CHICAGO—U.S. Surgeon General Vivek Murthy on Tuesday stressed the important role healthcare providers should play in promoting the value of addressing social determinants of health as a community good.
Murthy was the featured speaker on the last day of the inaugural summit put on by the Root Cause Coalition.
The two-day event included experts and healthcare providers from across the country to share their solutions in tackling poverty, food insecurity, homelessness and violence that have been found to impact health negatively and play a large role in creating an increasingly widening gap in health outcomes among people living in low-income and more affluent communities.
“I recognized very early on when I was practicing medicine that I could advise a patient to go for a walk after dinner to be more physically active, but if going for a walk after dinner—given the neighborhood my patient lived in—put them at risk for getting shot or being mugged, then they weren't gong to do that,” Murthy said. “I realized very quickly that the recommendations I made were only one small part of ensuring the patients I was caring for could actually get what they needed.”
Murthy said coming to that realization gave him a sense of powerlessness as a physician to make a positive impact on the health of his patients. “As a doctor, I realized that I had not really been trained in how to address those factors that were really blocking my patients from getting what they needed,” Murthy said.
One of the key topics discussed at the summit had to do with ways health systems could better garner the support of local stakeholders to work with them on community health initiatives. Murthy said healthcare providers should start by articulating the importance of addressing social determinants to policymakers and community groups outside of the public health sphere to improve their understanding of their role they play toward improving outcomes.
“As obvious as it is to those of us in this room, it is still news to many people who don't have health in their title that they can make a big impact,” Murthy said.
Murthy recognized the challenge in bringing others together to work on health goals was compounded by a dearth in the amount of data available to show how effective such partnerships can be in addressing social determinants.
“People often say that we are spending too much on healthcare right now,” he said. “I think of it often as the importance of insulating your house. Some people would say they don't have the money to pay for insulation so they will keep on paying high heat bills, while others will invest now so that down the line my heat bill will go down. That's the same rational argument that we have to make with health.”
Murthy said addressing the emotional well-being of patients was just as important to getting at the root causes of health disparities.
“I think of emotional well-being as one of the key pillars of health right alongside good nutrition and physical activity,” Murthy said. “But it is a pillar of health that has been often underappreciated and under-recognized.”
The shift in reimbursement from fee-for-service to value-based models has been the impetus for many providers in recent years to examine ways of addressing non-medical social factors of health.
A major determinant that has gotten more attention has been the effect a lack of stable housing has had on poor health outcomes in certain communities. It is the subject of a recent paper by the Root Cause Coalition, detailing steps some health systems have taken to improve health by providing forms of housing support.
Founded in 2015 by AARP and Ohio-based health system ProMedica, the Root Cause Coalition is a national organization that works to find solutions to address health disparities by focusing on social issues and their impact on health.