Sometimes, in medicine, the best way to help people achieve good health and stay well has absolutely nothing to do with a diagnosis or medicine. It may have everything to do with what the doctors can’t see in their patient or on a chart.
Social determinants of health, those environmental and social risks patients face where they live, play and work, have risen to the forefront of the population health discussion. Food insecurity, loneliness and lack of transportation, to name a few, have a real impact on whether people can achieve their best health.
Recently, Dr. Jennifer Avegno, director of the New Orleans Health Department, shared her thoughts with The Advocate in anticipation of an upcoming summit for local physicians, which I attended.
We learned from Dr. Laura Trunk of Humana about the CDC’s Healthy Days measure to quickly assess individuals based on their physical and mental health. We heard from Dr. Jennifer Burstain of Tulane University about the rising prevalence of isolation and how deeply loneliness affects health. Startlingly, nearly 40 percent of our seniors are lonely, which can shorten life span up to eight years.
Food insecurity impacts health profoundly. Particularly for seniors, lack of food raises diabetes risk by 50 percent, heart attack risk by 60 percent, and contributes to depression. What I found incredibly fascinating is the work being done at The Goldring Center for Culinary Medicine at Tulane University led by Dr. Timothy Harlan. Shaping the concept of culinary medicine, the organization offers cooking classes for health care providers, patients and families at the first dedicated teaching kitchen to be implemented at a U.S. medical school.
Given the pivotal moment we’re in now, we need to empower physician practices to identify environmental and social factors that affect their patients’ health and then connect patients with local resources — all in a way that fits into practices’ already crowded set of responsibilities.
We don’t have all the answers yet, but we have started the conversation with key stakeholders here in New Orleans. For now, doctors can start looking at the resources out there that can help us more easily identify these risks and find resources. The USDA has a simple screen for food insecurity and UCLA has one for social isolation all which can be found in tool kits provided by Humana and others.
Patients can start opening up to health care providers to tell doctors if they’re feeling down about being alone too often, or struggling to make appointments because of a lack of transportation, or if we need more (or healthier) food at home. Sometimes your health insurance company can also help support us with these issues.
president, Jefferson Parish Medical Society