Heavy reliance on data, partnerships essential to improving population health
From the discovery of antibiotics to the growing field of genomics, constant breakthroughs have reshaped medicine. Despite our advances, we are caught in the revolving door of reactive medicine’s focus on treating acute illness instead of a proactive approach promoting prevention and health.
We’ve begun to change our perspective, from a primary focus on treating disease to one that looks beyond the doctor’s office to the social determinants of health in communities we serve.
For example, in 2015 roughly 16.1 million American adults experienced depression, and 15.8 million households struggled to get enough to eat. The cost burden of these social determinants of health on the U.S. healthcare system is equally important. In 2014 alone, roughly $160 billion was spent on direct and indirect health-related costs related to food insecurity and hunger in the U.S.
Faced with these issues, it is difficult for many people to get healthy and stay healthy. We must broaden our perspective on the clinical care model to solve for these social, psychological and economic issues influencing health and well-being.
The new frontier of medicine includes both prevention and treatment of chronic conditions, with a focus on long-term outcomes. Addressing these social determinants will become a prerequisite for successfully practicing value-based care. The question: how do we prepare for this future?
In 2014, Humana declared a Bold Goal initiative—to improve the health of the communities we serve 20% by the year 2020. To track our progress, we use the Centers for Disease Control and Prevention’s Healthy Days survey tool to measure an individual’s mental and physical “Unhealthy Days” in a 30-day period.
Our 2017 Bold Goal report shows that from 2015 to 2016 we had a 3% improvement in Healthy Days across our Bold Goal communities. San Antonio, our most mature community, saw a significant 9% increase in Healthy Days, surpassing the 2017 improvement trajectory goal.
The CDC has measured Healthy Days for more than 20 years. In that time, the national trend line has remained relatively constant, showing a slight upward trend in recent years. With our large sample size and application of validated statistical methods, combined with our strategic work and physician and community organization partnerships, we expect to see continued improvements in Healthy Days.
To achieve our goals, we use a combination of clinical and pharmaceutical data, survey-based Healthy Days responses, and Robert Wood Johnson Foundation data on social determinants of health. Equipped with this knowledge, we gain a deeper under- standing about perceived health, chronic conditions and the barriers to health such as food insecurity, physical inactivity and social isolation.
Community health is incredibly complex, but an effective solution boils down to a simple formula: matching the intervention to the population. Understanding all the elements and how they work in unison requires insight that is only possible by leveraging all available data and connecting community needs with a diverse set of local and national partners. Then, it’s about setting goals to meet those needs.
These insights are further localized by working with physicians and other clinicians, as well as notfor-profit, for-profit and faith-based organizations in our communities. Analyzed in aggregate, this data has enabled our team to pinpoint the most significant social determinants of health that are preventing our members from experiencing more Healthy Days. We have identified food insecurity, social isolation and loneliness as opportunities to create more Healthy Days and have acted accordingly.
We realize it takes time to assemble the moving parts required to advance community health and have an impact. It’s also requires that organizations spanning local governments, academia, social services, clinical care and others work together to address social determinants.
Population health takes a sustained commitment from all of us to help people live healthier lives, both physically and mentally.
Dr. Roy Beveridge, left, is chief medical officer at Humana and Dr. Andrew Renda is director of its Bold Goal program.