Social, Racial, & and Economic Justice
Affordable coverage goes a long way in providing financial security and access to care, but it does not address the differences in health status between populations. A growing body of research points to the social determinants of health as responsible for much of the health inequities in our society. These include: educational attainment; race/ethnicity/gender and related discrimination; the built environment; stress and social support; early childhood experiences; employment; housing; transportation; and access to healthy food. Being poor is bad for your health and all too often so is being a person of color or LGBTQ.
Ultimately, we need a health care system and policies that supports efforts to address the social determinants of health. Health care providers and hospital systems can do so directly, for example, in their fulfillment of “community benefit” obligations by investing in farmer’s markets, exercise facilities, or early childhood educational programs in low-income neighborhoods.
Recent work by the National Quality Forum suggests that social determinants of health should be taken into account in payment reform and other delivery system reforms. Otherwise safety net providers who serve low income populations and other at risk groups are unfairly penalized. Providers should provide the same quality of care to all consumers and indeed may need to provide more care, different care or more comprehensive care to those on the wrong end of the social determinants of health. Health Access hopes to collaborate on solutions that move California forward to addressing social determinants of health.