Meet Them Where They Are
Confronting Social Determinants of Health
According to Healthy People 2020, about 60% of a person’s health is determined by their ZIP code. More than personal behavior or clinical care, where you live — your social and built environment — is the biggest factor affecting your individual and community health. For example, people who don't have access to grocery stores with healthy foods are less likely to have good nutrition. Where you live, the conditions there and other life factors are called social determinants of health (SDOH).
All SDOHs are linked to chronic disease or other health problems. Some of the common challenges related to SDOHs include:
Just promoting healthy choices won't eliminate health disparities. To solve the challenge of improving clinical health outcomes, we must first confront the persistent mitigating factors in the community — the SDOHs. Dr. Nina F. Miles Everett, Chief Medical Officer of Priority Partners, one of nine managed care organizations (MCO) in Maryland, talks about how only 20% of a person’s health is a product of clinical care.
“Do you have safe and supportive neighborhoods?” Dr. Everett asks. “Do you live in a place where the water is drinkable? Do you live in a place with sidewalks, with parks to play? If we tell you to exercise, can you do that?
“And then also your education, your job. Do you have a job that allows you to purchase the food that you need to be healthy? It’s very important that we address those things, because those things often distract our members from taking care of their health.”
Priority Partners acknowledges that the role of a health plan is now far more than covering health care services and coordinating a patient’s care. Covering more lives than any other MCO in Maryland, Priority Partners is integrating more and more services to address health care barriers.
Food insecurity is one of the most critical challenges affecting community health, so Priority Partners has focused a great deal of effort to address it. Thanks to its long-standing relationship with the Maryland Food Bank in coordinating community “food drops,” Priority Partners has delivered over 600,000 pounds of food to Maryland communities to date.
Priority Partners also creates opportunities for other community-based solutions, such as providing education and resources through its Community Health Advocates (CHAs), who are professional community educators who know and live in the communities they serve.
“Our CHAs are our eyes and ears out in the community,” says Kathy Pettway, Senior Director of Priority Partners.
CHAs serve on many collaborative health projects, attending local health fairs and community events, and provide a variety of health-related educational classes for adults and children.
Recommended by LinkedIn
Transportation is a challenge for many Priority Partners members. After all, you can’t get the care if you can’t get to the care, so Priority Partners provides a robust transportation program, covering the costs of rides to and from doctors’ offices to ensure its members get the care they need when they need it. Often something as simple as getting a ride is the difference between a preventive visit and a trip to the emergency room after disease has progressed.
“Thinking about transportation as much as we think about writing a prescription is absolutely critical,” Pettway says.
Another area where Priority Partners impacts members’ lives is through its Care Management program. While broad initiatives can support universal needs, many members require individualized care.
“It’s very critical for some of our more complicated members to have a care manager who really works one-on-one and understands their needs,” Dr. Everett explains.
That support can come in the form of in-home visits, accompanying members to appointments and providing translation services and other resources. Sometimes that may mean visiting a member in a homeless shelter, organizing a clothing drive or even something as simple as providing a mattress cover for an asthmatic child so he can suffer less and concentrate more in school.
“We have to meet them where they are,” Pettway says. “One size does not fit all.”
Still, health plans can only do so much. To go even further in its support, Priority Partners fosters close community partnerships. The plan’s efforts to combat food insecurity? By bringing community organizations on board, Priority Partners significantly increased its impact through its ambitious Cupboards Project.
Following the successful installation of three custom-built mini pantries in Maryland neighborhoods, Priority Partners launched a small fleet of three custom-converted “Club On The Go” mobile pantries. Operated by the Boys & Girls Clubs of Annapolis and Anne Arundel County and Harford and Cecil Counties, they are now bringing free healthy food and nutrition resources to Maryland neighborhoods.
“We have to… partner with community organizations — be part of the community — to understand what are the needs of the people, so we can design programs that address those needs and help increase their level of wellness,” says Dr. Everett.
With the help of another community partner — the Maryland Food Bank — Priority Partners began hosting “Healthy Hacks” cooking events. These were free, in-community live cooking demonstrations featuring a local chef who shows guests how to prepare easy, affordable and healthy meals. After the demonstration, attendees received the recipe plus all the ingredients so they can make the meal at home for free. Priority Partners provides other no-cost resources to help members develop healthy eating habits, such as “Good and Cheap,” a free cook book loaded with easy-to-make, budget-conscious meals.
Looking ahead, Priority Partners will expand its commitment to reducing food insecurity in Maryland and build strong community relationships to uncover other critical issues preventing good health. The goal is close the circle of support for members as part of Priority Partners’ broader efforts to build trust, provide resources and promote health literacy — to empower their members and communities. And that means meeting them where they are.
Listen to this podcast! Priority Partners’ Chief Medical Officer Nina F. Miles Everett and Senior Director Kathy Pettway explain the clinical impacts of SDOHs and the vital work Priority Partners is doing to support its health plan members and local communities in a recent podcast episode of JHHC’s Health Care Collaborations. Listen to it here.
Chief Medical Officer Priority Partners Managed Care Organization A Principled Leader who inspires & executes.
1yWhen you don’t meet people where they are…you miss them.