What questions do you have for our panelists? Do you have a success story or a failure that you would be willing to share with us?
A comprehensive new report examines a broad range of evidence and issues relating to health care in Canada, with insights and recommendations on reforms designed to bring that country’s health-related systems into the 21st Century. During NIC's upcoming webinar, two of the report’s authors, Daniel Dutton and Pierre-Gerlier Forest, will explain its findings, the importance of the social determinants of health and well-being to its prospects for success, and how its content is relevant to the U.S. as it considers next steps for the ACA, and perhaps life without it. Our third presenter will apply the learnings from Canada to the current US health and hospital environment, with insights regarding the implications for improving efficacy and efficiency.
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California Healthy Places
In California, there are efforts to mobilize SDoH aggregated data to inform the larger community. How do we partner with available Helath Care Data to create a description for ROI and or evolution?
The Social Determinants concept arose primarily as a contributing factor for the origins of various chronic illnesses. To date we really do not have a global set of definitions that are linked under around an overall-unifying concept of HEALTH. The origins of Social Capital began in the economics literature regarding the investment stategies that promote economic growth. The study of economic institutions by Elinor Ostrom identified Social Capital as Trust, Cooperation and Reciprocity that improves the management of a common pool resource (as in irrigation, forrest, fisheries). For healthcare, it is the portion of a public institution's budget devoted to healthcare. The portion of the USA economy devoted to health spending was 5% in 1960 and 18% in 2016.
Elinor Ostrom was an Nobel prize-winning economist who spent a life time studying the attributes of managing a common pool resource. The best summary of her voluminous research can be found on URL address below. The best ROI research for Social Determinant research is in the arena of disaster mitigaton. The ROI is variably @4:1. The best research focused on the rebuilding projects for two communities on the east coast of Japan following the tsumami disaster in 2012. Very insightful. I would advise everyone that social capital investments are unlikely to achieve robust ROI without community promoted and sustained (as in generational) processes. The best example of this in the US are the Cooperative Extension Service offices establish by Congress in 1914. This commitment was implemented, county by county, nationally to promote a link between the local urban and rural farms with their State's nationally supported university based, College of Agriculture. Interestingly, the US agriculture industry is the most efficient and effective among the world's advanced nations by a very wide margin. Our healthcare industry is... (you got it)!
For one person's attempt to connect a set of definitions for Caring Relationships, Collective Action, Community, Family, HEALTH, INSTITUTION, Social Capital and SURVIVAL COMMONS see the second URL below.
http://dx.doi.org/10.1026/j.jebo.2012.12.010 ; (Professor Ostrom's last publication before she died in 2012)
https://nationalhealthusa.net/paradigm-shift/rationale/ ; (Note: see pages 4 thru 10)
I have been speaking with a lot of health plans in the U.S. who are trying these initiatives but they have no idea how to calculate ROI or run the evaluations. Is this relatively straightforward? Is there a resouce I can share with them?
https://map.healthyplacesindex.org/
Is just one mobilized data set.
Who would like to work on the question of applying the ROI findings to policy discussions?
Uma Ahluwalia asks, "What tools help with equity-based budgeting?"
Thanks for your question during the post-presentation. I'd like to hear more about your specific work, feel free to follow-up.
Daniel Bach asks, "The gap between the potential scale that effective social programs could reach and what governments actually fund seems to be growing, are you aware of any research showing these disparities?"
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