More than anything else in our lifetime, the impact of the COVID-19 pandemic has illuminated the interconnectivity of all facets of our nation’s health and social welfare system. History will record our response, lessons learned and actions in hopes of mitigating future events. COVID-19 has placed a bright light on our country’s yet-to-be-realized opportunity to create optimal health.
When we fail to seriously address our society’s underlying chronic illnesses and fall short of protecting public health, we put the health of our people, institutions and economy at risk. Food security, adequate housing and freedom from poverty are among the most critical drivers of lifelong physical and mental health, yet our healthcare system is simply not designed to tackle these problems without partnerships.
As centralized providers of care in every community, health systems experience firsthand the significant impact that these social determinants of health play in our patients’ lives. To help improve the social drivers of poor health, health systems must increasingly become active partners in, or catalysts for, strong, strategic and well-coordinated multisector partnerships within communities. Prioritizing this work can help change the narrative on what “health and wellness” really means.
Examples of the ability of such multisector networks to improve measures of population health are emerging across the country, providing valuable case studies and learnings that can be adopted in other communities and inspire health systems to transform their approaches to building wellness and health in the communities they serve.
As president and CEO of Nemours Children’s Health System, I've seen firsthand how vital it is to take an active role in driving greater change when it comes to the health of our communities. Healthcare organizations and their leaders must be willing to forge new paths toward innovation and social change to address our society's health concerns.
My organization explored how healthcare institutions can lead and drive greater change and partnership for community health. Our results are summarized in a brief, titled "Preliminary Findings on the Role of Healthcare in Multi-Sector Networks for Population Health: Notes from the Field," which outlines key components for the formation and successful operation of such networks across the nation.
What are the secrets to building lasting and transformative partnerships to successfully address the social determinants of health for entire communities?
Partner with organizations to split the risk and the reward.
Healthcare systems are experts in delivering medical care. To fully deliver health and well-being, we must partner with experts in education, food security, adverse childhood experiences, transportation and other social determinants. We must also broaden the definition of health in relation to policies and practices by teaming up with state and community-based entities.
Adopt a population mindset.
The concept of “our patients” across the industry needs to fundamentally change. Currently, it means those patients in our hospital or on our clinic schedule. “Our patients” must come to mean all people for whom we are responsible and all of those in the communities we serve. Adopting a population-health mindset also dictates identifying and targeting services to subgroups of people with an increased need for health and social supports, such as those with poorly controlled asthma, or those with learning disabilities. Modern electronic systems have made it markedly easier for us to identify such groups so that we can directly provide the help they need.
Build trust.
Success in this catalyst role requires trust among partners and those we serve. To build trust, healthcare organizations need to create mechanisms (e.g., listening sessions, community forums, opportunities for co-design and leadership, etc.) to gather input from organizational leaders, community residents and partners to help improve conditions.
Prioritize the voice of the community.
It’s important to devise strategies to capture the voices of people with lived experience with nonmedical problems that greatly compromise their health and well-being. Healthcare institution leaders should cultivate collaboration and provide opportunities for community leadership and co-design. Additionally, inpatient screeners looking at underlying social determinants of health can help inform strategies by identifying the strongest areas of need.
Final Thoughts
For this next generation, more than any other population, this is healthcare’s most vital mission, because addressing these all-important social determinants will lift every child’s chances for lifelong health, well-being and success. This is how we can reduce chronic illness into adulthood and enhance public health for generations to come.
The work to build trust and gain traction is difficult and complex. Recognize that you can be a leader and a learner at the same time, especially in difficult times like those we face today during the COVID-19 pandemic. Take advantage of opportunities to leverage your organizational expertise, and seek to gain additional knowledge from learning from the other organizations you are working with. Treat community members as the experts they are. Engage authentically with the end users to understand what works for them and what will encourage them to engage in new systems.
