COMMENTARY | Oregon researchers are working to unravel the connections between personal health and societal influences
Two Portland-based healthcare research organizations are collaborating to understand how social determinants of health impact measures of health care quality.
Why is this important?
Research suggests that the social determinants of health – the conditions in which people are born, grow, live, work and age – may contribute more to health outcomes than medical care. These determinants include a wide range of social, economic and environmental factors such as availability of resources to meet daily needs (e.g., safe and affordable housing, healthy food), access to educational, economic, and job opportunities, social support, neighborhood and community safety and clean air and water. Differences in these factors help to explain why some people experience better health than others and why there continue to be such profound disparities in health outcomes in the United States. As part of its Healthy People 2020 initiative, the U.S. Department of Health and Human Services highlighted the importance of creating “social and physical environments that promote good health for all” through action in five key areas, including health care, education, neighborhood, economic stability and social and community context.
Insurers are increasingly implementing policies that tie the amount of reimbursement that health care providers receive to measures of health care quality. These measures of health care quality are typically based on clinical outcomes of patients, such as the number of patients who have uncontrolled diabetes or who go to the emergency room. Reimbursement amounts do not take into account the social determinants that impact health. Failure to incorporate these determinants into health quality measures may explain why health care organizations that serve low-income patients often appear to perform poorly on quality measures relative to those serving patients with higher incomes. There are concerns that ignoring patients’ social determinants in quality measures may unfairly penalize providers that serve patients with complex needs and further compound the burden of health disparities on vulnerable populations. Therefore, fuller understanding of the impact of these determinants on patient outcomes may have important implications for reducing disparities in health systems.
Local researchers from OCHIN Inc. and the Kaiser Permanente Center for Health Research-Northwest (CHR-NW) are partnering to study these important issues. OCHIN is a nonprofit health care innovation center that provides health information technology support and services to more than 500 clinical sites across 15 states. OCHIN works with community health centers that serve vulnerable populations across the country. Community health centers provide care regardless of a patient’s ability to pay, and their patients are largely low-income, often on Medicaid or uninsured, and are more often from racial and ethnic minority groups.
To read the full commentary, written by Erika Cottrell and Jean Baker click HERE
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