The NIC Collaboration Hub2024-03-29T07:02:42Zhttps://hub.nic-us.org/groups/social-determinants/resources/feed/allSocial Determinants of Health 201 for Health Care: Plan, Do, Study, Acthttps://hub.nic-us.org/groups/social-determinants/resources/social-determinants-of-health-201-for-health-care-plan-do-study-a2021-06-28T18:48:57.000Z2021-06-28T18:48:57.000ZAmanda Taylorhttps://hub.nic-us.org/members/AmandaTaylor<div><p>This discussion paper builds on SDoH 101 and explores in more depth the five things to be learned, including the science and prioritization of interventions, the creation of partnerships, and how the assets of the community can further these partnerships. It provides several frameworks for integrating approaches to SDoH, social risk factors, and HRSN in health care, and proposes Plan-Do-Study-Act (PDSA) cycles as a quality improvement (QI) approach for health care systems.</p>
<p><a href="https://nam.edu/social-determinants-of-health-201-for-health-care-plan-do-study-act/" target="_blank">Read the discussion paper >></a></p></div>"Housing is Health Care": The Impact of Supportive Housing on the Costs of Chronic Mental Illnesshttps://hub.nic-us.org/groups/social-determinants/resources/housing-is-health-care-the-impact-of-supportive-housing-on-the-co2021-06-28T18:44:23.000Z2021-06-28T18:44:23.000ZAmanda Taylorhttps://hub.nic-us.org/members/AmandaTaylor<div><p>This study examines how housing and in-home supports affect public spending on individuals with chronic mental illness in Maricopa County, Arizona. It does so through a comparative analysis of average costs per person per year across three housing settings: permanent supportive housing, housing with unknown in-home support, and chronic homelessness. Specifically, it analyzes costs for housing, health care, and criminal justice during the period of 2014-2019. It also features a small-sample (small-N) case study of a housing setting that provides individualized, 24/7 in-home support to individuals with chronic mental illness (CMI) who have high support needs, examining average costs per person before and after moving into that setting (2016-2019). Finally, the study outlines recommendations from interviews with dozens of experts who work with and care for individuals with CMI in Maricopa County about reducing costs and improving care.</p>
<p><a href="https://morrisoninstitute.asu.edu/sites/default/files/housing_is_health_care_report_2021.pdf" target="_blank">Read the study >></a></p></div>When Families Do Not Request Help: Assessing a Social Determinants of Health Screening Tool in Practicehttps://hub.nic-us.org/groups/social-determinants/resources/when-families-do-not-request-help-assessing-a-social-determinants2021-06-28T18:42:06.000Z2021-06-28T18:42:06.000ZAmanda Taylorhttps://hub.nic-us.org/members/AmandaTaylor<div><p>Using pediatric social determinants of health screening data from a large medical system, we explored social needs dislosures and identified which needs were associated with resource connection requests. Method: Data came from records of outpatient pediatric patients (0–18 years) seen between October 2018 and March 2020 (39,251 encounters). We assessed percent of encounters where families (1) indicated a social need, and (2) requested a resource connection. We conducted multivariable logistic regression to identify which needs were associated with resource connection requests. Results: Among all encounters, 8% indicated a need and 2% requested a resource connection. Among families indicating a need, needs associated with resource requests included: housing (odds ratio [OR], 3.49 [2.42–5.03]), employment (OR, 3.15 [2.21–4.50]), food (OR, 1.89 [1.41–2.52]), and transportation (OR, 1.82 [1.30–2.56]). Discussion: Families seldom requested resource connections to address social needs. Better understanding families’ interests in receiving assistance is an important next step in pediatric social determinants of health screening system development.</p>
<p><a href="https://www.sciencedirect.com/science/article/abs/pii/S0891524521000997?via%3Dihub=" target="_blank">Read the article >></a></p></div>A Guide to Using the Accountable Health Communities Health-Related Social Needs Screening Toolhttps://hub.nic-us.org/groups/social-determinants/resources/a-guide-to-using-the-accountable-health-communities-health-relate2021-06-17T14:07:05.000Z2021-06-17T14:07:05.000ZAmanda Taylorhttps://hub.nic-us.org/members/AmandaTaylor<div><p>In this document, we describe the health-related social needs (HRSN) Screening Tool from the Accountable Health Communities (AHC) Model and share promising practices for universal screening. HRSNs are individual level, adverse social conditions that negatively impact a person’s health or health care. HRSNs are distinguished from social determinants of health—the structural and contextual factors that shape everyone’s lives for better or worse—and can be identified by the health care system and addressed in partnership with community resources. Identifying and addressing HRSNs can have many benefits, including improvements to individuals’ health and reduced health care spending. We prepared this guide for health care and social service providers who are increasingly adopting the practice of universal HRSN screening.</p>
<p><a href="https://www.mathematica.org/publications/a-guide-to-using-the-accountable-health-communities-health-related-social-needs-screening-tool" target="_blank">Read the guide >></a></p></div>Key Findings and Implications from a Literature Review on Systems Change in Educationhttps://hub.nic-us.org/groups/social-determinants/resources/key-findings-and-implications-from-a-literature-review-on-systems2021-06-01T15:00:05.000Z2021-06-01T15:00:05.000ZAmanda Taylorhttps://hub.nic-us.org/members/AmandaTaylor<div><p>Building on decades-long efforts, various place-based partnerships have emerged seeking to improve the systems that impact individuals’ journeys from cradle to career and beyond. Their focus is on “systems change”— that is, shifting the conditions that produce and hold societal problems in place. As interest in investing in systems change grows among philanthropic and community development stakeholders, the field has seen a proliferation of research on systems change success. For funders and practitioners, sorting through the number of studies and determining how their findings can be applied to local contexts can be overwhelming. This brief summarizes the current research on critical components of successful place-based systems change in education, illustrating how these components play out in practice through narratives from five exemplary communities that have embarked on systems change efforts. Finally, it offers implications for funders and program implementers engaged in systems change.</p>
<p><a href="https://www.mathematica.org/publications/key-findings-and-implications-from-a-literature-review-on-systems-change-in-education" target="_blank">Read the report >></a></p></div>Adjusting Quality Measures For Social Risk Factors Can Promote Equity In Health Carehttps://hub.nic-us.org/groups/social-determinants/resources/adjusting-quality-measures-for-social-risk-factors-can-promote-eq2021-04-20T18:40:49.000Z2021-04-20T18:40:49.000ZAmanda Taylorhttps://hub.nic-us.org/members/AmandaTaylor<div><p>Risk adjustment of quality measures using clinical risk factors is widely accepted; risk adjustment using social risk factors remains controversial. We argue here that social risk adjustment is appropriate and necessary in defined circumstances and that social risk adjustment should be the default option when there are valid empirical arguments for and against adjustment for a given measure. Social risk adjustment is an important way to avoid exacerbating inequity in the health care system.</p>
<p><a href="https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2020.01764" target="_blank">Read the article >></a></p></div>Law and Policy Pathways to Preventing Housing Instabilityhttps://hub.nic-us.org/groups/social-determinants/resources/law-and-policy-pathways-to-preventing-housing-instability2021-04-14T18:58:07.000Z2021-04-14T18:58:07.000ZAmanda Taylorhttps://hub.nic-us.org/members/AmandaTaylor<div><p>Overview:</p>
<p>Housing instability is a public health problem that both causes and exacerbates health problems, erodes communities, and drives health inequities. Eviction specifically imposes damaging health consequences that can last lifetimes, or even generations. Families grappling with housing uncertainty experience physical and mental health challenges, from elevated rates of childhood and chronic disease and mortality to stress, depression, anxiety, and suicide. Those who lack stable housing are more likely to experience homelessness, unemployment, substance use, food insecurity, and violence. Housing instability makes it difficult for residents to invest in their homes, relationships, and neighborhoods; eviction can disrupt the fabric of entire communities. Laws and policies at both the state and community levels can work to address these negative impacts and promote housing stability by deterring serial eviction filings, adopting eviction diversion and prevention programs, providing tenants with access to legal representation in eviction hearings, limiting access to eviction records, and promoting community-based solutions to end homelessness and increase housing access.</p>
<p><a href="https://www.networkforphl.org/resources/law-and-policy-pathways-to-preventing-housing-instability/" target="_blank">Read the guide >></a></p></div>MULTI-SECTORAL ALLIANCE RESOURCE COMPENDIUM: National Alliance to Impact the Social Determinants of Healthhttps://hub.nic-us.org/groups/social-determinants/resources/multi-sectoral-alliance-resource-compendium-national-alliance-to-2021-04-05T20:10:06.000Z2021-04-05T20:10:06.000ZAmanda Taylorhttps://hub.nic-us.org/members/AmandaTaylor<div><p>Broadly, this compendium is intended to support multi-sectoral alliances focused on SDOH. We believe that stakeholders at different stages of that journey will find it valuable. We have included resources that will be useful to stakeholders who are: </p>
<ul>
<li>Interested in addressing SDOH in their community and want to learn more about why multi-sectoral alliances can be an effective approach,</li>
<li>Committed to developing a multi-sectoral alliance but need resources to get started, or</li>
<li>In established alliances and looking for guidance on certain topics.</li>
</ul>
<p><a href="https://leavittpartners.com/wp-content/uploads/2021/03/LPCA_NASDOH-Compendium_FINAL.pdf" target="_blank">Read the compendium >></a></p></div>Homelessness and Health Care: Lessons and Policy Considerations from the COVID-19 Pandemichttps://hub.nic-us.org/groups/social-determinants/resources/homelessness-and-health-care-lessons-and-policy-considerations-fr2021-04-05T20:07:06.000Z2021-04-05T20:07:06.000ZAmanda Taylorhttps://hub.nic-us.org/members/AmandaTaylor<div><p>This brief synthesizes innovative approaches and key lessons for supporting the health care needs of Californians experiencing homelessness during COVID-19. It presents the immediate public health challenges in responding to the pandemic and shares key programmatic efforts to support those experiencing homelessness. It also delves into considerations for California policymakers and stakeholders to leverage these lessons to prepare for the ongoing and continued impacts of the pandemic, and to inform future policy direction.</p>
<p><a href="https://www.chcf.org/wp-content/uploads/2021/03/HomelesssnessHealthCareLessonsCOVID19Pandemic.pdf" target="_blank">Read the issue brief >></a></p></div>Determining the feasibility of an index of the social determinants of health using data from public sourceshttps://hub.nic-us.org/groups/social-determinants/resources/determining-the-feasibility-of-an-index-of-the-social-determinant2021-03-23T17:42:31.000Z2021-03-23T17:42:31.000ZAmanda Taylorhttps://hub.nic-us.org/members/AmandaTaylor<div><p>Abstract:</p>
<p>Examining the feasibility of developing an index measure for the social determinants of health using public data is needed. We examined these characteristics at the ZIP code in California and New York using public data extracted from the US Census, American Community Survey, the USDA Food Research Access Atlas, and the Dartmouth Atlas. We conducted a retrospective study from 2000 to 2017. The main outcome was a novel index measure representing six domains (economic stability, neighborhood and physical environment, education, community and social context, food access, and health care) and encompassing 13 items. The index measure at the ZIP code was created using principal component analysis, normalized to “0” worse and “1” better in California (ZIP codes n = 1,447 to 1,515) and New York (ZIP codes n = 1,211 to 1,298). We assessed the reliability and conducted a nonparametric comparison to the Robert Wood Johnson Foundation County Health Rankings, Area Deprivation Index, Social Deprivation Index, and GINI Index. These measures shared similarities and differences with the novel measure. Mapping of this novel measure showed regional variation. As a result, developing a universal social determinants of health measure is feasible and more research is needed to link it to health outcomes.</p>
<p><a href="https://www.tandfonline.com/doi/full/10.1080/17538157.2021.1880413" target="_blank">Read the article >></a></p></div>One Year into the Pandemic: Implications of COVID-19 for Social Determinants of Healthhttps://hub.nic-us.org/groups/social-determinants/resources/one-year-into-the-pandemic-implications-of-covid-19-for-social-de2021-03-23T17:12:55.000Z2021-03-23T17:12:55.000ZHub Adminhttps://hub.nic-us.org/members/NIC<div><p>The Kaiser Family Foundation published an analysis of how COVID-19 has impacted the social determinants of health one year into the pandemic.</p>
<p><a href="https://www.kff.org/coronavirus-covid-19/issue-brief/one-year-into-the-pandemic-implications-of-covid-19-for-social-determinants-of-health/" target="_blank">Read the article >></a></p></div>A Social-Return-On-Investment Analysis Of Bon Secours Hospital’s ‘Housing For Health’ Affordable Housing Programhttps://hub.nic-us.org/groups/social-determinants/resources/a-social-return-on-investment-analysis-of-bon-secours-hospital-s-2021-03-23T14:15:25.000Z2021-03-23T14:15:25.000ZHub Adminhttps://hub.nic-us.org/members/NIC<div><p>Abstract:</p>
<p>Community health programs aimed at addressing the social determinants of health often face challenges demonstrating their impact through traditional economic evaluation methods of return-on-investment analysis, cost-effectiveness analysis, or cost-benefit analysis. Using a social-return-on-investment (SROI) analysis, we evaluated the broader social, environmental, and economic benefits of Bon Secours Hospital’s Housing for Health program, an affordable housing program aimed at addressing the social and environmental determinants affecting its community’s health in Baltimore, Maryland. Bon Secours currently has 801 units of affordable housing across twelve properties in West Baltimore. Results indicate the significant social value of the Bon Secours affordable housing program, generating between $1.30 and $1.92 of social return in the community for every dollar in yearly operating costs. These findings suggest that broader access to affordable housing could produce a positive social value and demonstrate the relevance of SROI for quantifying the impacts of community health programs.</p>
<p><a href="https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2020.00998?utm_medium=email&utm_source=hasu&utm_campaign=march2021issue&utm_content=drabo&utm_source=Newsletter&utm_medium=email&utm_content=Home-Based+Medical+Care%2C+Telehealth%2C+Housing+++More&utm_campaign=HASU%3A+3-21-21&vgo_ee=U4unNEAJkz6vbqAT07oZgOiIS83193%2B83Q2vWslix8I%3D" target="_blank">Read the article >></a></p></div>Social Determinants of Health Guidehttps://hub.nic-us.org/groups/social-determinants/resources/social-determinants-of-health-guide2021-03-10T17:49:04.000Z2021-03-10T17:49:04.000ZAmanda Taylorhttps://hub.nic-us.org/members/AmandaTaylor<div><p>In this guide:</p>
<ul>
<li>Relationship Between Social Care and Medical Care</li>
<li>Impact on Individual Health, Community Health and Population Health</li>
<li>Social Determinants of Health Data and Information Standardization and Use Infrastructure Standards</li>
<li>Social Determinants of Health Assessment</li>
<li>Workflow Considerations</li>
<li>Cross-Sector Stakeholder Considerations</li>
<li>The Impact on ROI of Healthcare Systems</li>
<li>Equitable Access to Broadband and Technology</li>
<li>U.S. Policies and Initiatives</li>
<li>HIMSS Public Policy Principles and Considerations</li>
<li>Global Policies and Initiatives</li>
</ul>
<p><a href="https://www.himss.org/resources/social-determinants-health" target="_blank">Read the guide >></a></p></div>Home quality and child health: Analysis of the Survey of Income and Program Participationhttps://hub.nic-us.org/groups/social-determinants/resources/home-quality-and-child-health-analysis-of-the-survey-of-income-an2021-03-10T17:38:11.000Z2021-03-10T17:38:11.000ZAmanda Taylorhttps://hub.nic-us.org/members/AmandaTaylor<div><p>Abstract:</p>
<p>Housing is considered a core social determinant of health (SDH) through mechanisms such as the quality, affordability, and location of the home. However, few nationally representative studies examine these mechanisms simultaneously with child health and healthcare use. To determine the associations between home quality and child health, a series of logistic regression analyses was employed using the Survey of Income and Program Participation (SIPP). The 2014 SIPP sample is a multistage, stratified sample of 53,070 housing units from 820 sample areas designed to represent the civilian, noninstitutionalized population of the United States. The analytic sample included 12,964 children aged 2–14 years. Poor housing quality was defined as whether the home had holes in the floor, cracks in the ceiling, plumbing issues, and/or pest problems. Outcome measures included child health status, number of medical visits, and hospitalizations. The results indicated that poor housing quality was associated with poorer health (OR = 1.16, 95% CI = 1.05–1.27) and a greater number of medical visits (OR = 1.11, 95% CI = 1.03, 1.20) after controlling for number of persons per household, neighborhood safety, nonmetropolitan status, parent’s ability to afford housing-related expenses, and other SDH. Future work investigating and intervening on the SDH in children could specifically include the quality and contexts in which homes are situated.</p>
<p><a href="https://journals.sagepub.com/doi/abs/10.1177/1367493520975956?journalCode=chca" target="_blank">Read the research article >></a></p></div>Examining the interfacility variation of social determinants of health in the Veterans Health Administrationhttps://hub.nic-us.org/groups/social-determinants/resources/examining-the-interfacility-variation-of-social-determinants-of-h2021-02-15T21:18:58.000Z2021-02-15T21:18:58.000ZAmanda Taylorhttps://hub.nic-us.org/members/AmandaTaylor<div><p>Introduction: Recently, numerous studies have linked social determinants of health (SDoH) with clinical outcomes. While this association is well known, the interfacility variability of these risk favors within the Veterans Health Administration (VHA) is not known. Such information could be useful to the VHA for resource and funding allocation. The aim of this study is to explore the interfacility variability of 5 SDoH within the VHA.</p>
<p>Methods: In a cohort of patients (aged ≥ 65 years) hospitalized at VHA acute care facilities with either acute myocardial infarction (AMI), heart failure (HF), or pneumonia in 2012, we assessed (1) the proportion of patients with any of the following five documented SDoH: lives alone, marginal housing, alcohol use disorder, substance use disorder, and use of substance use services, using administrative diagnosis codes and clinic stop codes; and (2) the documented facility-level variability of these SDoH. To examine whether variability was due to regional coding differences, we assessed the variation of living alone using a validated natural language processing (NLP) algorithm.</p>
<p>Results: The proportion of veterans admitted for AMI, HF, and pneumonia with SDoH was low. Across all 3 conditions, lives alone was the most common SDoH (2.2% [interquartile range (IQR), 0.7-4.7]), followed by substance use disorder (1.3% [IQR, 0.5-2.1]), and use of substance use services (1.2% [IQR, 0.6-1.8]). Using NLP, the proportion of hospitalized veterans with lives alone was higher for HF (14.4% vs 2.0%, P < .01), pneumonia (11% vs 1.9%, P < .01), and AMI (10.2% vs 1.4%, P < .01) compared with International Classification of Diseases, Ninth Edition codes. Interfacility variability was noted with both administrative and NLP extraction methods.</p>
<p>Conclusions: The presence of SDoH in administrative data among patients hospitalized for common medical issues is low and variable across VHA facilities. Significant facility-level variation of 5 SDoH was present regardless of extraction method.</p>
<p><a href="https://www.mdedge.com/fedprac/article/234322/health-policy?sso=true" target="_blank">Read the report >></a></p></div>ACF Memo: ACYF-CB-IM-21-02https://hub.nic-us.org/groups/social-determinants/resources/acf-memo-acyf-cb-im-21-022021-01-13T16:35:50.000Z2021-01-13T16:35:50.000ZAmanda Taylorhttps://hub.nic-us.org/members/AmandaTaylor<div><p>TO: State, Tribal, and Territorial Agencies Administering or Supervising the ACF grants and programs.</p>
<p>SUBJECT: Civil Legal Advocacy to Promote Child and FamilyWell-being, Address the Social Determinants of Health, and Enhance Community Resilience</p>
<p>PURPOSE: The purpose of this information memorandum (IM) is to highlight the importance of civil legal advocacy in advancing child and family well-being; addressing the social determinants of health; enhancing community resiliency; and to strongly encourage state, territorial, and tribal human services entities to work together to support access to civil legal advocacy.</p>
<p>INFORMATION: This IM emphasizes the importance of civil legal advocacy in advancing the well-being of children and families and maximizing the impact of the Administration for Children and Families (ACF) administered programs and grants that serve children, families, and individuals. This memorandum identifies the various means of funding civil legal advocacy; highlights models and partnership approaches to providing civil legal advocacy; and emphasizes the value of civil legal advocacy as a proactive, preventive, and restorative support to families and children.</p>
<p>ACF and its component offices and bureaus1 speak in unison strongly encouraging all jurisdictions to work together to ensure that families have access to high-quality, civil legal advocacy.</p>
<p><a href="{{#staticFileLink}}8419411497,original{{/staticFileLink}}" target="_blank">View the memo >></a></p></div>Latent Class Analysis to Represent Social Determinant of Health Risk Groups in the Medicaid Cohort of the District of Columbiahttps://hub.nic-us.org/groups/social-determinants/resources/latent-class-analysis-to-represent-social-determinant-of-health-r2021-01-05T18:12:42.000Z2021-01-05T18:12:42.000ZAmanda Taylorhttps://hub.nic-us.org/members/AmandaTaylor<div><p>Abstract:</p>
<p>Objective: To develop distinct social risk profiles based on social determinants of health (SDH) information and to determine whether these social risk groups varied in terms of health, health care utilization, and costs.</p>
<p>Methods: We prospectively enrolled 8943 beneficiaries insured by the District of Columbia Medicaid program between September 2017 and December 2018. Participants completed a SDH survey and we obtained their Medicaid claims data for a 2-year period before study enrollment. We used latent class analysis (LCA) to identify distinct social risk profiles based on their SDH responses. We assessed the relationship among different SDH as well as the relationship among the social risk classes and health, health care use and costs.</p>
<p>Results: The majority of SDH were moderately to strongly correlated with one another. LCA yielded 4 distinct social risk groups. Group 1 reported the least social risks with the most employed. Group 2 was distinguished by financial strain and housing instability with fewer employed. Group 3 were mostly unemployed with limited car and internet access. Group 4 had the most social risks and most unemployed. The social risk groups demonstrated meaningful differences in health, acute care utilization, and health care costs with group 1 having the best health outcomes and group 4 the worst (P<0.05).</p>
<p>Conclusions: LCA is a practical method of aggregating correlated SDH data into a finite number of distinct social risk groups. Understanding the constellation of social challenges that patients face is critical when attempting to address their social needs and improve health outcomes.</p>
<p><a href="https://europepmc.org/article/med/33273298" target="_blank">Read the analysis >></a></p></div>If social determinants of health are so important, shouldn’t we ask patients about them?https://hub.nic-us.org/groups/social-determinants/resources/if-social-determinants-of-health-are-so-important-shouldn-t-we-as2020-12-21T18:16:38.000Z2020-12-21T18:16:38.000ZAmanda Taylorhttps://hub.nic-us.org/members/AmandaTaylor<div><p>About:</p>
<p>Health inequities are worsening across Britain. Data from the Office for National Statistics (ONS) show that men in England’s most deprived areas die almost a decade earlier than those living in affluent neighbourhoods. For women, life expectancy is falling in deprived areas. During the coronavirus pandemic, the strong emerging relation between covid-19 death rates and area deprivation reported by ONS and Public Health England has shown the exacerbation of existing inequities and highlighted the need for more comprehensive datasets in order to understand and reduce them.</p>
<p>The measurement and description of health and social inequities tends to rely on data at the level of geographical areas rather than individuals. We consider the limitations of using geographical data and look at how the collection of individual level socioeconomic data by healthcare systems could help to deliver care that is responsive to patients’ social contexts and generate an enhanced dataset for research and monitoring of healthcare equity.</p>
<p><a href="https://www.bmj.com/content/bmj/371/bmj.m4150.full.pdf" target="_blank">Read the analysis >></a></p></div>Implementing a Targeted Approach to Social Determinants of Health Interventionshttps://hub.nic-us.org/groups/social-determinants/resources/implementing-a-targeted-approach-to-social-determinants-of-health2020-12-21T18:07:12.000Z2020-12-21T18:07:12.000ZAmanda Taylorhttps://hub.nic-us.org/members/AmandaTaylor<div><p>Abstract:</p>
<p>The scale of the coronavirus disease 2019 pandemic and its disproportionate impact on vulnerable populations has spurred unprecedented focus on and investment in social determinants of health (SDOH). Although the greater focus on social determinants is laudable and necessary, there is a tendency for health care organizations to implement SDOH programs at scale without rigorous evidence of effect, rather than targeting interventions to specific patients and assessing their impact. This broad, and sometimes blind, application of SDOH interventions can be costly and wasteful. We argue for rejecting the “more is better” mindset and specifically targeting patients who truly need and would substantially benefit from SDOH interventions. Matching interventions to the most appropriate patients involves screening for social needs, developing rigorous evidence of effect, and accompanying policy reform.</p>
<p><a href="https://www.ajmc.com/view/implementing-a-targeted-approach-to-social-determinants-of-health-interventions" target="_blank">Read the article >></a></p></div>NASDOH Issue Brief Waivers and Program Flexibilities: Lessons from COVID-19https://hub.nic-us.org/groups/social-determinants/resources/nasdoh-issue-brief-waivers-and-program-flexibilities-lessons-from2020-12-21T17:47:37.000Z2020-12-21T17:47:37.000ZAmanda Taylorhttps://hub.nic-us.org/members/AmandaTaylor<div><p>About:</p>
<p>NASDOH published its third issue brief in a series that discusses how key SDOH-related issues have been exacerbated during COVID-19. “Waivers and Program Flexibilities: Lessons from COVID-19” highlights the importance of federal health and social programs flexibilities amid the COVID-19 pandemic to meet social need, summarizes key reasons to retain and expand certain waivers and program flexibilities implemented during the public health emergency, and provides a set of recommendations to optimize use of waivers and program flexibilities.</p>
<p><a href="https://www.nasdoh.org/wp-content/uploads/2020/12/NASDOH-COVID-19-Commentary-Waivers-and-Flexibilities_FINAL.pdf" target="_blank">Read the issue brief >></a></p></div>Caring for the Whole Child: A New Way to Finance Initiatives to Improve Children’s Health and Well-being Issue Briefhttps://hub.nic-us.org/groups/social-determinants/resources/caring-for-the-whole-child-a-new-way-to-finance-initiatives-to-im2020-12-15T15:50:55.000Z2020-12-15T15:50:55.000ZAmanda Taylorhttps://hub.nic-us.org/members/AmandaTaylor<div><p>Executive Summary:</p>
<p>A growing recognition that socioeconomic factors affect health outcomes in significant ways is fueling new community investments and change in health care delivery systems. Often referred to as “social determinants of health” (SDOH), these factors refer to “the structural conditions in which people are born, grow, live, work and age” that have profound implications for an individual’s overall well-being. Addressing SDOH needs for children and their families is particularly important in light of the strong evidence that investments in the earliest years can have a potent impact on children’s development and their ability to thrive and grow to be healthier adults. Yet children have largely been left behind with respect to SDOH investments in part because the financing for these initiatives has relied heavily on the potential for a relatively short-term return on investment (ROI) for the health sector. SDOH interventions focused on children will produce health-related financial returns but typically on a longer time horizon, and they often will result in savings outside the health care sector (for example, to the child welfare system), giving rise to what is known as the “wrong pockets” problem. Given the extraordinary impact that the COVID-19 pandemic is having on the well-being of children, and most notably children of color, the urgency to act could not be more apparent.</p>
<p>A Children’s Health and Wellness Fund is a way to galvanize efforts focused on SDOH investments for children. On the most basic level, a Fund offers a mechanism to address the wrong pockets problem by facilitating a shared financing approach that reflects the shared interest and benefits of the many sectors that serve children—including health care, education, child welfare, and juvenile justice. A Fund can attract, collect, and administer funding derived from different sources that can help finance “whole child” care. Sources of funding can be diverse, including public and private funds that build on investments that ought to be made through Medicaid and the Children’s Health Insurance Program (CHIP). But a Fund can be more than a bank account that facilitates multisector investments and spending; by bringing together diverse actors, all with a strong interest in children, a Children’s Health and Wellness Fund can focus attention on children’s needs and spur action on their behalf.</p>
<p>This brief describes a pathway to ensure that children and their families benefit from SDOH investments. It reviews options for designing and implementing a Children’s Health and Wellness Fund with respect to each of the issues identified below, highlighting different models that can address the core components of a Fund. Critically, all these decisions require leadership from and close collaboration with the community to be served and a consistent and focused attention on promoting equity.</p>
<p><a href="https://www.manatt.com/Manatt/media/Documents/Articles/RWJF-Manatt-Caring-for-the-Whole-Child-Issue-Brief_12-1-20.pdf" target="_blank">Read the brief >></a></p></div>What Is the Best Strategy for Social Determinants of Health Screens?https://hub.nic-us.org/groups/social-determinants/resources/what-is-the-best-strategy-for-social-determinants-of-health-scree2020-11-09T19:47:33.000Z2020-11-09T19:47:33.000ZAmanda Taylorhttps://hub.nic-us.org/members/AmandaTaylor<div><p>Highlights:</p>
<ul>
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<p>Relying simply on community-level data rather than conducting an individual social determinants of health screening increases the risk a patient will fall through the crack in social services interventions, according to new data published in JAMA Network Open. In other words, conducting a social determinants of health screening with individual patients provides more granular information about patient needs than looking at overarching risk factors in a certain geographic region.</p>
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<p>Using census-tract level data, the researchers foremost worked to detect certain social risk factors based on community-level data. The researchers deemed a patient at-risk for social determinants of health if she lived in what the team determined to be an under-resourced neighborhood. Next, the team looked at individual-level social risk factor data gleaned from patient screenings. Those screenings asked patients about social challenges, like food insecurity, housing insecurity, and financial resource strain. The screenings provided individualized information about the social determinants of health.</p>
</li>
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<p><a href="https://patientengagementhit.com/news/what-is-the-best-strategy-for-social-determinants-of-health-screens?eid=CXTEL000000590793&elqCampaignId=16705&utm_source=nl&utm_medium=email&utm_campaign=newsletter&elqTrackId=55ed680616a04359bacc4a50fac8afea&elq=687006bb99e549449ab5bc47ab69774f&elqaid=17497&elqat=1&elqCampaignId=16705" target="_blank">Read the article >></a></p></div>Docs Keep Focus on Social Determinants of Health, Eye Reimbursementhttps://hub.nic-us.org/groups/social-determinants/resources/docs-keep-focus-on-social-determinants-of-health-eye-reimbursemen2020-11-09T19:22:21.000Z2020-11-09T19:22:21.000ZAmanda Taylorhttps://hub.nic-us.org/members/AmandaTaylor<div><p>Highlights:</p>
<ul>
<li>Nearly three-quarters of doctors agree that social determinants of health will put the biggest strain on the healthcare industry come 2021, according to the third part of The Physicians Foundation 2020 Survey of America’s Physicians. Another 44 percent said addressing health equity and inequity will be key for ensuring patient access to care, the survey showed.</li>
<li>Forty-percent of physician respondents agreed that socioeconomic issues—income, job security, educational attainment, and family support—are the most pressing social determinants of health. These factors influence other downstream social determinants of health. Addressing income inequality could help address housing security issues, for example.</li>
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<p><a href="" target="_blank">Read the article >></a></p></div>Top 5 Social Determinants of Health Domains for Payers to Addresshttps://hub.nic-us.org/groups/social-determinants/resources/top-5-social-determinants-of-health-domains-for-payers-to-address2020-11-03T17:11:03.000Z2020-11-03T17:11:03.000ZAmanda Taylorhttps://hub.nic-us.org/members/AmandaTaylor<div><p>Highlights:</p>
<ul>
<li>There are five social determinants of health domains, according to the Office of Disease Prevention and Health Promotion (ODPHP) Healthy People 2030 website. While certain domains will at times require more urgent attention than others, a robust social determinants of health strategy may seek to address all five. The five social determinants of health domains encompass economic stability, education access and quality, health care access and quality, neighborhood and built environment, and social and community context.</li>
<li>Social determinants of health strategies should first and foremost be anchored in the communities that the health plans are serving. However, payers can also evaluate their approach's comprehensiveness by assessing how they align with the five social determinants of health domains.</li>
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<p><a href="https://healthpayerintelligence.com/news/top-5-social-determinants-of-health-domains-for-payers-to-address?eid=CXTEL000000590793&elqCampaignId=16571&utm_source=nl&utm_medium=email&utm_campaign=newsletter&elqTrackId=6b39469146ac4cf0a91c42562de65df1&elq=ec636b0e3d5f421188c163ffa941ec5f&elqaid=17352&elqat=1&elqCampaignId=16571" target="_blank">Read the article >></a></p></div>Addressing Social Determinants of Health Through Dual-Eligible Special Needs Planshttps://hub.nic-us.org/groups/social-determinants/resources/addressing-social-determinants-of-health-through-dual-eligible-sp2020-11-03T16:25:27.000Z2020-11-03T16:25:27.000ZAmanda Taylorhttps://hub.nic-us.org/members/AmandaTaylor<div><p>Executive Summary:</p>
<p>The more than 12 million Americans who are dually eligible for Medicare and Medicaid often have multiple chronic medical and behavioral health conditions, longterm care needs, and significant social determinant of health (SDOH) needs. Addressing their SDOH needs could help dually eligible individuals by improving access to and the effectiveness of their Medicare and Medicaid benefits, improving health outcomes and quality of life, and reducing health care costs.</p>
<p>Increasing recognition of the impact of non-medical factors on health and health outcomes led Congress and the Centers for Medicare & Medicaid Services (CMS) to create pathways for addressing Medicare beneficiaries’ non-medical needs. Recent CMS guidance described Special Supplemental Benefits for the Chronically Ill (SSBCI), which can include non-primarily health-related supplemental benefits (e.g., meals, food and produce, non-medical transportation, pest control, indoor air quality equipment and services, structural home modifications) that could address SDOH needs Beginning in 2020, Medicare Advantage plans could offer SSBCI to members with certain chronic conditions.</p>
<p>The Association for Community Affiliated Plans (ACAP) is a national trade association representing not-forprofit safety net health plans. ACAP has 24 Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) members that enroll mostly full-benefit dually eligible individuals. ACAP and its D-SNPs welcome the opportunity to provide SSBCI, but recognize that the current funding mechanism for those benefits (i.e., plans’ rebate dollars) may not provide sufficient resources to meaningfully address the needs of dually eligible members.</p>
<p>With support from Arnold Ventures, ACAP partnered with the Centers for Health Care Strategies (CHCS) to develop: (1) a Gap Analysis exploring D-SNP members’ SDOH needs, how the SSBCI pathway is being used, and whether the SSBCI pathway provides sufficient flexibility and resources to address SDOH needs; and (2) a set of Policy Options that explore alternative ways for Medicare to provide D-SNPs with tools to address SDOH. Both the gap analysis and the policy options were informed by interviews with ACAP D-SNPs and nationally recognized subject matter experts.</p>
<p><a href="https://www.chcs.org/media/Arnold-Ventures-SDOH-Report-FINAL.pdf" target="_blank">Read the report >></a></p></div>Understanding the Upstream Social Determinants of Healthhttps://hub.nic-us.org/groups/social-determinants/resources/understanding-the-upstream-social-determinants-of-health2020-10-30T16:57:07.000Z2020-10-30T16:57:07.000ZAmanda Taylorhttps://hub.nic-us.org/members/AmandaTaylor<div><p>The term social determinants of health (SDOH) is often used to refer to any nonmedical factors influencing health, including health related knowledge, attitudes, beliefs, or behaviors (e.g., smoking); however, SDOH also include “upstream” factors, such as social disadvantage, risk exposure, and social inequities that play a fundamental causal role in poor health outcomes— and thus represent important opportunities for improving health and reducing health disparities. This paper describes and categorizes three types of approaches used to examine upstream SDOH. Social disadvantage approaches focus on the link between health and neighborhood conditions, working conditions, education, income and wealth, and race/ethnicity and racism; a potential causal link is the role of stress related to coping with these factors. Life course approaches focus on the link between health and critical or sensitive periods in exposure to risk (adverse childhood experiences, intergenerational transfer of advantage) as well as cumulative exposures; the potential causal link here may derive from the effect of social status on the regulation of genes controlling physiologic functions (e.g., immune functioning). Health equity approaches consider the link between health and social inequities stemming from socio demographic factors, such as class, immigration status, gender, sexual orientation, and disability status; social capital can serve to moderate or mediate the effects of these factors. The paper identifies several challenges to understanding upstream SDOH, including the long and complex causal pathways linking these factors with health, multiple intervening factors, limited ability to study these factors using randomized experiments, single disease focused research funding, and limited understanding of community buffers that can mitigate the effects of SDOH.</p>
<p><a href="https://www.rand.org/content/dam/rand/pubs/working_papers/WR1000/WR1096/RAND_WR1096.pdf" target="_blank">Read the report >></a></p></div>Siloed approaches to social determinants of health aren't enoughhttps://hub.nic-us.org/groups/social-determinants/resources/siloed-approaches-to-social-determinants-of-health-aren-t-enough2020-10-26T17:46:33.000Z2020-10-26T17:46:33.000ZAmanda Taylorhttps://hub.nic-us.org/members/AmandaTaylor<div><p>About:</p>
<p>Alliance for Better Health CEO Dr. Jacob Reider discusses the data and IT demands of coordinating SDOH efforts – and the imperative to serve underserved communities, where effects from COVID-19 will be felt long after the pandemic has subsided.</p>
<p><a href="https://www.healthcareitnews.com/video/siloed-approaches-social-determinants-health-arent-enough" target="_blank">Watch the video >></a></p></div>PUBLIC HEALTH’S UNIQUE ROLE IN ADDRESSING BOTH SOCIAL NEEDS AND SOCIAL DETERMINANTS OF HEALTHhttps://hub.nic-us.org/groups/social-determinants/resources/public-health-s-unique-role-in-addressing-both-social-needs-and-s2020-10-15T18:33:59.000Z2020-10-15T18:33:59.000ZAmanda Taylorhttps://hub.nic-us.org/members/AmandaTaylor<div><p>This is the second in a series of issue briefs from the National Alliance to impact the Social Determinants of Health (NASDOH) on key SDOH-related issues that have been exacerbated during COVID-19. This brief explores how the public health sector is uniquely positioned to assist at the intersection of public health, social needs and social determinants of health (SDOH), both during the current public health emergency and moving forward. This is one in a series of NASDOH commentaries and issue papers in the coming months addressing the key issues in more depth and, where possible, describing what we have learned.</p>
<p><a href="https://www.nasdoh.org/wp-content/uploads/2020/09/NASDOH_Public-Health-Social-Need_v4.pdf" target="_blank">Read the report >></a></p></div>Why Teamwork Is Key to Addressing Social Determinants of Healthhttps://hub.nic-us.org/groups/social-determinants/resources/why-teamwork-is-key-to-addressing-social-determinants-of-health2020-09-14T15:24:41.000Z2020-09-14T15:24:41.000ZAmanda Taylorhttps://hub.nic-us.org/members/AmandaTaylor<div><p>Healthcare organizations setting out on a social determinants of health program must rely on community partners to effectively meet patient needs.</p>
<p><a href="https://patientengagementhit.com/news/why-teamwork-is-key-to-addressing-social-determinants-of-health?eid=CXTEL000000590793&elqCampaignId=15875&utm_source=nl&utm_medium=email&utm_campaign=newsletter&elqTrackId=b15557aaa0584280a9f210719074eb4d&elq=b129fbb2c17f453bb7090e5c7030763a&elqaid=16644&elqat=1&elqCampaignId=15875" target="_blank">Read the article >></a></p></div>Social Determinants of Health Data Interoperability: A Concept Paper from the National Alliance to Impact the Social Determinants of Healthhttps://hub.nic-us.org/groups/social-determinants/resources/social-determinants-of-health-data-interoperability-a-concept-pap2020-08-22T19:41:43.000Z2020-08-22T19:41:43.000ZAmanda Taylorhttps://hub.nic-us.org/members/AmandaTaylor<div><p>In this concept paper, NASDOH, with the guidance from the work of the CARIN Alliance, outlines key opportunities to enable an interoperable data ecosystem where social needs information is shared seamlessly, privately, securely, and with consent to address individuals’ needs effectively and impact SDOH upstream.</p>
<p><a href="https://www.nasdoh.org/wp-content/uploads/2020/08/NASDOH-Data-Interoperability_FINAL.pdf" target="_blank">Read more >></a></p></div>