As we get a glimpse of the light at the end of the pandemic tunnel this summer, I think back to the early stages of the pandemic when celebrities, government officials, and media framed the viral outbreak as the “great equalizer.” A virus is incapable of discrimination, and many people (mostly coming from a place of privilege) believed SARS-COV-2 would transcend wealth, fame, race, and age. Instead, the effects of COVID-19 were informed by our country’s social institutions, and we witnessed health and social outcomes stratified by race, class, and age. We watched as the pandemic followed well-worn patterns filtered through the prisms of social determinants of health (SDOH) and health equity.

We know that SDOH, conditions in which we are “born, live, work, and play” contribute more to health outcomes than the delivery of clinical services. At the same time, preventable and unjust inequities in care, especially due to racism, lead to worse health outcomes for people of color. The undeniable impact of SDOH and health equity is often included in high-level conversations by policy experts and C-suite executives, but goes largely unacknowledged during a patient’s clinical care visit. Last year the Foundation for Health Care Quality took on the challenge to develop a community standard for assessing and addressing social determinants and health equity in clinical care.

In our workgroup conversations and key stakeholder interviews, we explored a rapidly evolving health and social service ecosystem with emerging best practices, technologies, and cross-sector partnerships. We heard from health systems integrating community information exchanges into their workflows, pilot programs working at the intersection of health and social services, and health plans developing innovative mechanisms to improve health equity. We quickly found that there is no one-size-fits-all solution to addressing health equity and social determinants, and instead developed a framework with five focus areas to target future activities. These focus areas include Planning, Identification, Tracking and Measurement, Follow-Up, and Incentives and Investments. We hope our initial work will help guide our state toward future collaboration and integration of health and social services.

While we continue to drive our health system to address holistic healthcare, you can read our final report, which was adopted by the Bree Collaborative in May 2021, and review our quick one-page summary. We look forward to future collaboration to improve the health and well-being of all Washingtonians!

Nick Locke, MPH
Program Coordinator, Foundation for Health Care Quality