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Social Determinants Updates

September 18  to October 2, 2020

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

In this newsletter you will find updates on how the health care system is helping to meet health and social needs during the current public health emergency, as well as other notable links to research, data, and news related to social determinants, and upcoming virtual events and opportunities.

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Member News

Home Health News:(9/30) – Signify Home and Community has announced a partnership with Independence Blue Cross called CommunityLink, a network of community-based organizations designed to break down the traditional barriers between social and clinical care and improve health outcomes for people who need help with non-medical services (such as help with food, housing, transportation, financial support, or other services) in the Philadelphia region.

Centene: (9/29) – In recognition of National Suicide Prevention Month, Centene reaffirmed its commitment to increasing suicide awareness and prevention through their Suicide Prevention program, which includes a comprehensive program for their beneficiaries and community partnerships with organizations like Tragedy Assistance Program for Survivors.

Revcycle Intelligence: (9/28) – Alliance for Better Health is recognized as an independent physician association of community-based organizations that is forging contracts with payers to address social needs in a way that generates return on investment and sustainable programs.

Open Minds: (9/29) – John Lovelace, President of UPMC For You, discusses how UPMC is addressing social safety net issues through a number of initiatives through the Center for Social Impact, which works to coordinate, evaluate and expand programming and innovations that address both social needs and social determinants of the communities UPMC serves.

Patient Engagement HIT: (9/22) – The American Hospital Association is featured in its article for its role in evaluating a five-year plan from Providence St. Joseph Hospital to fund research into COVID-19 health disparities and inform decisions for future population health policy.

Blue Cross Blue Shield: (9/21) – Blue Cross Blue Shield companies are working to increase the diversity in medical research to reflect diversity and improve the health of Americans by using grassroots efforts to recruit people to participate in the NIH’s All of Us Research program.

Social Determinants Accelerator Act

The Social Determinants Accelerator Act (H.R. 4004/S. 2986) would provide planning grants and technical assistance to help states and communities devise strategies to better leverage existing programs and authorities to improve the health and well-being of those participating in Medicaid. SDAA would also convene the Social Determinants Accelerator Interagency Council including program experts from across the federal government, as well as state and local government officials, and private sector and community-based organizations. If you are interested in learning more, here are links to our web page, bill text, fact sheet , and a list of current endorsers.
If your organization is interested in endorsing the Social Determinants Accelerator Act, please fill out
this form.

Shaw Local: (9/30) – Rep. Cheri Bustos, lead sponsor of the Social Determinants Accelerator Act (H.R. 4004) discussed the Social Determinants Accelerator Act in an interview about health care, education, and law enforcement, noting that access to fresh produce, quality medical care, and early childhood education are necessary to promoting good health and lifting individuals out of poverty.

Aligning for Social and Health Needs in the Community Webinar Recording

Aligning for Health and the American Hospital Association hosted a webinar on September 24th exploring how three leading health systems have worked to improve community health and to address health and social needs. In this webinar, you will learn about innovations and best practices, the impact of COVID-19, and the outlook moving forward. The full webinar recording and slides are posted on our website here.

Read more

SDoH in the News

STAT: (10/1) – Both biological and socioeconomic factors make individuals with diabetes more likely to suffer severe illness and death should they contract COVID-19. The pandemic has intertwined with and exposed two widespread problems: diabetes and disparities triggered by social determinants of health.

Politico Pro (Subscription): (9/30) – Achieving economic recovery from the COVID-19 pandemic could take years and could continue to impact the nation’s most vulnerable communities. Social and public services are facing budget delays or cuts as a result of the economic crisis, which has impacted housing, food, public safety, and other social needs among vulnerable communities.

National Institutes of Health: (9/30) – The NIH awarded nearly $234 million to help improve COVID-19 testing in underserved and vulnerable communities affected by coronavirus, funding 32 institutions to better understand coronavirus testing patterns and reduce testing disparities.

Bloomberg Law: (9/29) – While state health programs are increasingly being called upon to address social needs that have worsened the impact of the pandemic on marginalized communities, tightening state budgets could deter Medicaid’s focus on social needs.

Medical Economics: (9/29) – As more Americans face increased social needs, the health care system needs to develop sustainable partnerships with community-based organizations to address the long-term impact of the coronavirus pandemic on communities.

Medium: (9/29) – Build Healthy Places highlighted how the Better Health through Housing demonstration in Chicago provided the blueprint to expand a $13 million regional funding pool is helping chronically homeless people get off the street and into permanent homes and supportive housing.

UnitedHealthcare: (9/29) – UnitedHealthcare announced a $1 million contribution to Catholic Charities of Southern Nevada over the next three years to provide vital support to their Meals on Wheels Program and Renewing Hope Program for Men. CCSN will use the funds to provide up to 300 seniors with food deliveries, decreasing the current wait list, and increasing food security across Clark County.

Health Affairs: (9/29) – Despite the prevalent belief that tuberculosis is a disease of the past in the U.S., certain U.S. populations like Pacific Islanders, Native Americans and homeless people are increasingly prone to tuberculosis outbreaks The COVID-19 pandemic has set global tuberculosis elimination efforts back an estimated five to eight years, necessitating investments in meals as medicine and extending tuberculosis elimination work upstream by focusing on prevention by addressing socioeconomic factors such as undernutrition.

The Hill: (9/29) – Access to healthy foods is restricted by food deserts, food swamps, and inability to buy groceries due to financial insecurity or due to the coronavirus pandemic. This op-ed by a provider at Massachusetts General Hospital provides an overview of how health systems are well positioned to play a strategic part in fixing food insecurity due to their proximity to communities, central responsibility in treating chronic disease, and participation in value-based payment models that incentivize addressing patients’ health-related social needs such as food.

RISE Health: (9/29) – Looking at recent headlines concerning social determinants of health, RISE compiled articles detailing how the COVID-19 pandemic has led loneliness rates to double in adults, placed disproportionate financial strain on Latino, Black, and Native American households, and exacerbated other racial disparities.

Patient Engagement HIT: (9/28) – In this episode of the Healthcare Strategies Podcast, Julie Smithwich from the Center for Community Health Alignment discusses the importance of understanding how injustices have created health disparities in order to build a future with health equity.

WMDT: (9/28) – Highmark Delaware is giving $1 million for its BluePrints for the Community Grant program and the Delaware Community Foundation to study and balance social determinants of health, like economic and financial instability, access to education, and transportation.

The Atlantic: (9/24) – Zeke Emanuel and Risa Lavizzo-Mourey note that the health care system is responsible for about 10 to 15 percent of preventable mortality in the U.S., while socioeconomic factors have a greater overall impact on mortality. In this op-ed, the authors present five concrete changes to public policy, industry practices, and medical education that could address and improve health inequities.

mHealthIntelligence: (9/24) – A study by the Yale School of Medicine found that underserved communities are likely to use mHealth tools to gather data and participate in studies if those tools are well-designed and aided by community health outreach, highlighting to opportunity to bolster mHealth application usage among low-income populations by partnering with community organizations, hiring community health workers to facilitate engagement, and increasing hot spots to free high-speed WiFi to improve health and health outcomes.

Bloomberg: (9/23) – The COVID-19 pandemic has caused a vast drop in critical early child care for low-income children, with vaccinations for children under age 2 down 22 percent, dental services decreased by 69 percent, and child screening services for early detection of conditions like autism declining 44 percent over the last year, according to CMS.

HHS: (9/22) – To improve maternal health outcomes, HHS awarded approximately $341 million in funding to 55 states, territories, and nonprofit organizations through the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program and $16 million in funding to the State Maternal Health Innovation (STATE MHI) Program.

 Data Collection and Innovation

EHR Intelligence: (9/28) – As the gathering and integration of social determinants of health data into clinical data is becoming more common, the study of social informatics could help ease the integration process and help the health care system meet social needs and set up successful referral systems.

Healthcare IT News: (9/23) – The Connect Rx Wisconsin team won $1 million from Schmidt Futures to create an integrated network of health care and social service systems across Dane County, WI. The five health systems involved in the project are working alongside community partners to embed a social needs referral tool into the Epic EHR system to support social services referrals and SDOH.

JAMIA: (9/17) – In this Journal of the American Medical Informatics Association article, the authors highlight how social informatics can drive research that informs how to approach social determinants of health data, interoperability, execution, and ethical challenges involved in integrating social and medical care.

New Research and Reports

Research Square: (9/29) – This review provides a comprehensive overview of factors, particularly health determinants, that impact seasonal flu vaccination uptake among older adults. Findings revealed that older age and factors including multiple chronic diseases, preventive lifestyles, and frequent routine health care utilization positively affected vaccine uptake. Living and working conditions were also shown to be impactful determinants of flu vaccine uptake.

NASHP: (9/29) – COVID-19 has exacerbated longstanding issues facing states, including budget limitations, systemic racism, cost containment, and maintaining access to quality care. This blog explores how states can leverage payment systems and use cost containment strategies to improve chronic care and advance health equity.

Patient Engagement HIT: (9/24) – New research from the UNC Lineberger Comprehensive Cancer Center found that one in seven black women (13.4 percent) with breast cancer face a delay in care access following diagnosis, compared to only 7.9 percent of white women.

NEJM: (9/23) – Disadvantaged communities have been the most impacted by COVID-19 and have continued to experience reduced access to care, a widening digital divide, and inadequate supplies. This article reveals that, especially in times of crisis, investing in community health workers (CHWs) and community-based organizations can help address the social needs that disproportionately impact low-income, minority populations.

Patient Engagement HIT: (9/23) – New research from the Kaiser Family Foundation (KFF) and Epic Health Research Network (EHRN) confirms previous literature highlighting the racial health disparities resulting from COVID-19. The study shows that patients of color experience COVID-19 at higher and more severe rates compared to white patients, and that these populations may also experience barriers in accessing testing.

Becker’s Hospital Review: (9/23) – A new report from the March of Dimes found that 2.2 million women of childbearing age in 35 percent of U.S. counties live in maternity care deserts or areas where hospitals do not offer obstetric care, birthing services, or specialized providers.

JAMA: (9/23) – Recognizing the integral work of community health workers, this report calls for payers and health care systems to invest in a sustainable community health worker workforce that includes uniform payment models and consistent reimbursement mechanisms for their services as a way to address social needs and improve the social determinants of health.

Fierce Healthcare: (9/22) – A new report from U.S. News & World Report and the Aetna Foundation found that the healthiest communities in the country are also among those communities with the lowest rates of COVID-19 infections, highlighting the direct link between social determinants of health and the coronavirus pandemic.

AJMC: (9/19) – A recent research letter published in the Journal of Cardiac Failure highlights how SDOH can explain the differences in heart failure mortality observed over the past two decades. Socioeconomic status is a particular indicator of these observed trends.

Morbidity and Mortality Weekly Report: (9/18) – Researchers at the CDC in Atlanta found that between 2015 and 2017, the fetal mortality rate among non-Hispanic and Black women was more than twice that among non-Hispanic white and Hispanic women. The rate of fetal death attributable to maternal complications among non-Hispanic black women was three times that of white women.

Legislative Roundup

The HEROES Act: (9/29) – Representative Nita Lowey (D-NY) introduced H.R . 8406, the new iteration of the May COVID-19 relief bill, scaling the bill down to $2.2 trillion and adding additional funding provisions. The bill included provisions to support the modernization of data collection methods and infrastructure, both within Federal agencies and state, local, and territorial health departments. The purpose of such provisions is to increase data collection related to health inequities, such as racial, ethnic, socioeconomics, sex, gender, and disability disparities.

Helping MOMS Act of 2020: (9/29) – The House passed H.R. 4996, which would create a new state plan option under the Medicaid program to provide for and extend continuous coverage for pregnant and postpartum women for up to one year after a beneficiary gives birth. The bill, which was introduced by Representative Robin Kelly (D-IL) last year, would incentivize states by increasing their federal Medicaid match by 5%. The bill also requires a MACPAC report on using bundled payments to reimburse healthcare providers with respect to pregnancy related services furnished under state plans under title XIX.

Improving Mental Health Access from the Emergency Department Act of 2020: (9/29) – The House passed H.R. 2519, which authorizes SAMHSA to award grants to qualifying emergency departments to support mental health services. Grant recipients must use funds to implement innovative approaches to securing prompt access to appropriate follow-on care for individuals who experience an acute mental health episode and present for care in an emergency department. The bill was introduced by Representative Raul Ruiz (D-CA) in 2019.

House of Representatives: (9/21) – The House passed several health bills, including one to codify non-emergency transportation as a mandatory Medicaid benefit and another to strengthen maternal health care in rural areas:

  • Protecting Patients Transportation to Care Act: (9/21) – The bill, introduced by Reps. Buddy Carter (R-GA), Tony Cardenas (D-CA), Tom Graves (R-GA), and Sanford Bishop (D-GA), adds non-emergency medical transportation to the list of mandatory Medicaid benefits by codifying current Medicaid NEMT regulations.
  • Maternal Health Quality Improvement Act of 2019: (9/21) – The bill, introduced by Reps. Eliot Engel (D-NY), Larry Bucshon (R-IN), Xochitl Torres Small (D-NM), Bob Latta (R-OH), Alma Adams (D-NC), and Steve Stivers (R-OH) would create new programs under the Public Health Service Act to improve maternal health in rural areas, as well as programs to address racial and ethnic disparities in care and implement best practices in maternal care.

Special Committee on Aging: (9/16) – Senator Bob Casey (D-PA), the Ranking Member of the Senate Special Committee on Aging, released a report on reimagining aging in America, providing a blueprint to create health and economic security for older Americans. The report recommends policies that would remove barriers to accessing affordable health care, help older adults build and maintain secure retirement, and ensure all seniors can benefit from critical social services.

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