| Social Determinants Updates |
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October 14 to October 28, 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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Member News
EHR Intelligence: AZ HIE Forms Health IT Partnership to Improve SDOH Referrals (10/25) – Contexture, the health information exchange (HIE) for Arizona, announced a new health IT partnership with Unite Us that aims to improve social determinants of health referrals. The new SDOH referral platform, branded as CommunityCares, is designed to facilitate interoperability between health care and community service providers through a single statewide platform to streamline the SDOH referral process and access to social services.
American Hospital Association: Chair File – Bridging the Sectors to Improve Health of Individuals and Communities (10/24) – One way that hospitals and health systems are working to effectively address societal factors that influence the health of individuals and communities is by building collaborative teams and bringing together clinical providers with community partners, such as social service and home care agencies. The American Hospital Association recently updated the “Bridging the Sectors: A Compendium of Resources,” which links to a host of tools, assessments, case examples and evidence-based studies to facilitate this work.
CareSource: Wellness Fairs Improve Health Outcomes for Rural Americans (10/21) – CareSource partnered with Batesville Community School Corporation and Cincinnati Children’s on a wellness resource fair in Indiana. The fair offered opportunities for health screenings, vaccinations, mental health resources, tips on healthy cooking, and more, with the overall goal of improving health outcomes for rural CareSource members.
Navigate Wellbeing Solutions: Navigate partners with findhelp to advance health equity (10/20) – Navigate Wellbeing Solutions partnered with findhelp on an innovative partnership to enhance access to social services for 1.7 million Navigate users and address health disparities. Navigate clients will have the option to include a findhelp search on their employees’ wellbeing platform so employees can search for and receive social services in their area.
3M: Maternal morbidity opportunities for improvement (10/17) – While knowing there is widespread maternal morbidity in the U.S. is important, simply identifying maternal morbidity events is not enough. Creating fair risk adjustment and identifying variation in complications through a fair lens can show where there is opportunity. 3M is working on a study of the patterns of maternal complications over the previous two years, with a look at variation in complications by delivery site, practice, health plan lines, geography, age and race as potential variables.
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Join Aligning for Health and RISE for the Social Determinants of Health Policy Forum
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In cooperation with Aligning for Health, RISE is bringing together policymakers, policy experts, and practitioners from across the health and social services sectors to explore the current and future state of social determinants of health policy. Learn from, engage with, and network with government leaders on federal efforts to increase coordination and impact of programs and services that address health and social needs. In the heart of Capitol Hill, join the only forum gathering state and local governments, leading payers, providers, community-based organizations, and health networks providing insights into innovative programs, models, and best practices to advance whole-person health. Walk away with a better understanding of policies and programs that advance and support data sharing, collaboration, financing, accountability, and equity.
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Legislative Updates
Rep. Underwood: Underwood Calls for Immediate Passage of the Momnibus Act in Response to New Report Showing the COVID Pandemic Worsened Nation’s Maternal Health Crisis (10/25) - Rep. Underwood (D-IL) called for urgent investments in maternal health in response to a new report released by the Government Accountability Office (GAO), which concluded that the COVID-19 pandemic worsened maternal health outcomes and contributed to an increase in maternal deaths, specifically among Black and Hispanic communities. The report is based on a provision in the Maternal Health Pandemic Response Act, which includes robust investments in key federal programs to improve maternal health outcomes in addition to calling for this GAO review.
Rep. Bustos: Bustos Joins Peoria, Rockford, Eagle View Leaders to Announce Federal Funding for Local Health Projects (10/25) – Rep. Bustos (D-IL) joined Peoria, Rockford, and Eagle View health care leaders to announce funding for local health projects aimed at addressing health care and social needs. The funds were awarded through a program made possible by Fiscal Year 2022 Federal Appropriations secured by Rep. Bustos and formed based on the Social Determinants of Health Accelerator Act.
Access to Donor Milk Act: (10/18) – Reps. Houlahan (D-PA), Salazar (R-FL), Bice (R-OK), and Swalwell (D-CA) introduced the Access to Donor Milk Act of 2022 (H.R. 9196), which would protect and expand access to donor breast milk, bettering child health and combating the infant formula shortage. The bill would increase federal support for nonprofit milk banks and access to donor milk for medically-vulnerable infants.
To view a full list of the legislation we are tracking around social determinants of health, health equity/disparities, and maternal health, click here.
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Administration Updates
CMS: More than Half of All States Have Expanded Access to 12 Months of Medicaid and CHIP Postpartum Coverage (10/27) – CMS announced that more than half of all states have expanded access to 12 months of Medicaid and CHIP coverage after pregnancy, with Georgia and Pennsylvania becoming the 25th and 26th
states to be approved for the extended coverage.
ASPE: Healthcare.gov Enrollment by Race and Ethnicity, 2015-2022 (10/25) – The HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE) published a Data Point on changes in Healthcare.gov enrollment by race and ethnicity from 2015-2022, finding that enrollment for all racial and ethnic groups increased from 2020 to 2022. This suggests that outreach efforts and increased coverage affordability under the American Rescue Plan played an important role in increasing Marketplace enrollment among these beneficiaries and making progress in decreasing Marketplace coverage disparities by race and ethnicity.
ONC: ONC Informs CMS Ruling on Hospital Measures for Public Health and Health Equity Reporting (10/25) – The HHS Office of the National Coordinator for Health IT (ONC) published a blog examining an additional update to the Promoting Interoperability Program that reflects collaboration between CMS, ONC, and the CDC. The blog also looks at new policy in the Inpatient Quality Reporting program aimed at advancing health equity.
USDA: USDA Makes Major Investments in WIC to Improve Maternal and Child Health (10/19) – The U.S. Department of Agriculture (USDA) Food and Nutrition Service (FNS) awarded three grants totaling $53 million to improve outreach and program experience for participants in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC). Combined, these investments will help WIC reach more eligible mothers and young children and improve the service they receive throughout their entire experience with the program, setting them up for healthy outcomes and helping to reduce longstanding disparities in maternal and child health.
GAO: Maternal Health – Outcomes Worsened and Disparities Persisted During the Pandemic (10/19) – The Government Accountability Office (GAO) released a report finding that the COVID-19 pandemic worsened factors contributing to maternal health disparities, like access to care. COVID-19 was a contributing factor in one quarter of all maternal deaths in 2020 and 2021 combined.
GAO: Maternal Health – Availability of Hospital-Based Obstetric Care in Rural Areas (10/19) - GAO released a report following interviews with stakeholders around factors that affect the availability of maternal care in rural areas and efforts to address such factors. The report found that the number of hospitals providing obstetric services in rural areas has declined since 2014, which is particularly prevalent in low-income areas. Experts and other stakeholders said it is difficult for hospitals in rural areas to recruit and retain maternal health providers.
ONC: Where APIs meet Health Equity by Design (10/18) – ONC published a blog on the development of the FHIRedApp and how health IT can be used to better identify and mitigate disparities while enhancing opportunities for underrepresented populations. The blog outlines a case study of a ONC-funded FHIR project by the University of Texas at Austin’s Dell Medical School (Dell Med), which has developed a health equity-focused patient engagement platform that supports patient data access through FHIR.
CDC: Vital Signs – Influenza Hospitalizations and Vaccination Coverage by Race and Ethnicity (10/18) – The CDC released a Morbidity and Mortality Weekly Report (MMWR) which highlights racial and ethnic disparities in influenza disease severity and vaccination coverage, along with disparities in access to care.
CDC: Adverse Childhood Experiences During COVID-19 Associated with Poor Mental Health and Suicidal Behaviors Among High School Students (10/14) - CDC released a study
on adverse childhood experiences (ACEs) during the COVID-19 pandemic and associations with poor mental health and suicidal behaviors among high school students. The prevalence of poor current mental health and past-year suicide attempts among adolescents reporting four or more ACEs during the COVID-19 pandemic were four and 25 times as high as those without ACEs, respectively.
CMS: HHS Approves Arizona’s Medicaid Interventions to Target Health-Related Social Needs (10/14) - CMS approved Arizona’s Medicaid section 1115 demonstration that will help the state address health-related social needs through the “Housing and Health Opportunities” program. Arizona’s demonstration will test innovative interventions that target critical drivers of health outcomes, including housing insecurity.
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SDoH & Health Equity in the News
Kaiser Health News: Drivers in Decline – A Shortage of Volunteers Complicates Access to Care in Rural America (10/24) – There are several programs across the country that leverage volunteer drivers to help rural communities, mostly seniors, in accessing health care or social services. However, the number of drivers in such programs has steadily declined due to a variety of factors. Experts say that a decimated volunteer driver network would leave seniors with even fewer transportation options and could interrupt their health management, causing social services organizations to restrict their service options and deny ride requests when drivers aren’t available.
Health Affairs: Language Matters – Why We Need to Stop Talking About Eliminating Health Inequities (10/24) – This article asserts that advocates for health equity should stop talking about eliminating health inequities, as framing the focus on reducing differences in health obscures the reality that inequities affect us all. Furthermore, the language of “eliminating inequities” emphasizes individual-level solutions. This article explores these issues and proposes an alternative that is more aligned with what equity and justice truly mean.
Patient Engagement HIT: Behind the Scenes of Accountable Health Communities, SDOH Screening Model (10/24) – As a bridge organization through the CMS Accountable Health Communities (AHC) Model, Parkland Center for Clinical Innovation (PCCI) published an article this summer highlighting the Dallas Accountable Health Community, which has screened 12,548 individuals and flagged over 19,000 SDOH needs over the five-year program. Through social services referrals to CBOs, PCCI and its partners saw patients gain access to food sources, housing services, and other SDOH needs. That totaled to nearly 200,000 in food, and nearly $540,000 in utility and rent assistance.
Patient Engagement HIT: How Neighborhood Segregation Fuels Maternal Health Disparities (10/24) – According to researchers from the University of South Carolina Arnold School of Public Health, the pandemic exacerbated many of the racial maternal health disparities caused by neighborhood segregation, fueling a maternal health crisis that lands the US among the worst for maternal health outcomes in the developed world. The data
found that racial segregation perpetuated disparities in maternal mortality even before the pandemic, with inequities widening when comparing White and Hispanic birthing people after 2020.
Health Affairs: Payment Policy and the Challenges of Medicare and Medicaid Integration for Dual-Eligible Beneficiaries (10/20) - Dual-eligible beneficiaries have higher Medicare spending levels than Medicare-only beneficiaries because of multiple factors, including higher prevalence of health conditions and greater exposure to social risk factors. Poor alignment between the Medicare and Medicaid programs contributes to higher spending levels and worse outcomes for dual-eligible beneficiaries, which motivates efforts to integrate Medicare and Medicaid benefits. As strategies for integration evolve, so should strategies for how Medicare and Medicaid pay for services for dual eligibles, which this brief examines.
STAT News: Ensuring food security and health beyond the COVID-19 public health emergency (10/18) – Once the COVID-19 public health emergency (PHE) ends, so will the expansions to Medicaid and SNAP. Food insecurity, poverty, and poor health are often linked, and many individuals and families will experience the cumulative impact of losing access to both Medicaid and SNAP at the end of the PHE. This article outlines how health care organizations can play an active role in supporting patients navigating the systems necessary for them to access health services and achieve food security.
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Data & Innovation
State of Reform: Utah launches Healthy Places Index to track and improve health outcomes in disparate areas of the state (10/25) – The Utah Department of Health and Human Services launched a new online map that tracks and compares health data across the state to evaluate country, city, and neighborhood health. The Healthy Places Index, which is part of the state’s efforts to understand how geography, environment, and SDOH affect health outcomes, uses data and input from nearly 100 industry and community partners across the state, scoring eight community conditions such as housing, social and health care access, and transportation.
Healthcare Innovations: Civitas Gets Grant to Help Disseminate Gravity Project Standards (10/18) - Civitas Networks for Health received a $1 million award from Robert Wood Johnson Foundation to further the implementation and dissemination of Gravity Project social determinants of health standards. The 12-month project, which kicks off Nov. 1, 2022, will provide opportunity for shared learning, training and technical assistance, and in-person multi-stakeholder convenings.
Center for Health Care Strategies: Words Matter – Strategies to Reduce Bias in Electronic Health Records (October 2022) – Biases and stigmatizing language in the electronic health record (EHR) can be reflected through negative physician or behavioral descriptors of patients, often related to race and ethnicity. Biased language in the EHR can negatively influence a patient’s care across providers. This tool
outlines considerations for providers on how to write EHR notes that promote patient-centered care and dignity.
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New Research and Reports
Medical Economics: Hospitals are screening for social determinants of health, but programs, community partnerships lag (10/25) – A recent study
in JAMA Health Forum found that the pandemic sparked public interest in addressing social needs and health systems have made substantial investments to do so. Among the hospitals surveyed, 64 percent reported strategies for three areas: screening for SDOH, creating programs or interventions to address those, or working with external community partners to address SDOH. The results also suggest that rural hospitals, critical access hospitals, and safety net hospitals are not doing more, and in some cases, are engaging in fewer strategies to address SDOH of their populations, largely due to resource constraints.
State of Reform: Survey finds majority of Texans believe more state funding for SDOH is needed (10/19) – According to results of a new state survey by the Episcopal Health Foundation, 56 percent of Texans say health insurance should cover non-medical factors such as access to food and housing. A majority (65 percent) of respondents also said more state funding to address these factors would improve people’s health. Support for more spending was highest among Black (72 percent), Hispanic (75 percent), and younger (76 percent of the 18-29 age group) Texans surveyed.
Tufts Now: Medically Tailored Meals Could Save U.S. Nearly $13.6B Per Year (10/17) – Researchers at Tufts University conducted a study
finding that, alongside cost savings of $13.6 billion each year, expanding programs that prepare and deliver medically tailored meals for patients with serious illnesses could help avoid 1.6 million hospitalizations annually. Medically tailored meal programs, which typically deliver 10 healthy meals per week that are customized and fully prepared for individuals living with advanced illnesses, could result in $185.1 billion less in health care spending and 18.3 million hospitalizations averted over a 10 year period.
Cancer Reports: Association of neighborhood-level SDOH with psychosocial distress in patients newly diagnosed with lung cancer (10/17) - Patients with lung cancer experience high rates of psychosocial distress. They are also more likely to have unresolved, unmet social needs which may contribute to psychosocial distress. Despite this, neighborhood-level social determinants of health in relation to psychosocial distress have not been adequately investigated in patients with lung cancer. This study examines the association between neighborhood-level SDOH and psychosocial distress among a sample of newly diagnosed patients with lung cancer.
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Upcoming Events
November - December
2023
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SDoH Opportunities
October
November/December
Rolling Basis & 2023
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