What is your organization doing to move the needle forward in the quest for health equity and mitigating barriers to care? What challenges are you experiencing? Likely there are several obstacles, especially given that many of the issues have been rooted in societal inequalities, historical and contemporary injustices, disparities in health and healthcare, and adverse social determinants of health.
Summarized below are a handful or so of current initiatives and drivers for change intended to help forge us ahead, using a data-driven approach, as we traverse our way through these very complex issues. Some of the bottlenecks in reaching such goals include navigating through large seas of data needed to support initiatives, ensuring the data is high quality, and keeping up with the latest industry standards both from a semantic and syntactical perspective for semantic interoperability.
Health equity, health disparities, and social determinants of health (SDOH)
CMS, the largest provider of health insurance in the United States, is rolling out a new framework for health equity. In CMS Framework for Health Equity 2022-2032 CMS writes: “Consistent with the Department of Health and Human Services’ Healthy People 2030 Framework, CMS recognizes that addressing health and health care disparities and achieving health equity should underpin efforts to focus attention and drive action on our nation’s top health priorities.”
What is health equity?
Per CMS, health equity is the attainment of the highest level of health for all people, where everyone has a fair and just opportunity to attain their optimal health regardless of race, ethnicity, disability, sexual orientation, gender identity, socioeconomic status, geography, preferred language, or other factors that affect access to care and health outcomes.
What are social determinants of health?
Social Determinants of Health (SDOH), as defined in Healthy People 2030, are the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. And that last part is key here. They have a major impact on people’s well-being and quality of life.
The World Health Organization adds that social determinants of health are mostly responsible for health inequities – the unfair and avoidable differences in health status seen within and between countries. One of the overarching goals of Healthy People 2030, which sets data-driven national objectives to improve health and well-being, is specifically related to SDOH: “To create social, physical, and economic environments that promote attaining the full potential for health and well-being for all.” Since SDOH contributes to wide health disparities and inequities, mitigating social risk and needs is a primary approach to achieving health equity!
Improving SDOH data quality and interoperability to address health equity
Quality data around SDOH is necessary to accurately identify, act on, and measure social risk, needs, and health disparities. During the April 2023 CMS National Stakeholder Call, CMS outlined a key initiative to prioritize health equity data improvement across the agency stating, “Accurate data enables us to identify disparities and gaps and aids in the creation of evidence-based policies that meet the needs of the communities we serve”. In order to address any barriers inhibiting care at the individual and community level, we must ensure that the data is accessible to the right people, at the right time. Having the ability to share critical data between health and social care ecosystems, determining differences in care and outcomes for cohorts of patients and other analytic initiatives need accurate, reliable SDOH data.