Health And Human Services Integration: Generating Sustained Health And Equity Improvements

Fichtenberg, Caroline; Delva, Jorge; Minyard, Karen; Gottlieb, Laura M.

doi:10.1377/hlthaff.2019.01594

Cited by 68 publications

(54 citation statements)

References 32 publications

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“…While clinical partners and payers continue to support increased screening efforts, citing system costs savings as an incentive, it is not clear that strategies to shift those savings to CBOs and other providers is currently part of the strategy. Indeed, identifying sustainable funding strategies that benefit all sectors is a major theme across the emerging social needs literature (Fichtenberg et al., 2020). Without a shift of funding to support CBO provided services, it will be a challenge for these organisations to keep up with demand, close the loop and ensure the entire system will function.…”

Section: Discussionmentioning

confidence: 99%

“…The need for research and understanding of health and social system misalignment is crucial before the demand for CBO services grows in the way that clinical entities are planning to avoid a potential inability to provide needed services (Fichtenberg, Delva, Minyard, & Gottlieb, 2020; Systems for Actions, 2019). This study uses mixed methods – social network analysis (SNA) and qualitative methods – to examine the perspectives, resources, role and services provided by CBOs in response to changing health systems, as well as the impact on organisational carrying capacity related to the ability to receive referrals for unmet social needs.…”

Section: Introductionmentioning

confidence: 99%

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Exploring the capacity of community‐based organisations to absorb health system patient referrals for unmet social needs

Hogg-Graham

Edwards²,

Ely

et al. 2020

Health Soc Care Community

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This study examines the perspectives, resources, role and services provided by community‐based organisations (CBOs) in response to the integration of health and social services to address individual unmet social needs, as well as the impact on organisational carrying capacity related to the ability to receive referrals from health system partners. Mixed methods combining qualitative interviews with 24 organisations and Social Network Analysis with 75 organisations were completed in 2018 in two communities (Denton, TX and Sarasota, FL) with robust examples of health and social systems alignment. Findings suggest that while community organisations are embedded in robust cross‐sector networks, the potential increase in referrals from clinical settings is not something they are fully aware of, or prepared for, as evidenced by inadequate funding models, misalignment between capacity and capability, and a lack of coordination on screening and referral activities. Misalignment between clinical and CBO understanding of demand, needs and capacity present a potential risk in building strategies that integrate health and social services to address unmet social need. Failing to build a strong cross‐sector screening and referral infrastructure that considers CBO capacity from the start could undermine the goal of improving population health through the integration of clinical and social care.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Exploring the capacity of community‐based organisations to absorb health system patient referrals for unmet social needs

Hogg-Graham

Edwards²,

Ely

et al. 2020

Health Soc Care Community

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“…Along with increasing attention to social determinants of health and social interventions, some health care systems are using neighborhood-level data to identify patients for targeted social risk screening and referrals to social services and to identify vulnerable communities. 49,50 A few organizations offer promising practices by identifying and treating highly disadvantaged neighborhoods as "patients" to address social determinants. 51 Community needs assessments and implementation of strategies to improve community conditions are encouraged or required in various policy sectors (for example, health, early childhood), but the use of neighborhood data or an equity-focused analysis is not required.…”

Section: Policy Implicationsmentioning

confidence: 99%

Racial And Ethnic Inequities In Children’s Neighborhoods: Evidence From The New Child Opportunity Index 2.0

Acevedo‐García

Noelke²,

McArdle³

et al. 2020

Health Affairs

216

140

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Neighborhoods influence children's health, so it is important to have measures of children's neighborhood environments. Using the Child Opportunity Index 2.0, a composite metric of the neighborhood conditions that children experience today across the US, we present new evidence of vast geographic and racial/ethnic inequities in neighborhood conditions in the 100 largest metropolitan areas in the US. Child Opportunity Scores range from 20 in Fresno, California, to 83 in Madison, Wisconsin. However, more than 90 percent of the variation in neighborhood opportunity happens within metropolitan areas. In 35 percent of these areas the Child Opportunity Gap (the difference between Child Opportunity Scores in very low-and very high-opportunity neighborhoods) is higher than across the entire national neighborhood distribution. Nationally, the Child Opportunity Score for White children (73) is much higher than for Black (24) and Hispanic (33) children. To improve children's health and well-being, the health sector must move beyond a focus on treating disease or modifying individual behavior to a broader focus on neighborhood conditions. This will require the health sector to both implement place-based interventions and collaborate with other sectors such as housing to execute mobility-based interventions.A long tradition of social science research has examined how neighborhoods influence socioeconomic and health outcomes during the life course. 1 In the past decade increasingly strong evidence indicates that there has been a causal relationship between children's neighborhood environment and educational attainment, employment, income, and health outcomes. 2,3 In addition, a large body of research has documented high levels of racial residential segregation in US metropolitan areas and high levels of geographic concentration of both poverty and affluence. [4][5][6][7] Starting in the 1990s, groundbreaking work by George Galster and colleagues has connected these two research traditions, ar-guing that an unequal "geography of opportunity" in metropolitan areas-that is, differential access to neighborhood-based opportunityleads to inequities in outcomes by race and ethnicity. 8,9 Building on the geography of opportunity scholarship, [10][11][12][13] in 2014 we published the Child Opportunity Index to provide the child health field with a measure of children's neighborhood opportunity, which we defined as the context of neighborhood-based conditions and resources (for example, early childhood education, schools, availability of healthy food) that influence children's healthy development and long-term outcomes such as health and socioeconomic mobility. 14 Our goal was to facilitate analysis of the

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“…Care coordination spanning health care and social services merits special attention because organizations in these sectors often differ in organizational structure, financing, workplace culture, and other factors. 20,21 These differences create barriers to effective partnerships that do not exist when coordinating care within the health care system. It is thus plausible that care coordination across health care and social services manifests differently from coordination across specialties within health care.…”

Section: Introductionmentioning

confidence: 99%

Systematic Review of Care Coordination Interventions Linking Health and Social Services for High-Utilizing Patient Populations

Albertson

Chuang

O’Masta

et al. 2022

Population Health Management

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Recognizing that social factors influence patient health outcomes and utilization, health systems have developed interventions to address patients' social needs. Care coordination across the health care and social service sectors is a distinct and important strategy to address social determinants of health, but limited information exists about how care coordination operates in this context. To address this gap, the authors conducted a systematic review of peer-reviewed publications that document the coordination of health care and social services in the United States. After a structured elimination process, 25 publications of 19 programs were synthesized to identify patterns in care coordination implementation. Results indicate that patient needs assessment, in-person patient contact, and standardized care coordination protocols are common across programs that bridge health care and social services. Publications discussing these programs often provide limited detail on other key elements of care coordination, especially the nature of referrals and care coordinator caseload. Additional research is needed to document critical elements of program implementation and to evaluate program impacts.

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Health And Human Services Integration: Generating Sustained Health And Equity Improvements

Cited by 68 publications

References 32 publications

Exploring the capacity of community‐based organisations to absorb health system patient referrals for unmet social needs

Exploring the capacity of community‐based organisations to absorb health system patient referrals for unmet social needs

Racial And Ethnic Inequities In Children’s Neighborhoods: Evidence From The New Child Opportunity Index 2.0

Systematic Review of Care Coordination Interventions Linking Health and Social Services for High-Utilizing Patient Populations

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