Video: The new social determinant imperative


Aaron Kunkler


Addressing the social determinants of health has been a growing consideration in the world of health care and community services. During the 2022 Washington State of Reform Health Policy Conference, four of Washington’s most thoughtful stakeholders discussed what this means for the field in a panel called ‘The new social determinant imperative.’ 


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The panel included Anthony Davis, managing director of quality and accreditation services with Health Management Associates, Andrea Davis, vice president of government relations with Coordinated Care, Melissa Sherry, vice president of social care integration with Unite Us, and Nathan Buck, director of education and community services with Neighborhood House. 

Data, and how it is collected, was a major theme of the discussion. Sherry said as a tech company, Unite Us is focused on bridging the gap between health care and community-based organizations. They’re working to create data on whether people use services when they are offered. 

“Did they really go to the food bank? Were they able to get housing when they went to that shelter? And just the data and the power of data that comes from that, I think we’re so excited about the insights that come from that,” Sherry said. 

Anthony Davis said a focus he’s seen during the push for addressing social determinants is measuring how programs actually reduce disparities, and whether they’re having an impact on getting people better care. They’re examining how to connect data on outcomes between various providers. 

Buck said many of the services being provided in the community have been done for decades, and are known to be effective. But they’re at the stage of being able to link the services and activities of community-based providers to health outcomes, and that being able to connect on-the-ground services to health care can create better outcomes. A critical part of that is being able to follow the trail from investments to health benefits in communities. 

In the U.S., Sherry said, health and community systems decided to start screening for social needs and expanded to referral and tracking, and now are at the point where there has to be investments in it. She said they’re learning lessons from states like California and North Carolina which are creating programs where health care is paying for community-based services. 

In these places, state involvement helps when legislators put infrastructure dollars into health and community-based organizations. It also signals to payers that it’s fine to pay for social determinants programs. 

At the same time, Sherry said it’s important not to turn community-based organizations into health care providers due to more cumbersome requirements for providing health care. There also needs to be a focus on making data collection simple for community-based organizations. 

“How do we make sure community-based organizations have to click as few buttons as possible to be able to produce all of the data on the back end that payers need?” Sherry said. 

There are other unique solutions too, said Andrea Davis, like in California, where the state is using 1115 waivers to test out and pilot models to pay for things like rent and food, which also impact health. 

There’s not one answer to one problem, Andrea Davis said, like fixing homelessness. For example, in Seattle there are high rent prices, and in other areas of the state like Spokane, there are a lack of transportation and rural access. 

“I don’t think it’s necessarily like pick one social determinant and fix it,” she said. “I think it’s really looking at what are the problems in your community around you.”