Social Determinants of Health Take Center Stage

Posted on Thursday, October 25, 2018

Nearly 50 million Americans are “food insecure” – that is, they may not have adequate income to buy nutritious foods, and may need to make difficult decisions about how to pay for basic necessities (e.g., should I pay my rent or buy groceries?). Solving for this social determinant of health is essential to the success of our healthcare system, as food-insecure households spend 45% more on healthcare than those in food-secure households.[i] Beyond this, the healthcare industry is also beginning to recognize the importance of the concept of “food as medicine,” which embraces the idea that food is an essential part of the treatment of a chronic disease.[ii]

These topics took center stage at last week’s America’s Health Insurance Plans (AHIP) Medicare, Medicaid & Duals conference, at which I spoke last week.[iii] In addition to robust discussion around legislative updates – such as the Bipartisan Budget Act of 2018, which allows Medicare Advantage plans to add supplemental benefits that can improve or maintain the health of a chronically ill enrollee – many plans shared their perspectives on planning for integrating these new benefit structures in 2020.

This is an essential step for the role that nutrition will play in our healthcare system going forward. Research consistently shows that access to nutritious meals has the ability to reduce multiple areas of healthcare costs, including Emergency Department use and inpatient hospitalizations.[iv]

Our own research at Mom’s Meals shows an undeniable connection between a nutritious diet and patient health. In a current chronic care pilot study, with a midsize managed Medicaid plan, members with uncontrolled diabetes and pre-diabetes are receiving 90 days of meals (3 meals/day). Members with gestational diabetes receive meals for the duration of their pregnancy and 2 weeks after delivery. Initial results, including reduction in A1c and weight, trended positively. The health plan expanded the pilot to a full program, opening up participation across members referred by their providers.

I am delighted with this forward progress, but there is still work to be done. We need to see a continued collaboration between policymakers, health systems and hospitals, community organizations, and health plans to drive this positive change in our nation’s healthcare system. At Mom’s Meals NourishCare, we are excited to continue these necessary conversations to highlight nutrition as a key component influencing the health of all Americans.

[i] AHIP Issue Brief, “Access to Health Foods: Social Determinants of Health,” May 2018.

[ii] David Gorn, “Food as Medicine: It’s Not Just a Fringe Idea Anymore,” The Salt, January 17, 2017.

[iii] https://www.ahip.org/agenda_item/policy-changes-and-innovation-in-caring-for-members-with-chronic-conditions/

[iv] https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0999

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