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1) U.S. Playbook to Address Social Determinants of Health (SDOH)

Improving health and well-being across America requires addressing the social circumstances and related environmental hazards and exposures that impact health outcomes, often referred to as social determinants of health (SDOH). The U.S. Department of Health and Human Services defines SDOH as “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.” These community-level factors influence a variety of individual healthrelated social needs such as financial strain, housing instability and poor quality, food insecurity, lack of access to health care, and inadequate educational opportunities. An inability to meet these social needs puts individuals at higher risk for exacerbating health conditions such as heart disease, stroke, depression, cancer, and diabetes.

-- For example, food insecurity has been associated with a 15% increased risk of having a chronic illness, twice the odds of having mental health issues in mothers and behavioral issues in children, and 58% increased risk of death from any cause.
-- Numerous studies have established that lower levels of education are also associated with shorter life expectancy.
-- Research demonstrates that disproportionate exposure to  pollutants or hazardous waste and other environmental injustices is linked to adverse health problems such as lead poisoning, asthma, anxiety, and cancer.

Compounding the problem, unmet social needs can cause major disparities in health outcomes stratified by geography, race, ethnicity, age, income, disability status, and a number of other factors. Evidence also suggests that interventions addressing social needs can improve health outcomes. For example, research has found that housing individuals with HIV who are experiencing homelessness increases survival with intact immunity by 21% after one year. While the United States has made significant improvements in addressing these SDOH in recent years, there is more work to be done.

The Biden-Harris Administration is committed to improving the health and well-being of all Americans. Our vision is to enable every American to lead a full and healthy life within their community. The frequent organizational separation of health care from services such as housing or nutrition programs complicates efforts to address interconnected health needs. This Playbook lays out an initial set of structural actions federal agencies are undertaking to break down these silos and to support equitable health outcomes by improving the social circumstances of individuals and communities. The Playbook sets the stage for agencies and organizations to re-imagine new policies and actions around SDOH, both inside and outside of government. While the Playbook is a point of departure, it does not represent a final, comprehensive strategy for addressing SDOH. The vision and coordinating actions create a scaffolding upon which entities from all segments of society can build. These initial efforts are focused on individual and community-centered interventions with actions grouped into three pillars.

Pillar 1: Expand Data Gathering and Sharing . . .
Pillar 2: Support Flexible Funding to address Social Needs . . .
Pillar 3: Support Backbone Organizations . . .


2) Climate Change and Environmental Injustice as Social Determinants of Health -- OSTP blog

The Biden-Harris Administration is committed to improving the health and well-being of all Americans. To enable all people to lead full and healthy lives within their communities, the social and environmental factors that impact health outcomes must be addressed. The Administration’s strategic approach to addressing health related social needs is captured in The U.S. Playbook to Address Social Determinants of Health (SDOH).  This Playbook focuses on solutions to the gap between health and social services by expanding data access and sharing, implementing flexible funding approaches, and supporting backbone organizations. It also highlights federal programs, toolkits, and guidance that front-line workers and organizations can use to improve their delivery of health and social services.

Improving health equity by reducing disparities in SDOH is deeply intertwined with the Administration’s actions addressing climate change and supporting environmental justice. . . .   

The Administration’s actions to tackle the climate crisis — including our Investing in America agenda and efforts to promote environmental justice and increase equitable access to nature, and promote environmental justice (described in Executive Order 14008, Tackling the Climate Crisis at Home and Abroad, and Executive Order 14096, Revitalizing our Nation’s Commitment to Environmental Justice for All) are part of the foundation of a cohesive and bold strategy to address major upstream drivers of disparities in SDOH and health outcomes. The Biden-Harris Administration has made it a goal that 40 percent of the overall benefits of investments in climate change, affordable and sustainable housing, remediation and reduction of legacy pollution, and the development of critical clean water and wastewater infrastructure be directed to communities with a legacy of environmental pollution and disinvestment. . . .

Improving community health outcomes requires a multi-sectoral approach that addresses both the social and environmental drivers of health. Upstream interventions that address root causes of SDOH disparities are critical, along with actions that connect healthcare with programs and services to address interconnected social and environmental health needs.  The actions described in the SDOH Playbook align with the climate and environmental justice commitments of the Biden-Harris Administration to advance the vision of healthy, thriving communities that support the well-being of every American.


3) The Biden-⁠Harris Administration Takes Action to Improve Health and Wellbeing by Addressing Social Determinants of Health -- HHS press release

The White House and the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), is releasing several resources to help support federal agencies, states, local and tribal governments to better coordinate health care, public health, and social services. . . .

The social and economic conditions of the environments where people are born, live, learn, work, play, worship, and age affect a wide range of health, functioning, and quality-of-life outcomes. Recognizing this, the first piece of today’s announcement is the U.S. Playbook to Address Social Determinants of Health. The Playbook highlights ongoing and new actions that federal agencies are taking to support health by improving the social circumstances of individuals. This includes initiatives by HHS, Department of Agriculture (USDA), Department of Housing and Urban Development (HUD), the Department of Veterans Affairs (VA), the Environmental Protection Agency (EPA), and other federal agencies to align investments to finance community infrastructure, offer grants to empower communities to address health related social needs, and encourage coordinated use of resources and data to improve health outcomes.

The second resource is Medicaid and Children’s Health Insurance Program (CHIP) Health-Related Social Needs (HRSN) Framework https://www.medicaid.gov/sites/default/files/2023-11/hrsn-coverage-table.pdf. This document will provide guidance for more states, beyond the current seven, to structure programs that address housing and nutritional insecurity for enrollees in high-need populations. An example is a program providing medically tailored meals or helping homeless youth find and obtain housing. The guidance will also include an accompanying CMS Informational Bulletin (CIB) https://www.medicaid.gov/sites/default/files/2023-11/cib11142024.pdf.

The final document is HHS’s Call to Action to Address Health Related Social Needs https://aspe.hhs.gov/reports/hhs-call-action to encourage cross-sector partnerships among those working in health care, social services, public and environmental health, government, and health information technology to create a stronger, more integrated health and social care system through shared decision making and by leveraging community resources, to address unmet health related social needs. No one sector can do this work alone, so HHS is issuing a Call to Action to collaborate so that together we can achieve a future in which everyone, regardless of social circumstances, has access to aligned, high-quality, person-centered health and social care systems that can improve health and well-being. This Call to Action builds on the nation-wide call to action in the White House Challenge to End Hunger and Build Healthy Communities and complements the Biden-Harris Administration’s work to implement the National Strategy on Hunger, Nutrition, and Health.


4) HUD Reiterates Role of Housing as a Social Determinant of Health and Critical to Advance Health Equity

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