Integrating Social Care into the Delivery of Health Care Moving Upstream to Improve the Nation's Health (2019) / Chapter Skim
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1 Introduction
1 Introduction
Pages 19-32
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health care delivery system, which largely focuses on downstream activities. The health care delivery system is primarily focused on providing medical interventions to treat or prevent disease, but is not currently equipped to systematically address the many upstream factors that contribute to illness and poor health care outcomes.1 While the upstream-downstream story is often interpreted as enjoining clinicians to focus on disease prevention as well as treatment of acute or chronic illness (e.g., focusing on the role of diet, physical activity, and tobacco use in the onset of heart disease, rather than only focusing on the treatment of heart disease that may occur as a consequence of these behaviors)
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CHARGE TO THE COMMITTEE A broad coalition of foundations, social work associations and educational institutions, and other organizations came together to develop the Statement of Task that the committee was charged with addressing. The committee's task was to examine the potential for integrating services addressing social needs and the social determinants of health (SDOH)
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countries. SOURCE: Adapted from The American Health Care Paradox: Why Spending More Is Getting Us Less by Elizabeth H
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5. Emerging and evidence-based care models that incorporate social workers or other social needs care providers in interprofessional care teams across the care continuum (e.g., acute, ambulatory, community-based, long-term care, hospice care, public health, care planning)
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better coordinate roles for social needs care providers in interprofessional care teams across the range of clinical and community health settings; and (3) optimize the effectiveness of social services to improve health and health care.
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First, a broad search was conducted using key words related to the overarching topic areas of social work, social services, social welfare, the SDOH, care settings, models of care, integrated care, financing of care, workforce, quality assessment, and vulnerable populations, which were linked in various combinations using Boolean operators. Databases searched included Embase, Medline, Scopus, and Web of Science.
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Topics included the experiences of providing social care by several social service and health care organizations, support programs for family caregivers, and select federal government programs in support of providing social care. The third public session was held on November 13, 2018, via Web conference.
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Stockholm, Sweden: Institute for Futures Studies. TABLE 1-1 Five Key Areas of Social Determinants of Health Social Determinant of Health Examples of Underlying Factors Economic stability Employment Food insecurity Housing instability Poverty Education Early childhood education and development Enrollment in higher education High school graduation Language and literacy Social and community context Civic participation Discrimination Incarceration Social cohesion Health and health care Access to health care Access to primary care Health literacy Neighborhood and built Access to foods that support healthy eating patterns environment Crime and violence Environmental conditions Quality of housing SOURCE: HHS, 2019.
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. The consistent and compelling evidence on how social determinants shape health has led to a growing recognition throughout the health care sector that improving health and reducing health disparities is likely to depend -- at least in part -- on improving social conditions and decreasing social vulnerability.
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Social risk factors Social determinants that may be associated with negative health outcomes, such as poor housing or unstable social relationships. Social services Services, such as housing, food, and education, provided by government and private, profit and non profit, organizations for the benefit of the community and to promote social well-being.
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2017. Eliminating health disparities through action on the social determinants of health: A systematic review of home visiting in the United States, 2005–2015.
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2015. Beyond health care: Role of social determinants in promoting health and health equity.
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2008. Moving up stream: How interventions that address the social determinants of health can improve health and reduce disparities.
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