Future Directions for Addressing Social Determinants of Health

Sending a message the old-fashioned way: placing a letter into a vintage mailbox.
It’s election season, and the stakes feel higher than ever. For those of us in the social impact space, these moments could define our work. As our nation debates priorities and policies, staying informed and advocating for progress in addressing social and health issues is more critical than ever. The decisions made over the next few months will ripple through our communities for years to come, and it’s on us to make sure we’re ready to navigate—and shape—what’s next.

Last year, NNSI published a two-series blog analyzing the first-ever U.S. Playbook on Addressing Social Determinants of Health (SDOH). The Biden-Harris administration has made significant strides in addressing the SDOH, recognizing social circumstances’ profound impact on health outcomes. These determinants include key factors like housing, nutrition, education, and the environment that are deeply intertwined with the well-being of individuals and communities across the United States.

This Playbook, published in 2022, became a landmark effort that laid the groundwork for a more equitable approach to health. The Playbook outlines three main pillars designed to enhance health outcomes through a more comprehensive approach: 
  1. Expand Data Gathering and Sharing: Strengthening data collection and ensuring compatibility across healthcare, public health, and social care systems can enhance efforts to address SDOH. By improving data integration at federal, state, local, tribal, and territorial levels, communities can more effectively identify and respond to the social factors impacting health outcomes.
  2. Support Flexible Funding: Flexible funding mechanisms can enable communities to address their unique needs. For instance, the Medicaid in-lieu-of-services (ILOS) option allows states to offer non-traditional healthcare services, such as housing support or medically tailored meals. 
  3. Support Backbone Organizations: Backbone organizations are critical in coordinating efforts across sectors, acting as central hubs that connect individuals with the needed services. The government should facilitate the establishment of community backbone organizations and additional infrastructure to connect healthcare systems with community-based organizations, especially those focused on SDOH.

NNSI’s Recommendations for the Next Administration

While the Playbook lays the much-needed groundwork, significant challenges remain in successfully implementing these changes. NNSI believes the next administration needs to focus on addressing poor coordination and integration of these social services. Here are NNSI’s key recommendations for the next administration

1. Standardize Data-Sharing Practices

One of the most pressing challenges is standardized data-sharing practices across sectors and regions. We recommend establishing a national SDOH resource directory instead of maintaining individual resource databases to address this. With data interchange formats like the Human Services Data Specification, organizations can now easily share resource data across multiple platforms, including websites, mobile apps, call centers, and printed directories. To incentivize these data exchange practices, federal agencies such as the Department of Health and Human Services (HHS) should allocate additional funding to each state specifically for establishing and maintaining the national resource directory.

2. Invest in Evaluation Hubs

NNSI also recommends investing in evaluation hubs that measure organizations’ capacity to address SDOH and assess the demand for those services. These hubs would evaluate SDOH interventions on their accuracy (if each service episode was routed to the right provider), efficiency (the time it takes for clients to receive care), and effectiveness (if the appropriate service was successfully provided). Such practice would be key to improving the quality and impact of SDOH interventions and ultimately advancing community health outcomes.

3. Ensure Sustainable Funding for CBOs

Ensuring sustainable funding for community-based organizations (CBOs) is another critical step. CBOs play a vital role in addressing health-related social needs, but they often face financial challenges that hinder their ability to scale operations and maintain long-term sustainability. Innovative funding models and support mechanisms can empower these organizations to meet the growing service demand. 

4. Encourage the Development of Community Care Hubs

Finally, NNSI recommends that the next administration encourage the development of community care hubs. These hubs design networks that work. They develop relationships among organizations, intervene when referrals get stuck in the system, and lead the network in a continuous quality improvement process to improve the system. 

As you cast your vote this November, consider the importance of continuing and expanding efforts to address these interlinked social and health needs. At NNSI, we are dedicated to driving these initiatives forward so every American can lead a full and healthy life, and together, we can make that happen.