Social Determinants Updates |
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April 14 to April 28, 2023
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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Member News
Forbes: Why Data Will Be a Key Component of the Federal Government’s Nutrition and Health Equity Initiatives (4/21) – Socially Determined CEO and Co-founder Trenor Williams penned this article, highlighting that the federal government’s efforts to invest in and improve nutrition among Americans may not be successful unless these efforts are underpinned by a forward-looking, data-driven strategy. Improving the breadth, depth and accuracy of data is the first step toward implementing a more comprehensive and strategic approach, which involves identifying new sources of data that will be able to offer more comprehensive, equitable and scalable information on nutrition, hunger and health.
CareSource: Why improving access to legal counsel is crucial to helping improve affordable housing conditions and health outcomes (4/20) – This blog by CareSource
outlines that what is missing from the public debate around affordable housing is the crippling cost low-income renters must shoulder to fend off lawsuits by sometimes unethical landlords. As housing is one of the five domains of the social determinants of health, CareSource has invested in the Atlanta Volunteer Lawyers Foundation to create a program to support underserved communities in Atlanta with pro bono legal services for safe and stable housing.
American Hospital Association: The Health Equity Roadmap – One Year Later (4/18) - In March 2022, the American Hospital Association (AHA) Institute for Diversity and Health Equity (IFDHE) launched the Health Equity Roadmap, a national framework to advance health equity in hospitals and health systems. Within its first year of the launch, IFDHE engaged over 1,000 member hospitals in the Roadmap. Joy A. Lewis, senior vice president for health equity strategies and executive director of IFDHE and Leon D. Caldwell, senior director of health equity strategies, explained why achieving this milestone is monumental, and what’s ahead.
Healthline: Hidden Risk Factors like Language Barriers and Discrimination Can Make Women More Likely to Develop Heart Disease (4/13) – An estimated 60 million women in the U.S. live with some form of cardiovascular disease. The American Heart Association identified five social determinants of health in a recent statement that impact heart disease, including health care access. Michelle Horan, a registered nurse and COO of Healthy Alliance, shared that other daily stressors — such as care responsibilities and the potential of eviction — can reduce the capacity of underserved communities to access health care.
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Legislative Roundup
John Lewis Equality in Medicare and Medicaid Treatment (EMMT) Act (4/26) - Sens. Booker (D-NJ), Padilla (D-CA), and Brown (D-OH) introduced the John Lewis Equality in Medicare and Medicaid Treatment (EMMT) Act (S. 1296), which would improve access to care for all Medicare and Medicaid beneficiaries through models tested under the Center for Medicare and Medicaid Innovation. The bill would require CMMI to work with experts to consider health disparities when developing payment models.
Supporting our Direct Care Workforce and Family Caregivers Act (4/26) - Sen. Kaine (D-VA) and seven cosponsors introduced the Supporting Our Direct Care Workforce and Family Caregivers Act (S. 1298), which would award grants for the creation, recruitment, training and education, retention, and advancement of the direct care workforce and to award grants to support family caregivers.
Anti-Racism in Public Health Act (4/26) - Rep. Pressley (D-MA) and 43 cosponsors introduced the Anti-Racism in Public Health Act of 2023 (H.R. 2904), which would provide for public health research and investment into understanding and eliminating structural racism and police violence. The bill would declare racism a public health crisis, create a National Center for Anti-Racism, and establish a Law Enforcement Violence Prevention Program at the CDC. Bill Summary
Green New Deal for Health Act (4/20) - Rep. Khanna (D-CA) and 21 cosponsors introduced the Green New Deal for Health Act (H.R. 2764), which would establish a Green New Deal for Health to prepare and empower the health care sector to protect the health and wellbeing of workers, communities, and the planet in the face of the climate crisis. Sens. Markey (D-MA), Merkley (D-OR), Sanders (I-VT), and Warren (D-MA) introduced the companion legislation in the Senate (S. 1229). One-Pager
Health Equity and MENA Community Inclusion Act (4/19) - Reps. Tlaib (D-MI), Dingell (D-MI), Eshoo (D-CA), and Kelly (D-IL) introduced the Health Equity and Middle Eastern and North African (MENA) Community Inclusion Act (H.R. 2730), which would include Middle Easterners and North Africans in the statutory definition of a "racial and ethnic minority group".
Closing the Meal Gap Act (4/19) - Reps. Adams (D-NC) and Velázquez (D-NY) introduced the Closing the Meal Gap Act, which would require that supplemental nutrition assistance program benefits be calculated using the value of the low-cost food plan. Sens. Gillibrand (D-NY) and Welch (D-VT) introduced the companion legislation in the Senate. Bill Text
Elder Justice Reauthorization and Modernization Act (4/19) - Reps. Neal (D-MA) and Bonamici (D-OR) introduced the Elder Justice Reauthorization and Modernization Act of 2023 (H.R. 2718), which would reauthorize the Elder Justice Act and dedicates new funding to programs proven to safeguard older adults and adults with disabilities. Sens. Wyden (D-OR) and Casey (D-PA) introduced the companion legislation in the Senate (S.1198).
Addressing SILO Act (4/18) - Rep. Sanchez (D-CA) introduced the Addressing Social Isolation and Loneliness in Older Adults (SILO) Act (H.R. 2692), which would provide grants and training to support area agencies on aging or other community-based organizations to address social isolation among vulnerable older adults and adults with disabilities.
Sen. Booker: Booker, Adams, Underwood Introduce Bicameral Black Maternal Health Week Resolution (4/18) – Sen. Booker (D-NJ) and Reps. Adams (D-NC) and Underwood (D-IL) introduced the bicameral resolution recognizing Black Maternal Health Week “to bring national attention to the maternal health crisis in the U.S. and the urgent importance of reducing maternal mortality and morbidity among Black women and birthing persons. Black Maternal Health Week is observed from April 11 – April 17. The Hill Op-Ed
Aligning for Health Supports Letter to Congressional Appropriators Supporting CDC SDOH Program
(4/13) – Aligning for Health joined more than 150 in a letter to Congressional Appropriators requesting the CDC Social Determinants of Health program be funded at $100 million in FY2024. This request would support the CDC in expanding its ongoing SDOH efforts by funding another round of Social Determinant Accelerator Plans to states, tribes, territories, and/or localities to develop new or implement and evaluate existing SDOH plans.
To view a full list of the legislation we are tracking around social determinants of health, health equity/disparities, and maternal health in the 118th Congress, click here.
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Administration Updates
CMS: The Biden-Harris Administration Proposes New Standards to Help Ensure Access to Quality Health Care in Medicaid and CHIP (4/27) – CMS released two proposed rules that together would strengthen access to and quality of care across Medicaid and CHIP. The Medicaid Managed Care proposed rule (CMS 2439-P) would strengthen standards for timely access to care and monitoring and enforcement efforts; enhance quality, fiscal, and program integrity standards; and specify the scope of in lieu of services and settings to better address health-related social needs (HRSNs). The Ensuring Access to Medicaid Services proposed rule (CMS 2442-P) would ensure access to Medicaid services, proposing requirements that would promote health equity for people receiving Medicaid-covered home and community-based services. Comments are due by June 22, 2023.
HHS: HHS Announces $2.5M for Produce Prescription Programs in Indian Country (4/26) - HHS announced the availability of $2.5 million in funding for Native communities to support the development of produce prescription programs, which help individuals and families who are experiencing food insecurity and/or diet‑related health problems more easily obtain fresh fruits and vegetables.
HUD: HUD Awards $15M to Help Low-Income Seniors Age in Place (4/26) - The Department of Housing and Urban Development (HUD) awarded nearly $15 million to 13 nonprofit organizations, in addition to a state government to assist in undertaking comprehensive programs that make safety and functional home modifications and limited repairs to meet the needs of low-income elderly homeowners that allow them to age in place. Grants are provided through the Older Adults Home Modification Program (OAHMP).
HHS: During National Minority Health Month, HHS Organizes First-Ever Nationwide Vaccination Day Event to Bring Health-Related Resources to Black Communities (4/24) - HHS released a press release highlighting HHS’ nationwide vaccination day event intended to bring health-related resources to Black communities, partnering with seven organizations to provide free COVID vaccines in 17 cities.
CMS: Disparities in Health Care in Medicare Advantage by Race, Ethnicity, and Sex (4/19) - CMS released a report on disparities in health care in Medicare Advantage by race, ethnicity, and sex, which found that a substantial proportion of clinical care scores were below the national average for American Indian/Alaska Native, Black, and Hispanic enrollees.
HHS: Readout of HHS Secretary Becerra’s Roundtable on Black Maternal Health (4/18) - HHS Secretary Becerra hosted a roundtable discussion to commemorate Black Maternal Health Week (April 11-17). He emphasized the Administration’s work to address the underlying disparities in the health care system, to provide whole-person care to pregnant people and their families, and advance health equity across the country.
U.S. Census Bureau: New Research Links Medicaid and Census Bureau Data to Improve Study of Racial/Ethnic Health Disparities
(4/18) – The lack of data on race and ethnicity in Medicaid enrollment records is an increasingly significant public and policy challenge that the U.S. Census Bureau is trying to address. New Census Bureau research
found that linking Medicaid data with decennial census and American Community Survey data could help identify gaps and evaluate the quality of race/ethnicity information in Medicaid records. Overall, 19 percent of Medicaid beneficiaries were missing race/ethnicity information but this rate varied considerably across states.
CMS: CMS Releases New Guidance to Encourage States to Apply for New Medicaid Reentry Section 1115 Demonstration Opportunity to Increase Health Care for People Leaving Carceral Facilities (4/17) - CMS released a State Medicaid Director Letter to encourage states to apply for a new Medicaid Reentry Section 1115 Demonstration Opportunity, allowing state Medicaid programs to cover services for individuals who are incarcerated in the period immediately prior to their release. CMS notes that improving health care transitions and addressing social determinants of health – from case management to medication-assisted treatment – for individuals after they have been released from carceral settings increases the likelihood that they may continue to receive crucial substance-use disorder, mental health, and other health care treatment during this period.
HUD: HUD Announces $486M in Grants and $43M for Stability Vouchers to Address Unsheltered and Rural Homelessness (4/17) – HUD announced the second set of communities to receive grants and housing vouchers to address homelessness among people in unsheltered settings and in rural communities. This announcement includes $171.2 million in grants for 115 new projects in 29 Continuum of Care (CoC) communities, and adds to the first set of grant awards announced in February. Fact Sheet
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SDoH & Health Equity in the News
Michigan Department of Health and Human Services: MDHHS pilots community health worker program at COVID-19 neighborhood testing sites (4/24) – The Michigan Department of Health and Human Services (MDHHS) announced a pilot program for community health worker (CHW) services at select COVID-19 Neighborhood Testing sites to address community health needs. CHWs will offer on-demand referral services to essential health and well-being resources. Visitors to participating sites can meet with an on-site CHW to connect with community resources that include food access, housing supports, utilities assistance and health care enrollment.
Health Affairs: Medicaid Section 1115 Waivers – From Work Requirements to Social Determinants of Health (4/20) – This article reviews the recent history and current landscape of Medicaid Section 1115 waivers. The authors propose mechanisms for sustained advocacy on the part of the medical community, health law experts, researchers, and policy makers in opposing the use of waivers to impose work requirements and supporting the use of waivers to address social determinants of health.
Medical Economics: Physicians Foundation aims at social drivers of health (4/20) – The Physicians Foundation launched “Let’s Take 5 to Address Drivers of Health,” a new initiative to guide physicians in addressing economic and social conditions impacting health. The campaign starts with doctors asking patients about food security, housing stability, transportation access, utilities access, and interpersonal safety, and includes an implementation guide with how to screen patients for these factors with five steps.
Humana: University of North Florida and Humana Expand Meals on Wings Program to Address Food Insecurity Among Older Adults (4/19) – The University of North Florida and Humana Inc. collaborated to expand the University’s Meals on Wings program into two new communities to help increase the number of older adults who receive meal assistance. The Meals on Wings program addresses food and nutrition insecurity among older adults and provides a solution to the ongoing hunger problem. Humana also recently announced a $40 million national investment to improve housing stability for vulnerable members and communities.
STAT: Free Uber rides helped patients keep their prenatal appointments. Now the company wants insurers to pay for it (4/17) – Uber provided hundreds of pregnant patients in D.C. free rides to appointments in 2021 and 2022, saying patients who participated in the pilot were slightly more likely to get prenatal care. Uber is shopping the data around to insurers in a bid to get them to pay for the service to make the process of organizing and taking rides easier for both staff and patients. Uber Health also recently partnered with Medecision to make it easier for health plans and health care providers to break down transportation barriers preventing individuals from accessing non-emergent health care services.
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Maternal Health
Daily Times: Pols tout $945,000 to expand maternity care in Delaware County (4/25) - A new workforce development program to train perinatal community health care workers and doulas — funded by nearly $1 million in federal community project dollars — will take aim at reducing racial disparities in maternal health and infant survival rates for Delaware County mothers and children. The community project funding for this pilot program would be used to collaborate with expert community partners that will convene monthly to build programs to increase capacity for doulas and community health care workers in the county.
New York State Department of Health: NYS DOH Awards $8.9M to Promote Breast/Chest Feeding in Racially and Ethnically Diverse Communities (4/21) - The New York State Department of Health is awarding $8.9 million in funding to support the implementation and expansion of locally-coordinated networks across the state that will promote and encourage breast/chest feeding and infant human milk feeding in low income and racially/ethnically diverse communities, and to ultimately reduce breast/chest feeding health disparities.
CVS Health:
Aetna Better Health of Maryland announces pilot program with maternal health provider Mae (4/20) – Aetna Better Health of Maryland, a CVS Health company, announced a pilot program in collaboration with digital health solution provider Mae focused on reducing health disparities for Black expectant mothers. Mae offers participating members a community-led model of doula support along with an engagement platform that tracks their physical, social, and emotional needs during pregnancy and postpartum to inform the guidance and in-person support they receive.
The Texas Tribune: Texas House moves to expand Medicaid coverage to new moms for a year after childbirth (4/20) - The Texas House passed a bill that would allow low-income moms to stay on Medicaid for a full year after childbirth. The bill was approved with bipartisan support in a 132-8 vote. Allowing new moms to stay on Medicaid for 12 months is the top recommendation of the state’s Maternal Mortality and Morbidity Review Committee, which recently documented the staggering risks of pregnancy and childbirth in Texas.
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Data & Innovation
NCQA: NCQA Launches Race and Ethnicity Stratification Learning Network to Advance Health Equity (4/26) – NCQA launched the Race and Ethnicity Stratification Learning Network, a free, interactive, online tool that offers data and best practices to help health plans improve how they collect race and ethnicity data on their enrollees. Improving data collection of race and ethnicity data is vital to improving health equity. The data available in this new resource summarize the care of 20 million people enrolled in 14 health plans that reported results on five HEDIS measures, stratified by race and ethnicity.
NEJM Catalyst: Addressing Health-Related Social Needs through Systematic Screening and Integration of a Social Care Technology Platform (4/19) – Duke Health implemented systematic screening for health-related social needs (HRSNs) and NCCARE360, a social care referral network and technology platform, within its electronic health record (EHR). Using a tandem strategy of discrete HRSN identification (screening) and then referral placement, Duke Health increased overall identification of patient HRSNs and the ability to track outcomes of referrals. Using flexible point-of-care screening workflows led to effective and sustained HRSN screening, averaging 8,500 patients per month across 32 ambulatory clinics and inpatient encounters over 18 months.
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New Research and Reports
Milbank Quarterly: The Future of Social Determinants of Health – Looking Upstream to Structural Drivers (4/25) - Policy that redress social, economic, and political conditions are essential for improving population health and achieving health equity. Efforts to remedy structural oppression and its deleterious effects should account for its multilevel, multifaceted, interconnected, systemic, and intersectional nature. This perspective calls on HHS to facilitate the creation and maintenance of a national publicly available, user-friendly data infrastructure on contextual measures of structural oppression.
JAMA Network Open: Association of Health-Related Social Needs with Quality and Utilization Outcomes in a Medicare Advantage Population with Diabetes (4/21) – This study assess which health-related social needs (HRSNs) are associated with health care quality and utilization outcomes in a Medicare Advantage population with type 2 diabetes. Of 21,528 beneficiaries in this cross-sectional study, 56.9 percent had at least one HRSN; the most prevalent were financial strain, food insecurity, and poor housing quality.
International Journal of Maternal and Child Health and AIDS: Association Between SDOH Issues and Maternal Obesity Among American Racial/Ethnic Groups (4/18) - Social determinants of health impact various clinical health outcomes in the population. This study examined the impact of adverse social determinants of health characteristics on maternal obesity among hospitalized pregnant women in the US and its potential differential impact on women of different races/ethnicities.
MACPAC: Access in Brief – Health Care Experiences and Satisfaction by Race and Ethnicity (April 2023) – Racial and ethnic health disparities persist throughout the U.S. health care system. Measuring differences in access and use of services, satisfaction with and quality of care, and health outcomes can help to better understand the underlying causes of disparities and how to address them. This issue brief compares the demographics, health status, quality of care, and includes experiences and satisfaction with provided care, provider concordance, and perceived unfair treatment and discrimination of adults covered by Medicaid by race and ethnicity.
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SDoH Opportunities
April - October
Rolling Basis
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