According to focus group principal RJ Briscione, addressing the social determinants of health (SDOH) requires several key ingredients. Stay on the ground and talk to people face to face. And the ability to adjust and make changes.
Briscione led a panel on how addressing these social needs affects health equity. 2022 Oregon Reform Health Policy ConferenceJoining him on the panel are Jess Soltesz, director of social health at Kaiser Permanente Northwest, and senior medical director of clinical care at Central City Concern, an organization that serves Portland’s homeless. It was Richard Bruno, MD.
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The panel discussion had a common theme: data.Advocates across the healthcare sector has long been identified Stronger and more coordinated health data collection as a top priority for effective SDOH management. The panelists doubled down on this.
“How do we collect that data and make sure it reaches the people who really need it, not just the people who come to our clinics on a daily basis?”
Soltesz pointed out that there are “hidden groups” that the current SDOH outreach strategy has not reached, leaving the sector with incomplete data on its societal needs. People with SDOH tend to have less access to health care systems, so it is important that health care systems conduct proactive and purposeful outreach to individuals, she said.
“Unless you specifically target these demographics, you can’t really understand what the needs are,” she said.
A large part of this is the incorporation of more community-centred intervention methods, such as non-English data collection options and community health workers. It said it needs to be involved for a longer period of time in order to reach
“In our world, [SDOH are] does not appear until [patients] It shows a kind of high need in our healthcare system,” Briscione said. “Unfortunately, that’s the only way to measure things.”
Soltesz said health care systems don’t need to create new structures to collect social data, but rather partner with community-based organizations (CBOs) who are already doing this work to collect data they receive about their beneficiaries. I emphasized that it should be implemented by leveraging SDOH intervention.
Regarding SDOH’s data collection, Soltesz said:
Briscione and Soltes discussed how COVID has affected data collection efforts, highlighting the digital divide as a prominent impediment. If your organization relies on electronic outreach methods to identify social needs, only those with access to the required technology or sufficient technology literacy can participate. These were often “wealthy whites,” Briscione noted.
For example, when Briscione was facilitating the distribution of COVID vaccines while working in Etna, his team sought to target underserved populations and ensure access to vaccines by black people. We selected the vaccine retailers with the highest number of residents in the United States and brown.
But he found that only people who had the technology to book vaccine appointments online were signing up for appointments, not people who were meant to be underserved. did.
To remedy this, Briscione and his team instead distributed the vaccine through trusted CBOs that serve communities such as black churches. His team also purchased vehicles for mobile vaccine distribution rather than relying on an online sign-up process.
Soltesz added that it’s important to get involved in the community and learn directly from them how best to implement projects such as vaccine distribution. Present a pre-established plan to the community without consulting members
The panel also emphasized that collecting data is only one piece of the puzzle. Also, the data must be synthesized and used in a meaningful way. Bruno pointed out that there are many ways to accumulate data on SDOH— community health needs assessments, providers asking patients directly, payers asking beneficiaries — but there are not many effective ways to share it and use it to make a difference.
He said this provides opportunities for collaboration between the various organizations that collect the data. He urged stakeholders to stay up-to-date with his SDOH data continually emerging from the pandemic and think of ways to use this data to create joint solutions.
Panelists also cited several recent examples of successful SDOH-focused initiatives in Oregon.
Bruno talks about how important housing has been during COVID and how providing housing support can help protect Oregonians from the risk of overcrowding during a public health emergency like COVID. I talked about how it helps.he’s from portland safe rest village The initiative is a successful way the government has addressed the housing shortage for thousands of homeless people in Portland following COVID.
Through this project, the city implemented a “pod system.” The system demarcated areas or “pods” for unhoused individuals that contained essentials such as heating and accommodation. This allowed these individuals to maintain access to essentials while maintaining social distancing practices.
Briscione and Soltesz spoke about Health Share Oregon’s successful efforts to use data to reach out to members who may be at risk of heat- and climate-related health effects. Provide air conditioning units covered by MedicaidHealth Share Oregon reached out to members with pre-existing medical conditions, such as respiratory illnesses, to distribute approximately 300 air conditioners to Medicaid beneficiaries in need during this summer’s heat wave.
Briscione also spoke about Aetna’s partnership with Feeding South Florida. Feeding South Florida created Food Her Pantries in schools for food-insecure families to receive groceries. We also provided a survey in Spanish on the social needs of beneficiaries who participated in the program.
His team confirmed that transportation was an open issue for these families (many had limited access to transportation to pick up food or bring it home). ), implemented mobile “farms” where vehicles deliver food to the local network. A clinic close to the families who need them.
Briscione said the project found significant reductions in A1C levels in the target population.
“I think it’s going to be a model of starting with something and finding a good partner. You have to adapt, know what you want to measure and keep going,” he said.
