How a new wave of technology startups is tackling social determinants of health challenges

social determinants
Startups are working with health systems to provide the technology infrastructure to better coordinate health and social services. (noipornpan/GettyImages)

WASHINGTON, D.C.—Karen DeSalvo, M.D., chief health officer at tech giant Google, said she grew up as a “food insecure kid.”

“There’s a sense of embarrassment to be dependent on others, to be on the free lunch line,” DeSalvo said while speaking on a panel about social determinants of health at the Health Datapalooza conference Monday.

It’s one of the reasons DeSalvo, former assistant secretary for the Department of Health and Human Services (HHS), helped form a private-public collaboration to address the nonmedical drivers of health.

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The National Alliance to Impact the Social Determinants of Health (NASDOH) includes healthcare organizations, public health and social services groups focused on how technology, data and analytics combined with policy advocacy can help address social determinants of health efforts, she said.

As social determinant efforts become more data-driven, the industry has attracted new technology startups. 

RELATED: Kaiser Permanente building infrastructure to 'connect the dots' for social determinants

For instance, New York City-based Unite Us launched in 2013 with a software platform to help connect people to social services.

The company initially served the military population and has now built 55 networks of health and social service providers to help better coordinate patient care and services. The company is currently working to build 40 additional networks across the country, said Dan Brillman, co-founder and CEO of Unite Us.

The platform improves coordination, tracks outcomes and helps standardize data sharing between payers, providers, government services and social services, he said. “This was a technology problem that needed to be solved,” he noted.

The startup has raised $45 million with investors including Oak HC/FT, Town Hall Ventures and Define Ventures.

Kaiser Permanente has forged a relationship with Unite Us to build a new care network to better address social determinants for its millions of members. The Thrive Local initiative is designed to more effectively connect its 12.3 million patients to the community services they need, such as housing, food or transportation, the health system said.

Investing in the technology platform will help Kaiser Permanente address the “upstream” drivers of health, said Anand Shah, vice president of social health at Kaiser Permanente, while speaking on the panel.

“We can use the data to look at where we need to invest and to examine those structural and policy issues that create those care gaps,” he said.

Other companies in the space include Solera Health, which developed a platform to address chronic conditions and social determinants of health, NowPow, which works with NYC Health + Hospitals, among others, Papa, which offers “grandkids on demand” and Alphabet-backed CityBlock Health, which has raised $85 million to date.

Oak Street Health operates primary care clinics focused on Medicare beneficiaries and opens its locations in underserved areas. By embedding in communities, the practice can better address elderly patients' nonmedical needs, such as transportation to appointments and activities to combat social isolation, the company said.

Tivity Health provides nutrition and fitness solutions and focuses on tackling social isolation among aging seniors.

RELATED: How NYC Health + Hospitals is teaming with a startup to tackle food and housing insecurities

Beyond a tech solution

Health systems like North Carolina-based Atrium Health are using a data-driven approach to expand into food service programs. The health system started a Kids Eat Free program at two hospitals to provide meals to children in two counties. That program has fed 11,000 children so far, said Eugene Woods, president and CEO of Atrium Health.

The health system also helped raise $200 million to build 1,500 affordable housing units in local communities. “It doesn’t solve the whole issue. But our approach is to just do something, smart small, partner with other folks and start to make a dent,” he said.

But health systems continue to face challenges around reimbursement and scaling up social determinant initiatives beyond pilot projects, many stakeholders said.

The healthcare sector needs to collaborate with other sectors like housing and transportation to share ideas, data and funding to improve community health, DeSalvo said. And in order to move the needle on nonmedical drivers of health, these initiatives need to be tied to state and federal policy changes, she said.

“We have to move past side projects and weave it into policy,” she said. “The healthcare system has the majority of resources, but over time we need to invest in other sectors, so it’s not about charitable efforts. We need to have a society where no one has to worry about being food insecure.”

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