- Author: Alex King
- Date: July 19, 2018
As communities look at improving health outcomes for vulnerable populations—such as older adults, individuals with disabilities and/or chronic health conditions,…
Within the last decade, healthcare providers have expanded the lens through which they consider patient outcomes beyond just interactions within a hospital or clinic. They increasingly recognize that other factors, called “social determinants of health” or SDOHs, such as access to healthy food, stable housing, safe living environments, a source of income, and social supports, can be just as critical to patient outcomes as those traditional interactions. Mobility is a critical SDOH as it directly impacts an individual’s ability to access both healthcare services and other SDOH activities, such as employment, social gatherings, grocery stores, and housing.
Historically, most healthcare systems have not invested in addressing SDOHs, although a select few have made temporary, small-scale investments beyond their strictly defined healthcare purview, such as providing housing support, or opening a food pantry within the hospital. This is due in part to the lack of data discussing how social determinants influence a patient’s appropriate (or inappropriate) utilization of healthcare services, and how that behavior impacts the overall healthcare system. But the tide may be changing.
One sign of change is the requirement in the Affordable Care Act that requires hospitals to perform community health needs assessments (CHNAs) every three years to identify existing barriers to improving community health, and then to create an action plan to address those obstacles. Many of these CHNAs have subsequently focused on mobility issues, which include access to transportation, safe biking and pedestrian facilities, and the ability to reach essential amenities, among other factors that inhibit or enable people to achieve better health outcomes.
CHNAs, if used correctly, can be a helpful tool for communities. They provide a unique chance to improve the coordination of hospital benefits with other services and initiatives, with the goals of improving community health, well-being, and equity in access to healthcare services. Through the identification and analysis of the outcomes of these assessments, policymakers, hospital staff, and other local stakeholders are better prepared to create meaningful change.
As a result, it is important for mobility managers to understand CHNAs and the mobility challenges that local hospitals articulate. By doing so, mobility managers can contribute their expertise to improving health outcomes in their communities.
While hospitals’ missions are to address health, mobility managers can partner with them to tackle outside factors that inhibit healthcare’s ability to maximize the effect of their services. For those looking to address mobility issues, it is helpful to look creatively at potential implementation strategies. Past CHNAs and Action Plans tended to identify transportation as an important component of success that often went unaddressed, at least directly. However, the plans would direct hospitals to pursue activities focused on other social determinants that rely heavily on transportation, such as community safety or decreasing obesity through access to walkable spaces. Now that hospitals are beginning to understand the role that mobility plays in achieving the goals in their CHNAs, and are beginning to directly tackle those issues, mobility managers have the opportunity to impact the success of those initiatives, as well as benefit overall community mobility through the health care space.
Interested in learning more about CHNAs and the role they can play in community mobility? NCMM recently released an issue brief that dives deep into this topic explaining CHNAs, what steps certain communities, guided by their CHNAs, have taken to address mobility challenges, and what, if any, impact such strategies have had. The report also identifies opportunities and strategies for mobility professionals to play a greater role in the CHNA process and engage local healthcare entities in community mobility issues. Read it here.
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