| Social Determinants Updates |
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May 27 to June 10, 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
Stanford Medicine: (6/8) - Jonathan Shaw, MD, a clinical associate professor of medicine in primary care and population health at Stanford Medicine, teamed up with the Healthy Alliance to study the impact of the organization’s work on patient health outcomes and health care spending. The goal is to see if communities within the network have measurably better health and seek fewer reimbursements from Medicaid and other payers than those that do not. This article presents an interview with Shaw to understand how SDOH impacts health and more on this study.
American Hospital Association: (6/6) - SteelSky Ventures, which has been supported by the American Hospital Association (AHA), is among a growing number of health equity funds trying to provide greater opportunity to female and racially diverse entrepreneurs focused on developing solutions for health care providers. In a new AHA Innovation Dialogue, AHA Maternal and Child Health Council Chair Lara Khouri, executive vice president and chief strategy and transformation officer at Children’s Hospital Los Angeles, talks with SteelSky Ventures Founding Partner Maria Velissaris about where the fund is headed.
CareSource: (6/2) - CareSource donated $4,500 to the OhioHealth Mothers’ Milk Bank to sponsor 1,000 ounces of milk as part of a larger effort to increase access to adequate infant nutrition while the country is experiencing an unprecedented shortage of infant formula. The milk bank relies on donations from healthy, lactating women.
Fierce Healthcare: (5/31) - A new report from the Blue Cross Blue Shield Association found that undiagnosed and untreated major depression disproportionately affects Black and Hispanic communities. The report suggested solutions like expanding telehealth services and identifying ways to connect patients with providers of their preference as well as integrating mental and physical health care.
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Legislative Updates
Inside Health Policy: (6/2) - More than 70 stakeholder groups sent a letter, led by Aligning for Health and Trust for America’s Health, calling on the House Energy & Commerce (E&C) Committee to move on social determinants of health legislation after the Health Subcommittee considered several pieces of SDOH legislation last summer. The letter asks the Committee to take up legislation that would coordinate efforts to tackle SDOH by setting up an interagency council across federal programs to look at various authorities, opportunities and strategies in this area. The letter also asks that E&C support CDC’s work on SDOH and promote collaboration between CDC and others like CMS.
Improving Data Collection for ACEs Act: (5/31) - Sens. King (I-ME) and Murkowski (R-AK) introduced the Improving Data Collection for Adverse Childhood Experiences (ACEs) Act (S. 4332), which would direct the Secretary of HHS, acting through the Director of the CDC, to support research and programmatic efforts that will build on previous research on the effects of adverse childhood experiences. The bill would authorize $7 million annually over five years to support CDC research and data collection efforts to study the potential ties between childhood trauma and poor health conditions in adulthood.
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
HHS: (6/9) - The Health Resources and Services Administration (HRSA) announced the launch of the Building Bridges to Better Health: A Primary Health Care Challenge, a national competition to encourage innovation through technical assistance to health centers. Competition participants will accelerate the development of low-cost, scalable solutions to help HRSA-supported community health centers improve patient access to primary care and strengthen the link between health care and social services.
ASPE (6/7): The HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE) published an issue brief and inventory on federal efforts to address racial and ethnic disparities in Alzheimer’s disease and related dementias (ADRD). Addressing racial and ethnic inequities across the dementia experience - from differential prevalence of risk factors to a lower likelihood of diagnosis to poorer quality LTSS - has been a core principle of the National Plan to Address Alzheimer’s Disease since it was first released in 2012 and is reflected in work across the government.
CDC: (6/7) - The CDC published a blog on the barriers Asian Americans, Native Hawaiians, and Pacific Islanders (AA and NHPIs) face in accessing genetic counseling and genetic testing, which include limited English proficiency, cultural factors, lack of familiarity with the US health care system, and biases and stereotypes. The authors noted that a research agenda and public health action are needed to improve health equity in the implementation of genomics and precision medicine, including community engagement with AA and NHPI communities.
CMS: (6/6) - CMS published a blog detailing the CMS National Quality Strategy, an ambitious long-term initiative that aims to promote the highest quality outcomes and safest care for all individuals. Among the eight core goals in the strategy includes advancing health equity. CMS’ goal is to advance progress in creating a care journey that is free from inequity while optimizing opportunities, access and outcomes for historically underserved and under-resourced communities.
CMS: (6/3) - CMS launched a new Non-emergency Medical Transportation (NEMT) webpage as part of Medicaid.gov. The site outlines minimum requirements for drivers and contains recordings from recent stakeholder listening sessions designed to obtain input and shared learning about leading practices for improving Medicaid program integrity for NEMT.
Administration for Community Living: (6/3) - The Administration for Community Living released a brief highlighting a model that purchased and distributed technology devices to older adults and people with disabilities to reduce social isolation and loneliness in Illinois. A majority of the participants reported feeling less lonely and socially isolated after receiving a technology bundle through the program.
White House: (6/1) - The White House Conference on Hunger, Nutrition, and Health released a toolkit to help stakeholders lead conversations with their community, other organizations, and individuals about ending hunger, improving nutrition, and increasing physical activity, all while reducing disparities. The toolkit includes information about the five pillars that are the focus area of the conference: improve food access and affordability; integrate nutrition and health; empower consumers to make and have access to healthy choices; support physical activity for all; and enhance nutrition and food security research.
CMS: (6/1) - CMS announced it is now accepting applications for the 2022 Minority Research Grant Program (MRGP) Funding Opportunity for health equity researchers at minority-serving institutions (MSIs). CMS will award three grants of up to $333,000 each to researchers at MSIs who are investigating or addressing health care disparities affecting CMS Office of Minority Health’s target populations.
HHS: (5/31) - HHS announced the creation of an Office for Environmental Justice to better protect the health of disadvantaged communities and vulnerable populations on the frontlines of pollution and other environmental health issues. The new office will sit within the Office of Climate Change and Health Equity at HHS.
Department of Transportation: (5/27) - The Department of Transportation announced the reestablishment of the Advisory Committee on Transportation Equity (ACTE) under the Federal Advisory Committee Act (FACA). The objectives of the reestablished Committee include providing advice and recommendations to the Secretary of Transportation on comprehensive, interdisciplinary issues related to transportation equity from a variety of stakeholders.
HRSA: (May 2022) - HRSA released the second annual evaluation report for the Rural Maternity and Obstetrics Management Strategies (RMOMS) Program. The report documents findings from the 2019 Cohort’s first implementation year, September 1, 2020 to August 31, 2021. Key findings include that the three awardees in this cohort provided prenatal, labor, and delivery and/or postpartum care to 3,101 rural RMOMs participants, with nearly 2,000 deliveries. The RMOMS awardees brought in a wide range of partners into rural maternal health networks using different models, seeing success with patient navigators and challenges with patient-level data reporting.
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SDoH & Health Equity in the News
The Commonwealth Fund: (6/9) - State-based Affordable Care Act marketplaces could play a role in advancing health equity, and a first step is improving collection of enrollees' race and ethnicity data. This article provides two recommendations for states to improve race and ethnicity data collection: improve the application process and work with insurers to fill gaps.
Health Affairs: (6/9) - This article provides a background on recent efforts to promote housing stability for people eligible for home and community-based services. It delineates the ways in which new rules from CMS aim to address ongoing challenges within the Money Follows the Person program and describes other Medicaid-related efforts to support housing-related needs. Finally, the article highlights the need to study these initiatives as critical efforts to bridge housing and health care.
UnitedHealth Group: (6/8) - The United Health Foundation announced a $100 million commitment over 10 years to advance health equity and eliminate health disparities. This commitment will focus specifically on helping build a racially and ethnically diverse health workforce and will provide scholarships and support to 10,000 underrepresented future clinicians, among other areas.
Urban Institute: (6/8) - The Urban Institute announced the launch of its Office of Race and Equity Research, part of an ongoing organizational effort to advance equity. Through innovation in data analytics and research methods, the office will deliver evidence-based solutions and actionable policy to address structural racism and other entrenched inequities. Additionally, Urban Institute and PolicyLink experts have teamed up to form the Equity Scoring Initiative, an effort to design a scoring system that measures equity impacts in federal legislation. Their first publication, Scoring Federal Legislation for Equity, identifies the definition, framework, and potential applications for equity scoring.
Governor Kathy Hocul: (6/7) - New York Governor Kathy Hochul signed new legislation to create more flexible rules for converting underutilized hotel space into permanent housing. The law allows the state to address the affordability crisis of housing and convert empty, underutilized spaces into affordable homes in locations that would otherwise be inaccessible to many individuals, including families experiencing homelessness.
Patient Engagement HIT: (6/7) - Speakers at the Xtelligent Healthcare Media Social Determinants of Health Virtual Summit said that SDOH work must integrate cultural competence. Samara Grossman, LICSW, a program leader at a food security program in Dorchester in Boston, shared that it quickly became apparent that subsidized meals would not be fruitful and that cultural competency was a key element missing from this intervention. Examples like this show the importance of working with the community and that a one-size-fits all approach is not the answer in addressing SDOH.
URAC: (6/6) - URAC and the National Minority Quality Forum (NMQF) announced they will explore the establishment of health equity standards for use by URAC in its accreditation and certification processes. The goal of the partnership is the development of a recognition program to allow health care organizations to show their commitment to addressing and alleviating health disparities.
The Commonwealth Fund: (6/6) - Building more bridges between public health and health care can help us prepare for future emergencies and collectively tackle long standing health inequities. To reduce such inequities and promote antiracism, the New York City health department created the Office of the Chief Medical Officer to build these bridges and create a strategic plan that outlines how the public health system can partner with the city’s health care organizations to advance health equity across the city.
Highmark Health: (6/6) - Highmark Health and Allegheny Health Network announced the launch of a multi-year initiative to create a high-performing social care network that will compensate nonprofits that address social determinants of health. In the first year of the pilot, 20 nonprofits in Allegheny and Westmoreland counties will participate in the program and will be paid for providing services to members and patients who are referred to them for social services, food, job counseling, and transportation.
Milbank Memorial Fund: (6/1) - Researchers and policymakers are increasingly acknowledging the importance of addressing racial and ethnic inequities in mental health. Black, Indigenous, and People of Color (BIPOC) are more likely to require behavioral health services and less likely to access them — and more likely to have poor clinical outcomes. While attention has been directed toward increasing diversity in the mental health workforce to improve quality of care for BIPOC, more immediate solutions, such as cultural humility training for mental health providers, are needed.
Medpage Today: (6/1) - This blog highlights the need for leaders in the medical field to integrate social determinants of health and community engagement into learning cases and everyday practice. The author outlines three things that individual clinicians can do to improve the care of patients' social needs: know the patient, know the system, and work in an interdisciplinary care team.
Health Payer Intelligence: (5/31) - During the recent Xtelligent Healthcare Media’s Social Determinants of Health Summit, Tequila Terry, group director of state innovation and prevention and population health at the CMS Innovation Center (CMMI), shared how the center continues to address health equity through its Strategy Refresh and Accountable Health Communities model. “When we designed our new Strategy Refresh, we really wanted to focus on developing new models and modifying existing models to address health equity,” Terry explained. “And we called out specifically the need to address social determinants of health as part of that strategy.”
Patient Engagement HIT: (5/31) - Lyft Healthcare is dedicated to connecting patients with rides to medical appointments, and increasingly, resources to help address social determinants of health. Lyft has helped to address a number of social determinants across the nation, such as food security through a partnership with Martha’s Table in D.C. to provide rides to the grocery store for families living in food deserts.
AcademyHealth: (5/31) - AcademyHealth CEO Dr. Lisa Simpson spoke with Dr. Joshua Liao on the podcast Health Equity Conversations, which highlighted research priorities at the intersection of health equity and payment. Dr. Simpson discussed two opportunities to leverage research to promote equity through payment: an initiative being launched by AcademyHealth to identify a research agenda to drive care that is equitable and high value, and to foster a research community at the intersection of health equity and payment.
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Spotlight on Maternal Health
Anthem: (6/7) - Anthem, Inc. has partnered with Happify Health on a digital-first program that will bridge the gap between the unique physical and mental health concerns women face by connecting eligible members with Happify Health’s online pregnancy community. The program is part of Anthem’s ongoing support of women throughout the entirety of their maternal health journey with solutions such as ongoing education, case management, and care coordination.
CT Mirror: (6/3) - The State of Connecticut is taking steps to launch a certification program for doulas, a process which would allow those workers to seek Medicaid reimbursement for their services and reach more patients. Connecticut’s Public Health Department will appoint an 18-member panel to provide input, including recommendations for training, experience, and continued education.
Health Affairs: (6/2) - To address the disproportionate impact of the maternal health crisis on communities of color, one pathway to better outcomes is to invest in doulas, who have always been a part of communities of color and can step into a role that allows them to advocate for a mother at her most vulnerable. To truly support Black women and help reverse unacceptably poor maternal health outcomes for people of color, the authors call for prioritizing doula care as one policy action to get behind.
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Data and Innovation
Healthcare IT News: (5/31) - Better data standards are needed in electronic health records (EHRs) to understand possible risk factors for maternal mortality and poor maternal and infant health outcomes. EHR data differ by clinical settings, and data standardization across systems is essential for meaningful and unbiased use for research. Data standards must also be specific for maternal health to facilitate data linkages for a life span approach to women’s health that also includes their infants’ health.
Robert Wood Johnson Foundation: (5/31) - When data are unavailable for a marginalized racial/ethnic group, their needs are rendered invisible when policies are made, resources are allocated, and programs are designed and implemented, according to a new report by the Robert Wood Johnson Foundation. The report outlines key strategies for those planning, conducting, or funding racial/ethnic data collection, analysis or reporting in all sectors, such as using a health equity lens to determine which groups should be represented by disaggregated data.
Health IT Analytics: (5/31) - The National Library of Medicine awarded the Medical University of South Carolina (MUSC) and Clemson University $1.2 million to establish a new data science training program that will teach students to explore the use of big data to address health inequities. The SC BIDS4HEALTH program aims to make future data scientists more aware of health inequities and create career development pipelines in biomedical data science for students from underrepresented groups. The program will also place special emphasis on using data science to address the impact of chronic illness in rural communities.
NEJM Catalyst: (5/26) - Leaders at Humana have taken actions to better understand disparities in members’ health by developing a new health equity measure, which aims to guide disparity-focused initiatives and track progress in achieving health equity. While the measure is a work in progress, the authors of this article shared their learnings to create early transparency and drive synergy across the industry, while continuing to work on operationalizing this measure.
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New Research and Reports
The ASCO Post: (6/9) - Research published in the American Association for Cancer Research (AACR) Cancer Disparities Progress Report 2022 found that although overall cancer incidence and mortality are declining across all population groups, compared with White individuals, racial and ethnic minorities and other medically underserved populations continue to shoulder a disproportionate burden of cancer. Interrelated factors, such as SDOH and structural racism, create conditions that perpetuate these disparities and health inequities.
Healio: (6/7) - A recent study presented at the American Thoracic Society International Conference highlighted disparities in perceptions of health care satisfaction among Black and Hispanic patients compared with white patients. Researchers aimed to analyze the health equity gap by asking patients who were hospitalized for COVID-19 to voice their perceptions of their health care delivery. The responses highlighted unique challenges in access to health care and other social determinants of health faced by Black and Hispanic patients compared with white patients, such as inability to quarantine in a separate room or longer distances to a provider’s office.
Health Payer Intelligence: (6/7) - A new report from Cigna found that loneliness varies based on mental health, race, economic status, and age. Among adults who reported having a mental health condition, 85 percent said that they were lonely. Three-quarters of Hispanic adults and nearly seven out of ten Black or African American adults reported being lonely, around ten percentage points more than the average share of the overall population. Additionally, young adults were twice as likely to be lonely compared to seniors.
Patient Engagement HIT: (6/2) - A study led by the University of Texas at Austin Dell Medical School found that a four-week food security program removed access barriers to provide caregivers fresh produce and led to healthy behavior changes that improved children’s overall diet. The study examined how several weeks of free tastings of produce and grocery gift cards impacted the diet of children, which encouraged families to try unfamiliar food while reducing access to barriers, and also allowed families to have choices that aligned with cultural and taste preferences.
Journal of Investigative Medicine: (6/2) - The goal of this study was to describe COVID-19 patient-level demographics and clinical characteristics, and community-level social determinants of health that contribute to 30-day readmissions. About 6.5 percent of patients studied had 30-day, unplanned, all-cause hospital readmissions. Patient-level factors and community-level SDOH may be used to identify patients with COVID-19 who are at increased risk of readmission.
Journal of Adolescent Health: (6/1) - Researchers at the University of Michigan surveyed youth regarding their perspectives on their medical team’s role in addressing social determinants of health. The study found that most youth believe it is important for their medical teams to ask about and address SDOH, whether through providing information or referrals. The implementation of health care-based SDOH interventions for youth should optimize opportunities for face-to-face discussions about assistance during clinical encounters.
Health Affairs: (June 2022) - This study used data from a statewide public health-health system collaboration to describe trends in COVID-19 vaccination rates by racial and ethnic groups among people experiencing homelessness or incarceration in Minnesota. Vaccination completion rates among the general population and people incarcerated in state prisons were substantially higher than those experiencing homelessness or jail incarceration.
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Upcoming Events
June/July
June 10 - CMS Maternal & Infant Health Quality Improvement, “State Medicaid and CHIP Agencies and Obstetrical Partners: Working Together to Reduce Low-Risk Cesarean Deliveries.” Virtual. June 13 - White House Conference on Hunger, Nutrition, and Health, “White House Conference Listening Session.” Virtual. June 14 - HHS ONC, “SDOH Information Exchange: Technical Infrastructure and Interoperability.” Virtual. June 15 - Foundation for Social Connection and Far From Alone, “Conversations on Belonging, Connection, & Wellbeing.” Washington, D.C. June 15 - White House Conference on Hunger, Nutrition, and Health, “White House Conference Listening Session.” Virtual. June 23 - U.S. News & World Report, “Achieving Health Equity: Tackling the Medical Community’s Greatest Care Challenge.” Virtual. June 23 - Bipartisan Policy Center, “Summit on Housing Supply Solutions.” Washington, D.C. June 23 - Department of Housing and Urban Development, “Climate, Energy, and Healthy Housing: HUD National Healthy Homes Month webinar.” Virtual. June 24 - CMS Maternal & Infant Health Quality Improvement, “Using Data to Plan and Assess Quality Improvement Strategies to Reduce Low-Risk Cesarean Delivery in Medicaid and CHIP.” Virtual. June 27 - Institute for Medicaid Innovation, “Release Event: Medicaid Managed Care’s Pandemic Pivot.” Virtual. June 29 - CMS Maternal & Infant Health Quality Improvement, “Improving Maternal Health by Reducing Low-Risk Cesarean Delivery Affinity Group: Overview and Process for Expression of Interest.” Virtual. June 30 - Healthy Alliance, “New York State Food as Medicine Planning Kickoff.” Virtual. July 19 - HHS ONC, “SDOH Information Exchange: Policy and Funding.” Virtual.
Fall 2022
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SDoH Opportunities
June
July/August
Rolling Basis
Deadline: Open - Aligning for Health, Endorse the Social Determinants Accelerator Act Deadline: Open - Aligning for Health, Endorse the LINC to Address Social Needs Act Deadline: Open - Chairman McGovern, Endorse the White House Conference on Food, Nutrition, Hunger, and Health Act Deadline: Open - Trust For America’s Health, Endorse the Protecting the Health of America’s Older Adults Act 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
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