This is a guest post by Bechara Choucair, MD, the Senior Vice President and Chief Community Health Officer at Kaiser Foundation Health Plan, Inc. and Hospitals. He spoke on one of our panels in Cambridge and reflects on the meeting in this blog.
One of every three Americans is not confident in their ability to access basic social needs such as housing, transportation or food. That’s unacceptable, and one of many reasons I was motivated to join a panel at the Robert Wood Johnson Foundation and Harvard Global Health Institute’s Drivers of Health conference alongside New York Housing Authority’s Shola Olatoye, MassHealth’s Gary Sing and North Carolina Department of Health and Human Services’ Betsey Tilson. Together, we explored the tremendous opportunity facing health care organizations to address the social health needs of people in our communities and the disruptive strategies already underway to advance community conditions for health.
There is a growing recognition of the connection between unmet social needs and poor health outcomes. That becomes even more clear when we look at growing inequities in our communities and the health implications that come with them. Kaiser Permanente recognizes the need to elevate the role of social health to the same level as physical and mental health. I believe that we are at a pivotal point, and that in the years ahead we will begin to see a new standard set for social health, one that improves total health and advances affordability for healthcare throughout the country.
Because we know that being healthy isn’t just a result of high-quality medical care. Access to safe housing, balanced meals, reliable transportation and meaningful social connections are the building blocks for good health and wellbeing — and many Americans face challenges meeting these needs. In June of this year, Kaiser Permanente surveyed Americans to see if they reported having unmet social needs, and, if so, if they believed those unmet needs posed a barrier to health. We found that:
- 68% of Americans had at least one unmet social need, and one in four Americans reported that their unmet social need served as a barrier to health within the past year.
- In fact, 21% of Americans reported they prioritized paying for food or rent over seeing a doctor or paying for medication.
- Americans reporting unmet social needs were twice as likely as other respondents to rate their health as fair or poor.
These concerning trends spotlight the growing urgency to address social needs and elevate the community conditions that drive health, reminding us the time to act is now. As Robert Wood Johnson Foundation’s Executive Vice President Julie Morita shared in her opening remarks, the Foundation aims to seek bold and lasting change rooted in the best available evidence, analysis and science. The Foundation’s collaboration with Harvard’s Global Health Institute to create Drivers of Health, as well as last week’s convening, exemplifies this commitment by revisiting foundational thinking on social drivers of health to improve health outcomes nationwide.
As health systems anchor institutions within our communities, we have a responsibility and a unique ability to make a difference. Earlier this year Kaiser Permanente partnered with Unite Us to launch Thrive Local, a social health network that allows us to identify, address, and predict members’ and communities’ social needs to lift the total health of our communities. Over the next couple of years, we are scaling the program and expanding the social health network to all our regions across the country.
Some of our most critical work is focused on housing, because housing and health are inextricably linked. Strikingly, the life expectancy of a person experiencing chronic homelessness is on average 27 years shorter than that of people who are housed. With homelessness on the rise in our communities and affordable housing increasingly out of reach, Kaiser Permanente is working to make a significant difference, starting in Oakland, CA. I am proud that in just 10 months, we partnered with Bay Area Community Services to house more than 500 homeless adults over age 50 who have at least one chronic health condition.
Through Kaiser Permanente’s screening programs, we know that food security, housing and transportation are our members’ most pressing social health needs. In fact, we estimate that up to 3.5 million Kaiser Permanente members may be at risk for food insecurity on any given day. This is why programs like Thrive Local and our efforts to bolster SNAP enrollment are so critical – now, when our doctors, nurses and social workers ask members about their social needs, they’re able to refer them directly to an effective solution.
Removing barriers to social health requires not just an investment in our communities, but a concerted and continuing shift in public policy to advance conditions driving health. Through Kaiser Permanente’s work with CityHealth, we’re collaborating with the de Beaumont Foundation to support large cities looking to address a range of policies that impact community conditions for health, from complete streets to quality pre-K, smoke-free indoor air and affordable housing. These evidence-based policies can make real, lasting impacts in people’s everyday quality of life — exemplifying the need to address the social drivers of health to optimize the health of our communities.
To address health-related social needs, we need meaningful and ongoing engagement with the local community. Through partnerships with community-based organizations with unique expertise to address social needs, we can improve the conditions for health and wellbeing and strengthen communities.
As I reflect on last week’s discussions, I’m encouraged by the momentum across health care organizations in fostering a system that is more responsive to people’s social health needs while improving community conditions to prevent at-risk populations from experiencing homelessness, food insecurity and social isolation. I’m confident that collaborative research efforts like the Drivers of Health can help create a better path forward. With a clearer understanding of what it means to be healthy, we’re making real progress toward healthier communities where we can all live, grow and thrive.