Client perspectives call for more action from plans and providers, community-based organizations (CBOs) thrive in cross-sector collaboration, and loneliness and mental wellness remain areas of concern.
RISE’s virtual National Summit on Social Determinants of Health featured an impressive line-up of leading experts from cross-sector health care organizations who shared firsthand experiences, insights, and best practices to address challenges related to social determinants of health (SDoH). Here are three takeaways from select sessions:
SDoH clients need more engagement from plans and providers
SDoH clients provided direct feedback around the biggest issues that impact their access to health care during a focus panel session led by Kathleen Ellmore, managing director, Engagys. Eight clients participated in the discussion from their homes in Nashville, Tenn., where the summit was originally scheduled to take place.
Although the health plans, client circumstances, and challenges in their daily lives varied among the group, a common theme emerged: Clients need their providers and health plans to provide more outreach. Indeed, all eight panelists said it would be helpful if their health plans reached out more often. Only two out of the eight participants said their health plans have reached out to them to discuss how to overcome barriers outside of health care, and three of the eight said their providers have reached out.
Some of the common challenge areas for SDoH clients include food insecurity, cost of medication, and access to care.
One client, who had to forego her own medication in order to afford her son’s after an emergency surgery, said outreach from her health plan and assistance with food or medications would make a significant impact on her and her families’ health, as well as her stress level. The costs of the mortgage, food, and medications have been especially difficult amid the COVID-19 pandemic, she said. “It’s a breaking point; you get tired.”
Another client said he struggles with post-traumatic stress disorder (PTSD) and has been unable to meet with his therapist since the onset of the virus. Although he has tried online therapy services such as Talkspace, the panelist said it didn’t feel like the same level of support. “There are some things you can talk to someone about face-to-face more than over Zoom.”
Another said she has been unable to afford her medication for depression as the cost has jumped more than $50. If she chose to purchase the medication, she would have to skip meals.
Cross-sector partnerships directly impact SDoH
In another panel discussion, CBO leaders emphasized their eagerness to partner with health systems for continued improvements in SDoH. The CBO leadership panel was moderated by Denise Harlow, chief executive officer, National Community Action Partnership. She was joined by Zara Marselian, president and CEO, La Maestra Family Clinic, Inc.; Kristen Daugherty, LCSW, LISW, MBA, chief executive officer, Emergence Health Network; and Sharon Goodson, CCAP, executive director, NC Community Action Association.
Panelist said common challenges include billing, dueling electronic health records (EHRs), and funding. Collaboration with health care payers, providers, hospital systems, and others, who are much more well-funded, would allow CBOs to further their efforts while saving money upstream for the health system.
A great partnership has developed between NC Community Action Association and Duke Energy, explained Goodson. The community action agencies (CAA) collaborated with Duke Energy in 2014 to administer a program to provide energy assistance, helping families in poverty with appliances, repairs, HVAC systems and replacements, and weatherization measures, she said. Duke provided a $20 million investment in the program, which has now increased to $25 million because of the success of the program.
Program surveys found families assisted through the program now use less medication, require fewer doctor appointments, have seen an improvement in their asthma and mental health, and report less stress due to work needed in their homes, said Goodson.
Loneliness identified as serious health risk, heightened amid COVID-19 pandemic
David Meyers, vice president of stars, Cigna, shared survey results from Cigna’s U.S. Loneliness Index Survey. The findings indicate a concerning number of Americans struggle with loneliness, a SDoH that has increasingly worsened throughout the global pandemic.
A common misconception with loneliness is that it occurs to people who are alone, but it happens to people who are around others, too, explained Meyers. Loneliness can develop when people feel they can’t connect in a meaningful way, he said. “Loneliness is not chosen.”
In fact, two in five people surveyed were found to lack meaningful relationships, said Meyers. Other factors evaluated in the survey included age, social media use, income, and occupation.