Monday, November 18, 2019

Embedding Social Determinants Into Healthcare: A Resource Review for the Community

keywords and phrases:
Health equity, biopsychosocial model, integrated healthcare, social determinants of health (SDOH), data, telehealth, technology, electronic health record (EHR), interprofessional work, leadership and workplace, precision healthcare, reimbursement, health policy, public health, Lunchtime Listen recommendation

Resource Review: CHC’s interview on Embedding Social Determinants Into Healthcare System Process

Guest post by Steven Mui, MSOM, CAc

Resource reviewed: CHC Radio episode
Resource reviewed for this post was the podcast episode, “Addressing Upstream Causes of Poor Health: UCSF’s Dr. Kirsten Bibbins-Domingo on Embedding Social Determinants Into Healthcare” from the ongoing podcast Conversations on Healthcare®, published October 7th, 2019
An audio recording of this episode is about 25 minutes and available at this link.
Target audience: Hospital-based acupuncturists, social workers, community health workers, healthcare system leadership, those interested in research


Dr. Kirsten Bibbins-Domingo, Chair of the Department of Epidemiology and Biostatistics at the University of California at San Francisco discussed a report from the National Academy of Sciences on ways to incorporate social care into health care. She shared examples of what shifts are occurring in the American health system in managing upstream causes of disease. These upstream determinants include where we live and work and what we eat. She also shared how healthcare organizations can integrate and what components are needed to make it a reality.

Dr. Bibbins-Domingo identified two activities that must happen within a healthcare system to address social determinants of health: direct assistance to patients (i.e. vouchers for transportation and implementing telehealth options) and partnering with community organizations in alignment and advocacy to create policy. There was more emphasis on involving the community partners and participating in community-based settings as the key to success in these endeavors.

From a leadership standpoint, they must ensure that their interprofessional teams include experts in addressing social needs (i.e. social workers, community health workers, gerontologies), valuing what those areas of healthcare offered to the whole picture of health for the patient. All team members should be at least aware of the social determinants of health even if they are not directly treating that cause. Leaders should see the value in this type of focused care coordination for populations with complex co-morbidities.

When asked about major trends, Dr. Bibbins-Domingo spoke about a shift of reimbursement based on volume to value. This has forced healthcare systems to rethink their approach to these complex diseases and put the focus on the social factors of health. The other major trend is treating the adolescent population at high risk for disease by treating risk factors before the disease has a chance to take hold. As a researcher, Dr. Bibbins-Domingo also emphasized the importance of data in the efficacy of population health initiatives. She spoke about the need for diverse data in shaping healthcare strategies and providing new insights for population health. “Insights in biology comes from understanding the heterogeneity that exists in our population”, she said. These insights can then be used to create evidence-based policy by working with policymakers.

She finished the interview with a vision of more healthcare students who would be equally interested in research.

Keep building bridges!
photo credit Megan Kingsley Gale

This is important to hospital-based acupuncturists because…
Hospital-based acupuncturists can use this language when building relationships with other departments and specialties. Our medicine is grounded in the biopsychosocial approach to health and a significant portion of our patient population has complex co-morbidities. We can expand our roles out of the strictly “acupuncturist”, [we also teach self-care tools, such as] tai chi, qi gong, meditation, etc. To the teams we work with, I believe that we [have much to] offer.

Thank you to hospital-based practice colleague Steven Mui, MSOM, CAc for this resource review!

Related reading
More Blog posts related to Social Determinants of Health (SDOH) 

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