SDoH Strategy, Programs, and Infrastructure: The 3 Keys to Building a Network of Community-Based Organizations

Over the last 25 years, research has shown that social determinants of health have powerful effects on health outcomes, particularly food insecurity. Those who are food-insecure lack access to affordable and healthy foods, which has adverse effects on health and development. Maintaining a healthy diet becomes a subsidiary concern when there are multiple unmet social needs to address but social service programs offered by community partners can help address those unmet needs.

Compared to other wealthy countries, the United States has some unusual healthcare spending habits. Other developed nations like Germany, France, and the UK spend nearly twice as much on social services as they do on healthcare but in the United States, we spend almost twice as much on healthcare as we do on social services. However, there’s a growing consensus that social and behavioral factors determine over 60% of health outcomes and are better understood as intersectional health issues. There’s also significant evidence that shows that higher spending on social services addresses health outcomes more effectively than investing in healthcare alone. It’s clear that our priorities are misplaced.

“The places where people live, learn, work, and play”, known as the social determinants of health (SDOH), have been estimated to contribute from 40%-60% of an individual’s health outcomes.  For some time it has been known that community health workers (CHWs) play a significant role in improving patient outcomes and reducing the cost of care within a patient population. In fact, a report published by Icahn School of Medicine at Mount Sinai and the Office of the United Nations Secretary-General’s Special Envoy for Health, in 2016, showed how targeted CHW programs achieved returns on investment ranging from $2.28 to $4.80 for every dollar spent. Due to such studies, insurers, managed care organizations (MCOs) and other large health institutions are placing a greater emphasis on SDOH and many have begun to manage them more robustly.

Collie Thomas is an orderly at Johns Hopkins Hospital. Each day, she stocks patients’ rooms with supplies, transports patients, and delivers medical records. It’s not a glamorous job, but Collie plays an important role in helping the hospital run smoothly, and she is extremely grateful for the opportunity. Unlike many in our country, Collie has a steady source of income.

Women’s health has taken center stage in 2017, but not necessarily for positive reasons. As healthcare policies continue to be debated in Washington, essential healthcare benefits for women are in jeopardy, including prenatal and maternity care, mammograms, and birth control.

As National Women’s Health Week, it’s an apt time to promote, not demote, women’s health. National Women’s Health Week, led by the U.S. Department of Health and Human Services Office on Women's Health, serves as a time to advocate for women to make their health a priority. The annual campaign encourages women to improve their health, including regularly visiting a doctor, adhering to a healthy diet, exercising, and prioritizing mental health.

"Let food be thy medicine and medicine be thy food." - Hippocrates

Loneliness has evolved from a favorite topic of angsty teens to a serious public health crisis. Long thought of as a temporary state of mind, loneliness--broadly defined as “the distress people feel when reality fails to meet their ideal of social relationships”--now outstrips obesity as a predictor of early death.

In the foothills of the Appalachian Mountains, in the southeast corner of Kentucky sits a once-booming coal center. Today, Letcher County, home to 25,000 residents, is distressed; the community faces high poverty rates and poor health.

The story of Letcher County is all too familiar across rural America. About one out of five Americans, 60 million in total, live in places like Letcher County. Rural America has been hit hard in recent years. For half a century, coal mining and other industrial sectors drove the rural economy, and as a result these regions contributed greatly to our country’s overall economic health.