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The health care community is showing a significant and growing interest in the social determinants of health. The rise of population health, providers embracing risk, increased focus on community benefits and growing scientific evidence have all driven an appreciation that social factors such as income, education and food security can determine health status, health needs and health outcomes.
I've previously reviewed population health and population health management approachesfrom 30,000 feet. But a real question remains: How do health systems translate understanding about the social determinants of health into action?
The American Hospital Association has launched a valuable new set of tools focused on eight social determinants: food, housing, education, transportation, violence, social support, health behaviors and employment. These are the subjects of guides being published nearly monthly through early next year.
At the AHA Leadership Summit in July in San Diego, keynoter Rishi Manchanda, M.D., an evangelist for "upstreaming," as he terms it, urged health systems to get ready, get set and go upstream to deal with social determinants.
In my travels, I see many health systems addressing the social determinants of health. But few organizations, in my view, have done more to operationalizc iheir approach than ProMedica, a leading health system based in Toledo, Ohio. ProMedica serves as a role model for building a strategy that fully embraces the social determinants of health and makes it real for the community it serves. This is its story.
A thriving health system, a community in need
ProMedica is a highly successful, wellrespected, integrated delivery system with 332 sites of care, 4.7 million patient encounters systemwide, 13 hospitals and 323,000 lives covered by Its owned health plan, and with 800-plus employed physicians, $3.1 billion revenue and strong financial ratings.
Yet, when ProMedica leaders looked at their community recently, they found that:
* Toledo rated 99th out of 100 communities In the Gallup Well-Bcing Index
* 70 percent of adults were overweight
* 36 percent of low-income families were concerned about having enough food.
* Lucas County, of which Toledo is the county seat, ranked last among Ohio's 88 counties for infant mortality and low-birth weight babies.
* 28 percent...