The AAMC Center for Health Justice submitted comments to the newly launched Congressional Social Determinants of Health (SDOH) Caucus on Sept. 20 in response to its first request for information to identify resources, challenges, and opportunities for Congress related to the economic and social conditions that impact the health and wellness of communities in the United States.
The bipartisan 28-member SDOH Caucus was formed to coordinate federal health and social needs programs across many committees and agencies and to improve federal investment and impact across the many drivers of health, such as health care, food, housing, and transportation. In its comments, the Center for Health Justice identified and made recommendations around four key areas of focus for the caucus in addressing SDOH:
Challenges: From overcrowded homes (resulting from a lack of affordable housing) to the absence of paid sick leave that would facilitate vaccination and the lack of technological infrastructure to support remote working and learning, the COVID-19 pandemic has made it very clear that SDOH play the major role in determining which communities thrive and survive and which do not.
Improving Alignment: A lack of coordination and alignment between community organizations, public health entities, and health organizations is a significant barrier to developing and implementing successful SDOH interventions. To facilitate cross-SDOH coordination, the center strongly encouraged the caucus to develop policies related to the data needed to ensure efficient alignment between sectors so that individual and community needs are addressed holistically.
Best Practices and Opportunities: The significant expansion and accessibility of telehealth capabilities was made possible in large part by the willingness of the Centers for Medicare & Medicaid Services to create new coverage and payment policies. The center urged the caucus to lead efforts to support federal guidance or legislation to extend flexible reimbursement practices for providers offering telehealth services, including across state lines.
Transformative Actions: Failure to collect social risk data misleads and confuses patients, payers, and policymakers by obscuring important patient and community factors that contribute to poor health outcomes. Recent federal reports provide evidence-based confirmation that accounting for patients’ sociodemographics, their health-related social needs, and their communities’ SDOH is critical in validly assessing the quality of care — a key component of value-based alternative payment models.
In addition, the Center for Health Justice opined that authentic community engagement is needed to address SDOH and pointed to its Principles of Trustworthiness that were co-developed with local communities. The center also encouraged the caucus to increase community engagement initiatives, coordinate data sharing and collection, and ensure that community health needs assessments include plans to address local SDOH challenges.