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To effectively address social determinants, get comfortable with change

July 1, 2017

By JULIE MINDA

NEW ORLEANS — With the community benefit landscape changing dramatically in health care in recent years, hospitals and other providers are having to rethink their approaches to care delivery. Entire populations of people are now "the patient," and providers are increasingly being held accountable for these populations' health outcomes.

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A panel discusses population health during a pre-assembly community benefit program June 11. From left are panel moderator Fr. Michael Rozier, SJ, and panelists William Snyder, Dr. Samuel L. Ross, Tracy Neary and Corinne Francis.
Photo by Jerry Naunheim Jr./© CHA

To succeed in this environment, community benefit practitioners must be strategic, communicative, collaborative and flexible, according to panelists at "When Populations Become the Patient," a session at a community benefit program here before the Catholic Health Assembly. Panelists were Corinne Francis, system vice president, mission integration and community benefit for CHRISTUS Health; Tracy Neary, regional vice president for mission integration, St. Vincent Healthcare, which is part of SCL Health; Dr. Samuel L. Ross, chief executive, Bon Secours Baltimore Health System; and William Snyder, system vice president, external affairs for Presence Health.

The group discussed that treating populations of people requires health care facilities to become adept at addressing the social determinants of health, or the environmental and socioeconomic factors that can hinder people's ability to achieve and sustain optimal health.

But, said Snyder, the U.S. health and social services system is "unbelievably complex," and it is extremely difficult to organize hospital and community resources to respond to people's socioeconomic needs. There is a perpetual lack of time and funding for hospitals and other responding organizations to do such work, said Francis. There are always other priorities competing for hospital leaders' attention, said Ross. And, there's not always the needed sense of urgency among health care and community leaders to address social determinants of health, said Neary.

Though the Affordable Care Act provided incentives and a framework for addressing social determinants, it has been difficult for providers to determine how best to do so.

The panelists said to overcome such challenges, hospitals and other health care providers need to reframe how they view social determinants, recognizing that addressing them is central to care delivery, not an aside, said Ross.

All panelists said partnerships are essential to getting at the social determinants of health. It's important to broker relationships with organizations that are not the "usual suspects," said Francis. For example, ministry providers can partner with city councils that can address environmental health factors, including air quality and chemicals that affect ground water quality and sustainability. Working with community partners could uncover new sources of funding for programs that get at social determinants, said Neary. Health care leaders must be able to clearly articulate how addressing social determinants will positively impact stakeholders, including patients, community members, clinicians and business owners, said Ross. For instance, improving community health can make an area more attractive to businesses, which benefit from the productivity and lower health spending of a healthy workforce.

Persistence may be needed to bring community organizations into partnership to address social determinants, said Ross. "You may need to be a flea, nibbling at them."

Health insurance companies can be important partners in this work, noted Snyder. He said they, too, have a vested interest and often a depth of expertise in addressing barriers to care, to bring down health care costs.

Francis said there are exciting opportunities to improve community health, but it will require new ways of working and "being comfortable with being uncomfortable."

 

Copyright © 2017 by the Catholic Health Association of the United States
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