Earlier this month, the RISE Summit on SDoH: Building Healthier Communities, featured a focus group of five individuals from diverse backgrounds who shared their personal stories and insights on how factors such as income, education, housing, employment, social support, and access to health care have shaped their health outcomes.
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The session, facilitated by Kathleen Ellmore, managing director, Engagys, and Tiffany Robinson, director of Stars improvement, Humana, shed light on the complexities many individuals face when they try to engage with the health care system.
Here are five key barriers revealed throughout the discussion:
1. Transportation issues
Transportation emerged as a significant barrier voiced among the participants, notably affecting access to health care services. One panelist, who relies on public transportation to get to and from medical appointments, said public transportation has become increasingly unreliable post-pandemic. With buses running less frequently and erratic schedules, the panelist has been at risk of missing critical medical appointments.
This transportation gap not only delays care but can also lead to employment vulnerabilities, as missing appointments might affect job security.
While Medicaid does provide transportation benefits to help individuals reach health care appointments, misconceptions and lack of awareness often hinder members from actually using the service.
Another panelist, who has never been informed about how to activate the transportation benefits, noted that he has missed out on the opportunity for assistance.
2. Limited access to timely health care
Accessing health care has become increasingly challenging since the COVID-19 pandemic, as well as navigating provider shortages and long wait times.
Several panelists discussed significant delays in getting timely appointments. One said it took six months to get seen by a doctor. Another participant sometimes goes to the doctor's office in person to try and get an earlier appointment, something only possible with reliable access to transportation.
3. Environmental barriers
The conversation underscored how the environment in which individuals live significantly influences their health and ability to access care. The focus group spoke about how living in unsafe neighborhoods or areas without safe and healthy grocery stores can deter them from seeking medical attention.
One panelist highlighted this challenge, mentioning limited access to fresh food options, which further complicates nutritional health and overall wellness.
Another panelist also voiced concerns surrounding neighborhood safety, including gun violence, which has discouraged her from leaving home to access needed services.
Additionally, several panelists stressed how financial struggles have led to difficult decisions, causing them to choose between affording essential medications or food.
4. Confusion navigating health care benefits
Complex health care systems can often obscure available benefits and pathways to care. One panelist said she was confused by her health plan’s marketing materials. She found it challenging to understand the different benefits she was entitled to access. The jargon and overwhelming variety of plan options only contributed to her confusion and, ultimately, she missed opportunities for care.
Several panelists also shared their frustrations with inadequate communication from their health plans, including long wait times with customer service as well as interactions with unhelpful representatives.
When asked whether a video message explaining the different benefits would be helpful, several panelists said it would be so long as it clearly explained their benefits and resources.
5. Lack of acknowledgement of SDoH
The need to address social determinants of health (SDoH) in the health care conversation became apparent throughout the discussion. Two panelists said their provider or case manager have asked about their housing, food security, and overall wellbeing as part of their care approach. However, it’s inconsistent. Several panelists said they have not been asked at all.
Several of the panelists said they would like their health care providers to focus on their social needs more as part of their effective health care management.
Looking ahead
The key takeaways from the discussion underscored the need for:
- Increased collaboration between health care providers, policymakers, and community-based organizations to develop effective solutions
- Improved communication from health plans to provide greater awareness of available resources and benefits
- Acknowledgement of social needs related barriers to provide a more equitable and accessible health care system for all individuals
- Policy changes and community support to overcome these ongoing barriers to accessing health care