I mentioned in a recent column that teaching is one of my passions, which is why I’m so grateful to have this column as an educational platform to share what’s new in Michigan’s healthcare community. It’s not just news though; rather, an opportunity to learn what your local community is doing to promote better health outcomes – and encourage you to get involved. To that end, I’m excited about an initiative launched earlier this month by the Michigan Department of Health and Human Services addressing the social determinants of health (#SDOH) in the COVID era.
With funding from the CDC and Center for State, Tribal, Local and Territorial Support grants, and based on the concept of regional health exchanges for data, the state has created 11 regional Health Equity Advisory Councils, run by Backbone organizations (BBO), from the following regions:
· Genesee County
· Ingham County
· Kent County
· Oakland County
· Ottawa County
· Macomb County
· Muskegon County
· Saginaw County
· Washtenaw County
· Wayne County
Working with BBO community organizations such as ACCESS, Detroit Association of Black Organizations (DABO), Metropolitan Organizing Strategy Enabling Strength (MOSES) and Judson Center, the Councils will focus on capturing and sharing health disparities data in the manner best suited to their community’s needs. This will take data beyond color to also include health disparities in a wide array of cultural, religious, and ethnic groups throughout the state and identify gaps of care in the community that are best addressed through a regional or local lens.
It’s important here to distinguish that in capturing data on #SDOH, there is a distinction between social assessments in a healthcare setting and social determinants of health. A social assessment (sometimes called a social survey) considers for example, a patient’s practices on alcohol consumption, drug use, tobacco use and unprotected sex. The social determinants of health, on the other hand, consider an individual’s challenges to good health, such as education, income, employment, food insecurity, personal safety and transportation. A social assessment may uncover practices that are negatively impacted by such social determinants, but like social assessments, social determinants are not a diagnosis. They are an adjunct to a diagnosis; a support tool, if you will, that identifies situations adversely impacting a condition and offers a “prescription” to mitigate them. That’s why #SDOH assessments should be deemed of equal importance to social assessments – with data captured and shared accordingly.
For example, lack of transportation does not cause hypertension, but it can prevent a patient from receiving proper care at regular intervals, resulting in a worsening of the hypertension. In identifying the transportation issue through the provider’s reported assessment findings, Health Equity Advisory Councils can work with local organizations to fill that gap. In a unique
approach, the Health Equity Advisory Councils are empowered to devise community-based solutions, rather than follow agency-led directives.
I’ve written often of our organization’s pop-up COVID-19 vaccination clinics throughout SE Michigan. What became crystal clear to me -and reminded me of my years entrenched in Detroit’s Polish immigrant community – is the respect and authority that leaders and their cultural and ethnic community organizations hold in serving their distinct populations. I see a similar opportunity with the Health Equity Advisory Councils. Success here won’t be measured by the number of vaccines provided, though. It will look slightly different for each region, but success will be determined by how each region captures and uses its unique data to address the social determinants of residents who haven’t previously received the whole person care they deserve. Sharing data-driven solutions between regions for broader state impact will be an additional success metric.
Social determinants of health can no longer be a buzz phrase. It’s one of the most vexing, yet addressable, healthcare challenges of our time. If you are affiliated with an organization that can assist a Health Equity Advisory Councils or affiliated BBO, reach out to the one in your county and be part of the solution.