142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

300127
Assessing and addressing the social determinants of health in community health centers and other community settings

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 10:30 AM - 10:50 AM

Michelle Proser, MPP , Research Department, National Association of Community Health Centers, Washington, DC
Michelle Jester, MA , Research Department, National Association of Community Health Centers, Washington, DC
Rosy Chang Weir, PhD , Director of Research, Association of Asian Pacific Community Health Organizations, Oakland, CA
Craig Hostetler , Oregon Primary Care Association, Portland, OR
Clement Bezold, PhD , Institute for Alternative Futures, Alexandria, VA
Laurie Francis, BSN, MPH , Oregon Primary Care Association, Portland, OR
Ricca Prasad , National Association of Community Health Centers, Washington, DC
Yasemin Arikan , Institute for Alternative Futures, Alexandria, VA
Vivian Li , Association of Asian Pacific Community Health Organizations, Oakland, CA
Jessica Yen , Oregon Primary Care Association, Portland, OR
Shane Hickey , National Association of Community Health Centers, Washington, DC
Federally-Qualified Health Centers (FQHCs) are community-directed organizations that serve over 22 million people largely in medically underserved populations that confront social determinants of health (SDH).  Current medical acuity does not capture these non-clinical factors that affect health.  FQHCs need data to identify which non-clinical services are most needed for their patients and to form partnerships with public health and community organizations. 

To address this need, the National Association of Community Health Centers, Association of Asian Pacific Community Health Organizations, Oregon Primary Care Association, and Institute for Alternative Futures created a standardized patient risk assessment tool focused on the SDH.  Using the County Health Rankings as a framework, the partners developed a paper-based tool that is free for any interested provider and are now creating an open access Electronic Health Record template.  To determine which SDH domains and measures to include in the tool, the partners reviewed the literature, assessed existing health risk assessment tools, engaged diverse stakeholders, and sought feedback from an advisory group of experts.  

This presentation will present the tool, how it was developed, and how it can be used by any provider organization to better understand and manage their patient populations.  The tool’s potential long term impact will also be discussed, such as using standardized data to advocate for policy changes that address the SDH, test the impact of population-based interventions, and ensure adequate payment that provides fair compensation for caring for at-risk patients and that more fully supports the integration of clinical and non-clinical care.

Learning Areas:

Chronic disease management and prevention
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Public health or related public policy
Public health or related research

Learning Objectives:
Describe the importance and impact of collecting and standardizing patient-level data on the social determinants of health. Identify which social determinants of health domains and measures are linked to health outcomes and utilization as identified through the literature, an environmental scan, and stakeholder input. Discuss how data on patient risk profiles has been used to inform and expand operations beyond clinical care for population health management and to promote sustainability of interventions.

Keyword(s): Community Health Centers, Risk Factors/Assesment

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the manager of this project and have been involved in every step and activity of this project, from writing the grant, developing the workplan, executing the project, conducting the literature review, conducting the interviews, leading the meetings, and developing the tool and protocol. I know all of the details of this project, the results, and how we arrived at those results.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.