Addressing Patients' Social Needs Within Health Care Delivery is Key to Improving Health Outcomes and Reducing Health Disparities, Says New Report Supported by Josiah Macy Jr. Foundation
WASHINGTON — Whether a patient has a safe place to live or healthy food to eat has an important influence on their health, but such nonmedical social needs have not traditionally been addressed in routine health care visits. A new report from the National Academies of Sciences, Engineering, and Medicine, Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation’s Health, contains five overarching goals and associated recommendations that health care systems, government agencies, and others should implement to better integrate patients’ social needs into health care delivery.
Two trends are driving a need to integrate social care with health care, the report says. Firstly, the health care system is moving toward paying care providers based on health outcomes, rather than for individual visits or services. Secondly, there is increasing recognition that addressing the social determinants of health — nonmedical factors such as housing, education, neighborhood safety, and employment — has a profound impact on one’s physical and mental health.
“Even if people get the best medical care available to them, they may still have poor health outcomes if other social needs such as housing, reliable transportation, or a strong support system at home are not addressed,” said Kirsten Bibbins-Domingo, a general internist and vice dean for population health and health equity at the University of California, San Francisco, and chair of the committee that wrote the report. “Integrating social care into health care delivery can be transformative for addressing the individual needs of patients and the collective needs of communities. However, we need the workforce, financing, and infrastructure to do this effectively.”
Industrialized nations that devote more resources to social services than health care tend to have better health outcomes, the report says. In the United States, for every $1 spent on health care, about 90 cents is spent on social services, while other industrialized countries spend $2 on social services for every $1 spent on health care. Social services constitute a variety of activities — including home-help for the elderly, rent subsidies, child allowances and credits, childcare support, job training, and disability benefits. The challenge of financing the integration of social care with health care in the U.S. is a matter of defining what activities are considered social care, and how they should be paid for, says the report...