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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Investing in Interventions That Address Non-Medical, Health-Related Social Needs: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25544.
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INVESTING IN INTERVENTIONS
THAT ADDRESS NON-MEDICAL,
HEALTH-RELATED SOCIAL NEEDS

PROCEEDINGS OF A WORKSHOP

Rose Marie Martinez and Joe Alper, Rapporteurs

Board on Population Health and Public Health Practice

Health and Medicine Division

images

THE NATIONAL ACADEMIES PRESS
Washington, DC
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Investing in Interventions That Address Non-Medical, Health-Related Social Needs: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25544.
×

THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001

This activity was supported by the U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Health. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.

International Standard Book Number-13: 978-0-309-49647-6
International Standard Book Number-10: 0-309-49647-0
Digital Object Identifier: https://doi.org/10.17226/25544

Additional copies of this publication are available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.

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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2019. Investing in interventions that address non-medical, health-related social needs: Proceedings of a workshop. Washington, DC: The National Academies Press. https://doi.org/10.17226/25544.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Investing in Interventions That Address Non-Medical, Health-Related Social Needs: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25544.
×

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The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president.

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Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Investing in Interventions That Address Non-Medical, Health-Related Social Needs: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25544.
×

Image

Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence-based consensus on the study’s statement of task by an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and the committee’s deliberations. Each report has been subjected to a rigorous and independent peer-review process and it represents the position of the National Academies on the statement of task.

Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at a workshop, symposium, or other event convened by the National Academies. The statements and opinions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies.

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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Investing in Interventions That Address Non-Medical, Health-Related Social Needs: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25544.
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PLANNING COMMITTEE FOR A WORKSHOP ON INVESTING IN INTERVENTIONS THAT ADDRESS NON-MEDICAL, HEALTH-RELATED SOCIAL NEEDS1

DANIEL E. POLSKY (Chair), Bloomberg Distinguished Professor of Health Policy and Economics, Carey School of Business and Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University

JOHN AUERBACH, President and Chief Executive Officer, Trust for America’s Health

SETH A. BERKOWITZ, Assistant Professor of Medicine, Division of General Medicine and Clinical Epidemiology, School of Medicine, University of North Carolina at Chapel Hill

DAVE A. CHOKSHI, Chief Population Health Officer, New York Health + Hospitals Corporation

DEIDRA CREWS, Associate Professor of Medicine, Department of Medicine, School of Medicine, Johns Hopkins University

KAREN B. DeSALVO, Professor of Medicine, Dell Medical School, The University of Texas at Austin

ARVIN GARG, Associate Professor of Pediatrics, School of Medicine, Boston University

MAURICE JONES, President and Chief Executive Officer, Local Initiatives Support Corporation

Project Staff

ROSE MARIE MARTINEZ, Director, Board on Population Health and Public Health Practice

ANNA MARTIN, Administrative Assistant

Consultant

JOE ALPER, Consulting Writer

___________________

1 The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteurs and the institution.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Investing in Interventions That Address Non-Medical, Health-Related Social Needs: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25544.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Investing in Interventions That Address Non-Medical, Health-Related Social Needs: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25544.
×

Reviewers

This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.

We thank the following individuals for their review of this proceedings:

Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings nor did they see the final draft before its release. The review of this proceedings was overseen by HARRY J. HEIMAN, Georgia State University. He was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteurs and the National Academies.

Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Investing in Interventions That Address Non-Medical, Health-Related Social Needs: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25544.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Investing in Interventions That Address Non-Medical, Health-Related Social Needs: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25544.
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Acknowledgments

The National Academies of Sciences, Engineering, and Medicine wishes to express its sincere gratitude to Daniel Polsky, planning committee chair, for his valuable contributions to the development and orchestration of this workshop and to the members of the planning committee who collaborated to ensure a workshop complete with informative presentations and rich discussions. Finally, many thanks to the speakers and moderators, who generously shared their expertise and their time with workshop participants, and the U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Health for its support of this workshop.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Investing in Interventions That Address Non-Medical, Health-Related Social Needs: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25544.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Investing in Interventions That Address Non-Medical, Health-Related Social Needs: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25544.
×
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Investing in Interventions That Address Non-Medical, Health-Related Social Needs: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25544.
×

Acronyms and Abbreviations

ACO accountable care organization
CAPABLE Community Aging in Place—Advancing Better Living for Elders
CDC Centers for Disease Control and Prevention
CMMI Center for Medicare & Medicaid Innovation
CMS Centers for Medicare & Medicaid Services
DoN determination of need
ED emergency department
EHR electronic health record
HHS U.S. Department of Health and Human Services
HIPAA Health Insurance Portability and Accountability Act
HUD U.S. Department of Housing and Urban Development
IMPaCT Individualized Management for Patient-Centered Targets
NCH Nationwide Children’s Hospital
NIH National Institutes of Health
OECD Organisation for Economic Co-operation and Development
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Investing in Interventions That Address Non-Medical, Health-Related Social Needs: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25544.
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ROI return on investment
SIREN Social Interventions Research & Evaluation Network
SNAP Supplemental Nutrition Assistance Program
UCSF University of California, San Francisco
USDA U.S. Department of Agriculture
VA U.S. Department of Veterans Affairs
WIC Special Supplemental Nutrition Program for Women, Infants, and Children
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Investing in Interventions That Address Non-Medical, Health-Related Social Needs: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25544.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Investing in Interventions That Address Non-Medical, Health-Related Social Needs: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25544.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Investing in Interventions That Address Non-Medical, Health-Related Social Needs: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25544.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Investing in Interventions That Address Non-Medical, Health-Related Social Needs: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25544.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Investing in Interventions That Address Non-Medical, Health-Related Social Needs: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25544.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Investing in Interventions That Address Non-Medical, Health-Related Social Needs: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25544.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Investing in Interventions That Address Non-Medical, Health-Related Social Needs: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25544.
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Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Investing in Interventions That Address Non-Medical, Health-Related Social Needs: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25544.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Investing in Interventions That Address Non-Medical, Health-Related Social Needs: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25544.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Investing in Interventions That Address Non-Medical, Health-Related Social Needs: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25544.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Investing in Interventions That Address Non-Medical, Health-Related Social Needs: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25544.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Investing in Interventions That Address Non-Medical, Health-Related Social Needs: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25544.
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Page xiii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Investing in Interventions That Address Non-Medical, Health-Related Social Needs: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25544.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Investing in Interventions That Address Non-Medical, Health-Related Social Needs: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25544.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Investing in Interventions That Address Non-Medical, Health-Related Social Needs: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25544.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Investing in Interventions That Address Non-Medical, Health-Related Social Needs: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25544.
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With U.S. health care costs projected to grow at an average rate of 5.5 percent per year from 2018 to 2027, or 0.8 percentage points faster than the gross domestic product, and reach nearly $6.0 trillion per year by 2027, policy makers and a wide range of stakeholders are searching for plausible actions the nation can take to slow this rise and keep health expenditures from consuming an ever greater portion of U.S. economic output. While health care services are essential to heath, there is growing recognition that social determinants of health are important influences on population health. Supporting this idea are estimates that while health care accounts for some 10 to 20 percent of the determinants of health, socioeconomic factors and factors related to the physical environment are estimated to account for up to 50 percent of the determinants of health. Challenges related to the social determinants of health at the individual level include housing insecurity and poor housing quality, food insecurity, limitations in access to transportation, and lack of social support. These social needs affect access to care and health care utilization as well as health outcomes. Health care systems have begun exploring ways to address non-medical, health-related social needs as a way to reduce health care costs.

To explore the potential effect of addressing non-medical health-related social needs on improving population health and reducing health care spending in a value-driven health care delivery system, the National Academies of Science, Engineering, and Medicine held a full-day public workshop titled Investing in Interventions that Address Non-Medical, Health-Related Social Needs on April 26, 2019, in Washington, DC. The objectives of the workshop were to explore effective practices and the supporting evidence base for addressing the non-medical health-related social needs of individuals, such as housing and food insecurities; review assessments of return on investment (ROI) for payers, healthy systems, and communities; and identify gaps and opportunities for research and steps that could help to further the understanding of the ROI on addressing non-medical health-related social needs. This publication summarizes the presentations and discussions from the workshop.

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