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Why we must address social drivers of health as part of everyone’s health care journey

Originally published in The Tennessean, June 2024

Whenever I’m asked to share an example of health inequity that hits close to home, I think about how many Tennesseans struggle with food insecurity, particularly in urban areas.

There’s a misconception that food insecurity simply means people are at risk of starving.  But it actually refers to the affordability and accessibility of nutritious food.

In other words, there may be a prevalence of processed and fast-food options within easy driving distance in many communities, but these areas lack grocery stores or markets that offer fresh fruits, vegetables and proteins. And some may be able to put food on the table but can’t afford the healthier choices.

A social driver of health close to home

Food insecurity is a social driver of health, and several areas in Davidson County and Middle Tennessee are at increased risk.

Within our health equity report, we define these drivers of health as obstacles that can lead to health disparities, or unfair and avoidable differences in health status.

A lack of nutritious food consumption can lead to long-term health issues and complications. We’ve seen these effects on our Medicare and Medicaid populations, particularly. Oftentimes senior members may lack transportation or family assistance to drive long distances for healthy food, much less the financial stability  to afford it.

Many of our Medicaid members in the BlueCare Tennessee program are working multiple jobs to support their families and may rely solely on drive-thrus or canned goods from convenience stores to ensure everyone is fed. This is a stressful reality for so many in our state.

Each person’s life experiences and situations guide their health journey. And social drivers can affect anyone, not just those working to make ends meet.

These factors can also correlate with racial and ethnic identities because of the historic inequities these groups have faced.

Health areas impacted by inequity

Our data has shown that maternal health, cancer screening, chronic condition management, child and adolescent well-care, and behavioral health are all negatively impacted by social drivers of health, particularly among minority populations. Debt burden, education level, language barriers, and community safety can all disproportionately impact these populations  and their health care access.

For example, someone living in an area without public transportation and who speaks English as a second language may struggle to find a doctor and schedule a preventive care visit. That’s why BlueCross is taking proactive steps to address these drivers before they develop into health conditions.

Our BlueCare team has worked to decrease food insecurity in rural areas across the state by supporting the creation and maintenance of community food gardens.

These gardens support those living in food deserts. They’re a supplement for people who rely on social services, food pantries, and food banks to meet nutrition needs as well. BlueCare has also partnered with Nashville Community Fridge, providing fresh produce and pantry goods to families in need.

To improve health outcomes and promote preventive care, we’re introducing a statewide initiative called FarmBoxRX. BlueCare members will receive food boxes shipped directly to their doors after receiving well-child care or diabetes care.

Aligning efforts with our partners

Of course, this is just one of many social drivers of health that we’ve identified, measured, studied, and begun to proactively address. For all social drivers and risk factors, we’re increasing our coordination with providers and making it easier for them to contact us  so that we can get involved and steer our members toward available resources and help get them on track. That way we’re closing the loop between member, provider, community organization (where applicable) and health plan.

Our goal is to use this integrated approach to help people make progress toward their own goals for better health. But all of us have a role to play in addressing these social drivers.

Ask yourself, what are some barriers to care that you see in your everyday life, or maybe in the life of a neighbor or family member, and why are they there?

Sometimes simply putting yourself in someone else’s shoes can lead to understanding, inspiration and action.

About Sherri Zink, SVP & Chief Data Engagement Officer

A photo of the authorSherri oversees enterprise information assets and is responsible for establishing a corporate-wide data and analytics strategy that drives a competitive advantage for the organization.

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