navigation in this population.

Health Affairs: (11/1) - This study analyzed trends in adult COVID-19 vaccine coverage over time based on COVID-19 vaccine hesitancy and social vulnerability. Researchers found that each of these variables carries an independent association with disparities across counties in COVID-19 vaccine coverage, and counties that scored high on both hesitancy and vulnerability were especially likely to have lower vaccination rates.

Health Affairs: (11/1) - A factor in racial health inequities is socioeconomic disadvantage of racially segregated neighborhoods. This study quantified associations of neighborhood socioeconomic disadvantage in Chicago, as measured by the Area Deprivation Index (ADI), with racial disparities in COVID-19 positivity. The study found that patients living in Black majority neighborhoods had two times higher odds of COVID positivity relative to those in White majority neighborhoods. The ADI accounted for 20 percent of the racial disparity, however COVID positivity remained higher at every decile of the ADI in Black neighborhoods.

Center for Health Care Strategies: (November 2021) - State Medicaid and public health programs can advance health equity for the communities they serve, especially for people of color, working both within their agency and through cross-agency partnerships. Three broad strategies can be used to promote health equity: (1) advance internal-facing health equity work; (2) leverage data to drive health equity efforts; and (3) engage community members authentically. This brief outlines key recommendations to further Medicaid and public health opportunities and cross-agency partnerships that advance health equity.

Alliance to End Hunger: (November 2021) - A recent survey conducted on behalf of the National WIC Association and the Alliance to End Hunger looked at whether voters supported WIC. About eight in 10 voters nationwide support the program, and 76 percent of voters supported expanding the value of the WIC food package. Additionally, 76 percent of voters supported extending eligibility for postpartum women and 65 percent supported expanded eligibility so more families can qualify for WIC.

Institute for Healing Justice and Equity: (November 2021) - This study evaluated the effects of racial equity tool use on governmental policy change nationwide and identified jurisdictions working specifically with the Governmental Alliance on Race and Equity (GARE) and PolicyLink, discussing how these jurisdictions are addressing systemic racism and SDOH in their communities. Key findings include that racial equity tools can be used to address systemic racism and SDOH, and that over 107 jurisdictions have worked with national organizations to use such tools.

 Data and Innovation 

Business Wire: (11/2) - Socially Determined announced a new metric called the Digital Landscape metric that enables organizations to assess digital equity within a population or community and the impact it has on health outcomes and business performance. The metric was developed to address the underlying need for technology in today’s society and the role it plays in health care delivery outcomes and equity. The metric will also offer an analysis of factors related to digital access, affordability, digital literacy, and how they intersect.

EHR Intelligence: (11/1) - According to an article published in JAMA Network Open, health systems should leverage health IT solutions that capture and analyze SDOH EHR data to improve population health. EHR data in population health research can help provide more accurate findings compared to survey and claims data, given the lag time with claims data and limited scope of survey data that often occurs.

Upcoming Events

November

• November 15 - Corporation for Supportive Housing (CSH), “Medicaid and Social Determinants of Health: Options for Health Centers.” Virtual.

• November 15 - ASTHO, “Promoting Community Health Worker Leadership.” Virtual.

• November 16 - Health Affairs, “Lunch & Learn: The Future of Health System Transformation with Maninder Kahlon of University of Texas at Austin.” Virtual.

• November 16 - SAMHSA and HHS Office of Minority Health, “Advancing Behavioral Health Equity: CLAS Standards in Action.” Virtual.

• November 17 - Alliance for Health Policy, “Improving Health Care for People Experiencing Homelessness.” Virtual.

• November 17 - Network of Quality Improvement and Innovation Contractors, “Advancing Health Equity Among the Hispanic Population: Part 1 of a HRSA Webinar Series.” Virtual.

• November 18 - The Commonwealth Fund, “Advancing Health Equity: Federal and State Policy Solutions.” Virtual.

• November 18 - The SCAN Foundation, “Aging as a Women’s Equity Issue: Forging a Path Forward with California’s Master Plan for Aging.” Virtual.

• November 19 - Institute for Medicaid Innovation, “2021 Annual Medicaid MCO Survey Report Release.” Virtual.

• November 19 - Aging and Disability Business Institute, “Addressing Social Isolation in Rural America.” Virtual.

December

• December 7 - Health Resources and Services Administration, “Learning Series: Advancing Equity in Maternal & Infant Health - Session 2.” Virtual.

• December 8 - Systems for Action, “Can Subsidized Transportation Options Slow Diabetes Progression?” Virtual.

SDoH Opportunities

November

• Deadline: November 12 - Data Across Sectors for Health, Request for Applications: Learning and Action in Policy Partnerships (LAPP) Round 2
  

• Deadline: November 12 - Johnson & Johnson, Call for Applications: Health Equity Innovation Challenge

• Deadline: November 15 - Amazon Web Services, Call for Applications: New Global Program to Help Customers Develop Cloud Solutions to Advance Health Equity

• Deadline: November 19 - HHS Office of Minority Health, Request for Information: Efforts to Advance Health Equity Among Native Hawaiian and Pacific Islander Populations

• Deadline: November 19 - ASTHO, CDC Foundation, and Michigan Public Health Institute, Request for Applications: Strategies to Repair Equity and Transform Community Health (STRETCH) Initiative

• Deadline: November 22 - National Network of Public Health Institutes, Request for Applications: National Infrastructure for Mitigating the Impact of COVID-19 within Racial and Ethnic Minority Communities: The Vaccine Equity Project

• Deadline: November 29 - ASTHO, Request for Applications: Partnerships for Population Health Learning Opportunity

December

• Deadline: December 6 - National Collaborative for Health Equity, Call for Applications: Culture of Health Leadership Institute for Racial Healing

• Deadline: December 10 - Institute for Medicaid Innovation, Request for Information: Innovation During the COVID-19 Pandemic - MMCOs, SDOH, and Health Equity Best Practices

• Deadline: December 17 - HHS, HHS Racial Equity in Postpartum Care Challenge

Rolling Basis

• Deadline: Open - Anthem Foundation, Request for Proposals: Food as Medicine RFP
• 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 - Opportunity Starts at Home, Send a Letter: Tell Congress to Enact the Bipartisan “Family Stability and Opportunity Vouchers Act.”
• 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
• Deadline: Open - Data Across Sectors for Health, Survey: 2021 National Inventory of Data Sharing Collaborations for Health