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‘Social Determinants of Health’ factors help WellCare meet needs, offer Street Outreach Program

By Maridith Yahl
NKyTribune reporter

Where a person lives provides a lot of information about their health.

Social determinants of health (SDoH) are conditions and factors such as where a person is born, grows, lives, and works, all of which affect their health and quality of life. All of the factors are interconnected and can influence each other, according to the Centers for Disease Control and Prevention (CDC).

Linda Bates

“Your health is often related to your zip code,” says Linda Bates, Community Relations Coordinator, WellCare. “What that means is, according to where you live, there are assumptions that can be made about socioeconomic factors,” she says. The factors affect how well and how long we live by affecting our ability to make healthy choices, how safe we feel, or our social interactions – just to name a few.

WellCare, a Medicaid and Medicare provider in Kentucky, recognizes four main categories and their factors on social determinants of health:

• Socioeconomic factors: job status, family/social support, income, and community safety
• Physical Environment: the type of housing and setting lived in
• Health Behaviors: tobacco use, diet and exercise, alcohol use, and sexual activity
• Health Care: access to care and quality of care received

“It’s all the socioeconomic factors, physical environment, and your health behaviors that really have the overall impact on your health,” Bates says, influencing 80% of a person’s health. It is estimated only 20% of health is influenced by health care.

“Addressing social determinants of health is a primary approach to achieving health equity,” the CDC says. Knowing the needs can give way to solutions and how to provide them. Providing resources, says the CDC, can have a significant influence on health outcomes.

WellCare has found a way to provide help in finding resources and help address these issues. They created a Community Engagement and Community Connections Team.

“We don’t want our members to have to make the choice of, do I worry about getting my electric bill paid today or do I take my child to get their well-check because that’s truly what people face on a daily basis when you’re living in poverty,” says Bates.

The Community Connections Help Line (CCHL) 1-866-775-2192 is a resource not only for members but also for anyone in the community. If help is needed, call the CCHL number. “The Help Line is run and answered by people who are peer-based, so they have faced challenges before and have sought out help,” Bates says.

They ask for your zip code, to find nearby resources, do a needs assessment, and help determine what services you need/get. Callers are given the phone number of the resource to reach out to.

About two weeks later, callers receive a call back with follow-up questions asking if they found the services useful. The feedback is critical to help WellCare understand where there are needs within a community.

This is where the Community Engagement Team comes in. They are always looking for resources, Bates says. “That’s why we’re out in the community. I’m always out looking for resources and trying to stay on top of what’s going on in the community, so that if a member calls, they’re getting good information,” she says.

“When we are referring people to resources, we have been able to reduce the cost of healthcare,” Bates says. “By creating this database of resources we’re able to reduce unnecessary hospital visits and medical expenses,” she says. With the savings, WellCare invests the money back into the community through grants and partnerships.

In 2019 the CCHL received over 12,500 calls, making over 15,000 social service referrals.

Encouraging news comes from this.

By receiving these social service connections the recipients are 5.5 times more likely to schedule and attend their primary care visits, 2.4 times more likely to improve their BMI, and 1.4 times more likely to take better care of their diabetes-related complications,” Bates says.

“We can see definite positive outcomes which in turn help us identify programs to support throughout the state,” says Bates. WellCare has been working with the Welcome House in Covington since 2017 and is partnering with its Street Outreach Program.

The program began with three employees and nurses going out to the community to find homeless people to provide medical assessments.

Through the program, Bates says they determined one gentleman they assessed had diabetes. They cleaned his feet and checked for wounds to find that some toes were already amputated. They were able to start helping him adhere to his medications, so that he was able to do better overall.

Now the Street Outreach Program has an outreach bus and goes to libraries to provide their services while continuing to go into the community.

As a community, knowing the social determinants of health and the locations in most need can give rise to creative solutions and resources. Where a person lives should not determine their health, but it does. Finding ways to solve small problems woven in a web of complex issues is one way to begin the road to health equity.

Maridith Yahl is the NKyTribune’s health reporter

Thanks to Report for America, with support from the Ground Truth Project, St. ELizabeth Healthcare, Foundation for a Healthy Kentucky and the Douglas G. Martin Foundation. You, too, can support this reporting and other NKyTribune reporting with a tax-deductible donation today. Help us continue to provide accurate, up-to-date local news and information you can depend on.

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