The onset of the unprecedented COVID-19 pandemic exposed critical inherent vulnerabilities in the U.S. healthcare system and highlighted the importance of equitable healthcare access. Despite the best efforts of essential workers and federal employees in response to the global pandemic, the government’s response fell short for many Americans.
Those already in vulnerable communities were disproportionately impacted by this public health crisis. COVID-19 is by no means an outlier in this regard, and the inequities present in our current healthcare systems will persist even when the pandemic subsides.
What are the ‘Social Drivers of Health’?
In February, a survey of more than 1,500 doctors conducted by the Physicians Foundation found that eight in ten physicians believe the U.S. cannot improve health outcomes or reduce health costs without addressing social factors that affect patient health, also known as the Social Drivers, or Determinants, of Health.
As defined by the World Health Organization, SDoH include socioeconomic status, education, neighborhood/social and physical environment, nutrition and food security, health care access, digital access, and more. SDoH are a key facet to the overall theme of health equity.
A core focus for federal health agencies in recent years has been to review their current policies and processes through a health equity lens. In 2021, the Biden-Harris administration issued Executive Order 13985, Advancing Racial Equity and Support for Underserved Communities Through the Federal Government. The health equity lens gives way to innovative approaches to bridge and close equity gaps. Health equity is the attainment of the highest level of health for all people, where everyone has a fair and just opportunity to reach their optimal health.
With the recent emphasis on digital modernization throughout the government, it is paramount that industry partners empower federal healthcare agencies to improve lives and communities by bridging the technology gap to make IT an enabler of equitable healthcare, not an obstacle to operations. Some of the ways IT can help deliver a more equitable public healthcare system are via frequent and accurate data collection and by improving the capacity of digital infrastructure.
How do we get to an equitable future?
Given the complex societal and institutional dynamics involved, it is nearly impossible to understand all the facets of health equity. However, one of the best places to start is to recognize the ways in which SDoH impacts underserved populations, and an effective way to achieve that is to collect accurate health data on those populations.
By collecting accurate data, and analyzing the results of that information, agencies can identify the needs of these communities, how well those needs are currently being addressed and how better to address them in the future.
Once agencies have compiled the necessary data to understand the healthcare needs of their communities, it is imperative to reform existing policies to best serve those needs.
Policy makers should look critically at existing healthcare legislation and how it may contribute to gaps in access. Further, these lawmakers should create new policies that can bridge current inequities in federal healthcare systems.
The current administration has mandated that all agencies consider their policies through an equitable lens, and healthcare is one of the sectors that stands to benefit most in this regard.
Funding is a primary hurdle when striving to attain equitable healthcare, and so policymakers should consider how legislation is funded to ensure communities receive the resources required to meet their needs.
To strengthen the tenuous relationships between underserved communities and federal healthcare agencies, equitable health initiatives must go beyond quantitative analysis.
There are certain changes that can only be made when constituents, providers, and other stakeholders are able to sit down to speak with one another. By engaging in direct, productive conversations, each party establishes a better understanding of the other, and a clear idea of what progress looks like.
Comprehensive, accurate data collection is key
Before seeking to overhaul legislation or engage with the community, comprehensive and accurate data must be collected to inform decision making.
Through partnerships and assistance with organizations who acknowledge the role that SDoH play in equitable healthcare, agencies can harness the power of data to mitigate inequities to create tangible improvements in the current healthcare landscape.
This is a critical time in the federal healthcare system to recognize and address the shortcomings and health inequities of public healthcare in the U.S., and to begin the process of remedying those inequities to establish a safe, healthy future for all America
Kamala Green is the Social Drivers of Health program manager at Anthem Inc.’s National Government Services unit, one of largest contractors for the Centers for Medicare and Medicaid Services.
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