NASDOH offered ideas to the Commonwealth Fund Commission on a National Public Health System. In the response, we highlight that a strong and robust national public health system is vital to addressing SDOH in a sustainable and successful way. We offer a set of ideas to inform the Commonwealth Fund Commission’s vision for a national public health system, incorporating key insights and lessons learned from our members that span the public health, health care, and social services sectors.
In this advisory, NASDOH encourages states to leverage federal fiscal relief funding made available during the COVID-19 emergency, and other recent public health and social care funding streams, to advance data modernization and interoperability between public health and social care, health care, and social service providers.
This report provides a summary of the work of the National Alliance to impact the Social Determinants of Health (NASDOH) in 2021. This report was made possible through the support and engagement of NASDOH members.
In this issue brief, NASDOH summarizes select federal authorities that allow states to address social needs in the Medicaid program. We call on states and managed care organizations (MCOs) to leverage the available flexibilities to address social needs and we make recommendations to the Centers for Medicare & Medicaid Services (CMS) about how they can support the states in their efforts.
The Resource Compendium aims to support multi-sectoral alliances focused on the social determinants of health (SDOH). It contains resources like guidance documents, best practices, case studies, and tools to assist in developing and optimizing alliances and their impact in the community. We believe the compendium will be useful for stakeholders who are:
Now that a COVID-19 vaccine is available, we continue to see challenges that impact getting the vaccine to those who need it most. This commentary identifies short- and long-term challenges and other vaccine rollout implications related to SDOH and inequities that impact the country’s most vulnerable populations. We discuss concrete steps that federal and local governments should take to ensure that those at the highest risk for COVID-19 infection, serious illness, and death are prioritized during the COVID-19 vaccination rollout and we are taking every opportunity to meet their needs where they are.
This report provides a summary of the work of the National Alliance to impact the Social Determinants of Health (NASDOH) in 2020. This past year, NASDOH continued to work towards our mission of making material improvements in the lives of individuals and communities and, through multi-sector partnerships, advancing holistic, value-based, person-centered care that successfully impacts the SDOH.
This report was made possible through the support and engagement of NASDOH members.
This issue brief discusses how pooled funding is one mechanism to encourage cross-sector collaboration and ensure that a broad array of sectors jointly fund and share the benefits of SDOH investment. This brief highlights challenges that exist which inhibit pooled funding and provides 5 recommendations to the federal government to support collaborative SDOH investment and expand allowances for public fund pooling.
NASDOH published its third issue brief in a series that discusses how key SDOH-related issues have been exacerbated during COVID-19. “Waivers and Program Flexibilities: Lessons from COVID-19” highlights the importance of federal health and social programs flexibilities amid the COVID-19 pandemic to meet social need, summarizes key reasons to retain and expand certain waivers and program flexibilities implemented during the public health emergency, and provides a set of recommendations to optimize use of waivers and program flexibilities.
The NASDOH released a set of eight policy recommendations to the incoming Biden administration that set forth a bold leadership agenda on SDOH and highlight several specific actions that can be taken under each area. NASDOH looks forward to working together with the incoming Biden administration to establish SDOH as a new national priority and advance actionable policy solutions.
In this issue brief, NASDOH explores how the public health sector is uniquely positioned to assist at the intersection of public health and both social needs and social determinants of health (SDOH), both during the current public health emergency and moving forward. The issue brief provides policy recommendations to support these public health efforts adequately. This is the second in a series of NASDOH commentaries and issue papers NASDOH will publish addressing key SDOH-related issues that have been exacerbated during COVID-19.
In this concept paper, NASDOH, with the guidance from the work of the CARIN Alliance, outlines key opportunities to enable an interoperable data ecosystem where social needs information is shared seamlessly, privately, securely, and with consent to address individuals’ needs effectively and impact SDOH upstream.
In this commentary, NASDOH addresses key SDOH-related issues that have been exacerbated during COVID-19, including systemic inequity that makes communities of color most vulnerable to poor health outcomes. We discuss several areas where the nation should learn from our COVID-19 experience and address the root causes of disparities in order to improve health and reduce the impact of future public health crises and other emergencies.
In the coming months, NASDOH will release a series of commentaries and issue papers addressing the key issues in more depth and, where possible, describing what we have learned.
This report provides a summary of the work of the National Alliance to impact the Social Determinants of Health (NASDOH) in 2019. This past year, NASDOH continued to work towards our mission of making material improvements in the lives of individuals and communities and, through multi-sector partnerships, advancing holistic, value-based, person-centered care that successfully impacts the SDOH.
This report was made possible through the support and engagement of NASDOH members.
NASDOH has released the first in a series of issue briefs designed to address key issues and advance our national efforts to address social determinants of health. Foundational to addressing the social determinants of health is the identification of social risk through screening tools, which is the subject of this first brief.
As efforts to assess and address the SDOH increase, there is a pressing need to develop ways to measure the impact of such efforts and to hold systems accountable for progress. Prospectively aligning measures of success for SDOH interventions will enable comparisons across demonstrations or programs, reduce the burden of data collection, and provide useful evidence to support a sustainable business model for addressing the SDOH. NASDOH’s newly released white paper outlines framing principles to guide social determinants of health (SDOH) measurement development that, if adopted, can help organizations and sectors work collaboratively to align around a shared measurement framework.
NASDOH has developed a one-pager that highlights the importance, as well as the opportunities, of supporting state innovation and policies that address social determinants of health in the Medicaid environment.
NASDOH supports the Healthy People 2020 definition of the social determinants of health as the “conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.” See our one pager for more information on how health outcomes strongly relate to these upstream social determinants of health, and to economic vitality and business competitiveness, personal achievement, and prosperity.
The National Alliance to impact the Social Determinants of Health (NASDOH) has released a new white paper providing insights in to their action plan to systematically create a supportive policy environment to address social determinants of health. The paper introduces NASDOH’s plans to bring clarity to the current understanding of the issues, challenges, and opportunities for the health care system to address social determinants in concert with communities and the public and private sector.
NASDOH co-conveners, Governor Mike Leavitt and Karen DeSalvo, discuss the importance of a common measurement approach to understand the most effective interventions and establish best practices for addressing SDOH. In this opinion piece, they argue that prospectively aligning the national approach to measuring interventions now will accelerate our understanding of opportunities to improve the health and well-being of people and communities.
NASDOH co-conveners, Governor Mike Leavitt and Karen DeSalvo, highlight where and how Medicaid programs provide key opportunities to address social needs , and where there are opportunities to accelerate state innovation to address SDOH in their Health Affairs blog post.
NASDOH co-conveners, Governor Mike Leavitt and Karen DeSalvo, discuss the importance of addressing the social determinants of health to effectively transform and improve health care and health outcomes in a Modern Healthcare opinion piece. The article highlights the need for a unifying force that includes public, private, technology, and business sectors to successfully address social determinants of health.
We share a selection of recently published reports and articles on SDOH relevant topics.
In July 2022, Health Affairs released a piece co-authored by Shantanu Agrawal, Alice Hm Chen, Gary Price, and Rocco Perla entitled To Advance A National Health And Equity Infrastructure, Measure Drivers of Health. In the article, the authors state it is now time for our country to move from accountability for health care to accountability for health and health equity, which they suggest requires addressing the drivers of health (DOH): critical comorbidities such as food insecurity, housing instability, and access to transportation. The authors conclude that to improve health and tackle inequity, we must develop, implement, and improve DOH measures that are integrated into our core regulatory frameworks.
The American Medical Association (AMA) Senior News Writer Andis Robeznieks released a piece last month underscoring that though the recognition of the impact SDOH have on patients’ outcomes is growing as is the desire to incorporate SDOH factors in patient-care plans, awareness of an existing data infrastructure that could help physician practices do so is limited. In the piece, Robeznieks summarizes several ways in which SDOH can be addressed in clinical care, adding that payers are interested in collecting SDOH information by the simplest way possible and providers are interested in the ability to make the case for additional funding or coverage or reimbursement for addressing the social needs that are impacting the health of patient.
In May 2022, the Medicaid and CHIP Payment and Access Commission (MACPAC) released an issue brief on “Financing Strategies to Address the Social Determinants of Health in Medicaid.” The issue brief describes the extent to which Medicaid beneficiaries experience certain social risk factors that affect health and discusses the primary mechanisms—state plan benefits, contracts with managed care plans, and waivers and grants—that state Medicaid programs can use to deliver and finance SDOH interventions, as well as the statutory and regulatory limits on such activities.
A 2022 Systematic Literature Review of Health Center Efforts to Address Social Determinants of Health highlighted that health centers (HCs) play a crucial and integral role in addressing social determinants of health (SDOH) among vulnerable and underserved populations, yet data on SDOH assessment and subsequent actions is limited. The review showed that HCs primarily captured patient-level rather than community-level SDOH data. Studies also showed that HCs utilized SDOH in electronic health records, but capabilities varied widely. A few studies indicated that HCs measured health-related outcomes of integrating SDOH data. The review highlighted that many knowledge gaps exist in the collection, use, and assessment of impact of these data on outcomes, and future research is needed to address this knowledge gap.
In March 2022, ASPE released a report titled “Scoping Review Report: Data Elements for Research on the Role of Social Determinants of Health (SDOH) in Coronavirus Disease 2019 Infection and Outcomes in the U.S.” The purpose of the review was to identify and better understand SDOH data elements that are related to COVID-19 used in studies to analyze risk factors and associations. The focus of the review was on modifiable factors (e.g., income and housing) with substandard/inadequate housing being found to have significant associations with COVID-19-related outcomes. Other SDOH data elements (e.g., English proficiency, health insurance coverage, marital status, socioeconomic status) were also identified as having statistically significant associations with COVID-19-related outcomes. Race and ethnicity, while not SDOH data elements, were found to have statistically significant associations with COVID-19-related outcomes. The report provides insights on the importance of data standards development and implementation for SDOH, and the findings support the need for continuing investigation of how SDOH affects COVID-19 infections and related outcomes.
The Prevention Institute released a spring 2022 article entitled “The economy we need centers community health & racial justice,” which details a vision for a community health-based economy that is sustainable for people, communities, and the planet. The articles explains that a community health-based economy is one that is designed to produce racial justice; health equity; and health, safety, and wellbeing.
On January 19, the Surgeon General released its report on Community Health and Economic Prosperity. The report provides demonstrations to business leaders on how investing in community health can help improve the health of individuals and the economy. In the afterword, NASDOH co-convener, Governor Michael O. Leavitt, recognizes that NASDOH was established, in part, “to engage the business community to articulate the whole-of-society value proposition for addressing the social determinants of health.”
The de Beaumont Foundation launched a new webpage and report focused on the alignment of business and public health. The report was developed in partnerships with Johns Hopkins University and includes 7 recommendations made based on interviews with over 40 businesses and public health leaders who are addressing COVID-19 and want to strengthen health infrastructure.
The National Partnership for Women & Families released a series of new tools, titled Choosing Health Equity: Understanding Decision Points in Policy / Practice / Research. The resources and tools are designed to help health care stakeholders examine the ways in which structural racism manifests in health care research, policy and/or practice. They include questions and actions to consider when dismantling structural racism and building a more inclusive and equitable evidence base.