RISE looks at recent headlines concerning social determinants of health (SDoH).
Health care group aims to address the growing problem of elder homelessness
The Program for All Inclusive Care for the Elderly (PACE), which works to keep frail, older people in their homes, is now working to address a growing problem: seniors who don’t have homes.
KFF Health News reports that one in five people in the United States who were homeless in 2024 were 55 or older and that the number of men older than 60 living in shelters tripled from 2000 to 2020. Although many have experienced intermittent homelessness throughout their lives, there is a rising population of homeless adults due to a single incident, such as the death of a spouse, job loss, or illness. The publication notes that even those who have paid off their mortgages often can’t afford to pay for rising property taxes.
Advocates worry that the problem will only get worse with looming federal cuts to Medicaid. If people lose their health coverage, it will be harder for them to pay the rent, KFF Health News notes.
As a result, PACE, which is funded by Medicare and Medicaid, is working with senior housing projects, housing providers, and nonprofit developers to build housing. Currently there are 185 PACE organizations with 83,000 participants in the U.S. that enroll people ages 55 and older who are sick enough for nursing home care but provide for all their care needs so they can stay in their homes. PACE plans also provide medical clinics, adult day centers, and provide transportation to participants, according to KFF Health News.
Elevance Health, NACHC partner to partner to integrate food as medicine with primary care
Elevance Health and the National Association of Community Health Centers (NACHC) will undertake a new initiative to integrate Food as Medicine (FAM) programming with primary care in Community Health Centers (CHCs). The partnership aims to address food and nutrition insecurity and diet-related chronic conditions through clinical integration.
The new initiative expands Elevance Health’s existing regional Nourished Well program serving Medicaid individuals by training primary care provider teams within CHCs on the effectiveness of FAM for patients and families. The new program will help efficiently connect Medicaid members at risk for diet-related chronic conditions within CHCs to personalized nutrition and whole health supports, including medically tailored interventions, coaching, and referrals, all now accessible as part of regular primary care interactions.
“Incorporating Food as Medicine directly into primary care enables us to treat nutrition not just as a social driver of health, but as a clinical lever for improving outcomes,” said Shantanu Agrawal, M.D., chief health officer, Elevance Health, in the announcement. “Together with NACHC, we’re making nutrition integral to the way care is delivered—and not just an add-on.”
Elevance Health Foundation, the philanthropic arm of Elevance Health, will also separately support NACHC through a six-month FAM grant. With this grant funding, NACHC will assess existing regional FAM programs at CHCs, evaluate current and potential policies supporting FAM sustainability, and develop a scalable CHC FAM model integrating community resources, clinical interventions, and nutritious food delivery.
By strengthening care connections and reducing the administrative burden on care teams, the program will be able to enhance patient engagement, support chronic disease management, and reinforce preventive health efforts. It also fosters stronger quality metrics for CHCs and increases participation in essential services. The long-term vision includes developing a Nutrition Center of Excellence, jointly designed by Elevance Health, NACHC, and CHCs, serving as a scalable national model to promote food-based clinical care.
Study: US clinicians are more likely to doubt credibility of Black patients in medical notes
A new study, which analyzed more than 13 million clinical notes, has found clinicians are more likely to indicate doubt or disbelief in the medical records of Black patients than in those of white patients—a pattern that could contribute to ongoing racial disparities in health care.
The research, published in the August issue of PLOS One, found mounting evidence that electronic health records (EHR) contain language that reflects the unconscious biases of clinicians, and that this language may undermine the quality of care that patients receive.
Researchers examined more than 13 million EHR notes written between 2016 and 2023 for about 1,537,587 patients by 12,027 clinicians at a large health system in the mid-Atlantic United States. They used artificial intelligence (AI) tools to find which notes had language suggesting the clinician doubted the sincerity or narrative competence of the patient-for example stating that the patient "claims," "insists," or is "adamant about" their symptoms, or is a "poor historian."
Overall, fewer than one percent of the medical notes contained language undermining patient credibility—about half of which undermined sincerity and half undermined competence, according to the study announcement. However, notes written about non-Hispanic Black patients, compared to those written about white patients, had higher odds of containing terms undermining the patients' credibility. Moreover, notes written about Black patients were less likely to have language supporting credibility than those written about white or Asian patients.
The research team concluded that clinician documentation undermining patient credibility may disproportionately stigmatize Black individuals, and that the findings represent “the tip of an iceberg.” They say that medical training should help future clinicians become more aware of unconscious biases, and that AI tools used to help write medical notes should be programmed to avoid biased language.
“For years,” the authors said, “many patients—particularly Black patients—have felt their concerns were dismissed by health professionals. By isolating words and phrases suggesting that a patient may not be believed or taken seriously, we hope to raise awareness of this type of credibility bias with the ultimate goal of eliminating it.”