Updates from Sierra Nevada Memorial Hospital
Months after COVID-19 infiltrated the community, health care providers are bracing for an anticipated increase in non-medical impacts that shape health. Generally referred to as social determinants of health, these non-clinical factors include everything from economic stability, food security and physical environment.
There are many root causes such as intergenerational poverty, education, neighborhood and physical environment, and employment. As many as 66% of U.S. food insecure households have to choose to buy groceries or pay for medicine or medical care. According to, “Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity,” patients with unmet social needs have 10% higher annual healthcare expenses. The costs attributed to food insecurity alone is a staggering $155 billion.
In a 2018 Physician Foundation’s survey of 8,500 physicians, nearly 90% said their patients had a serious health problem linked to poverty or other social conditions. While proper medical care is essential to health, as much as 50% of an individual’s health can be attributed to non-medical factors. Hospitals are the place to care for the unhealthy, but health is also a responsibility at home, in school, the workplace, neighborhoods and community.
Dignity Health Sierra Nevada Memorial Hospital is looking beyond clinical solutions and is collaborating with business, nonprofits and government to address these challenges. A variety of strategies such as classes, shared grants, access to fresh food, referrals, and navigation of patients to community resources are meeting with some success. The hosptial foundation grant funding provided an opportunity for screening in the emergency department to streamline access of care. Additional funding enabled coordination between the hospital and Granite Wellness Center to navigate those struggling with substance abuse.
What is being done is a start, but in order to get to the root causes of social determinants of health and inflect deeper change, long-range strategies and a commitment to change by the community as a whole must be embraced. Addressing social determinants of health is a primary approach to achieving health equity. Health equity is when everyone has the opportunity to attain their full health potential and no one is disadvantaged from achieving this because of their social position or other socially determined circumstance.
A growing body of research highlights the importance of upstream factors that influence health and the need for policy interventions to address those factors. These are in addition to clinical approaches and interventions aimed at modifying behavior. Upstream health care is any health intervention that stems from a philosophy rooted in one simple question: “What would it take for this problem to never happen again?”
It is clear the effects of COVID-19 have shed light on the broad disparities within our community. Working together to ensure access to care and access to resources is one of the greatest gifts we can provide for our community. By doing so we lift up those that need us which in turn will make us a stronger, more viable community.
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