A better way to manage social determinants of health

Should healthcare be at the center of delivering all social services?

Yes, according to an article in Health Affairs that suggests placing healthcare delivery in the center of a spoke-and-hub system for a variety of social services being delivered in communities. The article was written by researchers at Harvard and Boston universities.

Research has shown that social determinants influence health. Among the biggest factors challenging hospitals is the fact that low-income minority patients consistently have poorer outcomes than more affluent patients. That has prompted some private businesses, such as CVS Health, to launch education campaigns to help some segments of the population to have better access to healthcare services.

The authors bring up three rationales for taking a hub-and-spoke approach:

First, social factors are often the overriding determinant in health outcomes, meaning they should be more closely blended together.

Second, the Centers for Medicare & Medicaid Services is launching an accountable health communities initiative, which calls for the coordination of care with a variety of nonclinical community partners. The CMS has been under significant pressure in recent years to gather and analyze more social determinants data to better understand how it can influence healthcare services.

But lastly, they make a fiscal and organizational argument: “Healthcare already controls huge amounts of funding which would be politically difficult if not impossible to wrestle away for other budgetary priorities, despite evidence at national and state levels to suggest that more social service spending relative to health spending is associated with better health outcomes," they write.