Leaders of the National Action Agenda to Advance Upstream Social Determinants and Health Equity say the effort aims to advance health equity and social justice, as well as value-based, person-centered care.
Daniel Stein, president of SOCI, said the collaboration also will facilitate a more effective response to health crises such as COVID-19, which has laid bare long-existing – but not always obvious – economic, social, racial and health inequities.
“The pandemic magnifies the importance of this effort,” he said. “It brings a lens to the populations that have always been at risk, underserved and under-resourced. It highlights the pain of those populations, but also those several strata up now finding themselves in need of government services. On another level, it highlights the extremely fragile nature of our non-system systems to address these disparities.”
Stein acknowledged that the problems occupy a “gigantic space,” and that to be effective addressing disparities the effort demands sharing data across systems that traditionally have operated vertically. This approach is critical to getting a full picture of the influences affecting someone’s life, he said. He cited as an example a homeless man diagnosed with diabetes who is given medicine that needs refrigeration.
“He has no place to keep his meds, so it’s worthless,” he said. “You need to think across the stream.”
The National Action Agenda includes the development of seven workgroups organized around individual social determinants of health, including: food (hunger and access); neighborhood and physical environment; economic mobility; education; community and social context (race, integration); health care; and legal services. Each group will bring together academic researchers, community organizations, government entities and provider groups, among others. Additional activities include a webinar series led by former California Department of Public Health Director Karen Smith, a national symposium at Stanford University and a proof-of-concept implementation project.
David Rehkopf, co-director of the Stanford Center for Population Health Sciences, said the collaboration sits perfectly with the center’s direction and mission.
“Our mission is to improve population health, and by publishing research papers we don’t do anything. We need to partner with others and bring people together. The innovative thing here is convening, to think through things to address problems. It’s a process of engagement and continuing to evaluate, to see what is working and not working with evidence from a variety of people.”
Rehkopf said individual policies and legislation can trickle down and affect massive improvements in health outcomes. He cited the impact of the federal and state Earned Income Tax Credit on reducing poverty, which he has for years studied and championed.
Both Rehkopf and Stein hope the collaboration among people from multiple sectors and with different backgrounds and voices will result in a handful of actionable recommendations that ultimately could be implemented to improve equity.
“Amid all the challenges going on right now there is an awareness and interest from a broader range of people to really work on issues of equity,” Rehkopf said. “Now is the time to do it and see what we can accomplish when we have this opportunity.”