Social Determinants of Health in Idaho: Evidence-Based Models for Bridging the Clinical to Community Gap
Mcallister Hall, Graduate Research Assistant
Gabe Osterhout, Research Associate
lantz McGinnis-Brown, Research Associate
Vanessa Crossgrove Fry, Research Director
Connor Sheldon, Program Officer
The focus of modern health care is changing. Today, it is widely recognized that health care doesn’t just happen at the doctor’s office; it happens in our home, work and school environments, and it is impacted by the socioeconomic context, or social determinants of health (SDOH), in those environments.
Recognizing this, the Blue Cross of Idaho Foundation for Health (Foundation) launched the Healthcare Innovation Initiative to bridge the gap between clinical and community services to create business solutions that address this shifting landscape of health care.
SDOH can be addressed through numerous channels in a community, this literature review identifies various programs across the United States (U.S.) that have been implemented and evaluated that can specifically bridge the gap between clinical and community settings and address socio-environmental and socio-economic conditions impacting health outcomes. This report aims to act as a resource and guide in identifying solutions suitable for implementation in Idaho.
Four main questions guided this project:
- To date, what has happened to bridge the gap between clinical settings and SDOH to improve health outcomes?
- Where have models been implemented and what stakeholders and resources were involved?
- How have the models created sustainable change?
- What models have potential to scale in Idaho with the support of the Blue Cross of Idaho Foundation?
Answering the first three questions created a foundation for identifying models with potential to scale in Idaho. Research was guided by the World Health Organization’s (WHO) definition of SDOH:
The conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic policies and systems, development agendas, social norms, social policies and political systems.
Innovative models, programs, and policies have been implemented across the U.S. and have proven effective in addressing SDOH and improving health outcomes of entire groups and communities of people rather than directly improving the health of individuals.
Models were identified through a thorough review of associated literature. Literature was accessed through the University of Wisconsin Population Health Institute and the School of Medicine and Public Health’s What Works for Health database, U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC) , as well as directed searches for relevant peer reviewed journal articles. Models were then evaluated on their potential to be implemented in Idaho based on political and legal feasibility and the core competencies of the Foundation including:
technical assistance, capacity building, convening stakeholders, and research. Finally, criteria were identified to aid in future determination of community readiness for each model reported.
Social Determinants of Health in Idaho
The following section, divided into three categories (Health Behaviors, Clinical Care and Social and Environmental Factors), describes certain SDOH impacting Idaho and introduces effective models that could be implemented or scaled up in the state. Suggestions are made regarding the steps necessary for implementation, including resources required and engagement of stakeholders.