A prescription to address healthcare’s blind side

If you have read Michael Lewis’ book, The Blind Side, or seen the popular movie based on it, you know that the title refers to the fact that quarterbacks, who are typically right-handed, can’t see when a 300-pound opponent is charging at them from the left side. Not being able to see the full picture puts the quarterback directly in harm’s way and makes it harder for his team to succeed.

There’s a blind side to health care too, and it’s keeping us from doing what matters most to improve people’s health and deal with our long term medical costs.

A recent poll of physicians revealed that 4 out of 5 believe that unmet social needs — things like nutritious food, transportation, adequate housing and employment assistance — are leading to worse health outcomes for their patients. And those physicians do not feel confident in their capacity to do much about them.

We know that our zip code can be even more powerful than our genetic code when it comes to people’s health.  Indeed, the conditions people live in day in, day out—and where and how they live, learn, work and play—have a greater impact on their health than the medical  care they receive to repair the damage to their health.

We can, and simply must, do more to keep people as healthy as possible in the first place.  And that means taking a serious look at those factors in our neighborhoods, workplaces and schools that shape our health from the earliest years of life.

Clearly, though, our current system does not give providers the capacity to address these factors. Given the chance, the physicians who were polled would write prescriptions for things like routine physical activity, nutritious food, adult education, transportation assistance and housing. They estimated that nearly 1 out of every 7 prescriptions they write, in fact, would be for social needs of their patients and their families.

For most doctors today, however, their hands are tied. They can’t hand patients that right prescription of medical care and connections to community resources that can help them take action to improve their health where they live, learn, work and play. Failing to deliver on what their patients need is discouraging  to all caring physicians .

An organization called Health Leads has bridged this gap for physicians and patients in the six cities in which they currently operate. It empowers doctors to help remove the social barriers that keep people from taking the actions they need to be healthy. Doctors at facilities where Health Leads exists literally write prescriptions that help struggling families access basic resources like heat for their homes, subsidized child care or food for their kitchen tables. The program’s skilled college volunteers then navigate the complex web of social services and community resources to help patients “fill” the prescriptions. In so many cases, there is help available, but neither the family nor the physician knew about it or could effectively access it.   Health Leads is an innovative and promising model the Robert Wood Johnson Foundation is supporting and testing in hopes that it can take hold far more widely across the country.

But — and Rebecca Onie, the dynamic leader of Health Leads, would tell you this herself — more can and should be done.

As we struggle as a country to reduce health care costs while increasing access to medical care, we also need to think about how these unmet social needs make it harder for people to live healthier lives. Physicians overwhelmingly wish the health care system would cover the costs associated with connecting patients to services that address their social needs, because they have no doubt that doing so would improve their chances of helping people get – and stay – healthy.

I like to think that Lewis’ Blind Side metaphor also has a second meaning, by referring to the overlooked connection between care given at the doctor’s office or hospital and the larger social sphere where our lives – and our health – happen.  If our leaders across the health care sector—from providers to policy makers to insurers— can empower doctors to address social factors as an integral part of care delivery, we can realize dramatically better outcomes in the health of all Americans, and especially the most vulnerable among us.

James S. Marks is Senior Vice President and Director, Health Group, Robert Wood Johnson Foundation.

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