Health & Social Needs

To reduce health disparities, we will advance a collaborative system, across sectors, that enables and facilitates the integration of social needs and health care.

THE BACKGROUND

PREVALENCE OF SOCIAL NEEDS

A 2022 Physicians Foundation survey of over 1,500 United States physicians found 95% of doctors surveyed indicated that some, many, or all of their patients had at least one social driver (SDOH) affecting the patient’s health outcomes. Financial instability and transportation were the top two SDOH that physicians reported as affecting their patients’ health, followed by housing instability, food insecurity, utility help needs, and interpersonal safety concerns. Meanwhile, 8 in 10 (83%) of physicians in the survey believe that SDOH contribute to physician burnout, and 6 in 10 (68%) physicians reported that managing patients’ SDOH has a major impact on physician mental health and wellbeing.

 

ECONOMIC STABILITY IS KEY TO GOOD HEALTH

Already, there is an overwhelming amount of evidence demonstrating that having access to stable and affordable housing, healthy food, a good education, and steady income impact anyone’s ability to live a healthy life, even more so than access to clinical care itself.

 

THE DRIVERS OF DISPARITIES

In addition, when such basic social needs go unmet they become the principle drivers of health disparities—something we’ve witnessed both regionally and nationwide in the coronavirus pandemic, which has had disproportionately deadly outcomes in minority communities.

THE HEALTH CONNECTION

Unmet social needs are directly associated with a number of entrenched health issues, including:

  • Nearly twice the rate of depression;
  • 60 percent higher prevalence of diabetes;
  • More than 50 percent higher prevalence of high cholesterol and elevated hemoglobin A1c, which is a signal of diabetes;
  • More than double the rate of emergency department visits; and
  • More than double the rate of no-shows to clinic appointments.

In addition, poverty, disability, housing instability, and residence in a historically Black or low-wealth neighborhood have been found to be associated with higher hospital readmission rates.

Recently, many stakeholders—state Medicaid agencies, policy makers, payers, providers and health plans as well as community-based services—have begun to recognize the importance of broadening medically-focused care programs to include elements that address social needs.

OUR STRATEGIES
  • We seek to make a strong business case for investing in addressing patients’ social needs as a core strategy for healthcare organizations.
  • We will help advance an enabling environment that can pave the way for the implementation of promising social interventions that can lead to improved health outcomes and greater coordination and integration of social and medical care.
OUR INTEREST AREAS

We are interested in projects that:

  • Facilitate connections and collaboration between stakeholders across the health care and social services sectors to address the social needs of low-income South Florida residents.
  • Support the adoption of technology platforms, within a collaborative infrastructure, that allow for increased efficiencies in the referral of patients and clients in need of health and social services
  • Support implementation, evaluation and scaling of social needs interventions, such as medical-legal partnerships and food pharmacies.
  • Advocate for and inform health care financing and payment mechanisms for social needs interventions.

For more information on these and other efforts that advance a system of health that integrates health-related social needs as a standard part of clinical care in South Florida, please contact Chief Strategy Officer Janisse Rosario Schoepp.

Our Impact Stories
Miami-Dade Black Maternal Health and Infant Health Equity Collaborative: Transforming Maternal Health Through Collaboration.

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Florida Keys Maternal Child Health Equity Collaborative: A Community Triumph.

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Ayesha Williams Draws on Personal Experience to Provide Trauma-Informed Care.

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Legal Aid Service of Broward County serves Memorial Primary Care patients to address ailments outside traditional medicine’s reach.

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