Want healthier communities? Address social factors

Ceci Connolly

To tackle the social determinants of health, Healthy People 2020 charges us with working collaboratively across sectors to address the unique needs of our communities. Public health agencies and community-based organizations have powerful partners in health plans and providers to achieve success.

Ceci Connolly, president and CEO of the nonprofit Alliance of Community Health Plans, a national consortium of 22 nonprofit health organizations, and a former national health correspondent for The Washington Post, discusses innovative initiatives ACHP member plans have launched to address the social determinants of health.

It’s official: “social determinants of health” has “transcended buzzword status,” among community health plans, with 80 percent of health plan executives reporting that they have begun tackling the social needs of their members. Health plans are becoming deeply engaged in these activities, speaking the language of the community, treating food as medicine and helping to provide stable housing.

Public health professionals are well aware that 75 percent of the factors affecting our health are believed to be non-medical, such as homelessness, hunger and lack of transportation. As the health care industry and communities come together to tackle barriers to care, experts from community health plans are sharing best practices for addressing social determinants. Their stories offer lessons-learned for how community health plans can take part in improving public health and addressing the social determinants of health.

Treat whole people

Mark Traynor, president and chief executive officer of UCare in Minneapolis, Minnesota, which has a long history of managing Medicaid patients in a culturally diverse urban area, emphasized the importance of seeing patients as “whole people.” He continued, “They are not costs to be managed. They are not market share to be gained. And they are not even diseases to be treated. They are people coming with the full freight of their daily experiences, their stresses, their family conditions.”

Meet people where they are; literally speak their language

In central Pennsylvania Geisinger Health Plan estimated that 60 percent of the no-shows at its primary care clinics were members who could not physically get there. To remove any stigma these patients might feel and to meet their need and desire to come to the facility, Geisinger created a popular transportation program. UCare takes that model further by employing call center staff, care managers and even drivers who speak Somali, Spanish and Hmong, reflecting the three major ethnic groups it serves.

Provide food – and hands-on instruction

For nearly 15 years, Boston Medical Center (BMC), which serves a significantly disproportionate number of disadvantaged patients, has been running a therapeutic food pantry to address food insecurity, which has consistently been negatively associated with health outcomes. “We now serve 7,000 patients a month,” said Kate Walsh, president and CEO. BMC physicians “can write a prescription for food just like they can write a prescription for insulin. You get a three-day emergency supply of food, which we can stretch to fit your household.”

Describing its program as “a mini Blue Apron,” Geisinger addresses both the nutrition and social isolation aspects of food insecure populations. Chief Medical Officer John Bulger explained, “not only do you get your box, but you also get a cooking class together.” Participants “started talking to other people who were food insecure and had diabetes; this took away the embarrassment.” Health outcomes underscore the return on investment, and result in a sizeable reduction in the total cost of care. “If you look at their weight, at their blood pressure, if you look at their hemoglobin A1C – all of those have come down; there has been a huge decrease,” Bulger said.

Address economic and housing insecurity, too

Prompted by a mother who told a pediatrician that she did not know how to do her taxes, BMC, which includes the BMC HealthNet plan, realized that families like hers were not getting to government assistance and volunteer tax prep centers in the city. BMC designed the StreetCred program to provide tax services to families in a trusted, frequented location – the pediatrician’s office. Walsh explained the phenomenal results: “Street Cred has returned over a million dollars over the last two years to the communities we serve through not only tax prep, but also by making sure that the people who are eligible for an income tax credit actually got it.”

For the last nine years, UPMC Health Plan in Pittsburgh has been working in partnership with Allegheny County’s Community Human Services to help adults who are disabled and chronically homeless not only better manage their health but also find stable places to live. For the people who have gone through the pilot program, UPMC has seen more use of primary care treatment and better medication adherence, along with declines in hospital admissions, emergency room visits, detoxes and crises.

For decades, nonprofit, community-based health organizations have been addressing social determinants of health as part of their mission to build healthier communities and inspire the entire industry to do better. Their successes offer a road map for others looking to make their communities healthier places to live. 

This article originally appeared on Public Health Newswire