social determinants of health

Is Your Non-Profit a Part of the Social Prescribing Movement?

Social isolation and loneliness are finding their foothold in clinical practice. While social isolation is an objective measure of a person’s interaction with society, loneliness is subjective and reflects how a person feels about themself. Social connections are correlated with severity of disease and having strong social connections has been shown to reduce the risk of death from any cause.

The happiness quotient in our life influences our overall wellbeing, our susceptibility to disease, and how well we respond to treatment. This recognition has led to the growth of the social prescription movement, with the expectation that enriching social connections can counter isolation and loneliness and positively impact wellbeing.

Pilot Programs and Global Playbook

How can community organizations that provide a plethora of support services to their constituents use this information? The World Health Organization has developed a toolkit to guide healthcare workers to connect patients to community-based non-clinical services that can support health and wellness. This global movement may look different in different parts of the world, but is built on the premise to provide holistic care by integrating community partners and resources within the process.

The sky is the ceiling for services that can be prescribed – from tailored food and housing assistance to arts and cultural activities – social prescribing can expand healthcare “from within the walls of a hospital out into the communities,” writes David Andersson from Bloomberg Philanthropies. And there is evidence to support this. Research by the EpiArts Lab at the University of Florida found:

20% lower odds of depression among along with improved memory and life satisfaction among older adults who are creatively engaged
Improved daily functioning and overall fitness among older adults who were engaged in leisure activities such as hobbies, arts and culture, exercise, social/community groups, etc

Making these resources accessible to the wider community is key, with cross-pollination of resources essential for success. Pilot programs that are underway include:

CultureRx: Launched in 2020 by Mass Cultural Council, their mission is to use cultural experiences as a protective factor in health and wellbeing
- They recently launched an arts-based social prescribing program in collaboration with Mass General Brigham and Art pharmacy
Arts & well-being: This partnership between a performing arts center and an insurance company in New Jersey provides health plan enrollees prescription-based access to arts and performances
Health Opportunities Pilots: This Medicaid program in North Carolina is focused on social factors such as housing, food, and transportation access for enrollees. Referrals can be provided by clinicians, community organizations, or self

Is your organization a part of this movement? Do you have any success stories? What are some challenges you faced? Share your experience with us.

A High-Powered Lens on Disparities in Maternal and Infant Wellbeing

Leave a Comment / Uncategorized / Surabhi Dangi-Garimella

This is a cliched but true statement: the COVID-19 pandemic laid bare societal inequities in the U.S., from both the socioeconomic and racial contexts. It also drew attention to disparities that persist in maternal and infant health and associated mortality. In 2020, for example, a majority of pregnancy-related mortality was documented among American Indian and Alaska Native (AIAN), Hispanic, and black women. Specifically,

Pregnancy-related mortality was 3X higher among AIAN and black women compared with white women
Black, AIAN, Native Hawaiian and Pacific Highlander women also have higher rates of preterm births, low birthweight births, and lack of access to late or prenatal care

Maybe this is just about the socioeconomic differences in our society, right? Wrong! College-educated black women (which may be considered a surrogate for socioeconomic parity) had higher pregnancy-related mortality compared to white women with the same educational attainment or with less than a GED! Black women in the high-income strata are as much at risk of dying during the first postpartum year as the poorest white women. Pregnancy-related complication rates (maternal morbidity) that lead to ICU admission are higher among AIAN, black, Asian, and Hispanic women.

There is no denying the correlation between socioeconomic gaps and access to adequate health insurance or medical care. Together, these factors can explain the dismal maternal and infant health outcomes among populations of color. However, studies show that racism is not far behind and that discrimination does drive disparities after controlling for social and economic factors. Black women surveyed by KFF shared experiencing discrimination from their healthcare provider or other medical staff because of their skin color.

Steps are being taken, and resources diverted, to address disparities and improve maternal and infant health outcomes, such as:

Expanded access to coverage and care
Increased access to providers and services focused on maternal and infant health
Diverse workforce
Improved data collection and reporting

Issue Receives Federal Support

The Biden-Harris Administration is backing this effort by the healthcare community to move the needle on reducing maternal morbidity and mortality rates in the U.S. In June 2022, the administration released a blueprint that shared concrete steps being taken to address these challenges, including:

Baseline health and safety requirements for hospitals with obstetric services, such as ensuring adequate supplies in the ER for obstetric emergencies and annual staff training on maternal health practices
Extended postpartum Medicaid coverage for new moms for up to 1 year after delivery and encouraging use of doula services
Launch of a National Maternal Mental Health Hotline
Incentivizing OB/GYN healthcare providers to serve areas with high need through scholarship and loan repayment assistance programs

In November 2024, CMS released new safety standards for staff and organizations that deliver obstetric services, including staff training on evidence-based maternal health practices and updating the QAPI program, which monitors quality of care.

Only time will tell whether these programs have it right.

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