Building Trust in Health Systems to Eliminate Health Disparities

“Health systems play a vital role in enhancing the health of the communities they serve, including historically underserved populations with disparate health outcomes. Eliminating health disparities is a critical aspect of enhancing population health that requires collaborative input from multiple entities including health systems, government agencies, community organizations, and residents. A lack of clarity among contributing entities about the roles and responsibilities of health systems in addressing root causes of health disparities make the challenging goal of eliminating them even more so. This raises questions in communities served about the extent to which health systems are truly committed to advancing health. The resulting tension compounds the historic lack of trust between health systems and underserved communities and undermines collaborative work toward mutually beneficial outcomes of improved health. Health system leaders need to lead in addressing this tension by building and sustaining trust with and for their communities.”

In this editorial from Jama Network’s Trust in Healthcare, the authors suggest that in order to address complex social problems, health system leaders will need to build trustworthy and lasting relationships with community institutions. Read the full article here.

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Social determinants of health - health care isn't just bugs and bacteria

Social determinants of health - health care isn't just bugs and bacteria

“Democrats and Republicans are coming together around a newly proposed, bipartisan legislation to help states and communities manage costs and improve outcomes for Medicaid recipients. Called the Social Determinants Accelerator Act, the bill was introduced on July 25 by Reps. Cheri Bustos (D-Ill.), Tom Cole (R-Okla.), Jim McGovern (D-Mass.) and Cathy McMorris Rodgers (R-Wash).

The bill received support from health-care industry groups like the American Hospital Association and Aligning for Health. It proposes planning grants and technical assistance for states and communities to address individual patient non-medical needs that are closely tied to health, like food security, housing stability, and employment. It also targets high-need Medicaid patients and improving the coordination of health and non-health services…”

While this is a good first step forward, ultimately, larger systematic problems like multi-generational poverty, institutional racism, and historic trauma will have to be addressed. To read the article in full, click here.

This article can be found in The Hill.

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10 ways cities are tackling the global affordable housing crisis

10 ways cities are tackling the global affordable housing crisis

“Affordability is not just about the ability to buy or rent a home, but also about being able to afford to live in it. This definition of affordability goes beyond meeting expenses related to operations and maintenance, taking into consideration transport, infrastructure and services. If a home is economical enough to buy and maintain but located too far from work or school, it cannot be said to be affordable.”

This article explores innovative ways cities are addressing housing affordability. From land acquisitions, repurposing vacant properties, and financing, many cities are taking innovative approaches to address the issue. Read the full article here.

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Food Insecurity Becomes Focus for Population Health Programs

Food Insecurity Becomes Focus for Population Health Programs

“Healthcare providers, payers, and other industry partners are increasingly recognizing that tackling food insecurity is a major component of a successful population health management program…

As the healthcare industry starts to ramp up its data-driven capabilities overall health system costs, asserts a 2017 study from BMC Geriatrics and Population Health Management. Access to federal food assistance programs such as SNAP reduced the likelihood of hospitalization for seniors by 14 % and cut the likelihood of nursing home admission by 23 %, the study said.

Public and private payers have been taking the lead in this area.”

This article from Health IT Analytic’s Population Health News explores how health systems are providing access to healthy food options, addressing food insecurity, and incorporating diet “prescription” programs. Read the full article here.

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8 Policies that Have Contributed to Place Based Health Disparities Across Generations

8 Policies that Have Contributed to Place Based Health Disparities Across Generations

"Where you live plays a significant role in how healthy you are. But when it comes to promoting health, not all neighborhoods are created equal. And neighborhoods with the best access to health-promoting resources — like quality housing, good jobs, well-maintained parks, healthy food, and excellent schools — aren’t accessible to everyone.

Today, many of the differences between neighborhoods exist because of decades’ worth of interrelated policies that have cumulatively influenced where investment and opportunity have concentrated and who has access to them. The result is increasing health disparities and exacerbated inequities in communities across the country. Read on to learn more about 8 laws and policies that have created unhealthy places and about tools and resources that can help heal policy harms and create healthy neighborhoods for all..."

Erik Calloway & Chassidy Hanley | August 6, 2018

The read the 8 policies from ChangeLab Solutions, please click here.

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Social Determinants are Core of North Carolina's Medicaid Overhaul

Social Determinants are Core of North Carolina's Medicaid Overhaul

"North Carolina is trying to make taking care of patients' social and environmental needs a sustainable, everyday part of a healthcare organization's workflow, Dr. Mandy Cohen, the secretary of the North Carolina's Health and Human Services Department, explained Friday at Modern Healthcare's Women Leaders in Healthcare conference in Nashville. She described the goal as buying health—not healthcare. 

Looking beyond what happens in the hospital or clinic is becoming the financial imperative for U.S. healthcare organizations as they move toward alternative payment models and take on more financial risk for a patient's health, said Cohen, who took on the role of secretary in January 2017 after serving as chief operating officer and chief of staff at the CMS during the Obama administration..."

Shelby Livingston | August 3, 2018

To read the full article, please click here. This piece appears in Modern Healthcare.

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Health departments placing stronger emphasis on equity: Achieving social justice in public health

Health departments placing stronger emphasis on equity: Achieving social justice in public health

"Data-driven public health policy has long been at the center of the Kansas City health department’s equity work, which began, in earnest, nearly two decades ago after data revealed a more than six-year life expectancy gap between the city’s black and white residents, with about half of the city’s annual deaths attributable to factors such as poverty, segregation, violence and lack of education. The data pushed the agency to begin the process of shifting its focus from health disparities to health inequities, with an eye toward remedying the conditions that confer greater health opportunity to certain populations over others.

After years of work, health equity values are part of everyday practice at the health department, with many of its equity wins driven by a mix of policy, partnership, data and community engagement. Just recently, for example, the health department successfully persuaded the city to adopt an official five-year business development plan that includes a strategic objective to increase overall life expectancy and reduce health inequities, with a goal of incentivizing development in neighborhoods in need of services and jobs..."

First in a series on health equity, which ties into the theme of APHA's 2018 Annual Meeting and Expo: "Creating the Healthiest Nation: Health Equity Now." This piece appears in the July edition of The Nation's Health.

Kim Krisberg | July 2018

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If health care is a small part of health, how does a safety net hospital adapt?

"At one of the busiest public hospitals in the nation, doctors have learned that to heal a patient on the inside, they must understand the patient’s world outside the exam room.

What kind of neighborhood do you live in? Are you buying healthy food? How are you getting to work? The questions are meant to uncover the root causes of what bring men and women into the Adult East Primary Care Clinic at the Los Angeles County-USC Medical Center, just east of downtown L.A. Once that screening takes place and a doctor understands how a patient's health is impacted by homelesses, lack of nutrious food or trauma, a team of providers is ready to help. Nurses, social workers, community advocates, nutritionists, mental health specialists, medical students, and volunteers are ready to link a patient to, say, food stamps or psychological care, said Dr. Jagruti Shukla, director of primary care at LAC+USC..."

Susan Abram | July 25, 2018

This piece appears in the Center for Health Journalism Fellowships Blog


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Can a Community Hospital Stick To Its Mission When It Goes For Profit

Can a Community Hospital Stick To Its Mission When It Goes For Profit

"After 130 years as a nonprofit with deep roots in the community, Mission Health announced in March that it was seeking to be bought by HCA Healthcare, the nation's largest for-profit hospital chain. HCA owns 178 hospitals in 20 states and the United Kingdom. 

The pending sale reflects a controversial national trend in the U.S. as hospitals consolidate at an accelerating pace and the cost of health care continues to rise. Proponents of hospital mergers say the change can help struggling nonprofit hospitals "thrive," with an infusion of cash to invest in updated technology and top clinical staff. But research shows the price of care, especially for low-income patients, usually rises when a hospital joins a for-profit corporation..."

To read the full article, click here.

Steven Findlay | July 19, 2018

This piece appears in Shots: Health News from NPR

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United Hospital Fund launches Second Phase of Early Childhood Development Initiative to Address Social and Economic Factors Affecting Children's Health

Eight hospitals are partnering with community-based organizations across NYC, with funding from United Hospital Fund, Altman Foundation, and the New York Community Trust. 

"United Hospital Fund announced that it is launching the second phase of its Partnerships for Early Childhood Development (PECD) initiative, which partners New York-area pediatric primary care practices with community-based organizations to better address the social and economic factors affecting the health of very young children.

PECD was launched in March 2017 with funding from a collaborative consisting of United Hospital Fund, the Altman Foundation, and The New York Community Trust. The first phase of the initiative was designed to help pediatric primary care practices screen children ages 0-5 for social and environmental risks that interfere with healthy development, and connect them, through partnerships with community-based organizations, with services that can address those risks."

To read the full article, please click here. This piece is from United Hospital Fund.

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