RISE looks at recent headlines concerning social determinants of health (SDoH).

Poll: 1 in 5 people had trouble accessing care during the pandemic

A new poll conducted by NPR, the Robert Wood Johnson Foundation, and the Harvard T.H. Chan School of Public Health finds a significant number of households that had a serious illness in the past year report trouble accessing care during the pandemic.

Indeed, one in five of the 4, 192 polled said they were unable to access care. Racial and ethnic groups were hit the hardest.

Among those who said someone in their household was seriously ill and couldn’t access care were:

  • 35 percent were American Indian and Alaska Native households
  • 24 percent came from Black households
  • 18 percent were from white households

Fifteen percent of Black respondents who said they had seen a provider in the past year reported they received poor treatment because of their race and ethnicity compared with only three percent of white respondents.

In addition to health care, the 54-page report based on the poll examines serious problems facing racial/ethnic minorities today, including serious problems with their finances, housing, neighborhood conditions, and personal safety.

The poll was conducted May 16-June 13 among 4,192 adults age 18 or older in the U.S. The survey included nationally representative samples of 1,216 white, 1,103 Black, 1,066 Latino, 552 Asian, and 180 Native American adults. Racial/ethnic minority adults in the survey were oversampled relative to their proportion in the national population, to allow for examination among smaller groups, and estimates were weighted using U.S. Census parameters to remove bias.

Study: Climate hazards can worsen 58% of infectious diseases

Climate hazards due to extreme weather connected to climate change worsen hundreds of known infectious diseases in people, including malaria, according to a new study published this week in Nature Climate Change.

Study authors conducted a systematic search for empirical examples about the impacts of 10 climatic hazards sensitive to greenhouse gas emissions on each known human pathogenic disease. They found that 218 out of 375—58 percent— of infectious diseases were aggravated by these climate hazards, such as flooding, droughts, heat waves, and wildfires.

Lead author Camilo Mora, climate data analyst at the University of Hawaii, told the Associated Press that the study doesn’t predict future cases. These are instances that have already happened. Infectious disease experts told the news outlet that the study serves as a warning about climate and health now and in the future.

Commonwealth Fund examines CMMI payment and delivery reform models that address drivers of health

Participants in The Center for Medicare and Medicaid Innovation (CMMI) payment and delivery reform models have implemented different approaches to support beneficiaries with social, economic, and location-based needs that drive health. In a new brief published by the Commonwealth Fund, analysts examine how the models have addressed drivers of health (DOH)-related needs and the factors that have helped or hindered participants from addressing these needs.

To conduct the study, authors reviewed evaluations, applications, and memos for 40 CMMI models. They found that in 23 of 40 models, participants addressed DOH-related needs either as a requirement or voluntarily. Typically, those strategies involved screening members for nonmedical, social needs and referring them to social services or community-based organizations. However, the evaluations weren’t standardized. Greater financial support and incentives, as well as technical assistance, would help participants better address DOH needs. Study authors recommended CMMI consider requiring a standardized DOH screening and incorporating performance measures in evaluations.

HHS awards millions to community health centers to advance health equity, strengthen health care workforce

The Department of Health and Human Services (HHS) announced this week it will provide millions to community health centers to eliminate inequities in care as well as funding to grow the health workforce and increase access to quality health care in rural communities.

In the first announcement, HHS said it has awarded roughly $90 million in American Rescue Plan funding to nearly 1,400 community health centers across the country to advance health equity through better data collection and reporting. In its quest to eliminate inequities in care and outcomes within communities of color and other underserved populations, the funding supports efforts improve data to better identify and respond to specific needs of patients and communities, advance COVID-19 response, mitigation, and recovery efforts, and help prepare for future public health emergencies.

“Community health centers have played a pivotal role in the nation's COVID-19 response, and now serve more than 30 million people across the country. Today's investments will help ensure that all patients have equitable access to the high-quality health care they deserve,” said HHS Secretary Xavier Becerra in the announcement.

In 2021, HRSA-funded health centers provided care for one-in-five residents in rural areas and one-in-11 people nationwide. One-in-three health center patients are living in poverty, and two-thirds are racial/ethnic minorities.

HHS has also invested $60 million to improve access to care in rural communities. The investment includes $46 million from President Biden’s American Rescue Plan to expand health care capacity in rural and tribal communities through health care job development, training, and placement. The funding includes support for critical health workforce needs in rural areas such as dental hygienists, medical or dental assistants, community-based doulas, and other frontline health care workers.

“Among the most important steps we can take to improve access to health care in rural communities, including access to behavioral health care, is to invest in growing the rural health care workforce,” HRSA Administrator Carole Johnson said in the announcement. “Today’s announcements are another important part of the Health Resources and Services Administration’s strategy to advance health equity for the nearly 65 million people who call rural areas home.”

Nearly one in five Americans lives in a rural area, and rural communities are becoming even more diverse. However, health disparities between rural and urban areas tripled between 1999 and 2019, with rural residents experiencing higher rates of heart disease, respiratory disease, cancer, stroke, unintentional injury, and suicide, and higher risk of maternal morbidity and mortality. Access to quality health care is at the heart of these issues.