Support for population health gained steam in 2018 from healthcare organizations that prioritized wellness and prevention initiatives despite decreased federal funding.
Providers this year invested in housing, anti-poverty and food insecurity efforts with the goal of long-term cost savings by creating conditions for patients to better manage their health.
But as interest in addressing social determinants has grown, action on broader public health issues has not kept up with the pace.
“Healthcare moved from downstream interventions to what I would call mid-stream interventions, but we have still failed to go upstream,” said Brian Castrucci, CEO of the de Beaumont Foundation, an organization that supports local and state public health programs to advance public health.
Meanwhile, federal funding for social services that were created to lift people out of poverty have been slashed.
In February, the White House for the second year proposed to cut funding to safety-net programs. President Donald Trump's fiscal 2019 budget sought to trim the Supplemental Nutrition Assistance Program by 27% and Section 8 housing assistance by 20% over the next 10 years.
Republican lawmakers also lobbied to include work requirements for SNAP recipients as part of a massive bill reauthorizing payments to farmers. Ultimately, that provision—which the Congressional Budget Office estimated would eliminate up to 1.2 million people from the program—did not make its way into the farm bill that passed Congress late in the year.