Addressing the Social and Economic Problems Undermining Health

The Robert Wood Johnson Foundation’s Vulnerable Populations Portfolio hosted a webinar on Thursday entitled HealthCare’s Blind Side: Exploring Solutions to Address Social Needs. You can read more about RWFJ’s work on addressing the social and economic determinants of health here. This webinar focused on developing ways to bridge the gap between traditional medical care and meeting social needs. The speakers considered how factors outside the medical system (social, economic, and geographic) shape our health, leaving physicians scrambling to address problems that can’t be fixed with medication or surgery. A RWJF report from last year documents that primary care physicians and pediatricians, particularly those serving marginalized communities, indeed understand the social and economic factors that affect their patient populations but lack the time, staff support, and resources to make changes to their care delivery model. My blog post on that report is here.

The webinar panelists identified a number of the structural barriers facing physicians and their patients. On the patient care side, for example, doctors may prescribe antibiotics for an infection, but families without reliable food access or transportation to get to a pharmacy won’t see the full benefit of the medication. Underlying social and economic problems are too often left untouched or are handled through uncoordinated efforts of individual providers. The panelists agreed that a systematic approach is necessary to build a bridge from clinics to the existing landscape of community resources. Policies at all levels can support the integration of social services with medical services. You can check out some of the ideas that have been proposed using the hashtag #RXSocial on Twitter.

An integrated approach to social and health needs could work in part by improving the utilization rate of benefits programs, such as SNAP (food stamps). Three in ten qualified Americans don’t receive SNAP. If these eligible families can be plugged into a health care system that recognizes the importance of family food security and connects them to an application for the programs they qualify for, they will be much better positioned to get and stay healthy. Promoting access and connectivity can help meet social needs in health settings.

While not explicitly identified by the panelists, the same logic can be applied to asset building services such as credit counseling, low-income tax filing assistance, or financial services for the unbanked like Bank On programs. Health care providers already recognize the profound impact of financial stress and instability on patients’ mental and physical wellbeing. Therefore, connecting social or economic needs with the health care system creates yet another opportunity to reach people where they already are. Integrating a social needs perspective into the clinic setting helps break down bureaucratic hurdles for families. This system also has the potential to give patients a greater sense of agency over their own health. By asking patients, “What’s important to you and how can I help?” (an approach one of the panelists recommended), providers can transform the patient-provider relationship for the better and start conversations about how to better address currently unmet needs.