With the transition towards value-based care, more health care providers recognize environmental factors play a significant role in health outcomes. As highlighted in a recent Hall Render article, these environmental factors, otherwise known as social determinants of health ("SDOH"), are the conditions in which people are born, live and age that affect one's quality-of-life and life expectancy. Hall Render recently hosted a webinar with Ashley Brand, System Director for Community and Homeless Health for CommonSpirit Health, and Pia Dean, Chair of the Board of Directors of Denver Health, to discuss how their organizations leverage health care assets, including real estate assets, to address SDOH.
Looking back at the webinar, three panelist statements stuck out:
1. "[A] person's health is . . . only minimally affected by the health care that they're receiving."
The panelists emphasized social determinants have a greater influence on health outcomes than medical care. According to a paper from the Institute for Clinical Services Improvement cited during the discussion, up to 50% of a person's health and well-being is based on social determinants, compared to medical care, which only accounts for up to 20% of an individual's health. A zip code can be, for example, a more powerful predictor of a person's health than his or her genetic code. Focusing only on improving the actual medical care provided to a person is, therefore, unlikely to lead to addressing the health disparities that exist in today's health care environment.
2. "We want to partner with everyone."
Although a health care provider can control the medical care a person receives, they do not necessarily control the environmental factors that affect a person's health. It makes sense, therefore, that health systems, specifically the two highlighted in the webinar (CommonSpirit and Denver Health), work with external community, state and national partners to address these issues. This not only includes affordable housing developers and community organizations but also other health systems or providers in a local market who may seemingly be competitors within that market. Health care providers should thus consider "thinking outside the box," as Ashley put it, when it comes to partnerships to address SDOH.
3. "I see in this generation that is coming, a group that says: 'I will not be satisfied until I can write a prescription for food and a prescription for housing.'"
Housing insecurity and health outcomes are directly related. It is, therefore, unsurprising Pia shared that in her recent conversations with medical students and residents, these individuals explained their desire to have some mechanism to address housing instability. Hospitals and health systems are seemingly taking note, as some providers offer programs for temporary, transitional housing for those experiencing homelessness. These programs led to fewer emergency department visits, shorter lengths of hospital stays and fewer missed appointments among those receiving housing assistance through the program. Although it seems counterintuitive, these systems are saving money and increasing health outcomes (specifically for the most vulnerable) by investing in housing in their communities.
Special thanks to Ben Jamison and Malcolm Sullivan, Real Estate Interns, for their assistance with the webinar and preparation of this article.
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