How Michigan's Taking Action on SDoH



"A person’s health and life expectancy should not be determined by their zip code," the office of Michigan's Governor Gretchen Whitmer recently stated, calling action to the often overlooked issues that cause health disparities within communities. 

How has the COVID-19 pandemic impacted Michiganders directly and what initiatives are being taken to address SDoH? 

SDoH in Michigan: worrying statistics 

The data around SDoH in Michigan lays bare stark disparities in health outcomes, many of them reflective of SDoH. 

The state has recently experienced a huge surge in new coronavirus infections—as many as 55,000 in a single week—with hospitalizations and deaths rising, too. This is troubling for a number of reasons, not least because it could amplify existing, and disturbing, disparities in health outcomes in Michigan. For example, Black people have accounted for 20 percent of COVID-19 deaths in Michiganders age 60 and over, a percentage that is roughly double their representation in the population overall.

Meanwhile, if we look beyond mortality, COVID-19 is amplifying SDoH needs in Michigan across the board. For example, while food insecurity has been rising dramatically across America—from 11 percent in 2018 to 38 percent at the height of the pandemic—vulnerable populations appear to be particularly at risk in Michigan. In fact, 1,359,650 people in Michigan are experiencing food insecurity today—and over 300,000 of them are children.

These SDoH challenges are in many ways a reflection of the broader economic picture in Michigan, a state in which the majority of jobs pay less than $20 per hour. (For context, a family of four would need $32.06 per hour simply to make ends meet.) It's also a state in which 16-year differences in life expectancy exist between communities that are only two miles apart on a map. If you compare life expectancy in certain Detroit neighborhoods with those in East Grand Rapids, for instance, the difference balloons to more than 30 years. 

Recognizing new grounds for optimism

SDoH are not only a major contributing factor behind negative health outcomes across the State of Michigan—they're also disproportionately affecting vulnerable populations and those most in need.

Yet the flip side of the coin is that more effectively addressing SDoH in Michigan could have a correspondingly outsized impact, and lead to substantially improved health outcomes for Michiganders at large. And in this last respect, recent developments suggest there may be grounds for optimism moving forward.

For one, Michigan already has five Community Health Innovation Regions (CHIRs) in place, and these have demonstrated the efficacy of SDoH interventions, having screened more than 300,000 Michiganders in just the last two years.

A few standouts to mention:

  • One CHIR introduced a program designed to better address mental health crises and serve as a stopgap to avoid unnecessary emergency room visits, with impressive results. So far, 88 percent of participants have been discharged back to their homes, curbing hospitalization costs and contributing toward the health of the community.
  • Another CHIR educated 275 Michiganders on the criminal record expungement process, which 74 percent of participants said had been cited as grounds for denial of employment in the past.
  • Across the state, CHIRs have been involved in important work to prevent vulnerable people from experiencing homelessness, particularly those struggling with addiction or being discharged from hospitals, prisons and other facilities.

These are all positive efforts that help change the story of SDoH in Michigan. But to ramp up that impact, health systems in Michigan will need to be more proactive in seeking out opportunities for greater collaboration and integration with CHIRs, community-based organizations (CBOs), and others from across the healthcare spectrum.

A recent study conducted in Michigan stresses the importance of “multifactorial intervention” in Michigan, or interventions that take into account all of the different factors—where we are born and where we live, learn, and work, or in other words, SDoH—as part of their approach. And we know these factors can impact as much as 80 percent of a person’s overall health.

Looking forward: what's next for Michigan?

From the numbers above, the mandate for Michigan to take direct action and address SDoH is clear enough. And encouragingly, as we have seen, momentum—in the form of evolving initiatives, increased involvement from health plans, and proposed legislative action—seems to be building in that direction. At Healthify, we’re certainly hopeful that this momentum will continue, and we'll do our part to monitor and report on the outcomes. 

Share our passion and sense of purpose? Get in touch with us at Healthify. Together, we can rewrite the story of SDoH.

Topics: healthcare policy food insecurity sdoh michigan

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