What They’re Watching: Richard Bettini, Waianae Coast Comprehensive Health Center

Richard Bettini is the President and CEO of Waianae Coast Comprehensive Health Center. He joins us in this edition of “What They’re Watching” to discuss community engagement in addressing the social determinants of health.

“Everyone is talking about the social determinants of health and trying to figure out a way to effectively be engaged in addressing these social conditions. So that’s a big topic. You know, I have spent many decades living and working on the Waianae Coast, which is kind of ground zero for a number of social conditions that we may want to positively impact, including cultural factors, educational factors, and housing — it’s sort of all there. And you know, we did 200,000 clinical visits last year, the majority of which is to low-income.

So I think the question is, how do we [address the social determinants]? And I hear some good ideas but I honestly believe, in my experience, that the most effective way is not to bring experts from outside the community into the community, even health plans with their ideas on how to address the social determinants. The key is going to be to empower communities — particularly where there’s a critical mass of low-income patients — to solicit their ideas directly. Even maybe taking a chance and throwing a few dollars at those communities to come up with their own ideas that they value. And I think that is, so far, a little missing from the equation. I hear some lip service to it but we really do, when it comes to low income, particularly Hawaiian communities, [need] to empower them to solve their own problems. And I think that’s the one thing I’d like to try to pursue with some of the health plan partners.”