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By Monica E. Oss

What’s in a percentage?

5%—The proportion of the population using 50% of health care resources

10%—The proportion of the population with an addiction

20%—The proportion of the population with a mental illness

29%—The proportion of population with medical conditions that have a mental illness

Bechara Choucair, MD, Senior Vice President & Chief Community Health Officer, Kaiser Permanente
Bechara Choucair, MD, Senior Vice President & Chief Community Health Officer, Kaiser Permanente

But 68%? According to Kaiser Permanente’s recent Social Needs in America Survey, that is the proportion of Americans who have experienced at least one unmet social need in the past year.  In his opening keynote address at the 2019 OPEN MINDS Management Best Practices Institute, Bechara Choucair, MD, Senior Vice President & Chief Community Health Officer, Kaiser Permanente offered a cutting-edge primer on the impact of social support programs on health care costs and described initiatives underway at Kaiser Permanente to meet the social needs of its members and for the people who live in the communities the organization serves.

What is in the Kaiser Permanente roadmap to healthier members through healthier communities? One key initiative is Thrive Local, a partnership with social coordination platform Unite Us (see Kaiser Permanente Launches Social Services Provider Network) that connects health care and social services providers to address pressing social needs (see Kaiser Permanente Launches Social Health Network To Address Social Needs On A Broad Scale). Kaiser Permanente members who screen positively for a social need, or who self-refer, will have access to an established network of social services providers. The network will track community partner referrals and service outcomes to measure if basic needs such as food, housing, or transportation are being met or if additional resources are needed. The program rolls out this summer and will expand to each of Kaiser Permanente’s 8 regions within three years.

Recognizing the connection between housing and health, Dr. Choucair discussed Kaiser Permanente’s focus on addressing the crises of housing instability and homelessness. Last year, the organization announced a $200 million impact investment fund to preserve and expand affordable housing (see The Future Of Housing Support), citing one of the fund’s first investments, a 41-unit affordable housing complex in East Oakland, California (see Kaiser Permanente Invests In Affordable Housing Complex In Oakland, California For $5.2 Million As Part Of Initiative To Improve Community Health By Addressing Housing Insecurity).

The integrated health system is also addressing homelessness directly. In Oakland, Kaiser Permanente identified by name 515 residents over the age of 50 experiencing homelessness with at least one chronic health condition. Working with local partner Bay Area Community Services, the organization has assisted more than 400 of those identified to secure housing support.

Finally, Dr. Choucair discussed the importance of policy to advance community health.  Through CityHealth, an initiative of the de Beaumont Foundation and Kaiser Permanente, the organization works to advance a package of evidence-based policy solutions that help millions of people live longer, healthier lives in more vibrant, prosperous communities. CityHealth rates the nation’s largest cities based on their progress in adopting an evidence-based policy packages that include:

  • Affordable Housing
  • Safer alcohol sales
  • Complete streets
  • Paid sick leave
  • Restaurant inspection/food safety
  • Healthy food procurement
  • Universal Pre-K
  • Clean Indoor air
  • Tobacco 21

The goal is to provide city leaders with a pragmatic yet aspirational package of policies that align with city priorities, to create healthier communities that support a better quality of life for every resident.

Dr. Choucair explained that Kaiser Permanente’s intention is not to come into the community and implement a top down approach. Rather, it is very important that communities have input and assist in co-designing what the social service network or specific social service (such as housing) looks like. The takeaways that gave me food for thought? The first is the term “social determinants.” He raised the question of whether new language is needed that doesn’t make social factors seem to “pre-determine” the outcomes of people’s lives. He talked about the “high evidence to hype ratio” for social service programs funded by health plans. He noted the importance of testing these programs to determine what works and what can make a difference. To do this, Kaiser Permanente is working with the Social Interventions Research and Evaluations Network (SIREN) to promote high-quality research around social determinants of health. Finally, he noted that health plans alone will not solve the problem of unfunded social support needs and that collaboration with communities, state governments, and federal policymakers are key.

This issue of the interplay between health and social supports will be the focus of our future coverage. For our recent coverage, check out MVP Health Care Partners With Healthy Alliance Independent Practice Association On Social Determinants, Can Social Determinants Of Health Replace Traditional Utilization Management?: An Aetna Case Study, and Taking Action On Social Determinants: New Social Support Models For Consumers With Complex Conditions. For even more, join us at The 2019 OPEN MINDS Technology & Informatics Institute on October 29 for the session, Managing A Holistic Approach To Care: Integrating Physical & Behavioral & Social Health Data featuring David E. Wawrzynek, MBA, Senior Associate, OPEN MINDS and John Falsetti, Director of Information Services, Maryville Academy.

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