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Social Determinants Updates

September 4 to September 18, 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

Indianapolis Recorder: (9/17) – As food insecurity rises in Indiana, CareSource’s Life Services program addresses crucial social needs such as food insecurity, including an initiative focusing on food access, food insecurity, and food education.

Centene: (9/14) – Centene has announced it is working with Samsung to expand access to telehealth for individuals living in rural and underserved communities by supplying providers with Samsung Galaxy smartphones to patients who would not otherwise have the ability to receive their healthcare virtually.

Unite Us: (9/9) – Unite Us published a new resource on Systems Transformation, taking a deeper dive into the role government can play and exploring the benefits to be gained from statewide referral networks by individuals, communities, health systems and plans, and state and local governments.

Social Determinants Accelerator Act

TFAH: (9/17) – A new report from TFAH on the State of Obesity found that the U.S. adult obesity rate is at 42 percent, which is the highest ever recorded. The report notes that COVID-19 related food insecurity puts more Americans at risk for obesity or worsening obesity and proposes policy solutions that require multi-sector initiatives and policy change to combat the growing obesity crisis. The report also highlighted the Social Determinants Accelerator Act as one policy solution to expand opportunities for public health and healthcare coordination.

Social Determinant Accelerator Act: (9/11) – Reps. Scott Peters (D-CA) and Joyce Beatty (D-OH) recently signed on as cosponsors to the Social Determinants Accelerator Act, bringing the total number of cosponsors up to 43.

BMC Health Services Research: (9/9) – In a study of community and health clinic approaches to addressing toxic stress and promoting protective factors among families with infants, the Social Determinants Accelerator Act was cited as a way to generate social determinants of health evidence to modify and sustain investments in social needs interventions and innovations.

In Collaboration with the American Hospital Association
Register for the Aligning for Health and Social Needs Webinar

Aligning for Health and the American Hospital Association are pleased to host a webinar on September 24th exploring how three leading health systems have worked to improve community health and to address health and social needs. Learn about innovations and best practices, the impact of COVID-19, and the outlook moving forward.

Register Here

SDoH in the News

Administration for Community Living: (9/16) – ACL recently awarded 11 grants totaling over $2 million over three years to fund innovative projects that will enhance the quality, effectiveness, and outcomes of nutrition services programs provided by the national aging services network.

NIH: (9/16) –NIH announced a $12 million award to RTI International for outreach and engagement efforts in racial and ethnic minority communities disproportionately affected by the COVID-19 pandemic. The funding will support teams in 11 states as part of the NIH Community Engagement Alliance (CEAL) to create CEAL program and provide technical and administrative support.

Health Affairs: (9/16) – The Robert Wood Johnson Foundation focused its annual forum, Sharing Knowledge, held earlier this year, on racial injustice and health. This blog post outlines several key takeaways about the intersection of racial justice and health, its current impacts and the tools and actions that will be most effective moving forward.

Psychiatric Times: (9/16) – The COVID-19 pandemic has revealed existing weaknesses in the mental health system, but also presents an opportunity for reform, especially for vulnerable and low-income communities.

CMS: (9/15) – CMS has released a Notice of Funding Opportunity (NOFO) for the Community Health Access and Rural Transformation (CHART) Model Community Transformation Track, which will provide up-front funding to up to 15 rural communities across the country and may address social determinants of health.

Post and Courier: (9/15) – The State of South Carolina is one of four jurisdictions nationwide chosen to participate in a new national program that aims to move child welfare systems from traditional, reactive protection systems to advanced systems designed to support holistic child and family well-being while precenting maltreatment and unnecessary family separation and taking social needs into consideration by leveraging community-based intervention services.

Health Affairs: (9/15) – As discussions continue around promoting equitable access to COVID-19 vaccines, pediatricians and other primary providers and Medicaid providers will be particularly important to the success of COVID-19 vaccination programs.

MedCity News: (9/13) – COVID-19 has shown primary care’s value in caring for diverse communities, building trust, reaching people in the languages they speak, and providing physical and behavioral health care services. Despite the role that primary care plays, the fee-for-service payment model does not support the comprehensive teamwork needed to provide patients with optimal care.

Dayton Daily News: (9/12) – The Ohio COVID-19 Minority Health Strike Force found that black and Hispanic Ohioans face an increased risk of COVID-19 and outlined a blueprint of recommendations to respond to and address these disparities.

Health Payer Intelligence: (9/11) – COVID-19 could be a catalyst to advance value-based care progress among payers, including efforts to move the needle on integrating social factors in healthcare, supporting social determinants of health interventions, and building partnerships with community-based organizations.

NASHP: (9/11) – States are beginning to explore pivoting hospital community benefit requirements to address disparities by COVID-19, with this article noting that one lever available to state policymakers is to require nonprofit hospitals to address health inequities in the community investments they make in exchange for tax exemptions.

Niagara Frontier: (9/11) – HRSA has awarded the YOU Center for Wellness at the Erie County Medical Center Corp with funding to support a food pharmacy program that will provide fresh food for HIV/AIDS patients co-diagnosed with high blood pressure and diabetes for one year.

GovTech: (9/11) – HHS released its Rural Action Plan, which is the agency’s first attempt to outline a comprehensive strategic framework to address health disparities in rural communities. HHS also announced 10 awards to address social needs of older adults and people with disabilities, as well as $30 million to improve telehealth capabilities in rural areas.

Health Affairs: (9/11) – Suspected opioid overdose deaths are surging during the COVID-19 pandemic. To improve buprenorphine access and advance health equity, it is important for policymakers to consider removing legal and administrative barriers to ensure treatment is equitably distributed and accessible among all persons. with this article highlighting key telehealth policy changes that would improve buprenorphine access while advancing health equity.

STAT: (9/10) – Lyft has continually expanded its medical transportation business to help address social needs. This interview with Lyft’s Vice President of Health Care highlights how Lyft is growing their business to close gaps in health care access.

Medical Economics: (9/10) – COVID-19 is revealing economic inequalities that are forcing some people to choose between health and financial stability. The “economic dislocation” of COVID is impacting nutrition access due to disruptions in the food supply chain and difficulties in affording food.

Patient Engagement HIT: (9/10) – A recent survey found that 57 percent of respondents felt that COVID-19 would push the health care industry to focus even more on the social determinants of health moving forward and place a greater emphasis on closing gaps to care and increasing access to care.

Baylor College of Medicine: (9/10) – Baylor College of Medicine announced a renewed commitment to address the inequitable health outcomes affecting underrepresented minorities, including furthering understanding of social determinants of health in both the design of clinical and bioethics research as well as the provision of clinical care.

Fierce Healthcare: (9/8) – A recent report from Better Medicare Alliance found that Medicare Advantage plans serve more people with social health risk factors like food insecurity than the FFS program. More than half of MA beneficiaries with annual incomes below the federal poverty line represent racial or ethnic minorities.

Patient Engagement HIT: (9/8) – As healthcare organizations increasingly pledge to address social needs and implement social determinants of health programs, they must partner with community partners to effectively meet patient needs.

State of Reform: (9/3) – The Oregon Health Authority has launched its new 2020-2024 State Health Improvement Plan, focusing on health equity and social determinants of health in five priority areas: institutional bias, adversity, trauma, and toxic stress, behavioral health, economic drivers of health such as housing and food insecurity and access to equitable preventative health care.

 Data Collection and Innovation

PEW Trusts: (9/16) – A recent survey highlights differences in how Americans perceive documenting and sharing data on social needs. While 75 percent of adults say they would be comfortable providing their own doctor with this information, only 48 percent were comfortable allowing their providers to share this information with other providers providing care. Focus groups revealed concerns with being pre-judged by their health care provider.

Medical Economics: (9/11) – With a growing recognition in health care that many chronic conditions can be improved by addressing social needs first, physicians need to educate themselves on the social determinants of health and begin integrating social needs screenings into their clinical practices.

HIT Consultant: (9/10) – Equality Health has launched the Social and Cultural Risk Assessment program in partnership with more than 1,400 primary care practices. The program aims to fundamentally change care delivery and achieve greater health equity for marginalized and underserved communities while relieving the administrative burden and lack of incentives for providers to screen for social needs.

National Resource Center for Patient/Family-Centered Medical Home: (9/8) – In partnership with the National Academy for State Health Policy, this fact sheet series discusses social determinants of health screening and referrals for children and youth with special health care needs and their families in Medicaid and Medicaid Managed Care programs.

Academy Health: (9/8) – The Robert Wood Johnson Foundation is making new COVID-19 data availability under its Health Data for Action program, connecting researchers with high value data to further discoveries that will advance the Foundation’s mission to achieve health equity.

New Research and Reports

STAT: (9/15) – A recent CDC report found that COVID-19 complications killed 121 Americans under the age of 21 through July. The report highlighted racial disparities, as 45 percent of the 121 people who died were Latinx, 29 percent were black, 14 percent were white, and 4 percent were American Indian or Alaska Native.

Nutrition Journal: (9/9) – This study conducted qualitative focus groups with parents and caregivers of patients who had screened positive for food-insecurity during visits to a large pediatric health care system in the Midwest, finding that parents envisioned an expanded role for healthcare systems in ensuring their children benefit from a healthy diet. The findings offer insights into why clinic-driven programs aimed at addressing healthy eating may have failed and how healthcare organizations may be able to more effectively intervene.

BMC Public Health: (9/2) – Interviewing participants who had been homeless for over a year about stigma in healthcare settings, this study found that medical students and the institutions they are a part of should reduce stigma against people who are houseless in medical systems and change their approaches to healthcare delivery and advocacy to better support the health of patients experiencing homelessness.

SIREN: (9/1) – A study examining how social needs cluster among low-income individuals found that women with children were more likely to need more space in their home and help to pay utility bills, low-income men were more likely to need a place to stay, and sicker adults were more likely to need money for necessities and unexpected expenses, as well as transportation.

Health Affairs: (September 2020) – New research found that adjusting for individual and community social risk factors did not have a meaningful cost impact on clinicians’ cost measure performance. MIPS episode-based cost measures do not appear to penalize clinicians who primarily care for patients with increased social risk.

SIREN: (September 2020) – Integrating recommendations from evidence-based clinical guidelines, this study found that family physicians can directly address the physical health, mental health, and social needs of patients who are homeless or vulnerably housed by championing outreach and onboarding programs that assist individuals in accessing patient medical homes.

SIREN: (September 2020) – This study conducted a systematic scoping review of how healthcare organizations are facilitating access to fruits and vegetables in their patient populations, finding that the overall quality of the studies was weak due to participant selection bias and incomplete reporting on data collection tools, confounders, and drop-outs, highlighting the need for improved study design and validated data collection tools.

Legislative Roundup

COVID-19 Health Disparities Action Act: (9/14) – Representatives Tony Cardenas (D-CA) and Bonnie Watson Coleman (D-NJ) introduced H.R. 8203 Act to address the impact of the COVID-19 pandemic on communities of color. The bill would require targeted testing, contract tracing, and public awareness campaigns, and outreach efforts specifically directed at racial and ethnic minority communities and other populations that have been vulnerable to the COVID-19 pandemic. Senator Bob Menendez (D-NJ) introduced a companion bill in the Senate.

Ending Health Disparities during COVID-19 Act: (9/11) – Representative Robin Kelly introduced H.R. 8200, which would help address COVID-19 health disparities by improving data collection, testing, contact tracing, treatment, public awareness, and federal oversight during the public health emergency. The bill also includes provisions from the Social Determinants Accelerator Act and other bills to increase community health care grants, strengthen culturally competent care, and boost health information technology.

Community Care Act: (9/8) – Representative Barbara Lee (D-CA) introduced H.R. 8192, which would allocate $8 million for the Public Health and Social Services Emergency Fund for the implementation of a comprehensive program to prevent and respond to COVID-19 in medically underserved communities.

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