Survey finds majority of Texans believe more state funding for social determinants of health is needed


Boram Kim


According to the results of a new state survey, 56% of Texans say health insurance should cover non-medical factors such as access to food and housing. 


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A majority (65%) of respondents also said more state funding to address these factors, often referred to as social determinants of health (SDOH), would improve people’s health. Support for more spending was highest among Black (72%), Hispanic (75%), and younger (76% of the 18-29 age group) Texans surveyed. 

Conducted by Episcopal Health Foundation (EHF), the phone survey interviewed more than 1,200 adults in the state to understand perspectives on and experiences with health care policies in Texas.

“EHF’s new research continues to show that your zip code, not your genetic code, really determines your overall health,” says Dr. Ann Barnes, EHF’s new President and CEO. “This polling data highlights that Texans want state leaders to address the social, economic, and environmental drivers of health. If we don’t act proactively beyond the doctor’s office, then we’re just left responding to poor health outcomes with sick care. We can’t achieve health equity in communities through medical care alone.”

Being unemployed or low-income was the most common social determinant that Texan adults (53%) have experienced, along with living in an area with poor access to public transportation (50%). 

“If the issue is not being able to get to the grocery store to buy food or to use food stamps, that’s a problem,” said Stephen Palmer, Managing Principal for Health Management Associates during a recent State of Reform panel discussion on the role of SDOH in Medicaid financing. “We definitely have food deserts where there are neighborhoods without access to healthy foods, like fresh produce.”

Texas Medicaid managed care plans currently utilize a performance-based payment system that rewards providers for improved health outcomes and efficiencies. According to the panel, although these current value-driven models provide a range of non-medical case management services intended to address SDOH, they are limited in scope. 

Palmer emphasized that identifying SDOH interventions and coordinating with community-based organizations to bridge those gaps were critical for the state’s managed care programs to be impactful.