I’ve been a health care writer and editor for more than a decade, and I’ve been afforded the opportunity to write about a wide array of topics, some I’ve enjoyed more than others. One topic that has always captured my attention and my heart is health care disparities. I was introduced to the topic while working on news feeds for the Robert Wood Johnson Foundation, and since then, I’ve taken a keen interest in learning and sharing information about this important subject.
All too often, where a person lives has an impact on their health. That’s why Healthy People 2020 now includes social determinants of health with the goal of “creat[ing] social and physical environments that promote good health for all.” Specifically, the social determinants of health topic within Health People 2020 was created to establish both social and physical environments that promote good health for all citizens, regardless of the neighborhood to which they happen to have been born.
Healthy People 2020 is not the only initiative that has recently focused on this topic. This year’s National Public Health Week dedicated one of its daily themes to “Starting from ZIP,” noting that there are grave health disparities from state to state and even county to county. For example, the Robert Wood Johnson Commission to Build a Healthier America notes that in the Washington, D.C., area, there is a 9-year difference in life expectancy between communities that are only 12 miles apart.
Recognizing that great strides must be made to address care disparities, hospitals in Indiana are leveraging the nation’s largest geospatial tool designed to improve community health.
After reviewing health needs reports from more than 100 hospitals, the nonprofit Indiana Partnership for Healthy Communities found that hospitals are most often using county-level health information for needs assessments and planning. According to Karen Comer, director of health geoinformatics at the Polis Center, a research unit at Indiana University-Purdue University Indianapolis, county-level data is not specific enough for appropriately targeted health interventions.
In response, the state has set a goal for hospitals to use a database called SAVI, which stands for social assets and vulnerabilities indicators, to better understand health disparities in the communities they serve and to collaborate with other hospitals and public health providers. SAVI was created in 1994 by the Polis Center and allows for correlation between health indicator data and historical data on social determinants of health, such as housing, education and crime that can negatively affect the health of individuals or an entire population. The Polis Center is now encouraging hospitals in the state to use this free resource to analyze community demographics and economic information and connect with resources to bridge gaps in provision of care—a piece of the puzzle that is often overlooked according to Sharon Kandris, the director of the SAVI project.
The next step for the project is for a “report card” that will track progress toward goals regarding social determinants of health. According to Comer, the state has already seen some improvements, with more hospitals collaborating and starting their needs assessment process early.
Although it’s just one state, the SAVI project in Indiana represents an important step forward in addressing care disparities. I’m excited to see more states adopt similar systems to improve the health of all residents, regardless of where they happen to live.